Denis O'Donovan (Fianna Fail)
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This is somewhat parochial, but I ask the Minister of State to outline the impact, if any, of the €900,000 cutback that has been announced for Bantry General Hospital. I have spoken to the Minister for Health, Deputy Reilly, on the issue on a number of occasions and he is fully aware of the significance of Bantry hospital due to its geographic location. It is on the list of unique small hospitals to be preserved and promoted. I accept that there must be budgetary constraints across the board.

The previous Minister, through the HSE, outlined a method of reconfiguration for Bantry hospital under which consultants from Kerry General Hospital, Tralee, Mercy University Hospital, Cork, or Cork University Hospital would attend every day. As evidence of that, one consultant, who is a plastic surgeon, comes to Bantry once a month, which is great for the people of west Cork and south Kerry. More of this should be done. The reconfiguration plan is still in its infancy and should be rolled out more quickly. This development was planned four or five years ago.

When I spoke to the Minister privately a few months ago, he said there was an ongoing review of small hospitals such as Bantry, possibly including such other hospitals as Mid-Western Regional Hospital, Nenagh, Mid-Western Regional Hospital, Ennis, and Letterkenny General Hospital, after which he would be making certain decisions. The Minister of State may not know whether that review has been concluded.

I am encouraged by the fact that the Minister recently visited Bantry and that he has a grasp of the geographical difficulties we face in that area. When I hear people in Dublin arguing about whether the new children's hospital, which we need, should be at the Mater hospital or in Tallaght or Crumlin, I think of a woman from the Beara Peninsula who had two very sick children and used to leave at 3 a.m. to get the first train to Dublin. It would take her 24 hours to get here. People from west Cork, Kerry or the remote parts of Donegal hear the arguments about where the children's hospital should be located. If we had our choice it would probably be in Portlaoise or somewhere closer to home, but that is not going to happen.

There is a consultant surgeon post at Bantry hospital which is currently occupied on a temporary contract. The gentleman concerned recently performed a minor operation on my own son, who had a hernia removed. We chose to go to Bantry to support the hospital. More than €2.5 million has been spent on upgrading the surgical theatre there. The surgeon's contract should be put on a firmer footing. I have raised this concern before. We have only one consultant surgeon, although we have consultants in other specialties. If he were to go for any reason, the consultant anaesthetist would fall with him, as it were - they follow each other - which would have a knock-on effect on patients on the medical side of the hospital, where we have one of the best intensive care units in Ireland. That is a concern I have. The Minister of State's answer may not include this, but it is something she might convey to the Minister. There should be at least a three-year contract. GPs are telling me they do not know from month to month whether this person will go. I think he is an African. He is very good, but he is here on a temporary contract. That uncertainty creates concern in the community, and many of the GPs are saying he, or somebody else, should be put on a three-year or five-year contract - something more definite - in the short or medium term.

Róisín Shortall (Dublin North West, Labour)
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I thank Senator O'Donovan for raising this matter. I am replying on behalf of my colleague, the Minister, Deputy Reilly. We are all aware that the health sector is facing significant funding challenges this year. However, the Minister is determined that the impact on services will be minimised by following best practice and through reform in the way services are delivered.

The service plan for this year reflects the programme for Government commitments for health and the savings targets set out in the Comprehensive Expenditure Report 2012-2014. With the scale of the financial challenge facing the HSE, there will be an inevitable and unavoidable reduction in services, but it will not be a straight line reduction. Bantry General Hospital, similar to other acute hospitals, must face this challenge of reduced budgets and align its 2012 activity and services with the budget allocated.

This year, the HSE south will continue its programme of reorganising acute hospital resources in Cork and Kerry to ensure the best possible outcomes for patients. Bantry hospital is actively participating in the clinical programmes, which will enable the hospital to maximise activity while reducing overall cost. These programmes provide a national, strategic and co-ordinated approach to a wide range of clinical services.

With regard to the Senator's query on bed closures, the HSE has informed the Department of Health that there are currently no plans to reduce bed capacity in Bantry hospital. The hospital management is aware of the retirement or resignation of seven whole-time equivalent staff in the hospital this year. Work has been under way since last autumn to prepare for this reduction, and the regional service plan of HSE south takes this into account. Furthermore, HSE south and the hospital management are seeking to mitigate the impact of the retirements on front-line services in a number of different ways. These include using the public service agreement to bring about greater flexibility in work practices and rosters, redeployment and other changes to achieve more efficient delivery of services. Some limited and targeted recruitment in priority areas will take place to help limit the impact of retirements on front-line services. Examples include a theatre nurse manager to secure the surgery service and a senior medical scientist to ensure continuity of the laboratory service. In response to the Senator's third query, hospital management is not aware of any other post that will be lost in the system at this time that may adversely affect the staff of the hospital.

The role of services in Bantry will be progressed as part of the Government's national framework for the reorganisation of small hospitals. In developing this framework the Government is clear that there is an important future role for smaller hospitals, in which they will provide services for more patients. The framework is expected to be submitted to the Cabinet shortly.

The main focus of the reorganisation of services at Bantry is the transfer of remaining complex surgery to Cork city, with a reciprocal transfer of day case surgery to Bantry. Surgical and medical specialties will also transfer outpatient work to Bantry. This will broaden the range of outreach services available to patients closer to home. A dedicated patient transport service is due to be made available in Bantry from mid-April. I hope this addresses the issues raised.

Denis O'Donovan (Fianna Fail)
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I thank the Minister of State for taking this matter on behalf of the Minister for Health, Deputy James Reilly, and the response is, by and large, positive. I am not being political or parochial, but since I became a councillor in 1985 Bantry General Hospital has been the backbone of my reason for being in politics. Even when Fianna Fáil was in government I did not have a problem in challenging its current leader, Deputy Micheál Martin, or the former Minister Mary Harney on certain issues. I continue to work for the sake of the hospital. I spoke to the Minister and I am encouraged by the fact that he has visited the hospital, is aware of what is happening there and has a grasp of what is needed. I look forward to positive outcomes for the hospital.

I thank the Minister of State for taking this matter in the Minister's absence. I will be glad to convey the news that, despite the financial cutbacks, the loss of jobs will be insignificant.

Róisín Shortall (Dublin North West, Labour)
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I hope that will be the case. The HSE has made a huge effort in ensuring cover to ensure services can continue, particularly in critical services. The Government sees a strong future role for Bantry General Hospital. The framework being developed for smaller hospitals is close to completion. While some activities, particularly the more complex work, will be transferred, there will also be movement in the other direction, including day case surgery. There is a strong and bright future for the hospital.