Brian Stanley (Laois-Offaly, Sinn Fein)
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I welcome the opportunity to speak on this matter and I join in the congratulations for the new Minister of State, Deputy Feighan. I would say that at one stage he felt he was down, but he was not out and he made a great comeback, and I congratulate him on his appointment.

I am disappointed that the Minister for Health, Deputy Donnelly, is not here. This is an important issue with regard to the Midland Regional Hospital Portlaoise. Page 47 of the programme for Government states additional capacity is required throughout the health system to deal with the growing population and, of course, Covid-19. Nowhere is this more true than the Midland Regional Hospital Portlaoise because it is dealing with the expanding population of County Laois, the fastest growing county in population terms outside of the Dublin region, and that of some of the surrounding areas, such as south Kildare and east Offaly.

Going back three years, there was a plan to remove the emergency department and other key services from the hospital, but a campaign was mounted which stopped it in its tracks. The then Minister, Deputy Harris, promised me and the two other Deputies from the county a quick public consultation, but three years later that public consultation has not happened. I said at the time that I thought it may be a stalling mechanism to get the then Government over a general election period and, unfortunately, my fears were confirmed.

When the Taoiseach was in opposition he met the Portlaoise hospital action committee and promised to deal with this issue and the lack of certainty about the hospital. Fianna Fáil made great play of it and great noise about it at the time. We still do not have it. Successive Governments have kicked the can down the road on Portlaoise hospital. This has gone on for decades and it cannot go on any longer. The one thing the staff, management, patients and the communities of Laois and the surrounding counties need is certainty. We need a clear plan for the future of the hospital. We have not had this and it cannot continue the way it has been going.

We need the Government to commit to putting in place a plan for the future of the hospital. This must include retention of the emergency department. Prior to Covid-19, on average 40,000 people used the emergency department in Portlaoise hospital. I must commend staff, management and everyone throughout the hospital for the way they have dealt with the Covid crisis. They have managed to keep it virtually free of Covid and it has been a huge effort. Recently, a relation of mine spent weeks there and could not heap enough praise on the staff. It is an elderly relative who, unfortunately, is in bad health at present. The hospital has a great track record.

If the Government does nothing else with regard to Laois and Portlaoise, will the Minister of State, along with the Minister, Deputy Donnelly, commit to putting a plan in place that gives certainty regarding the emergency department and the other key services in the hospital?

Frank Feighan (Sligo-Leitrim, Fine Gael)
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On behalf of the Minister, Deputy Donnelly, I thank Deputy Stanley for raising this matter regarding Portlaoise hospital. I also thank him for the kind remarks he made about me.

The Minister would like to reassure the Deputy that the most important issue regarding the consideration of services at the Midland Regional Hospital Portlaoise is that patient safety and outcomes must come first. As the Deputy is aware, the Midland Regional Hospital Portlaoise has been the focus of a number of reviews, investigations and reports in recent years. The reports points to the need for a reconfiguration of some services to ensure patients are treated in the most appropriate setting by specialist staff who can safely meet their needs. With these reports in mind, the Minister, Deputy Donnelly, is committed to securing and further developing the role of the Midland Regional Hospital Portlaoise as a constituent hospital of the Dublin Midlands hospital group.

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 governance structures of the Dublin Midlands hospital group. Significant work has been undertaken to strengthen and stabilise current arrangements for services at the hospital to ensure sustainable services are safely assured and adequately resourced. Funding has increased by 50% relative to the 2012 budget and staffing levels have risen by 36% from the 2014 base.

In addition to resourcing at the hospital, governance and management arrangements at the Midlands Regional Hospital Portlaoise have been strengthened. Additional clinical staff have been appointed and staff training, hospital culture and communications have improved. The Dublin Midlands hospital group has been working for some time on a draft plan for a new model of clinical service delivery at Portlaoise hospital which takes into account the need to develop services at the hospital in the context of developing the model of service provision for the entire hospital group.

The HSE group involved in developing the draft action plan for Portlaoise hospital focused on the risk issues and the interdependencies of the various clinical services in the emergency department, general surgery, general medicine, general paediatrics, obstetrics, gynaecology and neonatology. The draft plan has been submitted to the Department of Health but I would like to clarify that no decision has been made on it.

I emphasise again that patient and public requirements are paramount and have underpinned the Department's consideration of the draft plan. The Government is committed to investing in services, capital projects and staffing at Portlaoise hospital. The hospital has made considerable infrastructural improvements in recent years to improve the service user experience. These capital developments allow considerable service developments and additional recruitment of staff, and further solidify our commitment to securing and developing the role of the Midland Regional Hospital Portlaoise as a constituent hospital in the Dublin Midlands hospital group.

Brian Stanley (Laois-Offaly, Sinn Fein)
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I thank the Minister of State for his reply. I welcome the fact there has been increased funding and I acknowledge it because I did complain in the Thirty-first Dáil about the budget for Portlaoise hospital, which was substantially reduced. I also welcome the increase in staff numbers. I report in a positive way that this has made a difference. There were investigations and reviews with regard to the maternity services. It is now acknowledged that Portlaoise has excellent maternity services and outcomes. The Minister of State is correct that it is part of the Dublin Midlands hospital group and this network has been beneficial. I acknowledge all of this.

The missing piece of the jigsaw is to nail down and tie down once and for all the emergency department because if we take the emergency department out, we will lose other key services such as paediatrics, maternity and the ICU. Prior to the Covid emergency there were only two ICU beds in the hospital. This will need to be examined when we get to the far side of the pandemic, and I hope that will be soon. It is difficult to recruit senior medical staff. Staff have been recruited but it is difficult to recruit consultants and senior clinicians when there is no certainty.

The Minister for Health, Deputy Donnelly, visited the Coombe to show Government support for front-line staff. According to his statement, he also wanted to underline the Government's full commitment to the implementation of the national maternity strategy. Portlaoise is part of the integrated maternity network with the Coombe, so where does Portlaoise fit into the national maternity strategy? I want the Minister of State to communicate to the Minister and the Government that this is an important issue. It is about a serious issue in the middle of the country in a very busy local hospital.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I reiterate that the Minister, Deputy Donnelly, is committed to securing and further developing the role of the Midland Regional Hospital, Portlaoise, as a constituent hospital within the Dublin Midlands hospital group. A number of reports point to the need for a reconfiguration of some services at the Midland Regional Hospital, Portlaoise, to ensure that patients are treated in the most appropriate setting by specialist staff who can safely meet their needs. As the Deputy said, significant work has been carried out in recent years to strengthen and stabilise current governance and management arrangements for services in the hospital to ensure the provision of appropriate and safe care for patients.

No decision has been made on the draft action plan for Portlaoise hospital. The most important issue in the consideration of services at the Midland Regional Hospital, Portlaoise, is that patient safety and outcomes must come first. I thank the Deputy for his support. I also thank the staff who worked so diligently. We are very proud of the staff in Portlaoise hospital and, indeed, all front-line staff in the Department of Health across the country. It is wonderful that we are all at one in agreeing that we are very fortunate to have them. I note the Deputy's concerns about the hospital and I will engage with the Minister, Deputy Donnelly, and the officials in the Department of Health on the matter.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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In welcoming the Minister of State tonight and saying we are grateful to you for being here, as it is inordinately late that we are discussing this matter, it might be no harm at this early stage in the process to communicate to the Department of Health that there will be a very unhappy Dáil if the Department does in this Dáil what it did in the last and sends in Ministers of State to deal with issues for which they do not have delegated responsibility.