Seymour Crawford (Cavan-Monaghan, Fine Gael)
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I thank the Chair for the opportunity to raise this issue. No issue has caused more problems for people in the Cavan-Monaghan region than health. I urge the Minister to intervene to ensure that all available beds in Monaghan General Hospital are put to use in light of the fact that Our Lady of Lourdes Hospital, Drogheda cannot cope with even its own day surgery requirements and patients in urgent need there now find their appointments cancelled.

I raise this issue because this morning I learnt of the case of a woman who was to have a pin removed from her ankle in a day procedure in Our Lady of Lourdes Hospital. However, the procedure was cancelled at the last minute, as was a similar procedure for her neighbour, due to the lack of beds. I understand at least three or four other procedures were also cancelled. I am advised that the lady concerned may have her operation on Friday. It is over ten weeks since she had the pin inserted and a cast put on her foot after a serious break in her ankle. She is a main carer for her 82 year old mother and handicapped sister. This delay is just a symptom of the problem in Drogheda.

I had a letter dated 6 June from a consultant stating that he could empathise completely with a person such as I wrote to him about who suffered substantial delays in treatment. He said the bed situation in Our Lady of Lourdes was very difficult due to the volume of trauma victims and that it was not unusual for no patient to be admitted on his operating list for day treatment. This was very frustrating for everybody. According to some people there is no shortage of beds, but this has proven to be untrue in the case of the Drogheda hospital.

I highlight these two cases to demonstrate the impossible situation for all concerned. I demand that the Tánaiste and Minister for Health and Children, Deputy Harney, should check the facts when she and her experts state that patients in Cavan and Monaghan are now in danger.

The Health Service Executive and its teams state they must only allow level 3 critical care patients to be dealt with in Drogheda. This means that within three months all level 3 care for patients needing ventilation and other organ failure support should be centralised at Our Lady of Lourdes Hospital. This is not viable or responsible. We know beyond question that Drogheda hospital cannot cope currently with its load, not to mind an increased load.

The only reason there may be problems in Monaghan General Hospital is that the Government removed services and staff by devious means. There is now a danger it will use the Dáil summer recess to further cut services. I warn those who allow this to happen, whether the Minister, those she employs with taxpayers' money or those who support her in the House, that they will be exposed for the lives they put at risk. It is all very well to close down a service when a proper replacement service is in place, but to force people to use an ambulance service before decent roads or services are available is unforgivable.

Last night the Taoiseach advised the House of the many billions of euro he could spend. He tried to make people believe the Government has delivered on medical cards and home help, yet it is desperately trying to advertise doctor-only cards in order to get them into the system before the next election. It hopes people will forget that at least 100,000 medical cards have been lost over the past few years.

A 94 year old woman who is on her death bed can only get five hours home help per week. This works out at less than four hours in real terms. However, the HSE sends me and others a ten-page document that makes it seem the situation is different. The facts on the ground indicate otherwise. Health in Cavan-Monaghan is in crisis. No tall stories or shouting will change that. I urge the Minister for Education and Science, who is here to represent the Minister for Health and Children, to persuade the Tánaiste to examine the situation and see what she do about it.

Mary Hanafin (Dún Laoghaire, Fianna Fail)
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I will take this matter on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney.

Under the Health Act 2004, the Health Service Executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. The Department of Health and Children has been in touch with the HSE and has been advised that three hospital bed usage review groups have been established in the HSE north-east, one in the Cavan-Monaghan hospital group, one in the Louth hospital group and one in Our Lady's Hospital, Navan. I am advised that the purpose of these groups is to review, on an ongoing basis, bed usage in each hospital and to alleviate overcrowding where possible by the introduction of any initiative deemed appropriate; to develop and implement effective admission, transfer and discharge policies and procedures; to work in partnership to manage bed usage in each hospital or hospital group in a more effective manner; and to liaise with primary community continuing care colleagues regarding arrangements for clinically discharged patients. The membership of these groups includes nursing, medical and administrative representation.

In addition, an inter-hospital bed usage group has also been established to address bed usage issues in the north east and how they impact on the throughput of patients throughout the region, and to manage hospital bed usage more effectively. The membership of this group includes hospital management, directors of nursing and hospital consultants.

With particular regard to day surgery, the HSE has advised the Department that the establishment of a joint department of surgery in the Louth hospital group and the establishment of a single department of surgery in the Cavan-Monaghan hospital group has resulted in a more effective throughput of patients receiving surgery, with a result that waiting times for day procedures and surgical out-patient appointments have dropped considerably.

Following the recent publication of a review of acute hospital services in the former North Eastern Health Board area, the HSE is to establish a north east steering group to quickly address the issues that require immediate attention and at the same time develop a longer-term strategy to deliver a world class health service during the next ten years. The group will have representation from key stakeholders such as clinicians and primary care providers. There will also be widespread public engagement on the issues highlighted in the report.

The report concluded that the present system, where five local hospitals deliver acute care to relatively small populations, is exposing patients to increased risks, is not serving the community well and is not sustainable. The consultants believe there is an unprecedented opportunity over the next ten years to develop a very high quality responsive emergency and planned care service, in line with international standards, by developing local services within existing hospitals and other local centres supported by a new regional hospital.