Rory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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The final two matters have been taken together. Deputies Brendan Smith and Ó Caoláin, who have raised the issue of the recent difficulties in Cavan General Hospital, including the suspension of two consultants and the death of a young person, will have five minutes each.

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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I am very grateful to the Chair for giving us an opportunity to speak about this important subject. I am glad the Minister for Health and Children, Deputy Martin, is present in the House as we approach the midnight hour to hear our concerns.

At the outset, I extend my sincere sympathy to Brian and Rosemary Sheridan and their family on the death of their daughter, Frances. The North Eastern Health Board has announced that it has appointed an expert group to report on all the circumstances surrounding the death of Frances Sheridan. I appeal to the Minister to direct the health board to carry out the investigation in the most thorough manner possible and to complete it with the minimum of delay. That is the very least the Sheridan family deserves at this tragic time.

Last June I raised, by means of a parliamentary question and on the Adjournment, my concerns that surgical services were under threat at Cavan General Hospital. I expressed particular concern at that time about the threatened withdrawal by the Royal College of Surgeons of recognition of five surgical trainee posts in the hospital. The Minister for Health and Children was requested last August by the CEO of the North Eastern Health Board to establish an inquiry following the suspension of two consultant surgeons. It has been stated repeatedly that the suspensions arose from interpersonal difficulties between the two eminent surgeons. Management, particularly human resource management, is about dealing at the coalface with difficulties and grievances that arise in the workforce. Surely in this day and age there is enough know-how and expertise within an organisation the size of the health board to deal with interpersonal difficulties among some of its most senior employees. This type of issue, albeit a very important matter, should not end up with the Minister and subsequently with an inquiry. These issues should be dealt with and finalised by the employers of the concerned parties and emerging difficulties should be dealt with firmly, conclusively and fairly.

I gather from the Minister's comments in the broadcast media this evening that he has been frustrated, to say the least, in making progress on the inquiry. A third committee has now been established in the inquiry. It is obvious, judging from media reports, that the Irish Hospital Consultants Association has not acted in a manner to facilitate the speedy progress of the inquiry. It is also obvious that the conditions sought by the IHCA before it would nominate two members to sit on the inquiry have delayed the whole process. I would have thought an association such as the IHCA in its representative capacity would do everything possible to represent and protect the legitimate interests of its members, including the utmost co-operation with the inquiry so that it may undertake its work in a thorough and diligent manner and in the quickest possible timeframe. I hope the latest appointed committee can complete its work in a short period.

I meet on a constant basis with people who outline their great satisfaction with the work and expertise of the three consultant surgeons attached to Cavan General Hospital. I also know of the excellent work done and treatment provided in the medical department. The personnel attached to Cavan General Hospital in all disciplines are quite rightly held in high esteem by the community of Cavan-Monaghan, north Longford, south Leitrim and north Meath. Unfortunately, in every hospital there are some outcomes following surgical procedures or medical treatment which give rise to legitimate grievance and mourning for some families and, sadly, no way back for the patient.

The issues at Cavan General Hospital need to be resolved without delay. I understand that the medical board of the hospital recently contacted the Minister requesting a meeting. My advice to the Minister is to meet those representatives of the hospital staff. They are eminent medics whose priority is the good of the hospital and the well-being of the people of the hospital's catchment area. Cavan General Hospital is a relatively new hospital, with the most modern facilities. We want this hospital and all its departments, with its committed staff, working to full capacity.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I wish to share a minute of my time with my colleague, Deputy Crawford. I thank the Ceann Comhairle for the opportunity to speak on this important issue and I join Deputy Brendan Smith in welcoming the Minister to the House at this late hour.

The failure so far to have the promised inquiry into the dispute involving two now-suspended consultants at Cavan General Hospital is grossly unfair to the staff of the hospital, to the two suspended consultants and above all to the people of the region served by the hospital. At this stage the inquiry should be concluded and its recommendations already acted upon. I reiterate my call to the Minister to intervene directly and immediately in this unacceptable matter. It is a scandal that a dispute involving the IHCA over what doctors serving on the inquiry may be recompensed has resulted in this delay.

Back in August, when matters first came to a head, I called on the health board executive to ensure that the suspensions caused minimum disruption to patient services, as it had promised in its statement, but that has not been the case. Even prior to the suspensions, the dispute placed additional pressure upon the staff of the hospital. With the closure of the accident and emergency department at Monaghan General Hospital the position became untenable and this has continued up to the present. The Government bears much of the responsibility for the now inadequate provision of acute hospital care in the Cavan-Monaghan region. This follows on the closure of the maternity unit and the accident and emergency department in Monaghan.

