David Cullinane (Sinn Fein)
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We have had several discussions on the Adjournment in the House and on a number of occasions when the Minister appeared before us to discuss the Higgins report and its implications for the Waterford Regional Hospital and the Waterford region. I was against the grouping for the south and the break-up of the south-east region. Having said that, once the Government made its decision we need to ensure that the promises and commitments given by Professor Higgins in his report, and later by the Government and the HSE, are followed through and honoured. We must ensure that we make the best of the new hospital grouping. We must support it as best we can in order to ensure that the services at the hospital are protected, maintained and enhanced.

As the Minister will know, two solid commitments were given in the Higgins report that would be positive and of benefit to the hospital. The first commitment was that the hospital would become a university teaching hospital with academic links to Cork University Hospital and the appointment of five academic consultants. Have the consultant posts been appointed? If not, when will they be appointed?

The second commitment given in the Higgins report was to provide 24-7 cardiology services at the hospital. The report dealt with structural change so it was strange to include such a commitment. We discussed the matter on the Adjournment. The report talked about enhanced cardiology services but when Professor Higgins and the Minister were pressed on the matter they said that the provision of a 24-7 cardiology service was the aim. That is what we want for the hospital and that promise and commitment was given to consultants at the hospital. I seek clarification on the matter. The Higgins report talked about enhanced cardiology services for Waterford Regional Hospital. Did that translate into 24-7 cardiology services? If it did, when will the service be provided? I ask the Minister to appraise us on whether all of the positions have been filled. As we know, once groups are established there must be a CEO, chair and board appointed. Have the positions been filled? If not, when will they be filled?

I want the Minister to update the House on the status of the new grouping, the work done since the publication of the report, the progress made and give a timeframe for work that is outstanding. The two critical areas I seek clarity on are the 24-7 cardiology service and the five consultant posts.

Finally, I spoke to consultants who work at the hospital who said that five consultant posts are needed to protect and enhance services. They are as follows: two colorectal consultants in general surgery, two anaesthetists and one gastroenterologist. I ask the Minister to update us on whether the posts will be allocated and filled in the near future.

James Reilly (Dublin North, Fine Gael)
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I welcome the opportunity to outline progress regarding the establishment of hospital groups and to outline the position with regard to Waterford Regional Hospital specifically in that context.

The Report on the Establishment of Hospital Groups, which I launched on 14 May, is the most fundamental reform of the Irish acute hospital system since the foundation of the State. The introduction of hospital groups will provide for organisational change in the first instance, giving more autonomy and better enabling the reorganisation of services in a well planned manner. Over time, this will help to improve services and, most importantly, deliver better outcomes for patients. That is what the health service is about - patient care and improving outcomes for patients.

In July, expressions of interest were invited through the Public Appointments Service for appointment as chairpersons and members of hospital group boards. I have now appointed Dr. Tom Lynch as chair of the Dublin East Hospital Group, Dr. Frank Dolphin as chair of the Dublin Midlands Hospital Group, Ms Anne Maher as chair of the Dublin North East Group and Professor Geraldine McCarthy as chair of the South-South West Hospital Group, to which Waterford Regional Hospital belongs. These appointments are in addition to the existing chairs of the West-North West Hospital Group, the Mid-West Hospital Group and the Children's Hospital Group with Prof. Niall O'Higgins, Mr. Noel Daly and Dr. Jim Browne being the relevant chairs, respectively.

The Senator mentioned CEOs. I can confirm that CEOs and boards are already in place for the three aforementioned hospital groups.

The process of recruiting CEOs for the Dublin East, Dublin Midlands, Dublin North East and South-South West Hospital Groups is ongoing and, to the best of my knowledge, advertisements have been published in the newspapers. An open competition was held through the Public Appointments Service with a closing date set for 12 December. It is anticipated that interviews will be held in early January.

My Department is also working with the chairmen, including Professor McCarthy, with a view to appointing the other board members as soon as possible. I believe that the chairs should have an input into the process as they will have to chair and work with the board members.

A strategic advisory group is being established by my Department, chaired by Mr. Leo Kearns. The strategic advisory group will oversee the establishment of hospital groups and the subsequent re-organisation of acute hospital services. Each group of hospitals will work together as a single cohesive entity managed as one in order to provide acute care for patients in their areas, integrating with community and primary care. This will maximise the amount of care delivered locally while ensuring complex care is safely provided in larger hospitals.

Hospital groups will be required, within one year, to develop a strategic plan that will outline their plans for future services within the group area. The strategic plans will determine the way services are provided within each group, including the South-South West Group and Waterford Regional Hospital within that group.

As was committed to at the time of the report's publication, Waterford will continue to operate as a cancer centre under the national cancer control programme.

It will be the hub for the south-east renal service, and a regional trauma centre including emergency department, ear, nose and throat, and ophthalmology. It will also continue to provide invasive cardiology services for the south-east population. I understand that the Health Service Executive, HSE, is currently examining options within the existing hospital for the location of the second catheterisation laboratory.

In addition, an undertaking was given that my Department and the HSE would work with University College Cork, UCC, to enable Waterford hospital become a university teaching hospital, and this work is ongoing. UCC will be the primary academic partner for the South-South West Hospital Group. This will be to the benefit of all hospitals in the group across all services including cancer services and in the areas of research, education and innovation, and will secure the future progress of Waterford Regional Hospital.

David Cullinane (Sinn Fein)
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I thank the Minister for his clarifications but unfortunately he has not addressed the two core issues I put to him. First, will we see cardiology services provided 24 hours a day, seven days a week at Waterford Regional Hospital? I accept what the Minister said about a second catheterisation laboratory. If that is in place will it enable the hospital provide cardiology services 24 hours a day, seven days a week, which is important? Second, I welcome the working towards Waterford becoming a university teaching hospital but it was promised five academic consultant posts. When will those posts be advertised and filled?

James Reilly (Dublin North, Fine Gael)
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The Senator will appreciate that the number of posts will be overseen by the new chief executive officer of the group and that those matters will come to pass in due course. I want to inform the Senator that the new chair, Geraldine McCarthy, was in the House today to meet with representatives of the Oireachtas from the Waterford area. I do not know if the Senator was aware of that but I understood all Deputies and Senators had been informed of that meeting.

David Cullinane (Sinn Fein)
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I was not.

James Reilly (Dublin North, Fine Gael)
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That is regrettable because she would be very interested to meet with all Oireachtas representatives. We will have to check if an e-mail was sent or what happened in that regard.

The future of Waterford Regional Hospital is critical to the south east. I believe its future is underpinned and strengthened by being part of a hospital group. This is one of the underlying principles that guides our health policy, which is that the patient should be treated at the lowest level of complexity that is safe, timely, efficient and as near to home as possible.

David Cullinane (Sinn Fein)
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I am interested in the provision of cardiology services on a 24 hour, seven days a week basis.

James Reilly (Dublin North, Fine Gael)
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Hospital treatments that should take place in model 3 hospitals should not be taking place in quaternary hospitals . There should not be services in model 3 hospitals that should take place in model 2 hospitals, and there should not be services in hospitals that properly belong to primary care.

David Cullinane (Sinn Fein)
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I am talking about 24 hours a day, seven days a week cardiology services.