Marc MacSharry (Fianna Fail) | Oireachtas source

I welcome the Minister to the House and thank him for making time to be with us today. As the Minister is here, I wish to raise a different issue to the one being debated today. While I appreciate that this is, strictly speaking, an issue for the Minister of State, Deputy Kathleen Lynch, I ask that the Minister's office would make inquiries into the delay of the transfer of the management of Cregg House and the services it provides to people with severe and profound disabilities. I gather there is a very serious delay in that regard. A price-comparison was done by the HSE and Wisdom Services which showed that the services provided by Wisdom Services at Cregg House were €40,000 cheaper, per user, than those provided at HSE-run facility at Cloonamahon. Wisdom Services has announced its intention to discontinue service provision because it cannot afford to carry on. The HSE tried to replace Wisdom Services with other operators but none were interested because of the lack of funding. The HSE agreed to take over the provision of services itself. A statement was released by Wisdom Services today to the effect that the HSE is playing games with this issue. While I appreciate that this is Deputy Lynch's area, I ask the Minister to have his officials investigate the delay because the uncertainty for the service users and their families is of grave concern. I apologise for taking advantage of the Minister's presence to raise that matter.

On the surface of it, most people welcome the idea of hospital groupings, with shared services, shared expertise, centres of excellence and so forth. However, a number of questions require answers. When is the licensing going to take place? When will the legislation for the licensing come before the Houses? It is not on the legislative programme for 2013 so will it be published in 2014 or later? Who will the hospital groups report to? Further down the line we will see the development of hospital trusts but will they be independent republics, capable of doing whatever they want, with no connection to the government of the day? Will we merely provide the money for the hospital trust and allow the trust to spend it as it sees fit or will there be some level of responsibility attaching to the Minister for Health for the trusts? What is envisaged in terms of the reporting structure? That is somewhat uncertain at present. In 2015, the HSE will no longer exist and I am interested in what will happen at that point.

The two reports published recently on hospital groupings refer to smaller hospitals, of which there are many in this country. The Minister claims that the future of such hospitals is now secure because they will be carrying out certain types of procedures and discontinuing others. The difficulty I have with this, as someone from the north west, is that a different sub-structure will be required for Letterkenny and Sligo because of the unique geographic challenges of that region, which the Minister, Professor Higgins and many others have readily acknowledged. I have concerns about the power shift to Galway. Having researched health in this country in recent years, it seems to me that medical politics would put these Houses in the ha'penny place in the context of the manoeuvring that goes on. Consultants try to build up the numbers attending their particular hospital to show that they are doing more cases, can achieve better outcomes and so on. Under the proposed hospital grouping for the north west, the power focus would shift to Galway. However, as one oncologist said to me recently, Galway is already beyond capacity. That is just in terms of cancer treatment. Inevitably, if Galway has the budget and the CEO, it stands to reason that it will come first. If two sitting rooms in two houses need to be wall-papered, obviously one will do one's own first before doing the one down the road.

The level of expertise that will be available to hospitals like those in Letterkenny and Sligo will be hampered down the line by the fact that the centre of power is elsewhere, namely, in Galway. Rather than extend the clinical programmes that are so celebrated throughout the country in the context of cancer care and cardiology, we still have no plans or indeed any indication that we will have any cardio-catheterisation laboratory facilities in the north west. There is no centre for radiotherapy. Professor John Crown will testify, I am sure, that in the United States they would not leave 250,000 people without access to radiotherapy or cardio-catheterisation laboratory facilities but we are doing that. I must say that the previous Government is just as guilty in this regard as the current one, if not more so. There has been a tendency to take refuge in the notion of co-operation with Northern Ireland on this issue but that is very sketchy.

At the briefing in Buswell's Hotel with Professor Higgins I was shocked when I questioned him about the situation pertaining to Galway, Sligo and Letterkenny. The Minister attended that briefing himself and would have heard Professor Higgins saying that he hopes that "existing synergies" between those hospitals will continue but that in the fullness of time, the road to Galway will improve. This is a Professor of medicine who, in fairness, did a very thorough job in going around and meeting everybody concerned. He attended approximately 150 meetings and I welcome his report. However, if this is the vision for the delivery of health care in the north west of the country then I have a real problem with that. The current Minister for Health was the best campaigner, when in Opposition, for a better health service, and would not have accepted medical professionals telling him not to worry, that the approach to improving health services in the north west would be to do up the roads. Surely the people of the north west are entitled to a little more than that.