Brian Hayes (Fine Gael)

It would be an act of medical madness for the Government to allow Peamount Hospital in west Dublin to close as a result of a major downgrading of the hospital, which is proposed by a small unaccountable group. The case of Peamount is unique because of its position as the national centre for TB eradication. It is also unique because it has a capacity of more than 350 beds at a time when the bed capacity in the major acute hospitals in Dublin represents a major problem. I cannot see how any Government would sit idly by and watch this medical facility close when it is clear that there is a need for the medical expertise currently at Peamount.

The Eastern Health Board, the Medical Council and local GPs in the area want the hospital to continue its good work. We have yet to hear from the Minister for Health and Children, who seems to be oblivious to the current crisis in Peamount. This is despite the fact that the Minister provides close to €20 million per annum from the Department's Vote for the hospital. One must ask who or what is behind this deliberate act to close Peamount Hospital. We are told the report from Comhairle na nOspidéal on the hospital, which incidentally is three years out of date, was roundly opposed by the board of the hospital over two years ago. The board wrote specifically to the Minister for Health and Children rejecting the Comhairle proposals and a second report was then commissioned. In the context of this controversy, all the interested parties now want to know what has changed so dramatically in two years.

The immediate impact of the closure of the 60-bed chest hospital at Peamount would have a knock-on effect for many of the other acute hospitals in the Dublin region. The immediate impact of closing Peamount Hospital would be to put additional pressure on the already overcrowded major hospitals in Dublin because the acute hospitals can no longer refer patients to Peamount in respect of chest-related illnesses. However, as the Minister well knows, the expertise and, most important, bed capacity would be forever lost were the hospital to close.

Will those directly involved in the management of the hospital take into consideration the 70 local general practitioners who use the hospital on an ongoing basis to speedily turn around testing and other laboratory uses for local patients? Peamount Hospital is not a stand-alone hospital facility in that it has direct links with the local community it serves. The bottom line is that it works for the local medical infrastructure in the Newcastle, Lucan and Clondalkin areas of west Dublin. It would be a crying shame to lose it.

Will the Minister of State confirm in his reply why the CEO of Peamount Hospital can now determine admissions policy without recourse to medical advice? I am not aware of another hospital in the State where this is the case. It is daft to be downgrading this TB hospital when instances of the disease are on the increase and when Dublin hospitals are already overcrowded and understaffed.

The IMO recently warned about a shortage of beds in major Dublin teaching hospitals. We saw this for ourselves when there were instances of the winter vomiting bug and we noted the acute pressure it put on bed capacity in the greater Dublin area. Letting Peamount Hospital go by the wayside would escalate the crisis in our Dublin hospitals. Will the Minister for Health and Children intervene directly in this mess? It is high time he did, not only to save the hospital but also to integrate the services it offers into the wider provision of medical services in the greater Dublin area. We cannot afford to lose the hospital, nor can we attempt to treat highly infectious TB sufferers without endangering other acutely sick patients. Peamount Hospital has a special role to play in the control of tuberculosis and in the prevention of multi-drug resistant tuberculosis. Will the Minister support the medical director in the hospital, other local general practitioners and the entire west Dublin community by allowing this hospital to retain the services it provides?

The Minister of State, who is listening attentively to the debate this evening, should note that if we lose the chest hospital it will follow, as night follows day, that we will lose the other sections of the hospital which deal with learning disabilities and the young chronic sick and which provide services for the elderly. This cannot be allowed to happen given the investment of the Minister for Health and Children in the hospital, the hospital's role in dealing with the TB epidemic in the 1940s and 1950s and its strategic role in offering beds to the acutely sick in the greater Dublin area.