Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

While nobody can object to hospitals working together in groups and sharing services, a number of issues arise from the Higgins report on the establishment of hospital groups as a transition to independent hospital trusts, which was published this week by the Minister for Health. The absence of any specific commitments in the report for a number of hospitals nationwide raises questions about their future role in the health system. The report states, for example, that Letterkenny, Wexford and Kerry hospitals should continue to provide services currently available at those hospitals, which raises questions about the retention of services at other hospitals that have not been mentioned.

While it is recommended, for example, that in the Dublin east group, Wexford General Hospital should retain its full range of emergency, medical, surgical, maternity and pediatric services because of its geographical location, no such recommendation is made for St. Luke's in Kilkenny or the Midlands Regional Hospital in Mullingar. The likely fate of these hospitals is a cause for concern. Will they continue to provide the current level of services? St. Luke's in Kilkenny has an exemplary reputation for quality and efficient patient care. It is often seen as a role model for accident and emergency services. We are merely seeking clarity and we accept the need for reform of the delivery and configuration of health services. The same questions arise in respect of the south and south west group. It is recommended that Kerry hospital should keep what it has but no such recommendation is made for Clonmel. What is the position in this regard and can we be given an assurance that no change will be made to the services provided to south Tipperary?

The report goes to great lengths to reassure the people of Waterford, on foot of a vocal local campaign launched last year to retain services in the city's hospital, that it will continue to provide renal and cardiology services for the south east area. I presume Wexford and Kilkenny hospitals, which are in the Dublin east group, will continue to refer patients to Waterford.

In light of the decision to place Waterford Regional Hospital in a different hospital group, will a guarantee be given that hospitals in Wexford and Kilkenny will continue to make referrals to Waterford? I am concerned that this decision will result in a change of referral pattern, with referrals of cardiac and renal cases gradually shifting from Waterford Regional Hospital to Dublin hospitals that are in the same group as Wexford General Hospital and St. Luke's Hospital. I ask the Minister of State to clarify the matter.

The broader issue relates to the proposed hospital reconfiguration and transition to hospital trusts. The report on hospital groups states a board will be appointed and a chief executive officer will be recruited who must report back to the board with a plan for the new hospital group within one year of taking up the his or her position. The difficulty is that we do not know how hospital budgets will be reconfigured. How will the CEO, who will be the accounting officer, guarantee the services currently provided by the hospitals in each of the hospital groups? How will the Minister be able to guarantee services without a commitment to provide the capital and current funding required to provide the services outlined in the reconfiguration?

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