Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 31: To ask the Minister for Health and Children his plans to restore the services cut from Monaghan General Hospital [7612/11]

James Reilly (Dublin North, Fine Gael)
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Monaghan General Hospital provides day medical and surgery services, elective endoscopy, cardiac rehabilitation, non-invasive diagnostics, a minor injuries unit, radiology, diagnostic urology, dentistry, ear nose and throat and outpatient services. It also provides 13 step-down and 13 rehabilitation beds which allow patients to transfer from Cavan General Hospital and the HSE Dublin north east region for rehabilitation and step-down care. A CT scanning service which costs about €500,000 commenced in November 2010.

Monaghan General Hospital is an integral part of the Cavan-Monaghan Hospital Group. I am determined that it will continue to play an important role in the delivery of clinical services in the Cavan-Monaghan area and to patients in other parts of the north-east region.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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This is the first opportunity I have had to address the Minister on issues of concern to us all. I wish him well in his new role and responsibilities. It is no coincidence that I have chosen as the subject of my first priority question to him the hospital I know best, the one chosen to act as a blueprint for the decimation by a series of former Governments of local services at local hospital sites. Monaghan General Hospital was used as a template that was subsequently visited on other communities. The Minister will recall that his party colleague former Deputy Seymour Crawford and I were consistent voices not only in support of the retention of services at Monaghan General Hospital but also post the removal of these services.

Notwithstanding what he has said in a vague and non-committal reply, will the Minister make a commitment at the commencement of this Dáil to revisit the failed hospital configuration in the north east, specifically as it affects Monaghan General Hospital, while recognising the impact of the loss of services at both Louth County Hospital, Dundalk and Our Lady's Hospital, Navan? Will he restore all acute medical and emergency services to Monaghan General Hospital, the unanimous call in March of all elected members of Monaghan County Council, including the Minister's party colleagues? Will he undertake in the first opportunity open to him to answer questions as Minister for Health and Children to give a clear commitment to the restoration of these services? Accepting that it will be programmed, will he indicate his willingness to prioritise the restoration of an emergency department and the establishment of a medical assessment unit at Monaghan General Hospital?

James Reilly (Dublin North, Fine Gael)
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Monaghan General Hospital in the Dublin north-east region in terms of hospital services. We are under severe stress in terms of capacity. Underlying the health service is the principle that the patient should be treated at the lowest level of complexity that is safe, timely, efficient and as near to home as possible. With this in mind, we are looking very closely at Monaghan General Hospital, the hospital in Navan and others in the area to see how we might best meet the needs of patients. There is no question but that the service is under severe stress. We can change the way hospitals operate and work, checking on some of the larger centres; many of the issues involved may be addressed in this manner. Equally, I am persuaded that a good deal more could be done at Monaghan General Hospital. The clinical leads and the directorate are looking at the position in the hospital and in Navan also to see how we might provide more services. We want to maximise the benefits and outputs of all hospitals but, in particular, smaller county hospitals which, to my mind, have been under-utilised to date.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Does the Minister accept that the removal of services from Monaghan General Hospital and the other hospital sites to which I have referred has created an impossible working environment for consultants, doctors, nurses and other front-line service providers in County Cavan, in particular, but also in Our Lady of Lourdes Hospital, Drogheda? That is untenable and cannot be allowed to continue.

Will the Minister acknowledge that at the time of the removal of all acute services at Monaghan General Hospital in July 2007 the previous Government made particular promises, none of which has been delivered on? I refer specifically to the promised enhancement of the primary care unit and ambulatory service for the county. The opposite has happened. Last June both the rapid response 24/7 service, with its advanced paramedic facility, and the patient transport ambulance service staffed by two emergency medical technicians were moved from Monaghan to Castleblayney to compensate for the loss of services at Louth County Hospital, Dundalk, which is now servicing all of counties Monaghan and Louth. We had no compensatory measures introduced by the last Government. I hope Deputy Reilly will be the Minister who will address the critical health care and acute hospital service needs of the people of County Monaghan.

James Reilly (Dublin North, Fine Gael)
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There is absolutely no question but that there are big issues facing the health service. There is also no doubt that promises were made in the past and not kept. When certain plans for reconfiguration were designed, the part dealing with the removal of services was enacted with great haste, while that which was supposed to address the central delivery of services was much slower in coming about, or very often did not come about at all. It is not the intention of the Government to repeat that process. I would be first to admit that we must go through a process of rebuilding trust between the health service and those who use it. That is a big job and I hope Members on all sides of the House will co-operate in achieving it.