Arthur Morgan (Louth, Sinn Fein)
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Question 86: To ask the Minister for Health and Children if she has received a copy of the report on Our Lady of Lourdes Hospital, Drogheda which was drawn up by the joint department of medicine for the Louth hospitals and presented to the Health Service Executive in December 2006; the discussions she had with the HSE on this report; and if she will make a statement on the matter. [6545/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I take it that the Deputy is referring to a discussion document prepared by the joint department of medicine at Our Lady of Lourdes Hospital, Drogheda and Louth County Hospital in advance of a meeting between the joint department and the National Hospitals Office. I have seen a copy of the document and I am advised that it is the subject of ongoing discussions between the National Hospitals Office and the joint department. It outlines an increase in volume and complexity of medical activity at both Drogheda and Dundalk hospitals and notes the concerns of the joint department for patients and staff arising from this increase in workload. It includes an endorsement of the Teamwork report, Improving Safety and Achieving Better Standards. In line with the recommendations of the report, the HSE is developing a single medical clinical network for the whole of the north-east region, including County Louth.

Arthur Morgan (Louth, Sinn Fein)
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I am afraid it involves much more than what is covered in the Minister's reply. Is she aware the report states patients cannot access routine basic care requirements such as food, water and washing facilities? Is she aware it further states patients get better despite the service, rather than as a result of the care they receive and that large numbers are managed in a site not fit for the purpose by persons not trained for the purpose? It also states it is a testament to the staff that no fatalities have resulted to date with medical patients. That is the import of the report.

Is the Minister not ashamed of conditions in hospitals such as this? Is she shamed by the content of the report? What is she doing about it? I have already asked what discussions she has had on the report. She mentioned the Teamwork report. Is she aware that under that report, it is proposed that medical facilities from Louth County Hospital be transferred to Our Lady of Lourdes Hospital, Drogheda, thereby compounding the problems there? When the medical facility transfers to Our Lady of Lourdes Hospital, the accident and emergency unit will automatically follow. Is the Minister aware the intensive care unit will also transfer, compounding the problems in the Drogheda hospital where outpatients spill into the accident and emergency area? Accident and emergency patients have had to be housed in the maternity unit which is already at breaking point. The facilities in Drogheda are getting worse.

I would appreciate it if the Minister would address a serious issue I raised under Standing Order 31 last week. It concerns the Minister's view on these matters and on whether she should remain in her position. I raised the issue of her resignation and do so again today in a calm and measured manner. As long as these conditions persist in our hospitals, the Minister should consider her position carefully.

Mary Harney (Dublin Mid West, Progressive Democrats)
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There is nothing new in the Deputy's call for my resignation, as he calls for it frequently on the radio station in the north east.

Arthur Morgan (Louth, Sinn Fein)
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This is only the second time.

Mary Harney (Dublin Mid West, Progressive Democrats)
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I have visited both hospitals and seen at first hand the wonderful way in which the joint surgical department works. Essentially, day surgery is performed in Dundalk and more complex surgery in Drogheda. The system works well and the volume of surgical procedures in both hospitals has increased substantially as a result. The new road network makes the joint working process more acceptable than perhaps it would have been in a different era when the distance to be travelled was greater.

With regard to the report from the physicians of both hospitals, they suggest a similar process be put in place for medicine, that they should have a joint department of medicine — in effect, the two hospitals would work as one. Currently we might have patients on trolleys in Drogheda, while there are vacant beds in Dundalk. This makes no sense. If we can get hospitals such as those in Dundalk and Drogheda to work closely together, it makes more sense from patients' point of view.

As the Deputy is aware, there are significant deficiencies in the north east where we have five hospitals for a population of 350,000. The hospital admission rate in the area is 5.9 per 1,000. In the United Kingdom the rate is approximately 1.7 per 1,000. Half of all surgical cases and 30% of medical cases from the area are referred to Dublin. Therefore, there is a crying need for a state-of-the-art regional hospital and that will happen. That welcome decision has been made and endorsed by the Government. In the meantime, unlike other facilities and although we have made a decision to proceed with a new hospital, we must invest in the existing hospital infrastructure. We need a new accident and emergency department in Drogheda. This year over €6 million will be provided from the capital programme towards this year. We need other investment in personnel and staff in the region in order to provide services between now and the time we will have the new hospital in place.

It is not the case that nothing is happening. Much is happening. Above all else, we must take on board the reports commissioned and the advice of the training bodies on patient safety and accreditation. Dr. Eilís McGovern has been appointed by the HSE to oversee implementation of medium-term changes in the north east. The HSE and I have given an assurance that nothing will change until something better is put in its place. That is what is currently under way, and I expect the support of the Deputy and everyone else. Change is never easy, but patient safety must come first. We must use resources in County Louth as effectively as possible for the benefit of all patients.

Arthur Morgan (Louth, Sinn Fein)
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I would love if we adopted the principle that nothing should change until better facilities have been put in place. However, the opposite experience has obtained and I ask the Minister to examine that position. There should be a public inquiry into what is going on, such is the current state of crisis. Half of the cases in Louth are coming to Dublin for major operations because there are no facilities in the north east for them. I welcome the proposed regional hospital, but when one has hospitals in Monaghan, Louth and Navan closing and pouring their patients into an already overcrowded facility at Our Lady of Lourdes in Drogheda, there is not much chance.

I will give a brief example. The paediatric protocol was implemented in Louth on 10 April 2005, meaning that no children could be treated in the accident and emergency department of Louth County Hospital. They too are now having to be admitted to it and then transferred to Our Lady of Lourdes, joining an already excessive queue for basic treatment. Someone must examine what is going on because I have no doubt that in future, when there is some scrutiny of this carry-on, we will be told that the authorities did not realise the seriousness of the situation. I put the Minister on notice that we are absolutely at crisis point and that it is unacceptable. I call on the Government to act once and for all. It is already too late, but it should nevertheless address the situation.

Mary Harney (Dublin Mid West, Progressive Democrats)
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We are doing so, and for as long as I have been in the Oireachtas — 30 years this summer — hospitals in the north east have been a major political issue. Every time that we were about to get around to doing something imaginative, it was suddenly reversed, one of the reasons behind current problems. The consultant cardiothoracic surgeon appointed, Ms McGovern, is well respected nationally and internationally. She is the appropriate person to oversee implementation of a programme of reform in the region, in particular ensuring that patient safety is foremost in the minds of everyone involved in the change process under way. That is happening, as the Deputy knows.

Arthur Morgan (Louth, Sinn Fein)
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Things are still getting worse.

Mary Harney (Dublin Mid West, Progressive Democrats)
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He will also be aware that it is the most reviewed region in the country. There have been several reports, one of them being Teamwork.

Arthur Morgan (Louth, Sinn Fein)
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Matters have not improved.

Mary Harney (Dublin Mid West, Progressive Democrats)
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We have had several reviews and at last things are improving because decisions that should have been made years ago are being taken, particularly the decision to have a state-of-the-art hospital, something lacking in the region. That is why so many patients have to come to the Dublin area.

Arthur Morgan (Louth, Sinn Fein)
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The situation is worsening.

Mary Harney (Dublin Mid West, Progressive Democrats)
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People generally want to stay in their own region if the facilities are there and that is what will happen.