Róisín Shortall (Dublin North West, Labour)

I thank the Senator for raising this issue, to which I am responding on behalf of my colleague, the Minister for Health, Deputy Reilly. I am glad to have an opportunity to clarify a number of points.

The Government wants a health service which is safe, of high quality and affordable. Local hospitals can and should be a vibrant element of local health services. They should provide treatment and care at the appropriate level of complexity for patients in their areas. That care must be safe and not put patients at risk. HIQA has set out the type of services that can safely be provided in smaller hospitals in the reports on Ennis and Mallow hospitals. The HSE is developing proposals for future acute hospital services in Bantry General Hospital, in line with the national clinical programmes.

While the emergency department at Bantry General Hospital deals mostly with minor injuries, with an average of three attendances per day between 8 p.m. and 8 a.m. so far in 2011, Bantry's remote rural location is recognised and this needs flexibility in the application of all programmes of care being delivered. HSE South has in recent months again engaged with senior clinicians, GPs and management in Bantry, most recently on 2 September. Proposals are expected to be finalised in the coming weeks, consistent with the outcome of the comprehensive consultation process. The proposals will reaffirm Bantry General Hospital's crucial role in providing acute hospital care in west Cork as part of a wider network of acute hospitals across counties Cork and Kerry. However, no final decisions will be made on models of service delivery in small hospitals until the Minister has had an opportunity to study this in detail.

Pre-hospital emergency care is critical to the successful implementation of the HIQA recommendations on smaller hospitals. Current evidence suggests patient outcomes can be improved by better treatment and stabilisation at the scene, with ongoing treatment and transport to the most appropriate centre, even if that takes longer. On-duty service gives a modern emergency response service, involving paramedics, advanced paramedics, community first responders and GP out-of-hours services, working together to respond to emergencies. This approach is consistent with international best practice and will ensure compliance with HIQA response times and quality standards.

I am happy to confirm that no ambulance stations are closing in west Cork. In fact, the opposite is true; stations will be moving to on-duty status and away from on-call status. This means our highly trained paramedic crews are on site in their stations to respond to calls rather than having to travel to a station on being called out. It also means resources can be deployed dynamically, based on need and predictable demand rather than simply location, thereby giving greater flexibility and responsiveness. The dynamic delivery model means an on-duty emergency ambulance will be available from within the region, as required. This will produce better response times for people in counties Cork and Kerry and a better service. Other developments include improved arrangements for control and dispatch, practitioner deployment and inter-hospital transfers. All of these will allow the national ambulance service to provide a better, safer, more comprehensive and efficient emergency ambulance service for the people of counties Cork and Kerry.

There has been extensive consultation on Bantry General Hospital's future, both on acute services and pre-hospital support, with the staff, the public and public representatives. The need to change in order to ensure safety and the future role of the hospital is understood and supported. The HSE will continue to communicate with staff, the public, public representatives, health professionals and other interested parties on how best to provide services in the region. The Minister and the HSE recognise the importance of Bantry General Hospital and the contribution it has made and will continue to make to the provision of hospital services in the region.