Tom Sheahan (Kerry South, Fine Gael)
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I thank the Ceann Comhairle for affording me the opportunity to raise this matter on the Adjournment. I am glad the Minister of State at the Department of Health and Children, Deputy Moloney, is in the Chamber to address my concerns.

I chose the term "contraction" in my submission for the Adjournment because, after several announcements in the past week, health services in County Kerry are being decimated. At Kerry General Hospital, the Annagh ward, a male surgical ward, will only open five days a week. From now on, one should not even think of getting sick over the weekend in Kerry. How will, for example, an accident that requires male surgery be dealt with on a Saturday?

The hospital's orthopaedic unit, the Rathass ward, will be closed for six months for refurbishment. Where will male orthopaedic patients be cared for? It must also be remembered that Kerry's population doubles over the summer due to visitors. How will the health services deal with these extra numbers when these wards are closed?

Six beds in the psychiatric unit in the hospital have been closed. Psychiatrists across the country are inundated with cases. The other day I learned from a GP that 80% of his patients looking for anti-depressant prescriptions were under 30 years of age. However, six beds in the psychiatric unit in Kerry General Hospital are closed. In these cost-saving measures the health of the people of County Kerry is irrelevant.

Up to 21 community beds in the Rowan ward at St. Columbanus's Home in Killarney have been closed. The ward was upgraded in 2007 at much expense. I do not have the exact figure for the remedial works as it is quite difficult to get information from the Health Service Executive. Where are the health services going? The Minister of State and his colleagues are jeopardising the health of the people in the county. After the closure of the Rowan ward, the female community bed ward will be next to be closed. I met recently with union representatives at the hospital and they are concerned that capacity will be reduced from 150 beds to 97.

Some children in County Kerry have been on orthodontic waiting lists for the past seven years. Kerry General Hospital still does not have an accident and emergency consultant. The last one left because he had no supports such as junior doctors or a registrar. He went to Tullamore, the Minister of State's locality, because in a similar sized hospital there he had two registrars, ten junior doctors and two other consultants. Recently, I met with the HSE representatives in Kerry who believe they will not bother appointing a replacement accident and emergency consultant for the county. Will the Minister of State explain what he will do for the health services in County Kerry?

John Moloney (Laois-Offaly, Fianna Fail)
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The Minister for Health and Children, Deputy Harney, apologises that she cannot be present to reply to this matter.

As outlined and agreed in its national service plan, a key objective for the Health Service Executive for 2009 is to manage the delivery of activity targets. The Deputy will appreciate that the executive is facing financial pressures arising, to a large degree, from the broader economic situation, particularly an increase in the number of medical cards and lower receipts from the health levy. These cost pressures are factors outside the control of the HSE and, therefore, it must take measures to counter their effects in so as far as is possible. It must maintain a strong focus on achieving the maximum efficiency in the delivery of services. This will also require the co-operation and flexibility of all involved, including those working at the front line of care delivery, so that the effect on services for patients will be minimised.

Among the key objectives across the health service are the provision of a greater proportion of elective hospital treatment on a day basis, a shift in mental health services from the acute hospital setting to community-based services and the development of multidisciplinary primary care teams. In response to the serious challenges I have described, the executive management board at Kerry General Hospital is reviewing all areas across its services to ensure that all opportunities for increased efficiency are pursued and that the hospital remains within its allocated budget for 2009.

Specific areas identified for cost containment and efficiencies include the non-filling of management-administration vacancies, the co-ordinated planning of leave hospital-wide to ensure that locum cover is not required and ensuring that private patients are accommodated in the beds appropriate to such patients. One ward will also be converted from seven-day to five-day use. In other words, it will be closed at weekends. This will generate a significant saving without compromising patient care. Senior staff and heads of department at the hospital, as well as union representatives, have been briefed in respect of the efficiencies and cost savings plan being put in place. Local Oireachtas Members have also been briefed with regard to these measures.

The HSE must keep its financial position under constant review, particularly in light of the evolving situation in respect of demand-led schemes such as the GMS. Accordingly, the executive management board of Kerry General Hospital will continue to review its service delivery arrangements as necessary throughout the year. It is clear that the State and the agencies responsible for the delivery of public services face unprecedented economic and financial pressures in the current year. This represents a major challenge on many fronts. In the health sector, we will be obliged to deliver more for a given level of resources and this will require the co-operation of all involved. The key priority for the Government and the HSE in dealing with serious budget pressures on the health services is to ensure that the maximum level of service is provided within available financing and that the impact on front-line services will be minimised.