Denis O'Donovan (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Senator Mary Moran has kindly agreed to allow Senator Byrne to table his Adjournment matter on a health issue.

Thomas Byrne (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I am grateful to the Senator. I must attend an engagement so I owe her a favour. I also thank the Leas-Chathaoirleach for his stewardship of the Seanad this week and for allowing me to speak twice during the Adjournment debate. I appreciate his efforts.

In County Meath there are significant issues that need a response from the Government this evening or this week. My issue relates to the future provision of services at Our Lady's Hospital, Navan. The matter is urgent, particularly in light of the recent proposal to group hospitals. The Navan hospital is now part of the miscellaneous group that includes hospitals as far away as Wexford and Kilkenny.

Yesterday the report entitled Securing the Future of Smaller Hospitals: A Framework for Development was published. What services will be provided in Navan in the future? Paragraph 3.2, overview of services at a Model 2 hospital, clearly states: "The hospital will have a daytime Urgent Care Centre comprising a Medical Assessment Unit and Local Injuries Unit which will be open where feasible 7 days a week." With regard to an intensive care at Navan hospital, paragraph 3.3, medical and critical care services for a model 2 hospital, states: "This hospital will not have an ICU."

I am also concerned about the provision of orthopaedic services. The Navan hospital has been grouped with a number of hospitals, including Cappagh Orthopaedic Hospital. Does that mean that services will be moved out of Navan hospital? I am aware of one Meath person who is due to undergo an operation this week at the orthopaedic unit of the Navan hospital and will need an ICU bed post-operation. I understand from the report that such a person, even if orthopaedic services remained at Navan, would not be treated there due to the closure of the ICU unit, as per the smaller hospitals report.

Contrary to the contents of the smaller hospitals report, local Fine Gael Deputies have been out and about and stated in the media that the report was wrong about the services and that they will not close. I seek clarity from the Minister on the future provision of services at Our Lady's Hospital, Navan. The provision of hospital services is a huge issue in County Meath and 15,000 people protested in October 2010. At the time the Minister for Health and Children gave an assurance that services in Navan would not be downgraded. The new report suggests a change of mind and that he broke his promise.

In the weeks approaching the 2011 general election the Fine Gael team in Meath gave a commitment to provide a regional hospital for the north east in Navan. At the time they said that they were working on the initiative with a number of investors who could participate in a public private partnership. Today's Adjournment is a good forum to debate the matter. Yesterday the hospital report was published but there was no Topical Issues debate on it in the Dáil. I do not know if there will be a Topical Issues debate today on the subject. The Seanad is a good forum to seek a clear answer from the Government on the future of Our Lady's Hospital, Navan.

Dinny McGinley (Donegal South West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Senator for raising the matter on the Adjournment. I am not aware that it was debated in Dáil yesterday. I do not think that it was.

Thomas Byrne (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

That is what I said.

Dinny McGinley (Donegal South West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I am taking the Adjournment matter on behalf of my colleague, Deputy James Reilly, the Minister for Health. I thank the Senator for raising the matter and for the opportunity to discuss the reports that were launched on Tuesday. They signal a fundamental modernisation of the health system in line with best practice.

We know that the traditional practice of providing as many services as possible in every hospital is neither sustainable nor safe. The formation of acute hospitals into a small number of groups, each with its own governance and management, will provide an optimum configuration for hospital services to deliver high quality, safe patient care in a cost-effective manner. In the longer term, each group's viability and future prosperity will be realised by its ability to deliver a comprehensive range of services across the group.

The establishment of hospital groups will see small and larger hospitals working together as one. This is a key foundation stone for the eventual abolition of the HSE and the introduction of universal health insurance for the people. These huge reforms will take time but the establishment of hospital groups is a significant milestone in achieving the vision set out in the Future Health initiative.

Securing the Future of Smaller Hospitals: A Framework for Development, which the Minister also published on Tuesday, offers clear information about the role of our smaller hospitals and what they will do in the future. The framework focuses, in particular, on the role of nine smaller hospitals, including Our Lady's Hospital, Navan.

The hospital has the potential to carry out more complex surgery than most of the other smaller hospitals. More patients will be treated in Navan as part of the new hospital group. The hospital will do more work in a large number of areas including day surgery, diagnostics, rehabilitation and chronic disease management. Accident and emergency services will continue on a 24-7 basis as capacity issues within the group remain unresolved. Endoscopy services will be enhanced. Elective endoscopy and day surgery services will be further developed, including general surgery, gynaecology and urology to maximise utilisation of resources and reduce waiting times. Outpatient services will also be expanded. Discussions will commence immediately within the group to draw up a plan to address the issue in the context of the strategic plan which the group must develop within a year of its formation.

All hospital groups are required to submit a strategic plan in which to outline its plans for future services within the group area. Consultation will be a key component of this planning, including consultation with local communities. Smaller hospitals will play a crucial role in the delivery of services. The framework for smaller hospitals commits to the expansion of services delivered in smaller hospitals, especially in services such as day surgery, ambulatory care, medical services and diagnostics. In this regard, a new ED-minor injury unit is being constructed in Our Lady's Hospital, Navan.

When groups are established services can be exchanged between sites. This will result in the maintenance of activity in smaller hospitals. It will allow them to focus on the provision of high volume less complex care that is safe and appropriate. The measure is intended to lead to significant increases in overall activity in these hospitals providing care as close as possible to the local people's home.

Thomas Byrne (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The people of Meath will greet the Government's statement with great disappointment. Today is the first time that I have heard the new emergency department in Navan referred to as the "new minor injury unit". That is its formal description in the Government's reply. I am not making a personal attack on the Minister of State. He simply read the statement on behalf of the Minister who did not attend. We have been told that a new accident and emergency department is being constructed but today it was described as an "ED-minor injury unit". That would accord with the smaller hospitals framework document.

The Minister and the Government have stated:

Accident and emergency services will continue on a 24-7 basis as capacity issues remain unresolved. Discussions will commence immediately within the group to draw up a plan to address the issue in the context of the strategic plan which the group must develop within a year of its formation.

As I see it, services in Navan, particularly the accident and emergency department and the intensive care unit, are on death row. They are continuing for now but plans are afoot to get into the detail of how they will be stopped. That is completely wrong and unfair, particularly in light of the fact that the regional hospital has been taken out of the picture and that Navan is outside of the group containing the other hospitals in the north east, which I find astonishing. Now we have to wait to see what the capacity issues in the Mater Hospital are before anything happens in Navan. There will be huge disappointment in County Meath in this regard and I will pursue the matter with the Minister for Health himself in due course.

Denis O'Donovan (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

While I note the Senator's comments, it is only fair to point out that Deputy McGinley is only the bearer of the message.

Dinny McGinley (Donegal South West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

As I have said, the Senator's message will be conveyed to the Department and in the absence of the Minister, I must say that I believe the Senator is being overly pessimistic about Navan. Construction work is going on there at the moment and units will be built. However, we all know that if there is major trauma involved, patients will have to be transferred to one of the larger hospitals. In Donegal, such patients must go to Beaumont Hospital in Dublin. With all due respect, patients in Navan would not have to travel the same distances. The short response I have just read contains a list of guarantees which should reassure the people of Navan that their hospital will continue to operate as a vital cog in the wheel of health services provision for the people in the eastern region.