Denis Naughten (Longford-Roscommon, Fine Gael)
Link to this: Individually | In context

Question 87: To ask the Minister for Health and Children the status of plans to move inpatient surgery from the County Hospital, Roscommon; and if she will make a statement on the matter. [35304/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

Roscommon County Hospital and Portiuncula Hospital, Ballinasloe are closely linked and many consultant appointments are shared between the two hospitals. The HSE aims to maximise the range and volume of surgery and other services in each of the two hospitals by developing greater collaboration between them. This is designed to increase access by patients in Roscommon and east Galway-west midlands to high quality services locally.

The HSE has decided to create a joint department of surgery-anaesthetics between Portiuncula Hospital and Roscommon County Hospital, with shared consultant appointments. There are no plans to discontinue any surgical services at either facility. The HSE, in consultation with the staff in both hospitals is working out an implementation plan to give effect to this decision. The objective is to provide an appropriate structure for a high quality, sustainable and, above all, safe service for the people of the area in the future.

Denis Naughten (Longford-Roscommon, Fine Gael)
Link to this: Individually | In context

I thank the Minister for her reply. The initial announcement by the HSE indicated the transfer of inpatient surgical services from Roscommon County Hospital to the overcrowded Portiuncula Hospital, 40 minutes to an hour away, which is struggling to cope with the increased demand being placed on it from the west midlands, including Athlone. This would mean that patients in west Roscommon, for example, would have to travel for up to one and a half hours to access acute emergency care. Will the Minister clarify whether inpatient surgery will be retained at Roscommon County Hospital not only in the short term but in the medium term?

Will she also clarify whether the two surgeons currently based in Roscommon will remain there rather than being transferred to Portiuncula Hospital? A threat was made by the HSE to the effect that future developments at Roscommon County Hospital would not go ahead if it did not accept the original proposals. Will the Minister clarify the position in this regard?

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

Surgical activity was of a low volume at both these hospitals. In the case of Roscommon County Hospital, I understand there were as few as two to four procedures per week. The only way to ensure a safe environment for treatment is to maintain the skill base of surgeons through higher volume activity. As has happened in County Louth, for example, Roscommon County Hospital and Portiuncula Hospital will become effectively a single surgery department operating on two sites. Anybody who has concerns in this regard should go and see what is happening in Louth. I have seen the remarkable developments for patients, doctors, nurses and other staff.

Denis Naughten (Longford-Roscommon, Fine Gael)
Link to this: Individually | In context

Dundalk and Drogheda are only up the road from each other.

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

Both those facilities now have a far higher volume of activity and shorter patient waiting times. Developments have taken place that it was previously believed would never occur.

Provision has been made for a CAT scanner in Roscommon County Hospital and all the other developments to which the Deputy referred are proceeding. I understand the two consultants to whom the Deputy made reference are co-appointed and that this has always been the case.

Denis Naughten (Longford-Roscommon, Fine Gael)
Link to this: Individually | In context

That is not true.

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

I believe it is true. I am not certain they worked in both hospitals but I understand they were appointed to both places.

Denis Naughten (Longford-Roscommon, Fine Gael)
Link to this: Individually | In context

No, my understanding is that one of the appointments was a co-appointment but the other was a full appointment to Roscommon County Hospital. Will the Minister clarify whether the two surgeons will be based on the Roscommon campus? Will inpatient surgery services there be retained in the medium to long term?

I understand a consultant in emergency medicine, a third consultant physician and a consultant anaesthetist were to be appointed to Roscommon County Hospital. In addition, a consultant surgeon was to be appointed to serve both Roscommon and Portiuncula hospitals. A threat was issued, however, that these appointments would not be ratified on a formal basis, especially the third consultant physician post, unless the original proposals were accepted.

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

I said in my response that the new appointments would be to both hospitals. In other words, they will share anaesthetic and surgical staff and there will effectively be a single department operating on two sites. Subject to correction, I believe such posts were in the past appointed to both hospitals but it may not have operated in this way for training and other reasons. The main issue of concern in Roscommon is whether activity will continue there. I confirm that it will as long as it safe for it to do so. If the team is appointed to both hospitals, that level of activity can continue on both sides.

Joe Sherlock (Cork East, Labour)
Link to this: Individually | In context

Is the Minister aware of the criteria and terms of reference being used in regard to the review of acute hospital services in the southern region? Is she aware that the appointment of two consultant radiologists to Mallow General Hospital, promised since 2001, is still not completed?

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

We are seeking to organise hospital services based on the need for patient safety. Procedures will continue to take place in a particular environment where it is safe for them to do so. Where it is unsafe for them to continue, there must be change. I have pointed on many occasions recently to the example of breast surgery. In 2003, the last year for which we have figures, of the 1,800 breast surgeries that were carried out, 39 of the consultants involved performed fewer than five such surgeries per year. We know from international evidence that this is a highly dangerous scenario in that outcome survival rates are poor when such a low volume of surgeries is carried out. It is not a safe environment in which to operate. That happens in other surgical areas as well and not only in surgery. We cannot allow that situation to continue. I have said on many occasions that we cannot downgrade patient safety. We must be able to give assurance to a woman in Donegal, as much as to one in Dublin, that she will have access to the same standard of care.

In regard to the region about which the Deputy spoke, the idea is to ensure Mallow, Bantry, Cork and Tralee work closely together as a team providing an acute hospital service for the region, bearing in mind that we must also take on board patient convenience issues because of the long distances involved.

I have a very high regard for Mallow hospital because it came number one in the first hygiene survey and number two in the second one. It is a hospital I hope to visit shortly because what they do there is very impressive. The Deputy need not worry about Mallow hospital.