Damien English (Meath West, Fine Gael)
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I am delighted to raise this serious matter on the Adjournment. I take it that the Minister for the Environment, Heritage and Local Government, Deputy Gormley, is dealing with this as I note that once again the Minister for Health and Children, Deputy Harney, is not here because she is denying these facts. It is disgraceful that the Minister for Health and Children and the Government are downplaying this serious issue. The Minister's take on it is nothing short of a con job.

Why must the patients of the north-east region suffer because of Government cutbacks? We were promised this would not happen. In May, before the election, the Taoiseach and the then Tánaiste and Minister for Health and Children, Deputy Harney, stated there would be no cutbacks to frontline staff. In September and October when they were asked about cutbacks they stated no patients would suffer.

The north-east regional orthopaedic unit will close for a month. This unit serves a population of 400,000. It does on average 200 operations a month. The Minister is trying to dispute that, saying it does only six. According to her own figures yesterday, she admitted that the unit has looked after 16,000 patients in the first nine months. If one divides that number by nine, one gets 177 patients, which is much more than six. It is an insult to the people of the north east and to this country that the Minister keeps speaking of the figure six. It is a disgrace. I want that confirmed and I want her to come in here at some stage and admit that she was misleading people with that figure. Her own regional organiser employed by the HSE, which reports to the Government, has admitted publicly that the figure is approximately 180. The consultants have stated it is approximately 180. Who does the Minister think she is to continue misleading us by telling us lies, that the figure is six, which is wrong?

Brian O'Shea (Waterford, Labour)
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Deputy English should not use the word "lies".

Damien English (Meath West, Fine Gael)
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I feel strongly about it. It is "mistruths", which is the same. I should not use the word "lies". "Mistruths" is probably a better word to use and I apologise.

Brian O'Shea (Waterford, Labour)
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Deputy English should withdraw the word "lies".

Damien English (Meath West, Fine Gael)
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I withdraw the word "lies". It is a mistruth, but the figure is still wrong. It is much more than six. It is 177 to 180, according to her own figures. When this unit closes——

Ruairi Quinn (Dublin South East, Labour)
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Would it be acceptable if Deputy English said it was deliberately wrong?

Brian O'Shea (Waterford, Labour)
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The Deputy has withdrawn the remark.

Damien English (Meath West, Fine Gael)
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Deputy Quinn is correct. It is better to say it was deliberately wrong. This unit will close for a month, which will affect people scheduled for treatment in December, but it will also have a knock-on effect on every month during 2008. Each of the approximately 500 patients on the waiting list will suffer because of this cutback. It is wrong and deliberately untrue to continue saying only six people will be affected. Many more people will be affected. These patients will be left in serious pain.

Why were the consultants not informed when the decision was taken to close this unit? It is a disgrace that consultants who know how much pain patients are suffering were not even consulted about the closure of the unit. How is it safe for patients for someone to decide at the stroke of a pen to close this unit? This is a disgrace.

I accept the Minister may not have all the answers today but I have some questions to put to him. Why were the consultants not consulted on this serious decision? Why are the patients the ones who will suffer due to cutbacks when we were promised they would not? Does the Minister care about Our Lady's Hospital in Navan or this orthopaedic unit?

I did not receive any answers in the Minister's replies to parliamentary questions I tabled in recent days. She informed me it is not her responsibility. What exactly is the Minister for Health and Children supposed to do if not be in charge of our hospitals? It is ridiculous to say it is not her responsibility. Will the Government step in and prevent the closure of this unit? Will the Minister accept the figure of six patients is incorrect and totally and utterly misleading? Will the unit be fully operational in January?

If the unit is closed in December, no pre-operation assessment cases can be dealt with, so no patients will be ready for operation in January. In effect, this would result in two months of closure, which would be very serious. I seek clarification on this point. How much money does the Minister for Health and Children intend to save by closing the unit for a month? When a manager is absent due to illness, he or she can be replaced by a memo sent around the health service to find a replacement. A manager can be replaced but in this case it appears a unit must be closed.

