Michael Colreavy (Sligo-North Leitrim, Sinn Fein)
Link to this: Individually | In context

Question 7: To ask the Minister for Health if he will ensure the continuation of all services at Sligo and Roscommon hospitals in view of the non consultant hospital doctor shortage; and if he will make a statement on the matter. [17903/11]

Luke Flanagan (Roscommon-South Leitrim, Independent)
Link to this: Individually | In context

Question 26: To ask the Minister for Health his views on the downgrading of the services provided at Roscommon Hospital. [17856/11]

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I propose to take Questions Nos. 7 and 26 together.

As Minister for Health, I will not stand over unsafe practice in any setting nor will I allow patients lives to be put at risk. However, it is not my policy to close small hospitals or to diminish them in any way. My priority is to ensure safe, high-quality care for patients, provided in the most appropriate location.

The circumstances in Roscommon Hospital are a cause for serious concern. It is clear that the acceptance of acutely ill patients in Roscommon as at present cannot continue and we need to find a safe solution for patients without delay. The hospital has had significant problems recruiting NCHDs, to which I referred, and relies heavily on agency staff.

Last week, I met a group from Roscommon which is concerned about the future of the hospital. I asked senior clinicians from the HSE to attend that meeting. I also asked the CEO of the Health Information and Quality Authority, Dr. Tracey Cooper, to attend to outline the authority's concerns about the hospital.

The HSE has been working with local clinicians to finalise a plan to provide a satisfactory and safe level of service in the hospital. I have asked the HSE to submit the plan to me by the end of this week.

The Government is strongly committed to developing the role of smaller hospitals in Ireland, including Roscommon Hospital, so that they will play a key part in the services provided to local communities. Local hospitals can and should be a vibrant element of local services, providing treatment and care at the appropriate level of complexity.

I assure the House that services will continue to be provided at Roscommon Hospital, as part of the Galway University Hospital group. The nature of the services will change but the hospital will always have a key role. In particular, I expect to see an increased level of less-complex activity at the hospital for the benefit of the whole local community.

With regard to Sligo General Hospital, I have confirmed it will continue to provide vital services. I am monitoring closely the NCHD vacancies around the country. As of now, the HSE has not expressed specific concerns regarding the NCHD situation in Sligo.

We must be honest and straight. What is currently available at Roscommon hospital is not safe. I referred to fractures and orthopaedic surgeons. There is no surgeon or cardiac staff to insert a stent. There is no vascular surgeon or team to deal with multiple trauma.

I want to see a vibrant 24-hour service available, through an urgent care centre, to the people who attend Roscommon hospital. This centre should be staffed and the care should be delivered by doctors. Hospital doctors should deliver the care from 8 p.m. to 8 a.m. We are in talks with the local general practitioners to provide coverage from 8 p.m. to 8 a.m. If one sprained one's ankle, one would go to the care centre to have an X-ray. However, if one's ankle were broken in two places, one would need to go to Galway. If one caught one's hand in the lawnmower and cut one's finger, one would go to the centre to get sutured but if one's hand were mangled one would clearly go to Galway. The service was to be supplemented by an additional ambulance so there would be four ambulances covering Roscommon during the day and three at night. I can guarantee that. There will be extra paramedics available with a car to provide cover if all the ambulances are out of Roscommon at any given time.

These are services that I can control and which I will deliver. I do not control the NCHDs at present because I do not know the numbers, but when they become available I commit to their inclusion. People will have an urgent care centre and a safe service. The abiding message I want to send from this House today is that I want to replace that which is not safe with something that is safe.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

Go raibh maith agat.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Is Deputy Ó Caoláin speaking on behalf of Deputy Colreavy?

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

Yes, of course.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

I did not know that.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

I do not see him here anyway so I presume I am speaking on his behalf.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Deputy Luke Flanagan is present and he has tabled a question also.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

The Ceann Comhairle is only getting used to his role and should not be distracted from what we have just heard. I have just heard the Minister state Roscommon hospital is to become the home of an out-of-hours GP service from 8 p.m. to 8 a.m. There is no other way to describe this; it is simply unacceptable. The Minister and his party colleagues gave firm commitments to the people of Roscommon prior to the general election which have been restated line after line-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Could we have a question?

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

-----this week in one of the two local newspapers, the Roscommon People. We are all familiar with the commitments that have been made by Fine Gael and the Labour Party-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

This is Question Time. Could the Deputy ask a question, please?

