Bernard Durkan (Kildare North, Fine Gael)
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Question 109: To ask the Minister for Health and Children the position in regard to delivering general hospital services in the future; if the original co-location plan is to continue; if her attention has been drawn to the concerns about the Children's Hospital Crumlin, in Tallaght and in Naas; the intention to proceed as planned to relocate to the Mater Hospital site, Dublin; if it is intended to retain the full scale of services at the Adelaide and Meath and Crumlin Hospitals; if it is intended to provide centre of excellence quality to services at these locations without restriction in the future; her plans to retain the maximum extent and quality of services at these locations; and if she will make a statement on the matter. [39266/09]

Mary Harney (Dublin Mid West, Independent)
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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. There is significant international and national evidence that acute complex healthcare, 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, especially in day surgery, medicine and diagnostics.

The approach being taken by the HSE in relation to the configuration of acute hospital services will result in a system which will facilitate the maximisation of patient outcomes and the further improvement of the health status of the population.

The renewed programme for Government re-affirms the Government's commitment to the current co-location programme. The procurement process which is underway will continue. Projects will be developed within the terms of those project agreements which have been signed or which may be signed. Value for public money criteria remain in place and are to be met by each project.

The way to provide the best possible paediatric tertiary care most effectively involves the creation of one single national paediatric hospital, alongside a major teaching hospital, bringing together all the medical and nursing expertise for complex conditions. The concept of bringing together all three present services is widely accepted.

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 located with a leading adult academic hospital in order to optimise the outcomes for children. Following detailed consideration, it was decided that the most appropriate location for the new National Paediatric Hospital is at the Mater Hospital.

I am aware that concerns have been expressed in the past by some members of staff and families of patients and others who currently access Our Lady's Children's Hospital and the National Children's Hospital at Tallaght. However, I welcome the recent decision by the hospital to participate fully in the development of the project and to nominate representatives to the National Paediatric Hospital Development Board.

In 2009 the Government will provide over €250 million for the running of three children's hospitals in Dublin – Crumlin, Temple Street and Tallaght. The HSE is now pursuing ways in which services across the three children's hospitals can best be co-ordinated, to avoid unnecessary duplication and to achieve savings that can be put back into patient care. 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. The three children's hospitals in Dublin have agreed and developed a model for the development of a joint department of paediatric surgery. The clinical network across the three hospitals will make the best use of the resources that are available and will ensure a 'single system of care.' A recruitment process is underway to recruit three replacement surgeons that will then give the joint department a complement of seven surgeons (currently five in place, with one due to retire shortly). It is anticipated that these posts will be filled by year end.

The HSE also commissioned a review of paediatric critical care facilities and services in 2008 with a view to addressing any identified deficits in advance of the opening of the new National Paediatric Hospital. Other areas currently being examined in relation to increased co-operation are in the areas of renal services, genetics, endocrinology and dermatology services amongst others.

The new National Paediatric Hospital is scheduled to become operational at the end of 2014. Pending completion of the project, the HSE will continue to finance the provision and development of services at each of the transferring hospitals. The new hospital will include an associated Ambulatory and Urgent Care Centre at Tallaght. which is to open in advance of the new hospital. The plans for this proposed Ambulatory and Urgent Care Centre (AUCC) are being developed in conjunction with the new paediatric hospital and it is proposed to have the AUCC at Tallaght completed in 2013.

I understand that paediatric patients who currently attend Naas General Hospital may be transferred to Tallaght where appropriate. These patients will continue to access services at the AUCC in Tallaght or at the new National Paediatric Hospital if their condition requires it.