James Bannon (Longford-Westmeath, Fine Gael)
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I thank the Ceann Comhairle for affording me time to raise this important matter on the Adjournment, namely, the need for the Minister for Health and Children to outline her position in relation to the issuing of bogus appointments for a consultant who left the Midlands Regional Hospital, Mullingar, County Westmeath, last March and whether she stands over these actions, particularly if they are on a country-wide basis. What happened in relation to the "phantom" appointments with a dermatological consultant in the Midlands Regional Hospital between March this year and September, when I highlighted the deception in the press, was mind-blowing. The fact that it was endorsed by the HSE compounded the felony, and I use the word advisedly.

No matter how the parliamentary affairs section of the HSE tries to rationalise the matter and despite its admission of guilt, the fact that any health service would deliberately set out to deceive vulnerable patients by sending out appointments to see a consultant who had left a hospital months previously needs very urgent review. I am outraged that the HSE can mislead patients in a manner which is blatant and calculated to deceive. Given the high incidence of skin cancer in Ireland, the actions of the HSE, which are the Minister's responsibility, are criminal. Does she have any concern that holding patients at the mercy of appointments that were repeatedly made and cancelled at the last minute, with a consultant who did not exist, could or may have, led to fatalities?

I am extremely concerned that what happened in the Midlands Regional Hospital is, as we speak, being replicated around the country as this seems to be the directive that the Minister is sending out. If it is happening in one hospital, we can be sure that it is happening in others but will the trusting patients ever know the facts?

I have a response to a parliamentary question on the matter which states that the first consultant dermatologist was appointed to the Midland Regional Hospital in September 2007. This dermatologist resigned her post in March of this year. The response goes on to say that the HSE sought on several occasions to recruit a replacement. I believe from this answer that discussions have taken place with St. James's Hospital, Dublin, and the post is now to be immediately filled.

While this response is, I suppose, factual, it does not explain why these details could not have been outlined in the first place and patients told that there was no dermatologist available. They could have then been given the opportunity to make alternative arrangements to see another consultant or refer back to their GPs.

When I was first made aware of this situation last September, I was shown appointments for patients made for last April, up to and including this month, which is eight months after the consultant left to take up another position. The hospital's answer to this dubious practice was that "the appointments were made in good faith". That must be HSE speak for "con". This is disgraceful. It is taking unaccountability to new levels. What exactly are the functions of the Department of Health and Children and the HSE? Do the patients who are supposed to be the central focus of any health system have any rights under the Minister's watch?

Are they not entitled to an honest open and equal system that will provide the best care possible for each and every one of them? "Equality" is certainly not a word that can be associated with the Department of Health and Children and neither is "sanity". Recent madness in the Department saw already overpaid consultants given an increase of €25,000 while essential services at hospitals such as Mullingar are cut and patients left in life-threatening situations.

Cutbacks have seen the recent closure of 16 much needed beds in the Midland Regional Hospital. I have been reliably informed that 16 more are due to be cut. Will Minister inform me that this is not the case? With an already poor health infrastructure in the midlands, any further erosion of essential services would be a scandalous dereliction of duty. Playing God and deciding who should live and who should die is the next step for a Government that has completely lost touch with reality.

Noel Dempsey (Meath West, Fianna Fail)
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I am replying to this Adjournment matter on behalf of my colleague the Minister for Health and Children, Deputy Mary Harney.

The Midland Regional Hospital at Mullingar provides an extensive range of acute services to the population of Dublin and the midlands and, in particular, to people in the Longford-Westmeath area. The Government has shown its commitment to the hospital by the capital improvements that it has supported in recent years.

The first consultant dermatologist for the midlands was appointed to the Midland Regional Hospital, Mullingar, in September 2007. Prior to this, a consultant dermatologist from Temple Street Hospital provided two sessions per week at the hospital. In December 2008, the consultant dermatologist appointed at the hospital tendered her resignation to take effect from 31 January 2009. On 8 January 2009, approval was received from the consultants appointments unit to fill the post on a temporary basis pending the permanent filling of the post. In mid-January, the temporary post for consultant dermatologist at the hospital was advertised. There were no applicants for this competition. In February 2009 an offer of employment was made to a Belfast-based dermatologist to provide a temporary dermatology service at the hospital. However, it was not possible to agree contract terms with this consultant and he did not take up duty.

The post was then re-advertised in the press, journals and websites from 1 March to 27 March 2009. Resulting from this competition, two inquiries were received. Neither of these candidates met the qualifications for the post. The HSE sought on several occasions to recruit a suitable temporary replacement without success. Discussions have taken place between the HSE and a major teaching hospital in Dublin with a view to expanding the remit of the post. As a result of these discussions, the HSE intends to advertise the permanent restructured post in the coming weeks. In the meantime, the HSE is endeavouring to put arrangements in place pending filling of the post permanently.

The appointment times issued to patients by the hospital were based on an expectation, at the time, that the consultant post was about to be filled. Unfortunately, the expected appointment did not materialise. The hospital management regrets any confusion resulting from this. In the meantime, some patients who required urgent treatment have been seen in Dublin. Arrangements have also been made for children to be treated in Dublin. The hospital will continue to focus on the best possible quality of care for all its patients.