Joan Burton (Dublin West, Labour)
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I am grateful for the opportunity to raise the important issue of the reorganisation and restriction of emergency services at Connolly Hospital, Blanchardstown, Dublin 15. The hospital is situated beside the M50 and it serves a vast hinterland, including most of Dublin 15 and north county Dublin up to the Ashbourne Road, the Navan Road, Finglas, Cabra in the city and large tracts of counties Meath and Kildare. The hospital is at the centre of Ireland's key population growth over the past 15 years. People from all over the region have come to depend on the hospital for primary medical care and staff at all levels have striven to develop the hospital over the years in face of different and constant pressures.

The hospital was starved by the Minister for Health and Children of critically important investment in infrastructure such as modern diagnostic equipment, which is taken for granted in hospitals the world over. I have waged a long campaign to secure an MRI scanner for the hospital. However, that type of up-to-date diagnostic equipment was referred by a ministerial order of the Minister, Deputy Mary Harney, to the private hospital that was due to be co-located in the grounds. Like the Celtic tiger economy and the bubble, that co-located hospital has vanished into the mist.

The issue about the hospital that most concerns local people and those in the Blanchardstown hinterland is the suggestion that 24-hour accident and emergency cover is to be withdrawn and consolidated within other hospitals. In particular, there have been suggestions about a partnership between Beaumont Hospital and the Royal College of Surgeons in Ireland teaching centre of excellence which would mean a shift to Beaumont Hospital being the primary hospital in the new arrangement. According to a memorandum circulated to staff at James Connolly Memorial Hospital on 29 November last, the HSE intends to progress a full impact assessment, cost-benefit analysis, detailed planning and initial engagement regarding the phased reduction in 24-hour emergency departments in north Dublin from the current three sites to two sites. The three sites are James Connolly Memorial Hospital, the Mater Hospital and Beaumont Hospital.

Given the critical position of the James Connolly Memorial Hospital on the M50 and the fact that, unfortunately, gunshot injuries are a large issue in west Dublin and the hospital has developed a specialisation in this area which is recognised throughout Europe and the world and that these incidents tend to happen at night, what is happening in this review is worrying people in the area. The HSE memorandum states clearly that no decisions have been made with regard to the emergency service in James Connolly Memorial Hospital. I received a reply from the public affairs division of the HSE which indicated that the HSE is merely considering these issues at present.

While the notion of a co-located campus definitely has the possibility of introducing many savings, nonetheless certain key services are important. How advanced is this process? When is a final decision expected to be made? Will hospital staff and local people be consulted about the changes or are they to be presented with a fait accompli? Will the Minister publish the capacity study completed this year on the development of emergency services based at James Connolly Memorial Hospital? When they are completed will the Minister publish the impact assessment and the cost-benefit analysis for any new arrangements? Can the Minister give a commitment that the people who depend on the emergency services based at James Connolly Memorial Hospital will not suffer any diminution in these services that would put lives or the quality of patient care at risk in any way?

The staff in the hospital have been extremely co-operative with the change management process that is currently ongoing. As I said, the hospital serves a very large hinterland, including large parts of Dublin 7 and Finglas, the Dublin 15 area, north Dublin through to the Ashbourne Road and very large areas of both Meath and Kildare given what has happened to hospitals in Meath. People and the staff in James Connolly Memorial Hospital, where there is an exceptionally positive environment, deserve a considered response from the Minister.

John Moloney (Laois-Offaly, Fianna Fail)
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I will make every effort to give a considered response and to answer the questions posed by the Deputy. I apologise for the fact that my colleague, Deputy Mary Harney, cannot be here to respond.

The HSE has recently been considering how best to reform the way services are provided in Dublin North while reducing costs, maintaining a clear focus on patient safety, allowing people to be treated in more effective ways and protecting access to appropriate services. The way in which accident and emergency services are delivered in the region has recently been considered by the HSE in this regard. No decisions relating to the potential impact on any of the sites, including at James Connolly Memorial Hospital, have been made.

International trends point toward the provision of fewer emergency departments, based within larger hospitals that are focused on acute care services. There are potential advantages to having hospitals that specialise in elective, non-emergency care. Having protected beds for non-emergency care can eliminate the cancellation of procedures and operations which frequently occur when emergency patients have to be admitted to the beds. Reduced cancellations means that medical staff can schedule more patients, confident in the knowledge that beds will be available as planned. This allows the emergency hospital to focus primarily on acute care and so provide a better care experience to emergency patients.

However, such advantages must be weighed against the needs of the local population. The HSE intends to undertake a full impact assessment and cost-benefit analysis of any change to emergency department services. This will require detailed planning and engagement with a wide range of interested parties. The HSE has stressed that this project is at a very early stage and no decisions have yet been taken on the future of any particular service.

I do not have the specific information sought by the Deputy. I will respond to her within a few days.

Joan Burton (Dublin West, Labour)
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Does the Minister have an indication of the timeframe?

John Moloney (Laois-Offaly, Fianna Fail)
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No, because the HSE response is that it is at a very early stage. I will respond to the Deputy with the specific detail as quickly as possible.