Brian Stanley (Laois, Sinn Fein)
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I am glad to have an opportunity to raise this issue. I congratulate the Minister, Deputy Harris, on his appointment. It is a challenging brief and this is the first time I have had an opportunity to address him and I wish him well in it.

The report on the future of services at Midlands Regional Hospital, Portlaoise was to be completed last September.

We have waited long and hard for that publication. I believe it was finished months ago, but two weeks after the new Government was formed we were told that a draft report had been completed and sent to senior management at the HSE. General practitioners in and the people of County Laois, public representatives and I are very concerned about this issue, as are people living in surrounding counties, including south Kildare where the Ceann Comhairle lives and from where a lot of people using the hospital come. GPs have been made aware of the contents of the draft report and issued a lengthy response on it. I will not read everything they state, but they make a number of important points. They say it contains proposals to downgrade the hospital and that will exacerbate the negative patient experience in the region and result in needless and untimely deaths. They say there is no capacity to facilitate patients in any other centre. I am abbreviating what they say in the interests of time and because of my voice problem. They say they are receiving letters from hospitals fortnightly telling them not to refer patients to emergency departments because they do not have the capacity to deal with them. They say the plan is reckless in the extreme and shows no regard for patient safety. They outline the knock-on effects on other services at the hospital such as paediatric, maternity and mental health services. There has been a spike in the latter in County Laois. They say the plan will impact on the number presenting with self-harm. They also outline the difficulties regarding the effects on primary care services and say the MIDOC service is overburdened and that they have difficulty in filling shifts.

I have met the GPs many times, individually and collectively, and they are professional and responsible and not prone to exaggerating. I am not exaggerating. I attended the emergency department about six months ago and saw at first hand the pressure that it was under. The people living in County Laois and south Kildare and women from County Offaly who attend the maternity unit see the pressure it is under. I want the Minister to explain this to me and I say it with all sincerity: if the emergency department in Portlaoise is already one of the busiest outside Dublin and the departments in Tullamore and Naas cannot cope with their current workloads, where will the 38,000 or so patients who attend the emergency department in Portlaoise annually go? Is he aware that the ambulance service in the region is stretched to breaking point? How would patients in a critical condition be transferred to other hospitals? This is a point I raised at a meeting with the Minister's predecessor, Deputy Leo Varadkar, with other public representatives last year. I asked him, as I ask the Minister, whether he had spoken to the Minister for Justice and Equality and the Minister for Defence about the cost and the logistics of mobilising police and military convoys to transfer high security prisoners from Portlaoise Prison to hospitals in other counties and Dublin? This is a big issue. As of now they cross the road and there is a secure holding area in the hospital. Protocols are in place and there is very little mobilisation as the hospital is located only a few hundred yards away from the prison. This will be a real problem for the Irish Prison Service, the Department of Defence and the policing service which is already stretched. I put the same issue to the Minister and know that he will have a scripted response written by officials.

I am sorry about the temporary problem with my voice, but I raise this issue out of huge concern. If I was never a public representative or a member of a political party, I would be trying to do something about it. It is a serious issue. This is the second busiest emergency department in Ireland. The Minister is a fresh pair of hands and I really want him to consider this issue. He should not let officials in the HSE lead him by the nose. He should get a grip on the issue.

Simon Harris (Wicklow, Fine Gael)
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I thank the Deputy for raising this important matter and particularly for getting his point across, despite the difficulties with his voice. First, I reassure him that I am committed to securing and further developing the role of Portlaoise hospital as a constituent hospital of the Dublin Midlands Hospital Group. The most important consideration in any proposed change to services at the hospital is that patient safety and the outcome for patients must come first. As the Deputy knows, there have been a number of reports on the hospital in recent years. These reports have pointed to the need for the reconfiguration of some services to ensure patients are treated in the most appropriate setting by specialist staff who can safely meet their needs.

Since 2014 the focus has been on supporting the hospital to develop and enhance management capability, implementing changes required to address clinical service deficiencies and incorporating the hospital into the existing governance structures within the Dublin Midlands Hospital Group. Governance and management arrangements in Portlaoise hospital services have been strengthened, clinical staffing numbers increased and staff training, hospital culture and hospital communications improved. Service improvements include a number of additional consultant posts within the hospital, including in anaesthetics, surgery, emergency medicine, paediatrics and obstetrics, as well as additional physician and midwifery posts. Furthermore, investment in patient quality and safety, complaints management and patient engagement has also occurred in the past two years.

The Dublin Midlands Hospital Group has recently produced a draft plan for clinical service delivery at Portlaoise hospital. The draft plan has been discussed with my Department and is the subject of further work and consideration within the HSE. I stress that it is a draft plan with much further work to be done from the HSE's perspective. Any potential change to services at Portlaoise hospital, including plans for service reconfiguration, will be undertaken in a planned and orderly manner and take account of current use of services, as the Deputy asks; demands in other hospitals - another point he made - and the need to develop particular services in Portlaoise in the context of the overall service provided by the Dublin Midlands Hospital Group. The important point to note is that this work is being done to strengthen services in Portlaoise from a patient safety and quality perspective and ensure the services currently provided in the hospital are safe, adequately resourced and developed based on health needs. I will keep the Deputy and other Oireachtas Members in the Laois constituency informed on this matter.