Thomas Byrne (Fianna Fail)
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Connolly Hospital in Blanchardstown has caused considerable concern among people not only in Dublin 15 but also in County Meath, given that it is one of the main hospitals serving the southern part of that county. It has a higher profile at present because of the by-election in Dublin West. Prior to the last general election, Fine Gael and Labour Party candidates promised to protect services at the hospital. According to the Labour Party website, it promised to turn it into a world-class hospital.

In recent weeks I have been canvassing with my excellent colleague, Councillor David McGuinness, and heard first hand about people's fears about the future of the hospital. These fears are not being whipped up in the context of an election campaign, rather they are based on evidence of what is happening in the hospital. People feel betrayed by the broken promises made by the Labour Party and Fine Gael. A year ago the Minister for Transport, Tourism and Sport, Deputy Leo Varadkar, stated we were heading for a monumental disaster in the hospital, but he has been silent in regard to the latest news that there are to be 12 bed closures. Only last week the Minister for Social Protection, Deputy Joan Burton, indicated that she was encouraged by the Minister for Health's commitment to the hospital, but major changes have since been made in terms of bed reductions. There is confusion in Dublin West and County Meath about the promises that are being broken even before the election is held. The Minister for Health, Deputy Reilly, took control of the HSE directly when he appointed his own board. I welcomed his initiative because it is important that Ministers take responsibility, but it is now time to hold him accountable for what is happening in the hospital.

The Labour Party's literature explicitly claims to support the local campaign to retain services in the hospital. This is at variance with what is happening on the ground. At the very least, voters in Dublin West will not be duped in the same way as the people of Roscommon. While the Labour Party candidate is speaking about the cuts as going too far, being too deep and dangerous, we do not hear much from the Ministers concerned. I am glad the Minister for State at the Department of Health, Deputy Shortall, is in the House to outline for the people of Dublin 15 and County Meath the precise status of the hospital.

I acknowledge that there are no easy answers to funding the hospital or the health system in general. However, given the interactions in the north east between Connolly, Navan and Drogheda hospitals, changes in services in any of these hospitals will have knock-on effects. If the emergency department in Connolly Hospital is restricted or eliminated, people living in south County Meath will put pressure on Navan hospital. We are not sure if that hospital will remain open and the question, therefore, arises whether patients will have to travel to Drogheda. Serious concerns have been expressed not only by politicians but also by doctors, nurses and local residents.

My colleague, Deputy Martin, met hospital management this morning. I ask the Ministers, Deputies Burton and Varadkar, to sort this out and to provide the proper service they promised. They knew this country was in a serious financial position when they made that promise. In fact, the tax take has been larger than would have been expected when their parties' manifestos were being drawn up. An additional tax imposed by the Government - the pension levy - is raising €200 million more in revenue than is being spent on the jobs initiative. Therefore, the Government has money it did not expect to have at the time of the election. I urge it to invest that money in essential services, particularly health services, that benefit the people of this country. I would be grateful if the Minister of State could outline the exact position.

Róisín Shortall (Dublin North West, Labour)
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I thank Senator Byrne for raising this issue. I am responding to him on behalf of my colleague, the Minister for Health, Deputy Reilly. I emphasise that reports that services at Connolly hospital in Blanchardstown are to be downgraded are without foundation. The hospital will continue to provide a full range of acute services, including a 24-hour accident and emergency department. Connolly hospital, which serves a catchment population of 331,000, is an academic teaching hospital. It provides a range of acute medical and surgical services, acute psychiatric services, long-stay care, day care, outpatient, diagnostic and support services. Emergency services are provided on a 365-day, 24-hour basis. Multidisciplinary teams of medical, nursing and allied health professionals, as well as management and general support staff, play a pivotal role in the development, delivery, monitoring and evaluation of these services.

The efficiency of all services is being reviewed by the HSE in view of the current budgetary and financial position, which derives directly from the mismanagement of the economy by the previous Government, which was led by Fianna Fáil. The Minister has emphasised to the HSE that budgetary compliance must be maintained with the delivery of service levels set out in the national service plan. Activity and expenditure at Connolly hospital are ahead of the levels approved in the 2011 national service plan. A comprehensive review of services at the hospital has been undertaken by the HSE and hospital management. Certain measures have been taken as a consequence of this review. First, there has been a reduction in the use of agency staff and overtime hours. Second, the surgical day ward will be closed temporarily for two separate periods, involving a reduction from 24 to eight places when the first temporary closure takes place in November. Third, there will be a phased closure of 12 inpatient surgical beds between now and the end of the year. These changes are the direct result of the current budgetary and financial circumstances in the health system.

The HSE reviewed other possible options to save money or increase revenue, but concluded that they would not generate sufficient savings in the short term. The HSE has estimated that the cost reductions from the measures I have listed will save approximately €180,000 between now and the end of the year. The Minister, Deputy Reilly, has emphasised to the HSE the need to ensure the impact of these changes on patients is minimised and all changes are fully communicated. An announcement regarding these changes was made by the hospital manager on 5 October last, following a meeting of the hospital executive team, and communicated to staff by memo on that day. The changes are due to be discussed with the unions today. All measures are being reviewed on a daily basis by the hospital management team to ensure they have the smallest possible impact on patients and service users. All decisions on the alteration of patient services are carried out by the HSE in the interests of patient safety.

Thomas Byrne (Fianna Fail)
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The Minister, Deputy Varadkar, said last year that a serious loss of life would happen in north Dublin hospitals. The Labour Party and Fine Gael promised to retain services. They said they would do it even though they knew what this country's financial situation was at the time. As I said, the amount of tax that is coming in is greater than that expected at the time of the budget. The Government also has €200 million from the pensions levy that is not being spent on the jobs initiative. I urge the Government to stop saying Fianna Fáil caused all of this. The figures were available to the Government parties before they took office. They have collected more tax than was anticipated. It is about time they put the money where their mouths were at election time. In July, when this country's financial circumstances were known, the cuts mentioned by the Minister of State - the staff reductions, the temporary closure of wards and the phased closure of 12 beds - were described by the Labour Party candidate in the forthcoming by-election as "too far, too deep and too dangerous". He said that such "draconian measures" could not "proceed without hurting patient care and safety". Government policy is one thing, but it is about time candidates in election battles started saying another thing. I am glad the Minister of State said at the outset that "reports that services at Connolly hospital in Blanchardstown are to be downgraded are without foundation" although she qualified that by listing various ward closures. We appreciate her commitment to maintaining a 24-hour service at the hospital's accident and emergency department. A doctor told us yesterday that he expects the department to close. We will accept the commitment the Minister of State has given us. We will certainly hold the Government to that commitment.

Róisín Shortall (Dublin North West, Labour)
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I repeat that the Government is committed to ensuring the future of Connolly hospital. As I said, there are no proposals to downgrade the hospital. It is important for Senator Byrne not to be disingenuous when dealing with this issue. More than anybody else, he should know that no new money is available. When his party was in government, it brought this country to the brink of ruin. No new money is available. It has been perfectly clear that hospitals have to live within the budgets that have been set for them. The old system, whereby hospitals and other aspects of the health service sought supplementary budgets towards the end of the year, is simply not on at this point because there is no spare money. The Minister, Deputy Reilly, has made it very clear that hospitals must live within their budgets. They must provide the range and quantity of services they are contracted to provide. That is what is expected of Connolly hospital. That is the situation. We are committed to the future of the hospital. We are committed to ensuring there is no downgrading of the hospital. At the same time, it must be clear to the hospital that it is expected to live within the budgets it has agreed to live within.