Seán Sherlock (Cork East, Labour)
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On 9 August, when the Dáil was in recess, HIQA announced an investigation into ongoing services at Mallow General Hospital. Tonight I want to put forward the views of those I represent who have a particular interest in the investigation and who felt strongly that it was spurious and unnecessary.

The investigation was announced on the basis of a specific complaint about procedures from someone at the hospital. We now know that was not the case, and know there was no specific incident related to the treatment of a person. We also know the investigation arose from the fact that in April 2009, HIQA published the report of the investigation into the quality and safety or services in Ennis, that there would be recommendations arising from that, and that a report would follow for Mallow, which was a similar hospital but that had never been put forward by the HSE. It was on foot of that alone that HIQA decided to go into Mallow General Hospital.

The process at present is that HIQA has met representatives of the hospital and the staff and is continuing its investigations. The staff at the hospital operate in constrained circumstances and are punching above their weight. In June, after many years of campaigning, an executive management board was finally put in place. The hospital is under the auspices of CUH but for years it was left on its own, devoid of support from the larger hospital.

I will bet money that when the report is published, it will clearly show that the staff and personnel at the hospital have delivered, in spite of the HSE bearing down on them while refusing to put in place adequate funding. This report will vindicate the doctors, nurses and other staff in the hospital by showing they are in no way negligent and are doing more than they should to deliver services. It will also show that management structures were inadequate and the HSE never properly resourced the administrative function at the hospital, which led to inadequacies in terms of reporting procedures. It will also show that CUH never adequately recognised Mallow for the facility it is as part of its operation.

I want to point out that the staff support the hospital and maintain that services can be modified. They are willing to work with the HSE to achieve that and doctors, nurses and staff will buy into the change management process. We do not want to see a reduced service facility, however, or to see the hospital's capacity being sacrificed on the HSE's altar of cost efficiency. This is key because we will modify services but we must not reduce capacity. We can deliver the services within the hospital but we must be given the opportunity to do so.

Seán Connick (Wexford, Fianna Fail)
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I will be taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney, and I thank Deputy Sherlock for raising the question.

Patient safety is central to the delivery of health services and people must have confidence in the care they receive and have the best possible outcomes. The overwhelming consensus among clinical experts, as seen in cancer care, is that patients have demonstrably better outcomes where complex care is delivered with the necessary staff and equipment and with sufficient volumes of activity. The evidence also emphasises the need to provide timely emergency care to patients in an appropriate setting.

Achieving better outcomes for patients will require hospitals to change the services they deliver to their communities and how those are delivered. Reconfiguration of acute services in the Cork and Kerry area will produce improved services. The clinical benefits for patients will be significant and the treatment offered will be of the highest standard. The Minister and the HSE recognise the importance of Mallow General Hospital and the contribution it has made, and will continue to make, to the provision of hospital services in the region.

The HSE has not yet finalised its proposals for the future reconfiguration of the region's hospitals. In August 2010, HIQA announced an investigation into the quality and safety of services in Mallow General Hospital. The authority had identified concerns about the types of patients being treated, centred on major surgery, emergency and critical care services.

The purpose of the investigation is to ascertain whether safe, quality services and practices are in place and to ensure that, where there may be a serious risk to the health or welfare of a person receiving a service, such risks are identified and recommendations made with a view to eliminating or reducing risks for patients. In line with the terms of reference, the authority's review will include measures at local, regional, corporate and national level to implement the national recommendations in the authority's 2009 Ennis report; current arrangements for management and provision of clinical services in Mallow to minimize risks to patient safety, including critical and acute care and anaesthetic, surgical and emergency services; and local, regional, corporate and national clinical and managerial governance arrangements for safe care and transition to new service provision models. The authority will publish its report and recommendations following the completion of the investigation.

Finally, the Minister wishes to emphasise that she rejects any claim that the HIQA investigation is spurious as suggested in the text of the Deputy's question. HIQA is an independent statutory body that makes its own decisions about what investigations to carry out and in what way. The process will be entirely independent and there will be no pre-judgment of the outcome. The investigation will deal not solely with Mallow, but will also look at the wider context of acute hospital services in the region. The Minister supports the decision by HIQA to carry out an investigation and she believes that it will be to the benefit of service quality for patients. I am satisfied that the outcome of these processes will lead to a strengthening of the quality and safety of acute hospital services for people in the Cork and Kerry region and will ensure that they have access to health services that comply with best practice in the right facilities and in a timely manner.