Pat Breen (Clare, Fine Gael)
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Question 326: To ask the Minister for Health and Children if she will meet a delegation comprising the four Clare Oireachtas Members and members of Clare County Council to discuss the proposals published in the review of acute hospital services in the Health Service Executive mid-west and the implications of these proposals for the future of 24-hour accident and emergency services at Ennis General Hospital; and if she will make a statement on the matter. [1409/09]

Pat Breen (Clare, Fine Gael)
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Question 383: To ask the Minister for Health and Children, further to Parliamentary Question No. 539 of 24 September 2008, when she will publish the review of the acute hospital services report into services in the mid-west region; and if she will make a statement on the matter. [1123/09]

Pat Breen (Clare, Fine Gael)
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Question 384: To ask the Minister for Health and Children, further to Parliamentary Question No. 650 of 24 September 2008, her plans for Ennis General Hospital, County Clare; when the €39 million refurbishment of the hospital will commence; if accident and emergency services at the hospital are to be curtailed; and if she will make a statement on the matter. [1124/09]

Pat Breen (Clare, Fine Gael)
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Question 427: To ask the Minister for Health and Children her views of the proposals to centralise accident and emergency services in the mid-west region; and if she will make a statement on the matter. [1410/09]

Pat Breen (Clare, Fine Gael)
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Question 428: To ask the Minister for Health and Children if she will meet a delegation comprising the four Clare Oireachtas Members and members of Clare County Council to discuss the proposals to end 24-hour accident and emergency service at Ennis General Hospital; and if she will make a statement on the matter. [1411/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 326, 383, 384, 427 and 428 together.

The Government is committed to ensuring the delivery of the best quality health services possible, in an effective and efficient way. Ensuring patient safety is of paramount importance, so that people can have confidence in the services and that the best possible patient outcomes can be achieved. There is significant international and national evidence that acute complex health care, particularly for emergency medicine, complex surgical services and critical care should be provided in hospitals which are suitably staffed and equipped and which undertake sufficient volumes of such activity, in order to maximise clinical outcomes and ensure safe services. At the same time there is a significant range of less complex care which can continue to be provided safely in smaller hospitals.

Reorganisation of services must of course occur in consultation with the key stakeholders and on an incremental basis. I believe that it is important to work with health professionals and other interested parties to secure an increasing set of improvements over time. This approach will, I am confident, produce the best outcome for patients. The Health Service Executive has recently published the report which it commissioned from Horwath Consultants in association with Teamwork Management Services to examine the arrangements for the provision of acute hospital services in the Mid-West with a view to identifying the best configuration of such services in the region.

The Executive has indicated that certain changes to the present arrangements for the provision of some acute services must be made, in the interests of patient safety and also to make best use of the clinical resources available within the region. Detailed plans are currently being formulated by the HSE in relation to emergency care, critical care and surgical services. I have asked the HSE to furnish the Deputies with more detailed information on the changes proposed.

I have asked the HSE, in the context of the development of its capital plan, to consider the requirements of the Mid-West arising from the planned reconfiguration of services in the region. The HSE has submitted a draft capital plan which sets out its proposed short- and long-term priorities in the context of funding notified as part of Budget 2009 and changes in construction costs. Consultation on the draft capital plan is ongoing between the HSE and my Department. The Executive is currently engaged in providing additional clarification on its proposed capital developments. I have agreed to meet shortly with Oireachtas members and a delegation from Clare County Council to discuss the proposals being drawn up by the HSE.