Bernard Allen (Cork North Central, Fine Gael)
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I thank the Ceann Comhairle for the opportunity to speak on the closure of the Mercy University Hospital, Cork. I tabled a question to the Minister for Health and Children four weeks ago. She replied that it was a matter for the HSE. The HSE eventually sent a response but I decided to raise the matter on the Adjournment. Although it is no reflection on the Minister of State, Deputy Hoctor, whom I wish well, it is frustrating that the Minister who is directly responsible and who, in conjunction with the HSE, made the decision to close an essential ward of the Mercy University Hospital does not come into the House to answer important questions on the health and well-being of people in my constituency and the adjoining constituency of Deputy Clune, who is present.

The Mercy University Hospital took up the slack when the North Infirmary Hospital in Cork was closed in the late 1980s. This was a tragedy for the north side of Cork city but the Mercy University Hospital, located in the middle parish, took up the slack. Through the commitment of medical, nursing and non-medical staff, it delivered a service to the people of the area and never turned any paying or non-paying patients away from its doors.

To say that I received an answer is to be charitable to the author of the response. It was confirmed that the 31-bed St. Catherine's ward closed on 3 May 2008 and will remain closed until at least the end of 2008. This has resulted in the closure of 19 surgical and 12 medical beds. That will have a devastating effect on the health and well-being of people in my constituency and in the adjoining constituency that Deputy Clune represents. I take issue with the contents of the response. It is an insult to state that the plans were formulated with a view to maintaining all existing and essential services and minimising the impact on patient care. That is pure codswallop. The hospital is now being humiliated by the Minister, the HSE and the local senior management. This was done without informing public representatives, who cannot get information. The humiliation of the hospital was done in the interests of balancing the books.

Fianna Fáil made a big issue many years ago of health cuts affecting the elderly and the sick. That is what will happen in this case. To say that all existing and essential services will be maintained is untrue. In tandem with the closure of this ward, an accident and emergency unit that cost €5 million to build has been idle since January 2007. It will open on 1 June but will offer a service only during office hours. It is an emergency service but people do not meet accidents or have mishaps only during office hours. The claim in writing that all existing and essential services will be maintained is untrue. I will not say anything stronger than that because I would be reprimanded.

Having fulfilled its role through the years, the hospital is being humiliated. The response also stated that the local management board of the hospital took the decision to close the 31-bed unit. In theory, the board may have taken the decision but the gun was put to its head by the faceless people and some who are well known in the HSE. The choice was to close or face the consequences. To say that this was a decision made by local management is the washing of hands of responsibility for this closure, which will have a serious impact on people's well-being.

The HSE is running a dysfunctional system. It is out of control and has lost its direction. While people are suffering and administrators and medical staff are losing their jobs, Professor Drumm and his senior cohorts are taking their bonuses. If leadership is to come from the top, senior administrators and those who have failed to deliver should not take bonuses. This is a matter I will address tomorrow at the Committee of Public Accounts. It is a scandal that these people continue to take performance bonuses when services are not being delivered.

Máire Hoctor (Tipperary North, Fianna Fail)
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I am taking the matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. The Government is committed to the provision of a high level of quality health services throughout the country, including in the Cork region. The HSE is obliged to provide services in line with available funding. In turn, all its managers and agencies have a clear responsibility to operate within their designated budgets and achieve the service levels for 2008 as set out in the HSE's national service plan. These include service level targets for the acute hospital services nationally of over 2.7 million outpatient attendances, almost 600,000 in-patient discharges and over 580,000 day cases. HSE management at national, regional and local level reviews expenditure and activity levels on a weekly basis in order to ensure that hospitals are adhering to the service levels of activity for which they have been funded.

The HSE has advised that to ensure that they remain within their approved expenditure levels, all hospitals within the southern hospitals group have put together a budget break-even plan for 2008. These plans are based on a realistic assessment of achievable objectives for the hospitals within the group. The plans were formulated with a view to maintaining all existing essential and emergency services while minimising the overall impact on patient care. Hospitals within the southern hospitals group have identified a number of value for money and income generating initiatives that will realise some savings in 2008. These measures include a reduction in the use of agency cover, locum cover and overtime. Several areas of non-pay expenditure have also been targeted for reduction, most particularly staff travel and non-essential training.

Over the past three years, the HSE allocated significant funding to the Mercy University Hospital to enable it to cope with service pressures. In 2006, the budget allocation was €67.7 million, in 2007 it was €72.2 million, while this year €73.6 million was allocated to it. An analysis of the Mercy University Hospital expenditure by the HSE in the early months of this year indicated that the hospital would significantly exceed its budget allocation unless corrective action was taken. With this in mind, management at the Mercy University Hospital was required to readjust the hospital's expenditure levels. Accordingly, the hospital introduced a number of value for money and efficiency initiatives along the lines already mentioned. It has also promoted initiatives which support the concept of working better and smarter, such as pre-operative assessment clinics, same-day admission process and reducing the length of stay. However, as these steps would not in themselves have been sufficient to bring projected expenditure back in line with permitted levels, management at the hospital decided to close a 31-bed ward. St. Catherine's ward was closed on 3 May 2008 and will, I understand, remain closed for the remainder of 2008.

Management at Mercy University Hospital and the HSE continue to monitor carefully the impact of these initiatives on the hospital's overall budgetary position. The Minister has been assured by the HSE that every effort will be made to ensure the measures outlined will have a minimal effect on patient services. The HSE has indicated essential, elective and emergency services will not be affected and that planned hospital service activity levels at the Mercy University Hospital for 2008 will be met.