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

I have a question to ask.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

The Deputy should ask it. A minute has elapsed and the Deputy's time is nearly up.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

My question is simple - will the Minister accept that what he is proposing for Roscommon General Hospital represents a significant downgrading of the services the people of Roscommon have treasured over many years and rightly expected to be reaffirmed, protected and guaranteed on the election of the new Government? Does he accept that what he now proposes represents a significant diminution of those services that will have serious consequences? May I say, as a representative-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

The Deputy is way over time.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

-----of the people of Cavan and Monaghan that it most certainly reflects the same template that was introduced at the hospital in Monaghan, which template will ultimately lead to a further domino effect bringing about a loss of critical services? The people of Roscommon should not tolerate it under any circumstances.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

I ask Members to respect the Chair. The Deputy exceeded the time allowed. A minute is allowed per supplementary question. There are other Deputies in the Chamber. The Minister has a minute to reply to Deputy Ó Caoláin's supplementary question.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I reject the Deputy's contention that there is a diminution of services. I have just explained to him that what is currently available is not safe. It is not safe as adjudicated by the clinicians in the hospital, who will no longer stand over the circumstances that obtain.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

They should make the service better rather than do away with it.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

The Deputy should allow the Minister to reply.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I can come to that in a moment. I refer to the position on safety as adjudicated by HIQA and clinicians in my Department. I am seeking to make the location safe and to ensure there is a 24-hour service. It will be an enhanced service from a general practitioner's point of view because one will now be able to have X-rays at night, which was not the case heretofore. The service will be enhanced because people will now know exactly what they are getting. People will not turn up at the hospital having heart attacks in the false belief that they will be looked after in a comprehensive fashion.

Let me quote some statistics for the Deputy.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

The Minister has exceeded his time.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Thirty patients per day pass through the accident and emergency department. Fewer than one per day is transferred to Galway. Some 25%-----

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

If one has a heart attack after 8 p.m. in Roscommon, one should not go to the local hospital.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

The Minister is over time. I call Deputy Luke Flanagan.

Luke Flanagan (Roscommon-South Leitrim, Independent)
Link to this: Individually | In context

When I first heard the Minister was getting into politics, I was overjoyed.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Please ask a question. The Deputy is using up his time.

Luke Flanagan (Roscommon-South Leitrim, Independent)
Link to this: Individually | In context

Fair enough. Did the Minister know this place was not safe when he made a promise in a letter and confirmed that Fine Gael undertook in accordance with its policy on local hospitals to retain the emergency, surgical, medical and other health services at Roscommon hospital which were present on the formation of the 31st Dáil and upgrade such services where feasible? Did he know at the time the accident and emergency services at the hospital were not safe, as he claims they are now? If he did, why did he make that promise?

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

The first paragraph of the letter which Deputy Flanagan quoted is correct. The second paragraph states in the event of the accident and emergency unit being downgraded we are committed to reinstating a 24-7 service where feasible. Let us have accuracy on the record of the Dáil.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
Link to this: Individually | In context

You always throw in the-----

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

The question is a straight one. Was I aware? No, I was not. The Mallow report had not been published. The Ennis report suggested a review needed to be done but no such review was done, so I was not aware. I must preside over what is safe. Apart from being a Minister, I am a doctor, and I will not preside over what is not safe. I will not ignore expert advice from colleagues in the hospital and in HIQA; I cannot do so and it would be absolutely irresponsible of me to do so.

I am seeking a solution and I am saying to the people of Roscommon today that the solution I see is the one I have outlined, but it is contingent on me getting NCHDs which I may not be able to do.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

It is not the one the Minister offered in February.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I did not interrupt Deputy Ó Caoláin.

We know what was on offer in February; we now know what we are faced with-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

I ask the Minister to please not respond to-----

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

-----and if Deputy Ó Caoláin can predict the future with absolute certainty, then fair play to him.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

The Minister is over time.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I want to make one important point. People have spoken about the golden hour. This is a concept from the 1970s and 1980s which has been superseded by much information, many reports and peer review journals which show one is better off, even if one is more than an hour away-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Sorry Minister, you are over time.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

-----going to a high-volume centre. One's chances of survival increase by 25% - one in four. Let us do what is safe. Let us be honest.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Please respect the Chair. You are over time.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I apologise.

Denis Naughten (Roscommon-South Leitrim, Fine Gael)
Link to this: Individually | In context

In light of what the Minister has just said on the golden hour, will he have an independent evaluation done on this? Contrary evidence exists on the golden hour.

