Michael Mullins (Fine Gael)
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I welcome the Minister of State, Deputy Shortall, back to the House and call on Senator Denis O'Donovan to propose the first motion.

Denis O'Donovan (Fianna Fail)
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I also welcome the Minister of State to the House to speak briefly on the issue concerning one of, if not the most, geographically peripheral hospital, Bantry General. It is an old hobby-horse of mine. I was involved in the action committee back in the 1980s.

There is grave concern at present and a public meeting is being called by a member of the Minister of State's party on Friday night to address a couple of issues. First, the reconfiguration of the ambulance service seems to indicate there will be a loss of acute ambulance services in the peninsular and west Cork regions, places such as Mizen Head and Allihies. Many people do not realise when they talk of being close to the hospital that the nearest hospital, Cork University Hospital, is roughly a two and a half hours drive on somewhat unconducive roads.

Bantry General Hospital currently has an accident and emergency unit of sorts. It is not in the full sense of what that means, but there is a 24 hour, seven day a week service there. In the event of a casualty, it has probably one of the finest intensive care units in Ireland. There are four excellent consultants in Bantry General Hospital. There are cutbacks in different departments and there is a grave fear that, whether it is the ambulance reconfiguration or the reduction of the number of consultants from four to three, any diminution of services would create havoc in this area.

The population base for Bantry General Hospital is approximately 65,000 and takes in a little of south Kerry as well. The important point to note is that not that long ago the hospital had a maternity unit, which is now closed and which we accept will never reopen. What the public will not accept is a scenario where current services, including the assessment unit and minor injuries unit, would be closed at weekends or even during the week by operating on an 8 a.m. to 8 p.m. basis. This would create considerable difficulties because we are so far away from the centre of attention. We will never get a cancer unit or full cardiac unit in the hospital but what we have, we should hold.

The public, public representatives across party lines and the HSE agreed to the reconfiguration of services so that there would be an improvement. We have a relatively new hospital. A couple of Ministers have visited it over the years. It was only built in 1960. The theatres are under-utilised, and in the reconfiguration it was hoped that a consultant for day elective surgery procedures would come, possibly from Tralee or Cork, and at least keep the flag flying there.

The purpose of my motion is that there are concerns. I am not one for public meetings, major protests or whatever. I seek reassurance from the Minister of State, Deputy Shortall, or the Minister, Deputy Reilly, that the facilities in Bantry General Hospital which are not utopian, as we would like to have them, but for which we have fought for several decades will be retained and that there will be no diminution of services, whether it be ambulance services, a reduction in the number of consultants or the removal of its 24-7 facilities.

Róisín Shortall (Dublin North West, Labour)
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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.

Denis O'Donovan (Fianna Fail)
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I thank the Minister of State for her response which, by and large, is reassuring. I hope the fears being generated at local level can be set aside and what the Minister of State has set out will produce positive rather than negative results. I hope that in the coming months the commitments given by the Minister through the HSE on reconfiguration, in particular with regard to acute services, elective surgery and so forth, will be met.