Frances Fitzgerald (Dublin Mid West, Fine Gael)

I am replying on behalf of my colleague, the Minister for Health, Deputy James Reilly.

Navan hospital is an integral part of the Louth/Meath hospital group and the Minister is determined that it will continue to play an important role in the delivery of clinical services in the Louth/Meath area and to patients in other parts of the north-east region. At present, Navan hospital continues to provide a 24-hour emergency department. The Minister has stated that any changes to the operation of the emergency department can only be carried out after significant improvement in the performance of the emergency department at Drogheda. To fully consider the issues involved, the Minister will take account of the current organisation of acute services in the region and the important clinical programmes being developed by the HSE. The Minister acknowledges the need for communication with the local community at this time and understands that the HSE is available to meet community representatives, as he is himself.

In this regard, the Minister met the consultants in Navan hospital and with the Save Navan Hospital Alliance last week. At that meeting, the Minister set out the position with regard to the emergency department at Navan hospital. The Minister is absolutely clear that due to need to ensure the safe delivery of services and the best outcomes for patients, changes need to take place at the emergency department. However, he has been equally clear that such changes need to be carried out in a planned way and that there will be full consultation on any changes. The Minister estimates that it will be at least six months before any changes to the emergency department in Navan can be effected.

The hospital continues to be the regional centre for elective orthopaedic surgery, including complex joint replacement surgery. This surgery is a combined service with Our Lady of Lourdes Hospital, Drogheda.

The debate over smaller hospitals has been dominated for far too long by what they cannot do. We need to move the debate on and focus on those things that they can do safely and efficiently, thereby ensuring the best outcomes for patients.

The Minister has repeatedly emphasised the extremely important role that smaller hospitals have to play in services for their local community. He believes that such hospitals can and should provide as wide as possible a range of services close to the local community. They should be the cornerstone of locally based services and should have strong links to the local community-based services and to the larger hospitals in their region. As the Minister previously stated, too often we have focused on what we are taking away rather than what we can add to services there.

All of this will be done with full regard to the safety issues highlighted by HIQA in its reports on Ennis and Mallow hospitals. When this framework is implemented, smaller hospitals will have vibrant role, doing more work, not less, and meeting as many as possible of the needs of their local community while delivering safe health services with better patient outcomes. That is the goal.