Will the Minister ensure the HIQA terms of reference are amended to deal with the issue of travel times? The single biggest issue for the people of County Roscommon is the fact that Galway University Hospital is in excess of an hour and a half away from them. This is the specific concern they have which is not being addressed.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

I will call on local Deputies only as there is not enough time.

Brian Stanley (Laois-Offaly, Sinn Fein)
Link to this: Individually | In context

I have indicated for a long time.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

Surely there is nothing in Standing Orders about local Deputies.

Frank Feighan (Roscommon-South Leitrim, Fine Gael)
Link to this: Individually | In context

Will the Minister elaborate on the letter regarding the safety of Roscommon hospital?

Does he have any control over HIQA? It seems to be determining what happens in our hospitals and health system throughout the country? As politicians, we give commitments on safety. We also make commitments prior to elections and I ask the Minister what role he has to play in response to HIQA.

Brian Stanley (Laois-Offaly, Sinn Fein)
Link to this: Individually | In context

I have not been taking up the Ceann Comhairle's time by raising matters under Standing Order 32.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

I appreciate that but the time is up.

Brian Stanley (Laois-Offaly, Sinn Fein)
Link to this: Individually | In context

The Minister mentioned that acute surgery services in some small rural hospitals would not be retained. Last year, 41,000 emergency cases went through Portlaoise hospital. The Minister mentioned 475 NCHD posts were to be filled, 221 of which have been. Portlaoise hospital has four in place already-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

We are not discussing Portlaoise.

Brian Stanley (Laois-Offaly, Sinn Fein)
Link to this: Individually | In context

-----with two more are on standby. Last Friday, I sought a meeting with the Minister on behalf of Deputies-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Sorry Deputy, this is Question Time.

Brian Stanley (Laois-Offaly, Sinn Fein)
Link to this: Individually | In context

I am asking a question.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Please resume your seat.

Brian Stanley (Laois-Offaly, Sinn Fein)
Link to this: Individually | In context

I am asking the Minister whether he will contact the HSE management-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

No, he cannot.

Brian Stanley (Laois-Offaly, Sinn Fein)
Link to this: Individually | In context

-----today and ask it not to pull acute surgery services from Portlaoise hospital due to the fact that he is-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Did the Deputy hear me? The next time I ask him to resume his seat I ask him to please do so. We are discussing Roscommon and Sligo, not Portlaoise. I ask the Minister to reply to the questions about them.

Will Deputies please refer to Standing Orders and learn how to put a question? Time periods of two minutes and four minutes are allowed for replies. Time is up for this question.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Important issues have been raised.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

They may be important but I must stick by the time limits.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I accept that.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Other Deputies are waiting for questions to be answered.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Am I allowed answer the two queries?

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Yes, very quickly - you have one second.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I cannot do it in one second, sorry.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Do the best you can.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I will certainly ask HIQA to look at its terms of reference with regard to travel time. This is perfectly reasonable. I have no issue whatsoever with getting independent verification on the golden hour because plenty of information exists and it has been superseded. The figures are quite clear, with 25% better survival rates through going to a high-volume centre even if one must travel an hour and a half.

Deputy Feighan asked me to elaborate on the letter. I do not have the letter so I cannot do so. However, with regard to control over HIQA, I wish to make an important point and I ask the Ceann Comhairle to allow me to do so. HIQA is the regulator of our health service. It would be inappropriate, improper and very unwise of me to interfere with it. Everyone in this House knows, and to the cost of the country, what happened when - I believe - a regulator was last interfered with, and this was the Financial Regulator.

Barry Cowen (Laois-Offaly, Fianna Fail)
Link to this: Individually | In context

He was not. Nobody interfered with the regulator.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

He did not regulate at all.

Luke Flanagan (Roscommon-South Leitrim, Independent)
Link to this: Individually | In context

Where are your resignations boys? You promised them. There have been no resignations like you promised. You would not be here now if you had told the truth.

Pearse Doherty (Donegal South West, Sinn Fein)
Link to this: Individually | In context

Maybe if we had interfered with the last regulator we might not be where we are.

Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context

Does the Minister have evidence? A very serious allegation has been made by a senior Minister that the previous regulator was interfered with.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Please resume your seat. I am not responsible for the answers given.

Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context

An allegation was made across the House that the previous-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Please resume your seat.