Alex White (Dublin South, Labour) | Oireachtas source

On behalf of the Minister, Deputy James Reilly, I thank the Senator for raising this matter, which provides an opportunity to discuss with the House the reports that were launched yesterday. As the Minister has said, these proposals signal a fundamental modernisation of our health system organisation in line with best practice. The objectives of the hospital groups are: to achieve the highest standard of quality and uniformity in hospital care across each group; deliver cost effective hospital care in a timely and sustainable manner; encourage and support clinical and managerial leaders; ensure high standards of governance, both clinical and corporate; and recruit and retain high-quality nurses, non-consultant hospital doctors, consultants, allied health professionals and administrators in all our hospitals. The introduction of groups will provide for organisational change in the first instance, offering more autonomy to providers and better enabling the reorganisation of services in a well-planned manner. Over time, this will help to improve services and deliver better outcomes for patients.

When it became clear in November 2012 that there might not be sufficient medical professional consensus and support for a stand-alone network or group in the south east, a further period of intensive discussions with the four acute hospitals took place. As a result, there is now a broad acknowledgement within the consultant establishment in those hospitals that the future development and prosperity of all four facilities is best served by accepting the proposal outlined in the Higgins report which places Waterford Regional Hospital and South Tipperary General Hospital, Clonmel in the south-south-west hospital group and Kilkenny and Wexford hospitals in the Dublin east group. Waterford will continue to be a cancer centre under the national cancer control programme. It will, in addition, be the hub for the south-east renal service and a regional trauma centre. It will also continue to provide invasive cardiology services for the population of the south east.

In addition, an undertaking was given that the Department and the Health Service Executive would work with University College Cork to enable Waterford hospital to become a university teaching hospital linked to UCC. Discussions with the university have also taken place and agreement reached in principle on developing closer links, leading in due course to parity status with Cork University Hospital. These discussions have been shared with the Royal College of Surgeons in Ireland, which has a strategic interest in Waterford Regional Hospital as a major undergraduate teaching campus for its students. In short, Waterford Regional Hospital is to become a fully recognised university teaching hospital linked to UCC, with all the privileges associated with that status. In furthering this proposal, UCC is committed to putting in place academic clinical appointments on an incremental basis at professorial, senior lecturer and tutor levels, with associated administrative support. Discussions within the new group's corporate governance structure and in turn with the HSE and the Department of Health will now commence to give effect to these changes.

The traditional practice of providing as many services as possible in every hospital is neither sustainable nor safe. Experience in Ireland and beyond informs us that a co-ordinated system of care is clearly better for patients than a more sporadic approach from hospital to hospital. I am confident that the formation of hospital groups will lead to safer, more effective and more efficient services for all patients. We are all agreed that the focus in all of this must be on what is best for patients. That is the starting point. We do not start from an existing hospital - I am speaking generally here, not specifically about Waterford - and look outward in terms of seeing how we can maintain or preserve everything that has always been available at that particular location. I appreciate that this is not the Senator's perspective, but it is important to state it. We must begin by considering how best to serve the needs of patients and organise care at the optimum level for all citizens. People are usually patients for a short period of time but they are citizens all the time. The focus must be on building the best possible services around the interests of the patient. From his contributions in the House, I know the Senator will share that perspective.

Several commentators, including the leader of the Senator's party in the other House, expressed concern yesterday about a lack of detail in the proposal. Once the groups are established, it will be a matter for each of them to examine some of the outstanding issues that need to be addressed in terms of the best configuration of care across the group. Those types of decisions will be left to the groups.

In terms of the specific issues the Senator raised, I have indicated that Waterford Regional Hospital will continue to be a cancer centre, a hub for the south-east renal service and a regional trauma centre. I also referred to the enhancement of the status of the hospital through its links with UCC. We would all agree that the teaching element of a modern hospital is vitally important. In fact, there would be questions to answer if a hospital as advanced and important as Waterford were left without a teaching dimension to its work.

That would be of concern to people, and that will not happen here. There will be professorial and teaching positions in this hospital, which will give it great strength and endurance. I have no doubt that Waterford Regional Hospital will endure to serve patients for a considerable period into the future.