Nicky McFadden (Fine Gael)

I raise this issue relating to the MIDOC service in the midland region. MIDOC is an out-of-hours general practitioner service for the people of the midland region which has been in operation for ten years.

We in the Athlone area have no hospital — Portiuncula is 15 miles away and Mullingar is 28 miles away. We have no primary care unit. This week the HSE is closing our long-stay residential facility for the elderly. The HSE has reduced the number of hospital services for the elderly. This residential care centre has been reduced to 40 from 200. We have no health service whatsoever in the Athlone area, and now there is a threat to the MIDOC out-of-hours general practitioner service.

This has arisen because there are new tax rules being imposed by the Revenue Commissioners for locum doctors. Up until now, locum doctors were deemed to be self-employed and according to Revenue they are now PAYE workers. They have been recognised as being self-employed for over 100 years.

The MIDOC, with which I am closely associated because I worked in a medical practice, was budget neutral and may even have worked at a deficit. It provided excellent care for the 20,000 people in the Athlone area and now it is under threat.

I am asking the Minister what we will do. The accident and emergency service is under threat. There were ten people on trolleys in Mullingar Hospital the other night. Due to the moratorium, there are beds being closed every week in the midland region. I do not know what we will do. Where will it end? Ultimately, it is the responsibility of the Minister to ensure the future of a high quality general practitioner out-of-hours service for people considering that there is a consistent erosion of our services.

Portiuncula Hospital is under threat, Roscommon Hospital is under threat and Mullingar Hospital is under threat. Post mortem services were taken from Mullingar hospital last month and sent to Tullamore. Recently, there was a case where a post mortem could not be carried out in Tullamore and it was sent to Cavan.

I despair at what is happening to the people of the midlands and our health service. I ask that the Minister of State give me a reply that will satisfy the people in the Athlone area, namely that our MIDOC service will be retained at least to the same standard that we have had.