Fergus O'Dowd (Louth, Fine Gael)
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I thank the Ceann Comhairle for allowing this matter to be debated. There is great concern in County Louth for the future of its acute hospitals. This concern is accentuated by the lack of consultation between the Health Service Executive and hospital management, people working in hospitals, public representatives and the public in general. There is a real fear, due to leaks of reported meetings of the HSE in The Irish Times and stories in The Sunday Business Post about whether there would be one new hospital, no new hospital or whether hospitals would close. The only we thing we know is that this report is in the hands of the HSE and I ask the Minister to publish its content.

The report is by Teamwork Management Services and is entitled Safety and Achieving Better Standards — An Action Plan for Health Services in the North East. The report has been published in a climate where significant cuts were announced this morning on the national airwaves to the acute hospitals in the north-east region. I express my concern at the fact there will be no new developments at Louth County Hospital or at Our Lady of Lourdes Hospital in Drogheda; that the proposal to appoint a new oncologist in Drogheda may not go ahead to save €600,000 in the HSE; that there will be a ban on recruiting agency nurses, which will be under very strict rules; and that MRSA sufferers will now be removed from private rooms and placed in rooms with fellow MRSA sufferers. Is this an improvement in services? Does this improve patient safety? Will this achieve better standards? It clearly will not do so. Maintenance will be reduced by almost €500,000 in the acute hospitals in Drogheda and Dundalk. At what price are these cutbacks taking place? It has also been announced that equipment will not be replaced. Renal dialysis in Cavan is also under challenge.

The health services are in an absolute mess. The Minister and the Minister of State could not care less about it and are not funding services in the north east. It now looks like they want to close a number of hospitals in the region. We believe that all the acute hospitals should be kept open in the north east, which means not closing the hospitals in Dundalk and Drogheda. This report was carried out with no consultation with hospital staff. If administrators were not in the hospitals, the staff were not spoken to. There is no transparency and no openness in the HSE. I ask the Minister to publish this report immediately so we can discuss this outcome.

Tim O'Malley (Limerick East, Progressive Democrats)
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I am taking this matter on behalf of the Tánaiste and Minister for Health and Children, Deputy Harney. I thank the Deputy for raising this matter.

Under the Health Act 2004, the Health Service Executive has responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Issues relating to the provision of acute hospital services in the north east have been the subject of much debate in the House in recent years. There has been a number of reviews carried out on hospital services in the north east. These have included North East Hospitals — the Next Five Years, published in 1998, Report on Maternity Services in the North Eastern Health Board, published in 2000, Risk Assessments on the Cavan/Monaghan and Louth/Meath Hospital Groups, published in 2001, Maternity Services Review Group to the North Eastern Health Board, published in 2001 and Comhairle na nOspidéal Report on Maternity and Related Services in the North Eastern Health Board Area, published in 2003. In addition, there has been a number of hospital-specific reviews and reports carried out by bodies such as the Royal College of Surgeons in Ireland and the Medical Council, and by external risk assessors and consultants.

Earlier this year the HSE commissioned Teamwork Management Services to undertake a comprehensive review of acute hospital services in the north east and to provide an action plan for achieving the best possible acute care for patients in the region. The terms of reference for the review were to determine with reference to international best practice the optimal configuration of hospital services and consultant staffing for the geographic area and population of the north east which will provide safe, sustainable, cost-effective and high quality services and take account of the existing transport infrastructure and the availability of services in adjacent areas; to evaluate the benefits and risks associated with current provision of acute hospital services on five sites serving a population of approximately 350,000; to review the current capacity, usage and deployment of consultants, beds, theatres, day case, outpatient, accident and emergency, diagnostic and other facilities in the hospitals in the region and compare them to international norms; to consider the current and potential contribution of primary care services, including out-of-hours GP services, ambulance and advanced paramedical services in reducing risk to patients; to take account of current and projected demographic trends affecting the north east; and to make recommendations to the CEO of the HSE on the above considerations, including short-term and long-term recommendations on the future configuration of acute hospital services and consultant staffing, which will minimise risk to patients and provide high quality and safe services to patients with reference to international best practice.

The review began in March 2006 and has recently been completed. The report, entitled Improving Safety and Achieving Better Standards — An Action Plan for Health Services in the North East, was received and endorsed by the board of the HSE last week.

The CEO of the HSE has been instructed by the board to engage with staff and other stakeholders in the north east during the coming weeks. The manner and timing of publication of the report is a matter for the HSE.