The death of nine year old Frances Sheridan of Cootehill has added to concerns about the difficulties at Cavan General Hospital. I visited the family of the deceased child yesterday in Cootehill and I again express my sympathy to Brian and Rosemary Sheridan and their children in this time of terrible grief. However, pending the result of the autopsy and the report of the health board inquiry, it is too early to draw conclusions. Whether this tragedy is directly related to current difficulties at the hospital is an open question. The family expressed gratitude in my presence for the care and support they have received at Cavan General Hospital in the past, which I and countless thousands of others would also willingly declare. However, it is long past time for all these issues to be addressed, including the commencement and conclusion of the promised inquiry into what led up to the suspension of the two consultants, the stabilisation of the consultant presence at the hospital and the restoration of on-call status to Monaghan General Hospital, which is a related difficulty.

Seymour Crawford (Cavan-Monaghan, Fine Gael)
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I thank Deputy Ó Caoláin for the opportunity to speak on this tragic issue. The death of Frances Sheridan, aged nine, has brought back into the limelight the extremely serious problem of the mismanagement of Cavan-Monaghan hospital group. I express my sympathy with the Sheridan family, as I did personally yesterday. I am disgusted by the media intrusion into this family's great tragedy.

The problems of this hospital group have gone beyond a joke. Top-quality nurses and staff are under severe pressure because of the Minister's lack of leadership and that of the health board executives. The health board members must also carry the blame, because all but one of those representing County Cavan ignored the problems being experienced in Monaghan and now the overflow from Monaghan General Hospital is causing many of the problems at Cavan General Hospital. The Minister has failed to bring Monaghan General Hospital back on call since last July. The health board management and the Minister have allowed Cavan General Hospital to lurch into a similar situation, with many patients failing to receive the treatment they deserve. Good hospital staff and services are now receiving very bad publicity. The Taoiseach must take responsibility for this and the Minister must come under scrutiny and consider his position. I have had a good relationship with the Minister and have worked closely with him as much as I could. However, Monaghan General Hospital is still not on call and there are serious problems in Cavan General Hospital. There are serious questions to be asked. People and patients must come first. Internal disputes and management problems must be dealt with by someone who cares — someone who will take things under control.

I will finish with a quote from a five-page letter I received from a Cavan constituent who was treated in Monaghan General Hospital:

In the fifties, dedicated doctors and nurses were fully equipped to deal with patients on arrival. Now fifty years later, in the age of modern times and technology, we are fighting for and praying for hospital survival.

I will pass this letter on to the Minister because it is revealing.

Micheál Martin (Cork South Central, Fianna Fail)
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I thank the Deputies for raising these issues on the Adjournment. I take this opportunity to offer my deepest sympathy to the Sheridan family on the death of Frances. I do not propose to comment on the specific circumstances of the case in respect of the family's privacy at this time. In addition, the State pathologist has conducted a post mortem, the results of which are awaited.

This afternoon, I met the chief executive officer of the North Eastern Health Board and was briefed on the board's response. An expert group has been established by the chief executive officer to undertake a review of all factors involved in the case. The review will cover the period from Frances' first contact with Cavan General Hospital on 7 January 2004 to her untimely death on 1 February 2004. The expert group is comprised of senior clinical, nursing and risk management personnel. The chief executive officer has assured me that the review will be completed as a matter of urgency.

With regard to the suspension of two consultant surgeons in Cavan General Hospital, I have recently appointed a committee of inquiry to examine matters of complaint against the two consultants. The two consultants concerned have been suspended without pay since August 2003. The recently established committee is the third such one to be appointed by me in this matter. The legislation details and provides the framework by which these committees are established. Once the health board has notified the Minister of suspension, he is obliged to establish a committee of inquiry. The Minister can be subsequently involved as the person to whom the person suspended can appeal the outcome of the inquiry. There is a difficulty as to what I can say about the inquiry and events surrounding it, due to this quasi-judicial role.

The first inquiry established in September 2003 had to be disbanded due to the withdrawal of both the appointed chairman and one of the consultant representatives. A second committee was appointed by me in October 2003. This had to be disbanded in December 2003 due to a perceived conflict of interest of one of the consultant representatives and the subsequent refusal of the second Irish Hospital Consultants Association nominated member to continue.

The intervening period has been taken up with an extensive exercise to identify consultants, without any potential conflict of interest, who would be willing to serve on the committee of inquiry. The Irish Hospital Consultants Association has been unable to submit a list of names to perform this work due to the non-payment of fees to its members, despite the Department's willingness to provide locum cover for both committee members, to indemnify all committee members against legal action arising from committee work and to pay travel and subsistence to the consultants concerned.

I am confident that the new committee, established with the assistance of retired consultants, will allow the matter to be progressed without further delay. My Department looks forward to receiving the recommendations of the committee in due course.

Every effort will be made to establish, as a matter of priority, the circumstances which gave rise to the tragic death of Frances Sheridan. I anticipate that the work of the expert group will be completed as a matter of urgency and will be the subject of early discussions with the chief executive officer of the board.