Billy Kelleher (Cork North Central, Fianna Fail)
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I appreciate being selected. The reason I raise this issue is because I want clarity on the closure of the gynaecological theatre in University Hospital, Galway, to all procedures other than emergency operations and caesarean sections. The INMO expressed serious concern about the recent closure of the theatre. We are trying to get to the bottom of why there is talk of suspending elective surgery for five weeks in the theatre.

As the Minister of State, Deputy Lynch, is well aware, the nursing staff who have worked extra time are owed 2,700 hours, comprising 1,000 hours in annual leave and 1,700 hours for on-call work. The nurses have been told to take time off during the five-week period. If this is true, it is evident that there was no capability to plan for the loss of seven nurses due to early retirement and sick leave, which also resulted in some difficulties. It is quite clear that the theatre is not working at full capacity. The staff have been told they must take their time off over the next five weeks while the theatre is closed to elective surgery or else lose their entitlement.

The staff have worked exceptionally hard. They have put their shoulders very firmly to the wheel and have assisted in trying to deal with the backlog and difficulties faced by underfunded health services. I do not expect the Minister of State to wave a magic wand on this issue. We all realise that budgets must be adhered to, but the difficulty is that there was no planning to ensure there would be no loss of expertise and capacity required to run a gynaecological surgical theatre on foot of the loss of front line staff. The Minister's statement in the House that there was a plan for all eventualities is threadbare.

Why is a theatre being closed to elective surgery for five weeks? Why have the staff been told that if they do not take off the hours they are due during the five-week period, they will lose them. I refer to the staff who have been at the front line dealing with challenges continually and working under extremely difficult conditions.

I visited the hospital last year and noted a hugely committed staff. They were willing to put in every effort to ensure the hospital ran as smoothly as possible. Obviously, there are capacity issues and the reduction in the hospital's budget is exacerbating the problem. In recent weeks, due to staff shortages, it has not been possible to run the theatre at full capacity. On occasion, the gynaecological staff must use the main theatre in the hospital and theatre time in Mayo General Hospital and Portiuncula Hospital in Ballinasloe for urgent elective surgery. Despite this, a theatre remains idle in University Hospital, Galway.

All I ask for is clarity, not for me but for the staff. The INMO has expressed serious concern over the manner in which this matter has been handled. The staff deserve better.

Kathleen Lynch (Cork North Central, Labour)
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I am responding on behalf of the Minister for Health. I appreciate the Deputy raising the issue.

The Government has determined that, in line with its commitment to reduce the size of the public service, health sector employment numbers must be reduced to approximately 102,100 whole-time equivalents in 2012. The end-2011 outturn was 104,400 whole-time equivalents. Therefore, a net reduction of 2,300 whole-time equivalents is required during 2012. The cumulative impact of staff reductions from this year and previous years presents a significant challenge for the health system in delivering services.

The priority is to reform how health services are delivered to ensure a more productive and cost-effective health system. The 2012 national service plan sets out what actions will be taken in the context of reduced staffing levels and a reduced budget. Staff in University Hospital, Galway, and, in particular, in the gynaecological theatre, are working very hard to ensure continuity of service. To ensure the maximum service possible is provided to patients, theatre sessions have been provided and utilised in the main theatre in the hospital and also in the theatres in Mayo and Portiuncula hospitals to support operations for women.

I must emphasise all emergency and urgent operations, including cancer-related procedures, have been carried out and all patients requiring caesarean sections have also been accommodated. Several minor elective procedures have been deferred and will be rescheduled when the gynaecological theatre resumes full capacity in the first week in April. In recent weeks, staff shortages due to the moratorium on recruitment and retirements have meant that it has not been possible to run the theatre to full capacity.

Two and a half agency staff have been recruited recently to cover the staff shortages and are being trained. This will lead to greater flexibility with rostering. It is important to note the staff will not lose annual leave, as has been reported in the media. Planning for staff exits from the health services commenced in October last year and is now being intensified at regional and local service level. The focus of these plans is on maintaining essential front line services such as emergency departments, intensive care and maternity services.

The Health Service Executive is seeking to mitigate the impact of the retirements on front line services by using the provisions of the public service agreement to bring about greater flexibility in work practices and rosters, redeployment and other changes to achieve more efficient delivery of services. It will also deliver greater productivity through the national clinical programmes to reduce the average length of stay, improve day of admission surgery rates and increase the number of patients treated as day cases. There will also be some limited and targeted recruitment in priority areas to help limit the impact of retirements on front line services.

Deputy Kelleher is correct that the flexibility shown by health service staff and the way in which they have filled in for other staff members who exited the public service deserves recognition. We owe them a debt of gratitude and they have been working very hard in ensuring the delivery of the type of service we want. That includes the staff at University Hospital, Galway.

Billy Kelleher (Cork North Central, Fianna Fail)
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I thank the Minister of State for her reply. In part, it gives comfort that annual leave will not be lost by staff at the hospital. The issue of 1,700 hours for on-call work is another matter which the Minister should relay to the HSE to be clarified. As she said, these are the staff who have worked above and beyond the call of duty to provide care and ensure the theatre in question operated at premium capacity.

While the Minister of State did not say it, we talk in general about the cancellation of elective surgery as if it were not urgent. It is urgent to the person who requires it, particularly with gynaecological and cancer-related procedures. Will the Minister of State ensure the recruitment and training process continues unabated to ensure there is a return to full capacity at the theatre in question rather than patients having to travel to other hospitals in the region for surgery? We must get back to providing excellent care at University Hospital, Galway, which the staff want to do too. Will the Minister of State clarify the position on the 1,700 hours for on-call work?

Kathleen Lynch (Cork North Central, Labour)
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I do not have the information on the on-call hours to hand. If the matter of the on-call hours is clarified, I will ensure the Deputy receives information on it. As he knows, however, some times there might not be clarity around an issue.

Up to eight hospitals have been identified as having particular challenges with staffing, of which University Hospital, Galway, is one. This is being worked on intensely which is why there was an immediate recruitment of two and a half agency staff to fill staffing gaps. An outside group is conducting a serious review of how the service can be improved, as well as to see where staffing gaps occur because it is not always about the service needing tweaking.