Ulick Burke (Fine Gael)

Following the publication several weeks ago of a Comhairle na nOspidéal report on neurosurgical services, it became clear there was to be the continuation of only two units in the country. Galway was not to have a unit. The report claimed the provision of a third unit would impinge on the viability of the other two. However, the report makes the best case possible in support of the provision of a unit in University College Hospital, Galway.

This time last year the Minister for Health and Children, Deputy Harney, visited University College Hospital, Galway. She indicated that neurosurgical services should be established in Galway as part of the Government's health strategy. She claimed such a service was required if there was to be regional autonomy. Certain accident cases requiring specialist neurosurgical treatment could not be transferred to Dublin for distance reasons. The case for the service in the west was made to her in an impressive presentation before Christmas last year. It is ironic that the position has changed.

Neurosurgeons at Beaumont Hospital have said that a State-run emergency air ambulance service would be preferable to establishing a neurosurgical unit on the western seaboard. They acknowledged there could be an argument for a unit for emergencies and spinal injuries.

Six reasons were given in the report why a neurosurgery unit should not be located in Galway. These are in fact the best reasons there should be. The Comhairle na nOspidéal report team comprised four medical people and two lay people. The report stated there was an "insufficient catchment population to maintain the skills of staff in a Galway unit". It stated 750,000 was the population figure needed for a viable unit. Despite this, the report's appendix B stated such a unit in Galway would cover the old western health board area of Galway, Roscommon and Mayo together with north-west Donegal, Leitrim, Sligo, Clare, parts of Limerick, north Tipperary, Offaly and Westmeath. This catchment area, as the appendix stated, comprises 1.025 million people.

The report's authors visited Australia, New Zealand, Scotland and England to examine units there. Many of the units they visited catered for populations of fewer than 1 million people. The report stated that no small units had been opened in these countries, yet on 15 June 2006, a unit was opened in Waikato in New Zealand with a population catchment of fewer than 800,000 people.

They visited Aberdeen in Scotland with a population catchment of 500,000, the nearest to Galway. The report stated:

Aberdeen Royal Infirmary is the largest hospital in the Grampian region. It has in excess of 1,000 beds and provides a complete range of medical and clinical specialties, with the exception of heart and liver transplantation. The neurosurgical unit, with a population catchment of 500,000, is staffed by 3 consultant neurosurgeons, 4 consultant neurologists, 1 full-time consultant neuroradiology, 1 consultant neuropathologist and 2 consultant neuroanaesthetists.

The report continued:

Management and consultant representatives in Aberdeen stated their belief that the neurosurgery unit in Aberdeen is viable and necessary, particularly to ensure rapid access to services. It was stated that there is a need to increase the consultant staffing to 4 consultant neurosurgeons.

The Fine Gael Party leader, Deputy Kenny, in the Dáil today highlighted the crisis in neurosurgery. No one in the west is asking that they receive a service at the expense of Dublin or Cork. No new appointment has been made in Beaumont Hospital. The technical equipment in the hospital is breaking down. Two eminent consultants, including Ciaran Bolger, have stated that people's lives are in danger. The first conclusion of the report is fallacious and those professionals who put their names to it should not be allowed to go unquestioned.

The second conclusion stated there was insufficient catchment population to maintain the skills of staff in two regional units. One consultant in Cork has stated if the catchment area in Cork were encroached upon by the provision of an additional unit in Galway, there would be problems for the Cork unit. Unashamedly, he was stating the preservation of his patch and the turf war between Dublin and Cork is more important than the health and safety of people in the west.

The report also concluded that the establishment of a third unit would be likely to inhibit the development of a tertiary neuroscience centre. The Minister for Health and Children would not have made the statement she did on her visit to Galway last Christmas if that was the case.

The most damning conclusion of all concerned the changing trends in demands for neurosurgical services. The report claimed that with new medicines and medical procedures, fewer people are in need of neurosurgical services. However, statistics show there has been a 3% increase per annum in the demand for such services. Will the Minister of State ask the Minister for Health and Children, Deputy Harney, once and for all to support this request as she did 12 months ago. This report is an opinion. It is not policy.

Nobody in Galway is trying to hinder the development of those services in Cork or Dublin. A neurosurgeon in the United States has made an offer, with no strings attached, and €1 million additional funding is available from the widow of a former professor, Pat Dwyer. The equivalent of €5 million is available, with no strings attached, to provide this service. Why is Galway the second tier of all the services in the west? I do not think the Minister for Health and Children would allow that label to be used in this instance.