Last April or May, prior to the election, we were promised in a big announcement by the Minister, Deputy Dempsey, that Our Lady's Hospital, Navan was due to get a medical assessment unit which would solve the problems experienced by the casualty department. We were promised it would open in July 2007 but construction has not even started yet and it is not due to open until 2008. This is another promise on which we have been let down.

We were also led to believe the medical assessment unit would be a permanent one but we have learned since the initial announcement that it is an interim unit which will close in 2009. Why are the people of the north east expected by the Government to accept a second-class health service? This is not good enough. People are suffering and will continue to suffer. What does the Government intend to do?

I have respect for the Minister for the Environment, Heritage and Local Government, Deputy Gormley, but I no longer respect the Minister for Health and Children, Deputy Harney, since she got her figures wrong. I hope the Minister will bring the message to the Government that the north east can no longer endure constant cutbacks.

Since the election three announcements have been made about Navan Hospital: first, the closure of this unit; second, that there would be no medical assessment unit; and third, the withdrawal of cancer services. I am convinced all this information was available prior to the election. It was misleading and a con job not to have told people the truth in the north east. For years the people there have suffered from a lack of investment in the health service, yet they are expected to continue accepting the situation. This is not good enough.

It was confirmed during the week by the Health Service Executive's regional network manager that many vacant posts in the north east were not filled in 2007. Therefore, the current cutbacks do not look as bad as they would otherwise have. We do not appear to have to cut back as much as is actually the case. Posts were deliberately not filled in order to save money and it was decided to postpone the bad news regarding cutbacks for November and December. We need answers.

John Gormley (Dublin South East, Green Party)
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I thank Deputy English for raising this matter. I will be taking the matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney.

The Department of Health and Children is advised by the Health Service Executive that the orthopaedic department in our Lady's Hospital Navan, which performs elective orthopaedic procedures, will not be admitting patients for the month of December.

The Health Service Executive has advised that each year, before, during and after Christmas, there is a reduction in demand for elective orthopaedic services, such as hip replacements, in Our Lady's Hospital. Last year the orthopaedic unit closed completely for the month of December.

Damien English (Meath West, Fine Gael)
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Construction work was under way.

John Gormley (Dublin South East, Green Party)
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The Health Service Executive advises that six patients who have had procedures booked for December will be given alternative appointments for January 2008. Patients suffering fractures or trauma, as well as day cases and those with outpatient appointments, will continue to be treated during the month of December.

The Health Service Executive has indicated that the orthopaedic department in Navan is ahead of its set targets for procedures for 2007.

Damien English (Meath West, Fine Gael)
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With respect, this is not a factory.

Brian O'Shea (Waterford, Labour)
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The Minister should be allowed to speak without interruption.

Damien English (Meath West, Fine Gael)
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I understand that, but this is an insult to the people of the north east.

Brian O'Shea (Waterford, Labour)
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The Minister should be allowed to speak without interruption.

Damien English (Meath West, Fine Gael)
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There is no point in reading out the reply. It is a waste of time. It is an insult.

John Gormley (Dublin South East, Green Party)
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If there is no point in reading it out, I will not read it.

Damien English (Meath West, Fine Gael)
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It does not say anything. We can go on the figures.

Brian O'Shea (Waterford, Labour)
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The Minister should be allowed to speak without interruption.

Damien English (Meath West, Fine Gael)
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This is a crazy situation.

John Gormley (Dublin South East, Green Party)
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At the end of September the total number of elective procedures performed was 1,603, of which 331 were major joint replacements and 1,272 were other orthopaedic procedures.

The overall context for public hospital services in the country is that for each of the past three months of this year, we can still expect about 100,000 patient discharges, on a day case and inpatient basis. This excludes accident and emergency services. I say this to illustrate the high levels of service that continue to be offered in our public hospitals.