Joe Carey (Clare, Fine Gael)
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Question 132: To ask the Minister for Health and Children if she will intervene in order to prevent the planned closure of 24 hour accident and emergency services at Ennis General Hospital, County Clare; and if she will make a statement on the matter. [14702/09]

Pat Breen (Clare, Fine Gael)
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Question 133: To ask the Minister for Health and Children the additional resources which have been put in place in view of the plans to close the 24 hour accident and emergency at Ennis General Hospital, County Clare going ahead from 6 April 2009; and if she will make a statement on the matter. [14704/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 132 and 133 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 the best possible patient outcomes can be achieved.

The HSE has commissioned a number of reviews in relation to how acute hospital services should be organised, including the Teamwork/Horwath Report in relation to the Mid-West region, which the Executive has recently published. The Report highlights the need for changes to be made in the provision and organization of acute hospital services across the region, particularly in relation to accident and emergency services, critical care, acute surgery and medicine. The Report found that the services were too fragmented, carried increased risks for patients and staff and were not sustainable in the future.

The HSE has indicated that certain changes to the present arrangements for the provision of some acute services, including accident and emergency services, must be made, in the interests of patient safety and also to make best use of the clinical resources available within the Mid West region. The HSE has been engaged in a consultation process with key stakeholders as it formulates detailed plans in relation to emergency care, critical care and surgical services in the region.

The HSE plans involve the reorganisation of the arrangements in Ennis and Nenagh so that these hospitals provide an urgent care/minor injuries service for 12 hours a day as part of a regional Accident and Emergency structure. These hospitals will also continue to admit appropriate medical cases. Protocols are in place to ensure that all trauma, paediatric and obstetric emergency cases will be brought directly to the major tertiary centre rather than the local hospital. As part of the new arrangements the ambulance services in North Tipperary and Clare have been enhanced and an advanced 24-hour paramedic service is in operation.

The plans also involve the reconfiguration of Acute Hospital services into a network and their better integration with primary care services across the region, with a regional centre at the Regional Hospital Limerick that will deal with complex and specialist cases. The changing nature of health service delivery is such that smaller hospitals can meet much of the demand for less complex services, especially those that are increasingly done on a day case basis. Day surgery and diagnostic service activity at Nenagh and Ennis will also be significantly enhanced.

I am satisfied that the measures being taken by the HSE are necessary and appropriate in order to ensure the provision of safe and effective health services to the people of the Mid West region. My Department has asked the HSE to respond directly to the Deputy in relation to the detailed operational issues raised.