Dáil debates

Tuesday, 24 October 2006

8:00 pm

Photo of Seymour CrawfordSeymour Crawford (Cavan-Monaghan, Fine Gael)
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I thank the Ceann Comhairle for the opportunity of speaking on the Teamwork report. With apologies to the Minister of State, Deputy Conor Lenihan, I would like to have seen a Minister from the Department of Health and Children come to the House to discuss this major national report, which contains 115 pages in total. We will not be able to do it justice in ten minutes but it is vital to Monaghan General Hospital.

That hospital has been the subject of more reports than any other. One of the most important of those reports was carried out by Mr. Bonnar. Its findings were to have been implemented and funded but in the end it was ignored. His report showed what could be done with safety in mind at the hospital. The Teamwork report highlighted many difficulties due to the Government failure to do what the Bonnar report and other proposals recommended. The Government failed to provide the promised staff and even forced others to leave. Monaghan General Hospital's brand new theatre was often left idle while the State, through the National Treatment Purchase Fund, paid others to carry out operations in some less well-equipped private hospitals. Monaghan General Hospital was carrying out such work for Northern Ireland before the then Minister, Deputy Martin, allowed it to be taken off call.

During the years that Monaghan General Hospital was off call, many lives were lost. The Teamwork group was brought in to look at the overall north-east region that suffered serious problems as a lack of leadership led to issues being dealt with through the courts system. This lack of management was highlighted by the independent Pat Joe Walsh report. It substantiated what I and others highlighted in this House on many occasions but was ignored by the Minister.

Mr. Chris Lyons, who is in charge of the hospital group, recently stated that the Teamwork plan was based on international best evidence and that it was a unique opportunity to lead health care in Ireland towards a model which provides best quality care.

In a reply to my parliamentary question, the Minister assured me that no service would be taken away until a better service was put in place, yet Mr. Lyons is now rushing ahead to close down services in Monaghan General Hospital and using all sorts of spurious excuses. He told us recently that the Teamwork report was a bottom-up exercise but in reality the Teamwork report personnel refused to meet anyone who knows or cares about the patients and users of Monaghan General Hospital.

Several Ministers, including the Minister of State's brother, Deputy Brian Lenihan, promised that meetings would be arranged with those who understood and were willing to discuss the issue of the Teamwork report, but this did not happen. The report was published and the Government allowed for its implementation without debate in the House.

The first proposal was to centralise all level three care at Our Lady of Lourdes Hospital, Drogheda. It was proposed to close units in Cavan, Louth and Dundalk as well as Monaghan. It is known that Drogheda is not able to cope. This was obvious when they had to send Pat Joe Walsh to Monaghan at a time when it was clear he was not fit to be moved, yet it is Monaghan that is under question. When the report was issued, the Minister for Health and Children, then Tánaiste, stated that Monaghan would have to be closed while Our Lady of Lourdes Hospital got off scot free.

A young handicapped man had his life saved by Monaghan hospital just last month. His parents asked me to put this on the record of the House. From what was said today on local radio, it seems that Mr. Lyons now seems to be moving the critically ill patients to Cavan, yet there is no room there except on trolleys. Cavan hospital is also to be closed. What is the Minister doing about this? Has she any understanding or care? She has never once visited Monaghan General Hospital and it is clear she does not want any open or frank discussions about it.

I thank the Minister of State for coming to the House to reply but I urge him to ensure that the House has a full discussion on this major report. Mr. Chris Lyons has stated this report is not just applicable to Monaghan General Hospital but is a template for all Ireland. I hope the Government backbenchers will wake up to that fact and realise the serious implications it will have for an all-Ireland health service.

Photo of Conor LenihanConor Lenihan (Dublin South West, Fianna Fail)
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I will reply on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I am informed that all Ministers associated with the Department of Health and Children are on ministerial duties associated with their portfolios this evening.

Photo of Seymour CrawfordSeymour Crawford (Cavan-Monaghan, Fine Gael)
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They are certainly not in Monaghan.

9:00 pm

Photo of Conor LenihanConor Lenihan (Dublin South West, Fianna Fail)
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The Health Service Executive has recently established a steering group and a north-east project group to oversee a programme designed to improve safety and standards across the acute hospital network in the north-east region. The decision was taken having regard to the issues raised in the report prepared for the HSE by Teamwork Management Services, entitled Improving Safety and Achieving Better Standards — An Action Plan for Health Services in the North East, and taking account of the findings of the recent report into the death of Mr. Patrick J. Walsh. Led by the HSE's national hospitals office, the steering group has representation from key stakeholders such as clinicians and primary care providers. The project group is being led by a consultant surgeon from outside the region.

The Teamwork report concluded that the present system, where five local hospitals deliver acute care to relatively small populations in the region, is exposing patients to increased risks and creating additional professional risks for staff. The report highlights the need to develop a high quality and responsive emergency and planned service, in line with international standards, by developing local services within existing hospitals and other local centres supported by a new regional hospital. The HSE recently published the report of the independent inquiry into the death of Mr. Walsh. The report details the difficulties that arose in trying to secure Mr. Walsh's transfer from Monaghan to either Our Lady of Lourdes Hospital, Drogheda, or Cavan General Hospital. It also exposes a failure in communications between clinicians and hospitals in the region. Since the death of Mr. Walsh, a new protocol for patient transfer has been put in place. It provides that all requests for transfer from Monaghan General Hospital to Cavan General Hospital or Our Lady of Lourdes Hospital, Drogheda, should be granted and processed immediately.

International best practice demonstrates that patients have better outcomes when treated in hospitals with appropriate numbers of specialist staff, high volumes of activity and access to the right diagnostic and treatment facilities.

Patient safety and quality must be paramount and must be the key drivers in the reconfiguration of our acute hospital services. The policy of the Government is to provide safe, high-quality services that achieve the best possible outcomes for patients. This will mean rebalancing service delivery so that those services that can be safely delivered locally are delivered locally and that more complex services that require specialist input are concentrated at regional centres.

The HSE has given the Minister an assurance that, in progressing the implementation of the teamwork report and the report of the independent inquiry into the death of Mr. Walsh, there will be no discontinuation of existing services until suitable alternative arrangements have been put in place.