Denis Naughten (Roscommon-South Leitrim, Fine Gael)
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I thank the Ceann Comhairle for giving me an opportunity to raise this important issue this evening. A statement issued by the HSE on 12 May last, in which plans for a reduction in non-consultant hospital doctors were announced, will have consequences for services in Roscommon, Portiuncula and Mullingar hospitals. It is clear from discussions with health management and professionals that a perfect storm is being allowed to develop by the HSE, in order to facilitate the implementation of the Hanly report by means of a hatchet. The HSE is referring to this as "reconfiguration". It involves the transfer, over time, of accident and emergency and surgery services from Roscommon and Portiuncula hospitals to the University College Hospital in Galway. It will also involve the closure of the local maternity unit in Ballinasloe, which is the only maternity unit in the country to be accredited as a "baby-friendly" hospital.

The HSE is using the shortage of non-consultant hospital doctors and the introduction of the EU working time directive as a means of downgrading services at Portiuncula and Roscommon hospitals. This staffing issue is threatening the operation of the accident and emergency departments at both hospitals, which currently operate 24 hours a day, seven days a week. The overnight downgrading of these hospital services, without planning, will result in the loss of life locally. Foreign non-consultant hospital doctors are not coming to Ireland for a number of reasons. Red tape and the short duration of visas represent a major part of the problem. This is not something that has happened overnight. It is only now, at the 11th hour, that the Government has started to discuss the issue and to try to resolve the problem. It did not become a priority for the Government until it started to realise not only that it will affect the smaller hospitals, as secretly planned, but also that it will threaten the operation of the major regional centres. This is a deliberate act of national sabotage.

The management of the HSE claims that it will provide a better and safer service and that non-emergency work will be transferred from the regional centres, such as the University College Hospital in Galway, to the local hospitals. While some people in the Ballinasloe area may be naive enough to believe this, the people of Roscommon have seen the HSE renege on previous commitments. The HSE claimed all surgeons appointed to the amalgamated departments of surgery between Portiuncula and Roscommon would be joint appointments. We now find out that the Roscommon hospital has been air-brushed from these surgical contracts and the posts will be shared between University College Hospital Galway, UCHG, and Portiuncula. Eventually, these particular surgeons will be relocated to Galway city.

The people of Roscommon were told by the Minister of State, Deputy Michael Finneran, that they either use or lose their hospital yet no funds have been provided to upgrade the sterilisation facilities to ensure additional procedures could be performed in the hospital. In the past four years not one patient has been put through Roscommon County Hospital under the National Treatment Purchase Fund even though the hospital has the capacity and no waiting lists.

Roscommon was promised additional out-patient clinics. Instead, the HSE has reduced the number of clinics that take place at the hospital. On 23 April, at a meeting with local public representatives in Portiuncula Hospital, HSE management informed them the super manager would not be appointed until the end of the year at the earliest. Yet, less than a month later, the HSE made an announcement of an appointment without any notice. I understand the individual in question is a consultant radiologist, Mr. David O'Keeffe, based in UCHG. His appointment will cover six acute hospitals, community services and long-stay hospitals in an area that takes three hours to travel across, more than it takes to travel from Dublin to Cork.

While I have no doubt that Mr. O'Keeffe is a fine individual, with all due respect to him, we do not need another Brendan Drumm Óg to do the Government's dirty work in implementing the Hanly report.

Will the Minister of State clarify what will happen to accident and emergency services in Portiuncula and Roscommon hospitals? What is the secret intention behind the establishment of this new super manager and the reneging on previous commitments regarding future services?

Michael Finneran (Roscommon-South Leitrim, Fianna Fail)
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I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

The Government is committed to ensuring the delivery and maintenance of the best quality health service possible and in providing the highest standard of patient care in an effective and efficient way with the resources allocated. Roscommon and Portiuncula hospitals play an important part in the HSE West network of acute hospitals and provide a range of acute, diagnostic and support services to both adults and children in their catchment areas which include east Galway, Roscommon, north Tipperary, Offaly and Westmeath.

The HSE has been working in recent years to enhance collaboration between UCHG, Portiuncula and Roscommon hospitals in the provision of services. This is occurring, for example, in the reconfiguration of the surgical and anaesthetic departments of Portiuncula and Roscommon hospitals into a joint department of surgery and anaesthesia. In addition the HSE, in line with the commitment in its national service plan for 2010, has commenced the process of preparing a plan for the future configuration of acute hospital services in the HSE West as a whole. A process of dialogue with the hospitals, staff and other interests has begun and will continue to be conducted on a consultative and inclusive basis in the interests of ensuring safe, effective and sustainable services in the years ahead.

The HSE plans to recruit a manager with responsibility for UCHG, Portiuncula Hospital and Roscommon County Hospital. This initiative involves the expansion of the current post of manager at Galway and is designed to promote good co-ordination of service delivery. The purpose of this is simply to improve management processes and thereby improve services for patients. This planned appointment is also in line with the approach on the governance of acute hospitals recommended in the Health Information and Quality Authority's 2009 report on quality and safety of services at the mid-western regional hospital Ennis. This report identified integrated governance across hospital networks as an important factor in ensuring higher quality services for patients.

The current position on this matter is that the public competition conducted by the Public Appointments Service did not result in the selection of a successful candidate. The HSE is, therefore, considering further options in order to provide for this key appointment and hopes to be in a position to make an announcement presently.

The Minister is satisfied the plan to recruit a manager with responsibility for the hospitals will enhance the capacity for collaboration in service provision, provide a more strategic approach to the management of the hospitals concerned and ensure the provision of better and safer services to the people of the region. Both Roscommon and Portiuncula hospitals will continue to play key roles in the provision of hospital services to the population of the west.

Denis Naughten (Roscommon-South Leitrim, Fine Gael)
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With all due respect to the Minister of State, that reply was a load of rubbish.