Seán Fleming (Laois, Fianna Fail)
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9. To ask the Minister for Health his plans to recast the Midland Regional Hospital in Portlaoise, County Laois, as a model 2 hospital; and if he will make a statement on the matter. [13755/16]

Simon Harris (Wicklow, Fine Gael)
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I thank Deputy Fleming for this question. I am committed to securing and further developing the role of the Midland Regional Hospital in Portlaoise as a constituent hospital within the Dublin midlands hospital group. Patient safety and outcomes must come first. As Deputy Fleming knows, a number of reports on the hospital in Portlaoise have been published in recent years. These reports pointed to the need for 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, on implementing the changes needed to address clinical service deficiencies and on incorporating the hospital into the governance structures of the Dublin midlands hospital group. Governance and management arrangements in Portlaoise have been strengthened, additional clinical staff have been appointed and staff training, hospital culture and communications have improved.

The Dublin midlands hospital group recently produced a draft plan for clinical service delivery at the Midland Regional Hospital in Portlaoise. I want to stress that the draft plan, which has been discussed with officials in the Department of Health, is currently the subject of further work and consideration by the HSE. Any change to services at the hospital, including any plans for service reconfiguration, will be undertaken in a planned and orderly manner and will take account of current use of services, demands in other hospitals and the need to develop particular services at Portlaoise in the context of overall service reconfiguration in the Dublin midlands hospital group. It is important to note that this work is being done to strengthen services in Portlaoise from a patient safety and quality perspective and to ensure the services currently provided by the hospital that are not viable are discontinued and the services that are viable are safe, adequately resourced and developed on the basis of health needs. I am confident that any changes will improve services for patients at the Midland Regional Hospital in Portlaoise. I have to emphasise at this stage that no decisions have been made. There is quite a body of work to be done in this regard.

Seán Fleming (Laois, Fianna Fail)
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I welcome the Minister and congratulate him on his new position as Minister for Health. I wish him every success in the interests of the people of this country, who depend on our health service. Essentially, I am calling today on the Minister to reverse the plans for the downgrading of the Midland Regional Hospital in Portlaoise that are being considered by the HSE regional manager. She has produced a plan to reduce the services provided at Portlaoise to the level associated with a model 2 or category 2 hospital. Such an approach, as set out in the draft plan referred to by the Minister, would mean that a full accident and emergency service would not be available at Portlaoise into the future. If that were to happen, we would not have a proper paediatric or maternity unit in the hospital because such units require the presence of a full-time accident and emergency department. As the Minister knows, the hospital in Portlaoise has one of the busiest accident and emergency departments outside the major cities of this country. Up to 35,000 people attend it every year. People who need urgent treatment might not be able to make the journey to Dublin, Naas or Tullamore. This will put lives at risk. Patient safety must come first. Everybody knows that the accident and emergency unit in Portlaoise is overcrowded and that additional staff are required to deal with this situation. The HSE's approach, which involves trying to curtail services rather than upgrading them, is a dangerous one.

Simon Harris (Wicklow, Fine Gael)
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I thank Deputy Fleming for his good wishes. I emphasise that no decision has been made on Portlaoise or on the services mentioned by the Deputy. Officials in the Department of Health have been liaising with the HSE on the significant body of work that needs to be done in relation to the draft report that has been drawn up by the HSE. This work will answer some of the significant questions that have been asked here by Deputy Fleming. I want to make it crystal clear that nothing will be done to compromise patient safety and everything will be done to address patient concern. I cannot be clearer than that. Any decisions taken will have to be based on clinical evidence. Decisions about the provision of health services should be made by clinicians and not by Ministers for Health. There is a body of work to be done in that regard. I have read the media commentary. I know there has been some commentary in local newspapers and in national media outlets. I say respectfully to everybody that there is a body of work ongoing here. No decision has been made. Any decision that is made will be based on an assessment of the issues that have been outlined by Deputy Fleming and the other Deputies from the Laois constituency. I refer to issues like service provision and the capability of other hospitals. Consideration will be given to what should be provided in Portlaoise and what could be provided elsewhere. As I have said, there is quite a way to go in this regard. I will certainly keep the Deputy informed.

Seán Fleming (Laois, Fianna Fail)
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I am pleased that the Minister has an open mind on this matter. A great deal of further discussion will be required. I will set out the essential problem that has arisen in Portlaoise. As the Minister has mentioned, a number of reports have previously been published. The maternity unit has had a troubled history. It was under-staffed for several years. Twenty additional staff have been provided in Portlaoise over the past year or so. As a result, a first-class maternity service is now available in the region under the direct supervision and management of the Coombe hospital. The accident and emergency department at the hospital needs a similar staff upgrade. A lazy approach should not be taken just because there is a difficulty. I understand that HIQA officials are in the hospital this week. They are carrying out a number of inspections as we speak. These reports should be used to improve services. They should not be employed as a lazy excuse to downgrade services. This issue has arisen since the new regional manager arrived. She announced last autumn that she wanted to curtail the accident and emergency department by providing a daytime-service only, but she was told she could not do that. She was sent away to draft a report to back her original preconceptions. That report is now in front of the Minister. I am saying to the Minister that we need to keep the accident and emergency department in Portlaoise. As we all know, the triage service at the hospital currently sends some patients to the stroke unit in Naas. If there is a major car crash, injured people are sent to the trauma unit in Tullamore. That is fine but the facility in Portlaoise, which is used by 30,000 people every year, needs to be maintained in the interests of patient safety.

Simon Harris (Wicklow, Fine Gael)
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The Deputy is right to acknowledge the additional staffing that has been provided at the hospital in recent years. According to the information that is available to me, an additional 65 posts have been filled at Portlaoise Hospital since 2014, comprising 17 medical posts, ten nursing posts, five allied health professionals, 24 patient and client care staff and nine administrative staff. I have a more detailed list here, but I probably do not have time to go through it.

There has been significant investment. As I acknowledged at the outset, a lot of effort has been put into this hospital in terms of addressing a number of issues over the past number of years. I have no intention of stating anything other than the factual position. There is still a substantial body of work to be done. There are still conversations that need to be had at a clinical level in terms of what services can be provided and in what hospital within the hospital group. That work is ongoing. What I can assure the Deputy and the people of Portlaoise today is that all of this will happen in an orderly and planned manner and that people will be kept informed of any developments.

Seán Fleming (Laois, Fianna Fail)
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Will the Minister send me a copy of what he did not get an opportunity to read on the record?

Simon Harris (Wicklow, Fine Gael)
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It is a breakdown of the 65 posts. I will send that to the Deputy.