Joe Carey (Clare, Fine Gael)
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Question 151: To ask the Minister for Health and Children if she will report on the discharge policy and procedures and its implementation for geriatric patients from Mid-West Regional Hospital Limerick subsequent and previous to the adopting of the Teamwork reconfiguration of accident and emergency; and if she will make a statement on the matter. [22113/09]

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

Joe Carey (Clare, Fine Gael)
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Question 152: To ask the Minister for Health and Children if she will report on the timeframe for implementation of outstanding elements in relation to medical services as outlined in the Teamwork report on the reconfiguration of acute services in the mid-west; and if she will make a statement on the matter. [22114/09]

Noel Coonan (Tipperary North, Fine Gael)
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Question 201: To ask the Minister for Health and Children when all beds, paramedics, emergency department consultants and ambulances promised for a hospital (details supplied) in County Limerick in the Teamwork report commissioned by the Health Service Executive will be delivered; the timeframe for same; the number that have already been put in place since services have been transferred to this hospital from Nenagh General Hospital as recommended in the report; and if she will make a statement on the matter. [22418/09]

Jan O'Sullivan (Limerick East, Labour)
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Question 205: To ask the Minister for Health and Children if, in advance of an estimated extra 3000 surgical cases being transferred from Nenagh, Ennis and St. John's to the Mid-West Regional Hospital, Limerick in July 2009, she will ensure that recommendation 13.3 of the Health Information and Quality Authority report on Ennis Hospital is implemented; if she will also ensure that the MWRH, Limerick has adequate capacity and staff to cope with the increased case load; and if she will make a statement on the matter. [22436/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 152, 201 and 205 together.

The fundamental objective of Government health policy is to achieve the best possible health status for the population. The Government is committed to ensuring quality health services are 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. 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.

The first phase of the reconfiguration of acute hospital services in the HSE Mid West involves 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. This took effect on the night of 6/7 April. In the context of the re-configuration process, the level of staffing of the ambulance services in Clare and North Tipperary has been enhanced and an advanced 24-hour paramedic service is also now in operation. Advanced paramedics are trained to a standard which equips them to provide more complex pre-hospital care than other personnel. This includes the administration of a wider range of drugs and the urgent assessment and treatment of patients with life threatening conditions. Protocols are in place to ensure that all trauma, paediatric and obstetric emergency cases brought directly to the major tertiary centre at Limerick Regional Hospital rather than to Ennis or Nenagh.

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. 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 Deputies in relation to the matters that they have raised.