Bernard Durkan (Kildare North, Fine Gael)
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Question 130: To ask the Minister for Health and Children if she will provide an assurance that there are no plans currently available or proposed to reduce in any way the scale, quality or future development of services at Naas General Hospital, Naas, County Kildare and that the Health Service Executive has not been given a mandate to determine such policies; and if she will make a statement on the matter. [20901/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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As this is a service matter it has been referred to the Health Service Executive for direct reply.

Bernard Durkan (Kildare North, Fine Gael)
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Question 131: To ask the Minister for Health and Children if she has given instructions or directives to the Health Service Executive to undertake a review of services at all regional and general hospitals here; if it is intended arising from same to reduce the scale and quality of services currently available at such locations; and if she will make a statement on the matter. [20902/09]

Bernard Durkan (Kildare North, Fine Gael)
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Question 136: To ask the Minister for Health and Children if reviews are currently under way throughout the hospital services with a view to re-centralisation which will result in diminution, downgrading or closure of some services at regional hospitals; and if she will make a statement on the matter. [20907/09]

Bernard Durkan (Kildare North, Fine Gael)
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Question 137: To ask the Minister for Health and Children the number of hospitals intended for closure or downgrading over the next five years; and if she will make a statement on the matter. [20908/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 131, 136 and 137 together.

There is no question of closing acute hospitals, or of "downgrading" the services they provide. The fundamental objective of Government health policy is to maximise the health status of the population. The Government is committed to ensuring quality health services, delivered efficiently and effectively. Ensuring patient safety is paramount, so that people can have confidence in the services and that the best possible patient outcomes are achieved.

It is widely recognised that treating a low volume of cases in higher-volume specialties is not conducive to optimal patient care. In order to ensure the best possible outcomes for patients, clinicians must be able to maintain their specialist skills by treating a sufficient number of cases. It is more difficult for specialists to maintain their skills in smaller hospitals when treating a low volume of patients. This has implications for how we organise acute services generally.

The HSE has commissioned a number of reviews in relation to how acute hospital services should be organised in particular regions. These reviews have highlighted the need for changes to be made in the provision and organisation of acute hospital services in the regions concerned, particularly in relation to accident and emergency services, critical care, and surgical services. Importantly, the re-configuration of services also involves developing smaller hospitals to provide a much greater proportion of less complex care, especially in day surgery, medicine and diagnostics. This underlines the fact that smaller hospitals can be reconfigured to provide important services for their local community, rather than being diminished or "downgraded".

The Government is committed to a process of change which is incremental and which involves appropriate consultation and discussion with those affected. The HSE is proceeding on this basis.

Question No. 132 answered with Question No. 10.

Question No. 133 answered with Question No. 23.

Question No. 134 answered with Question No. 69.

Question No. 135 answered with Question No. 58.

Questions Nos. 136 and 137 answered with Question No. 131.

Question No. 138 answered with Question No. 69.