Brian Stanley (Laois-Offaly, Sinn Fein)
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I thank the Ceann Comhairle for the opportunity to raise the important matter pertaining to the services at the three midland hospitals, namely, Mullingar, Portlaoise and Tullamore hospitals. Options are being considered at present for the three hospitals, including a number of different measures. Discussions are ongoing regarding the provision of services at the three hospitals with serious implications in particular for acute surgery at Portlaoise hospital. Last year, the Midland Regional Hospital, Portlaoise, was the 11th busiest hospital in the State. In that year, 41,000 emergency cases were dealt with there and this compares with 24,000 cases in Naas. If acute surgery is discontinued at Portlaoise hospital, it will have huge implications for both that hospital and for Tullamore hospital. Tullamore hospital cannot cope with the increased workload, as the staff there already are under severe pressure. Core services at Portlaoise will be undermined. For example, the maternity, paediatric and accident and emergency services all rely on and require acute surgery facilities to be in place in order to function properly. Patient care will be compromised at both hospitals and this must all be considered in the context of growing pressure and longer waiting lists.

I am informed that among the options being considered are to have on-call acute surgery - whatever that means - available for reduced hours or that acute surgery would be taken away from Portlaoise. The timeframe for a final decision is very short, by 1 July at the very latest. The new regime will be in place by 11 July.

The main issues are supposed to be the availability of doctors who are referred to as the NCHDs, non-consultant hospital doctors. I am informed that Portlaoise will have an adequate number of NCHDs for July in order to continue with the current level of acute surgery at Portlaoise hospital. This should not be an excuse. I also ask the Minister to ensure that Naas hospital is included in the ongoing review of services because this hospital will provide a larger pool of staff. The other issue is funding. I know that this presents a challenge for both Tullamore and Portlaoise hospitals and also for Mullingar hospital. However, services can be maintained with careful management and with existing funding. I am sure the Department is open to giving a small amount of extra funding to ensure the hospitals do not run out of money.

Before the general election, both Government parties, Fine Gael and Labour, gave clear commitments to make health a priority. The Minister for Health when he came into office promised to take a very direct hands-on approach and to have his Department directly in control of health provision. I welcome this promise because I have listened for years to nonsense about the HSE being responsible and someone else being responsible, yet here was the Minister having a straight line of responsibility and this is welcomed by Sinn Féin on this side of the House.

However, last week I received a one-line response about this major reconfiguration of services in Portlaoise. The reply stated that the matter was being referred to the Health Service Executive for a direct reply. That is a very poor response, considering the commitments given.

I hope that acute surgery will be retained at the hospitals and I hope it will not be ended at Portlaoise, which is the busiest hospital with 41,000 emergency cases last year. I hope it will not happen under Fine Gael and Labour's watch. What we need in Laois-Offaly is for the Minister to intervene directly and ensure that the core services and in particular, acute surgery, will be retained in Portlaoise and Tullamore.

Ciarán Cannon (Galway East, Fine Gael)
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I am replying to this Adjournment matter on behalf of my colleague, the Minister for Health, Deputy James Reilly.

At national level, the HSE is working intensively to ensure there are sufficient non-consultant hospital doctors, NCHDs, in each hospital, following the next rotation of posts due in July. I can confirm that the provision of hospital services at the three midland hospitals is currently being addressed by the HSE in light of a possible shortage of NCHDs to cover services in Portlaoise, Mullingar and Tullamore hospitals. The shortage of NCHDs is an issue internationally as well as nationally and the HSE is working to ensure that services in each hospital can continue to be provided safely.

The HSE, in conjunction with the management of the three hospitals, is considering contingency measures aimed at ensuring continued safe delivery of hospital services in the event that any vacancies which may arise cannot be filled. The regional director of operations in the mid-Leinster area of the HSE is in ongoing communication with the clinical and nursing directors and senior consultants of the hospitals to discuss and develop contingency plans in advance of the next rotation of NCHDs.

Hospital management is working with clinical directors in a planned way to devise contingency arrangements which can be implemented in hospitals if required. A project team has been established, chaired by the clinical director and led by the director of nursing. Consultative meetings have commenced with clinicians in the midlands and this consultation will continue over the coming weeks as plans are developed. Clinical expertise with particular emphasis on patient safety issues will inform this contingency planning.

The HSE is also putting in place a number of processes to address the issues contributing to this difficulty on a short, medium and long-term basis to ensure that hospitals continue to offer a high level of care to all patients. A recruitment drive for a new intake of non-consultant hospital doctors is under way and a number of other initiatives are being considered, in particular, to ensure that hospital emergency departments continue to offer a high level of care to all patients in a timely and appropriate manner.

The Minister is committed to ensuring that the issues referred to will be addressed by the HSE and that services at the three midland hospitals at Mullingar, Portlaoise and Tullamore, will continue to deliver the best and most appropriate services to all patients.