Seán Power (Kildare South, Fianna Fail)

I thank Senator Ulick Burke for raising this issue this evening. I am replying on behalf of my colleague, the Minister for Health and Children, Deputy Harney.

I welcome this opportunity to inform the Seanad of the position with regard to the development of neurosurgical services. The Health Service Executive, HSE, recently published a review of neurosurgical services in Ireland which was prepared by the former Comhairle na nOspidéal. It focuses, in particular, on the provision of adequate capacity and consideration of equity of access to neurosurgical services.

Neurosurgery is provided at the national centre in Beaumont Hospital and in Cork University Hospital. In summary the report recommends that the future development of safe, high quality neurosurgical services in Ireland would be best served by a two-pronged approach involving increased capacity in Dublin and Cork, and improved access to neurosurgical units, including transport and telemedicine facilities for referring hospitals.

The report identifies a clear need for significant investment in neurosurgical services. It states that the development of services must be contingent on organisational reform. This includes the need to put in place clear clinical leadership to guarantee service quality; to ensure appropriate linkages between neurosurgical units and crucially to develop clinical pathways with referring hospitals which do not have on-site neurosurgical services.

The HSE is committed to progressing the recommendations of the report to ensure the development of neurosurgical services in Ireland is in line with international best practice. A national neurosciences needs assessment is under way. Neuroscience includes neurology, neurophysiology and neurosurgery. This assessment is guided by previous Comhairle reports on neurology and neurophysiology and the recent report on neurosurgery. It aims to identify the requirements for neuroscience services as a whole across the country.

I understand an interim progress report is due to be submitted to the National Hospitals Office shortly and the final report will be submitted in February next year. The HSE is pursuing the development of additional neurology services in Waterford, Limerick and Sligo. This will facilitate the management of patients who live outside Dublin who may need neurosurgical opinions or interventions.

The Government provided an additional €3 million in 2006 to develop neuroscience services and the recently published Estimates for the Health Service Executive provide a further €4 million to continue these developments into 2007.

Comhairle na nOspidéal considered the case for a neurosurgical unit in Galway at length. Representatives of the Western Neurosurgery Campaign met the Comhairle committee to put their case for neurosurgical services to be located in the west. Comhairle's conclusion was that a unit in Galway would not be viable. It also considered that the needs of the entire population would be ill-served by the division of neurosurgical expertise and resources between three neurosurgical units.

The reasons for this decision include insufficient catchment population in the west; changing trends in demand for neurosurgical services; international experience on the viability of small neurosurgical units; significant scope for improving services by increasing capacity in existing units as well as providing improved transport and telemedicine facilities. Comhairle's conclusion is that the needs of neurosurgical patients would be better served by increased capacity in the existing units and the development of systems that promote rapid assessment, diagnosis of injury and transfer, than by the development of a third unit.

The report acknowledges that this decision will be a disappointment to many who have campaigned for the establishment of a neurosurgical unit in the west. The HSE is convinced, however, that the implementation of the recommendations of the report represent the best way forward in building a high quality neurosurgical service that will meet the needs of the entire population.