David Cullinane (Sinn Fein) | Oireachtas source

I welcome the Minister of State to the House. Yesterday, the long awaited Higgins report into the establishment of hospital groups in the State was published. As the Minister of State knows, six groups will be established and there will be consolidation of smaller and larger hospitals with academic links to universities. We can differ on whether the concept of groups or trusts is good or bad. I want to raise the concerns of many people in Waterford and the south east regarding what is being proposed.

Waterford Regional Hospital, it seems, will be renamed as Waterford university hospital and become a full teaching hospital. That proposal has its merits and attractions. As it stands, however, Waterford is serving five counties, namely, Waterford, Kilkenny, Carlow, Wexford and south Tipperary. It provides specialist services and tertiary care in areas such as cancer, neurology, renal services, ear, nose and throat, ophthalmology and a range of other services. Most of those specialties require a critical mass to justify their retention, which comes from the population base. In that context, there is a real concern at the prospect of two hospitals in the same region, St. Luke's General Hospital in Kilkenny and Wexford General Hospital, being assigned to an entirely different group or trust from the one to which Waterford Regional Hospital is assigned.

The Higgins report refers to a leakage of patients away from Waterford Regional Hospital to hospitals in Cork and Dublin. In fact, in a briefing last night, Professor Higgins alluded to 10% of patients from Wexford travelling to Dublin. In a situation where Waterford will be in one group with Cork, while Wexford and Kilkenny will be in an entirely different group, and those trusts will in time be competing for patients, how does the Government intend to secure the retention of existing services at Waterford? If the leakage of patients from the region to hospitals in Dublin or Cork continues, then there is a genuine and rational concern that this could, at some point in the future, be used as justification for downgrading services at Waterford. How can we guarantee that Waterford Regional Hospital, if it becomes a university hospital, will continue to function as a regional hospital and will retain all of the regional and tertiary services it currently provides? What guarantee can the Minister give in regard to these services and how can he fulfil that guarantee in actions as well as words?

We were told prior to the publication of the Higgins report that Waterford would be providing cardiology services on a 24-7 basis. This, in fact, was to be one of the carrots contained in the report. However, what the report actually refers to is enhanced cardiology services. Indeed, both the Minister and Professor Higgins were very clear when questioned last night that there is no commitment to the provision of that service at Waterford. Will the Minister of State clarify this issue? The current situation is that Waterford Regional Hospital is not providing a 24-7 cardiology service for the region as it should and must. If the Minister of State is in a position to confirm that this service will be introduced, what timeframe is envisaged for its establishment?

Professor Higgins has indicated that the decision not to recommend the retention of the south east as a region was the lack of shared vision or cohesion among the facilities there. Will the Minister of State indicate what shared vision there is between Mallow General Hospital, for example, and Waterford Regional Hospital? What shared vision is there between Mullingar, Wexford and Kilkenny? The argument regarding lack of cohesion is a red herring and I do not see how the Minister can justify these proposals on that basis. I am asking these questions out of a genuine concern, which is shared by many people in the region, regarding the retention of services at Waterford Regional Hospital.