Arthur Morgan (Louth, Sinn Fein)
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I appreciate the opportunity to raise this important issue on the Adjournment. Successive Ministers have attempted to fool the people of the Dundalk area with a plethora of announcements, reports, reviews, recommendations and yet more announcements. The fact remains that there were better services at the Louth County Hospital, Dundalk, 30 years ago than there are today. Shame on the Government for presiding over such a scandalous situation.

The children's ward was the first to go, followed by the maternity ward and then the gynaecological unit. In 2001, we were told the maternity unit was to be closed temporarily yet it remains closed today. We were to get a midwife-led unit in its place. In June 2003 we were told by the then North Eastern Health Board that the building identified for future use as a midwifery-led unit would require some modification and extension and a suitable scheme was to be prepared for consideration. This work was to have been completed in 2004 subject to funding being made available. Although it will soon be 2006 there is no sign of these works.

The latest attack on the hospital came last month when a directive was issued by the HSE ordering an end to all breast surgery procedures at Louth General Hospital. We were also promised a renal dialysis unit yet there is no sign of this unit either. The kitchens at the hospital urgently require upgrading. We have had three announcements since 2002 on the approval for kitchen upgrading but it has yet to materialise.

Similarly, we were promised two modular theatres. The Minister for Foreign Affairs, Deputy Dermot Ahern, danced a merry jig on this issue, boasting about the great work he had done for the hospital. That promise has been reduced to one modular unit. I can inform the Minister for Foreign Affairs that it still has not been delivered.

The Tánaiste and Minister for Health, Deputy Harney, met a delegation from Dundalk Town Council last May. She promised the members she would consider the issue of a CT scanner for Louth General Hospital and that she would visit the site in July. More broken promises from a Minister. She still has not visited Dundalk.

The Tánaiste and Minister for Health and Children recently announced that her Department would provide matching funding for the provision of a CT scanner at Bantry General Hospital. Fair play to it. I call for similar funding for a CT scanner for Louth General Hospital. We will not be treated as second-class citizens by this or any other Minister. Our hospital cannot survive without a CT scanner. The Minister of State knows that, yet he is still dragging his feet on this important issue.

Yet another ludicrous document relating to the provision of services at Louth County Hospital has emerged recently, this time from the Royal College of Surgeons, signed by Professor Arthur Tanner. The third item in this document instructs that the consultants must have absolute discretion to transfer a patient from Dundalk to Drogheda at any time, with immediate effect. The fourth item in the document states that beds must be made available in Drogheda, without question, and on an immediate basis where such transfers are requested. How can this work in practice? If there is no bed available in Drogheda and a patient is to be transferred from Dundalk, is the sick and, perhaps, dying patient in Drogheda to be removed from a bed, placed on a trolley and pushed into the corridor to make room for the equally sick and, perhaps, dying patient from Dundalk? This document is indicative of the lack of rationale or any semblance of proper management at a senior level in the HSE.

I will give an example of what could work to resolve some of the health care crisis in the north east region. The six surgeons based at Our Lady of Lourdes Hospital, Drogheda, who have a lower throughput of procedures than the two surgeons at Dundalk, could be allocated a small number of additional "splits" with Louth General Hospital. This would have the immediate effect of bringing Dundalk back to the status of a training hospital and addressing in some way the infrastructural deficit in the north east region.

I urge the Minister of State, Deputy Tim O'Malley, to make clear in his reply whether we can expect him to address the litany of issues raised on behalf of people in the Dundalk catchment area who are currently being denied adequate health care services by the Government. They have been denied a proper and adequate health care system over the past eight and a half years when the Government has been in office. I look forward to the Minister of State's reply.

Tim O'Malley (Limerick East, Progressive Democrats)
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I thank Deputy Morgan for raising this matter on the Adjournment. In raising the matter, he provides me with an opportunity to outline to the House the position on the development of services across the Louth-Meath hospital group. The Department is advised by the Health Service Executive that there are no plans to downgrade Louth County Hospital, Dundalk, and that the hospital is guaranteed an active role in the delivery of acute hospital services within the group.

This policy is reflected by recent service developments such as the establishment of a joint department of surgery between Our Lady of Lourdes Hospital, Drogheda, and Louth County Hospital, Dundalk, in January 2005. This development has resulted in increased elective activity in Louth County Hospital and a reduction in waiting lists on both sites. In April 2004 the Department approved the appointment of a design team to prepare an outline development control plan for the hospital. Design teams have been appointed to advance the provision of two modular theatres at a capital cost of €3 million and for the upgrading of the kitchens at Louth County Hospital at an estimated capital cost of €1.4 million. A cardiac rehabilitation unit opened at the hospital in 2002, an additional 14 beds were provided under the national bed capacity initiative at a full-year revenue cost of almost €1.5 million, a new consultant physician with a special interest in endocrinology was appointed in April 2004 to support these beds, and a new consultant in emergency medicine has been appointed with sessional commitments to Louth County Hospital. The Department sanctioned the purchase of almost seven acres of land at Louth County Hospital in December 2003 at a cost of €2.6 million.

Arthur Morgan (Louth, Sinn Fein)
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A private hospital will be built on the site.

Tim O'Malley (Limerick East, Progressive Democrats)
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Tóg go bog é. Is the Deputy against that also?

Arthur Morgan (Louth, Sinn Fein)
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The Minister of State said the purpose of——

Tim O'Malley (Limerick East, Progressive Democrats)
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The purpose of this purchase is to have a strategic land bank that will be of benefit to acute services.

On breast surgery services in the north-eastern region, the HSE has informed the Department that following the resignation of the lead breast surgeon for the region, breast surgery has been carried out in the Louth-Meath hospital group at Our Lady of Lourdes Hospital, Drogheda. The post of lead breast surgeon for the region, based in Our Lady of Lourdes Hospital, Drogheda, is scheduled to be advertised by the Public Appointments Service on Thursday, 13 October 2005, with a closing date of 10 November 2005.

Since 1997, approximately €37 million in cumulative additional funding has been made available to the north-eastern region for the development of appropriate treatment and care services for people with cancer, including a sum of €600,000 which was allocated this year for cancer services in the region. This investment has enabled the funding of an additional ten consultant posts and support staff in key areas of cancer care across the region. BreastCheck, the national breast screening programme, has been available to women in the 50 to 64 age group throughout the north-eastern region since 2000. Mobile units provide screening to women in the target age group approximately every two years. Follow-up treatment for those diagnosed with breast cancer under the programme is provided in the BreastCheck clinical units in Dublin.

We can only maintain progress in the fight against breast disease if the delivery of high quality care and adherence to best practice comprise our main priority. For this reason, the Tánaiste recently established a national quality assurance group, under the chairmanship of Professor Niall O'Higgins, for symptomatic breast disease services. It is an important milestone in the development of quality breast disease services. This group will develop an agreed set of interdisciplinary performance indicators for the management of symptomatic breast disease. The objective is to ensure that the same expert guidelines apply to women regardless of the hospital in which they are treated.

The arrangements I have outlined which are being put in place by the Health Service Executive are designed to enhance the overall level of hospital services across the Louth-Meath hospital group.