Camillus Glynn (Fianna Fail)

The people who are making the comments about Members are the unelected ones. I make no apologies for saying that I am anxious that phase 2B of the general hospital in Mullingar, which is at the design stage at present and in respect of which the development control plan is almost ready, should proceed. I am reliably informed that it will do so. It is to be expected that Members will root for their own areas and I certainly have no apologies to make for doing so. However, there is a bigger picture and people must recognise that all services cannot be provided on a local basis. There will be occasions when specialist services will be provided in a number of centres nationally. Such services cannot all be provided in our own back yards.

The Minister stated that hospitals will not be downgraded. This report is not about downgrading hospitals, instead the task force has pointed to the need to bring services closer to patients. It has stated that local hospitals should be a key part of an integrated hospital service for their regions, providing as wide a range of services as close as possible to the local community. They would meet most of the local population's need for hospital care by providing appropriate diagnostic and treatment facilities and a greatly expanded proportion of election day surgery and elective medical procedures for the relevant region, which would involve an increasing volume of elective procedures that are often performed in larger hospitals. Anyone with experience of medicine is aware that before the advent of day surgery, people were admitted to hospital for minor procedures and took up hospital beds. There was no need for that.

A key part of the Hanly proposals is the need to ensure a well trained and well equipped ambulance service that can provide immediate care for emergency patients. The focus is not on taking the patient to the nearest local hospital, rather it is getting the patient to the hospital best equipped to deal with their condition. Taking a patient as quickly as possible to a well staffed and well equipped major hospital is by far the best course of action. What do we do? We must put patients first – it is all about the patient.

I referred to the locally elected member being an important conduit in the delivery of health services. When one compares them to the monkey and the peanuts, the monkey was terribly expensive by comparison to the locally elected representative. I ask the Minister to include local democratic input in the new structures. This is vitally important and failure to include it would be fundamentally wrong.