Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 57: To ask the Minister for Health and Children if she will intervene to prevent the removal of all acute in-patient services from Monaghan General Hospital, as planned for 31 May 2009; and if she will make a statement on the matter. [20655/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Transformation Programme for the North East region has been informed by the Teamwork Report to the Health Service Executive (HSE) which demonstrated that the service configuration in the region was unsustainable. A series of focused and necessary service changes are being implemented across the region.

The transfer of acute medical care from Monaghan General Hospital to Cavan is subject to a number of dependencies first being in place, including the development of an enhanced ambulance and pre-hospital thrombolysis service. The recently opened Medical Assessment Unit at Cavan will also support the transfer of services from Monaghan. The timeframe for this transfer is currently under review by the HSE. The changes proposed by the HSE, which I support, are for reasons of patient safety. The HSE will continue to work with all stakeholders to bring about the improvements in a carefully planned way that puts patients first.

Bernard Durkan (Kildare North, Fine Gael)
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Question 58: To ask the Minister for Health and Children the position in regard to the future development and delivery of the health services for children; the degree to which it is intended to continue the provision of services at such locations as Our Lady's Hospital for Sick Children, Crumlin, Dublin; if it is intended to reduce, downscale or in any other way reduce or interfere with the standard and quality of services available there; if she has authorised a reduction in the budget to Crumlin or other hospitals in order to meet economic guidelines; her views on the anxiety and concern of the parents of sick children at such a prospect; if she will give an assurance that there will be no attempt in any way to reduce the scale and quality of services for sick children but on the contrary will indicate the way it is intended to provide an increased and improved paediatric service; and if she will make a statement on the matter. [20647/09]

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Question 72: To ask the Minister for Health and Children if she will intervene to prevent the closure of wards at Crumlin Children's Hospital, Dublin. [20658/09]

Joanna Tuffy (Dublin Mid West, Labour)
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Question 123: To ask the Minister for Health and Children if she will reverse the decision in relation to the closure of wards and cutbacks in Our Lady's Hospital for Sick Children in Crumlin, Dublin; and if she will make a statement on the matter. [20884/09]

Bernard Durkan (Kildare North, Fine Gael)
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Question 135: To ask the Minister for Health and Children her plans for the future of Our Lady;s Hospital for Sick Children in Crumlin, Dublin; if action is being taken that can ultimately lead to a diminution of services available at the hospital which in turn will cause anxiety, concern and distress for the parents of sick children; and if she will make a statement on the matter. [20906/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 58, 72, 123 and 135 together.

The provision of high quality hospital services for children will continue to be a priority for the Government. The Children's Health First Report commissioned by the Health Service Executive indicated that the population and projected demands in this country can support only one world class tertiary paediatric hospital. It recommended that the hospital should be in Dublin and should, ideally, be co-located with a leading adult academic hospital. Following detailed consideration, it was decided that the most appropriate location for the new National Paediatric Hospital is at the Mater Hospital. The hospital will also include an associated Ambulatory and Urgent Care Centre at Tallaght which is to open in advance of the main hospital.

The Government is committed to the development of the National Paediatric Hospital as a priority. The project is proceeding as planned and is being overseen by the National Paediatric Hospital Development Board which was established in May, 2007. The HSE is working closely with the Board in progressing the project, which is scheduled for completion in 2014. Services will continue to be supported and developed at Our Lady's Children's Hospital until such time as the new National Paediatric Hospital is opened.

In common with all hospitals, Our Lady's Children's Hospital, Crumlin is facing considerable challenges in delivering a high quality service to its patients, while remaining within budget. The Hospital is committed to providing the full level of services that it promised in its service plan for 2009. The top priority will be to protect patient care. So far this year, Crumlin Hospital has delivered more treatments to patients than for the same period last year. In the first three months of 2009 there were 2,745 treatments for children as in-patients and 3,841 as day cases– up by 244 over 2008. Crumlin also had 21,252 attendances at the out-patient department – up by 1,041 from the first quarter of last year.

The allocation to Crumlin for 2009 is €139.6m, an increase of some 39% over the last five years. There was a reduction of 3% this year, in line with the budgetary constraints we face across the system. A particular challenge for the Hospital is that it is operating at some 100 posts above its employment ceiling – it employed 1,650 people (wholetime equivalents) at the end of March compared with its ceiling of 1,550. This is contributing to its current financial difficulties.

The HSE is working closely with Crumlin Hospital to achieve an agreed programme of savings, totalling €6.5m this year. The focus of these savings will be on non-pay areas of expenditure and on protecting front-line services. On this basis, the HSE believes that the Hospital will achieve a break-even position this year.

I believe that we need to look now in a more strategic way at the way in which we provide paediatric services in Dublin. In 2009 the Government will provide over €250m for the running of three paediatric hospitals in Dublin – Crumlin, Temple Street and Tallaght. I believe that we can achieve significant cost savings if services and practices are more closely integrated across the three hospital sites, even before the new National Paediatric Hospital has been completed. With this in mind, the HSE is pursuing ways in which services across the three hospitals can best be co-ordinated, to avoid unnecessary duplication and to achieve savings that can be put back into patient care.