Catherine Murphy (Kildare North, Independent)
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Question 10: To ask the Minister for Health if, following the retirement of large numbers of staff from the health service in recent weeks, he has identified the services which have been particularly affected by staffing resource reductions; if he will outline these shortfalls in detail by type of service and geographical area affected; if he will outline proposed redeployments intended to alleviate gaps in service provision; and if he will make a statement on the matter. [16442/12]

James Reilly (Dublin North, Fine Gael)
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The main service areas that have been identified as critical in the context of the grace period retirements include maternity hospitals and critical and intensive care, as well as community nursing services.

It is, therefore, necessary to be as innovative and flexible as possible in order to mitigate the impact on services of reduced budgets and staffing. The mitigation measures which are in place include changes in work practices, staff redeployment, rostering and skill-mix changes, revised business processes, integration of services and streamlining of management structures. I acknowledge the great work and commitment of staff in ensuring a safe service has been maintained and in maintaining the number of people on trolleys throughout March at 17% despite the challenges they faced.

Some limited recruitment of new staff is also taking place to ensure that key specialist services are maintained. However, the priority is to reform how health services are delivered to ensure a more productive and cost effective health system. The need for dynamic and proactive management of the reduced budgets and staff will continue throughout the year. Last week, I announced a new initiative around training of clinical leaders, managers, nursing staff and GPs in management, which will ensure they are given the skill set and tools to do the job we require of them. Many excellent people who previously worked in administration or as clinicians are currently in managerial positions in respect of which they have received no specific training. While they are willing and able to do the job we need to ensure they have the required tools to do it.

The HSE National Service Plan 2012 acknowledges that there will be inevitable and unavoidable reductions in services this year owing to the scale of the financial and staffing challenge facing the health service. I am satisfied that suitable arrangements are in place at national, regional and service specific levels to proactively manage the impact on front line services. Since the end of the grace period there has been daily communication between the national director of integrated services and regional management teams to ensure that any issues or risks identified are addressed. No new issues have arisen and all essential services are being maintained.

Catherine Murphy (Kildare North, Independent)
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I have been contacted by constituents who are concerned about the delivery of services in my area. One particular area of concern is that of disability services in terms of specialty, in respect of which there has always been a lopsided distribution of specialist staff, based either on discipline or geography. Getting information regarding disability services for young children even by way of a telephone call is seriously problematic in my area, never mind delivery of services. I would welcome a national audit of disability services delivery. It is not justifiable that one particular county can have a service while another does not.

My second question relates to maternity care, in respect of which the master of the Rotunda expressed concern prior to the deadline of 29 February. Is the Minister satisfied that maternity care can be safely delivered in this country with the current number of staff?

James Reilly (Dublin North, Fine Gael)
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I visited the National Maternity Hospital and met with the new master, who is the first female master in the history of this State. Staff at the hospital are dynamic and the recently opened new theatre will provide greater access for the patients they serve. There is no question but that from a capital perspective we could do with new maternity hospitals. While in the past I have been told that our hospitals should not perhaps deliver more than 10,000 to 12,000 babies I have since been told during discussions with clinical leads in this area that there is no reason we could not have two, or even one, maternity hospital in Dublin. I am not suggesting that will be the outcome but it is an issue we need to look at. I would like to see facilities greatly improved.

The Deputy asked if we have sufficient staff to maintain a safe service. The answer to that question is "Yes, we do." Every endeavour has been made and arrangements have been put in place to ensure delivery of a safe service. The last thing we want to do is create further anxiety for those looking forward to the birth of their child. It is a nervous enough time for people. I am happy, having met with the clinical lead for obstetrics and gynaecology, and having visited several of the hospitals, that a safe service is being delivered.

On the disability issue, every effort was made to ensure protection of disability services, in respect of which the budget cut was a maximum of 3.5% while the cut elsewhere in the health services ranged from 5% to 7.5%. I have discussed this matter with my colleague, the Minister of State, Deputy Lynch. There is a recognition that there are huge resources within the NGOs in terms of ancillary care, including psychologists and so on, which could be freed up to allow the provision of greater care within the system.

We are looking at all areas in an effort to reform how services are delivered and people work, thus allowing for more service to be delivered to the patient.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Before we move on, I understand the Tánaiste would like to make an announcement.