Tim O'Malley (Limerick East, Progressive Democrats)

The Hanly report proposes that local hospitals should have substantially increased services in a number of extremely important areas, such as elective day procedures and out-patient work. Instead of having to travel to the major hospitals for many medical and surgical procedures, the report proposes that these would be provided on-site in local hospitals, closer to local communities. This can only improve the services available locally. We must ask ourselves how this can be represented as a diminution of services in smaller hospitals when the report proposes precisely the opposite.

Let us consider more closely what the Hanly report proposes for accident and emergency services. It points to a huge body of evidence that treatments for serious and urgent conditions, including those which may be life threatening, are best provided at a location where there is a full range of specialties available on-site. These include medicine, surgery and anaesthesia as well as a range of important back-up services in such areas as X-ray and pathology. To do this, and to cover a full 24-hour, seven day period within a 48-hour week, we need hospitals with at least 45 to 50 consultants. At present, many smaller hospitals have as few as ten consultants and there would not be sufficient work for 45 or 50 consultants in each of these hospitals. The doctors themselves would become deskilled and this would impact on the provision of high quality patient care.

What is proposed instead? A very workable alternative is put forward, which is based on two key elements. First, local hospitals will continue to cater for approximately 70% of all the patients they currently see in accident and emergency departments. People with minor injuries and minor non-life threatening illnesses will continue to be seen at their local hospital. This amounts to considerably more than the "dressing station" to which some have referred. In fact, local hospitals will continue to treat a substantial majority of the patients with whom they currently deal.