Seán Sherlock (Cork East, Labour)
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I am disappointed the Minister for Health and Children, who has primacy for this issue, has left the Chamber. I would have liked if she stayed for the five minutes allocated to me on this issue. There was a proposal made at the end of March that the number of consultants operating at Mallow General Hospital be reduced from three to two. This was on the termination of a contract of employment. The result of the termination would have been to reduce accident and emergency cover within the hospital from seven days to five, resulting in Monday to Friday cover from 9 a.m. to 5 p.m. This decision was already taken, a fait accompli and, but for the actions of people such as the Mallow Hospital Action Committee, of which I am secretary, Friends of Mallow Hospital and general practitioners who came out fighting and held a press conference, deciding that an expression of "no confidence" would be placed in the management of Mallow General Hospital, the management would have proceeded with the decision without a "by your leave".

Because of the action, the furore, and the amount of public protest as a result of the decision, the HSE has stated that it is in a position to fill the post with a locum consultant until the end of May. We have no commitment in writing that the HSE is intent on the continuation of a third surgical position at Mallow. We fear the intention of the HSE and the Minister to downgrade our hospital and reduce by stealth the number of surgical posts in the hospital, thereby reducing the accident and emergency services and funnelling everything to CUH which, if one believes the HSE, is the new Jerusalem in the south and will solve all our ills. We believe the process will have a detrimental effect on the lives of the 100,000 people in the catchment area of Mallow General Hospital, having an adverse effect on medical outcomes. CUH is ill-equipped to deal with the extra work load this development will entail.

I call on the Minister of State to give guarantees in writing that Mallow, as a secondary care facility, will continue as the centre of excellence that it is, that the 100 GPs referring patients to the hospital will have the accident and emergency cover they need and that there will be three surgeons or more to provide the service to more than 100,000 people who require it. We also want to ensure that the hospital — an excellent facility — goes from strength to strength and will not be downgraded any further.

We demand a clear commitment in writing from the HSE, that it will ensure the continuation of a third surgical position so that we can deliver services to our people on the ground. We have no confidence in the current management system because we have listened to promises on the roll-out of a CT scanner, which has been idle for more than three years. We have no radiologist in the hospital, which was promised. We have no executive management board, which was promised and for which the HSE stated it would embark on a consultation process. The dogs on the street know that a 15 minute consultation with one or two GPs does not constitute a consultation in our book. We call for the instigation of an executive management board so that we can call into question any decisions on the future of the hospital and examine and provide an audit report of any accounting procedures relating to the hospital.

We want to see a centre of excellence at Mallow. It has a positive effect on the outcomes of patients in the region and we will oppose vehemently any attempt by the HSE to downgrade services. We want to see firm commitments from the Minister of State and to see the third post instigated in perpetuity so that the people of the region can have a proper standard of care, and excellent care at that.

Jimmy Devins (Sligo-North Leitrim, Fianna Fail)
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I am taking this debate on behalf of my colleague the Minister for Health and Children, Deputy Mary Harney.

The Government is committed to ensuring the delivery of the best quality health services possible and doing so both effectively and efficiently. Ensuring patient safety is of paramount importance, to ensure that people can have confidence in the services and that the best possible patient outcomes can be achieved. The Health Information and Quality Authority was established on a statutory basis in 2007 and is responsible for driving quality and safety in the health and social care services. In 2007 a new Medical Practitioners Act was enacted, the first major overhaul in 30 years of the law regulating the medical profession. In 2007 the Minister also established the Commission on Patient Safety and Quality Assurance to develop proposals for a health service wide system of governance based on corporate accountability for the quality and safety of all health services. In this context it is essential that every health care provider and facility is fully cognisant of patient safety issues and takes account of these in the organisation, management and delivery of services.

In respect of Mallow General Hospital, the HSE has indicated that patient safety is of paramount importance to the hospital management and that it intends to undertake a systems and risk management review of surgical services at the hospital. Draft terms of reference are being drawn up and will be discussed with the relevant parties before they are finalised. To ensure that surgical services continue to be delivered safely in the meantime, the hospital management met recently with the Irish Hospital Consultants Association and consultants at Mallow General Hospital and they have agreed arrangements for consultant surgeon cover at Mallow General Hospital, which will apply until 31 May 2008.

The parties have also agreed to meet and discuss arrangements for surgical services after this period. The HSE will continue to work closely with all involved to ensure that a high quality service is available to all patients at Mallow General Hospital.

Seán Sherlock (Cork East, Labour)
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The Minister of State did not address one point that I raised and it is an insult to the people of the region that a Minister of State can give such a bland reply in the House.

Jan O'Sullivan (Limerick East, Labour)
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I understand the Deputy's feelings but there is no right of reply.

Seán Sherlock (Cork East, Labour)
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It makes a mockery of the House, with all due respect.

Michael Ahern (Cork East, Fianna Fail)
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It is, with all due respect, thanks to this Government that Mallow is so well looked after.