Billy Kelleher (Cork North Central, Fianna Fail)
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Question 509: To ask the Minister for Health when will the review of orthopaedic services at St Mary's Orthopaedic Hospital Cork be completed; when the findings will be published; if the opinion publicly expressed by him prior to the general election that there would be no downgrading of services at St Mary's prevail regardless of the outcome of the review; and if he will make a statement on the matter. [17456/11]

James Reilly (Dublin North, Fine Gael)
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I am committed to ensuring that acute hospital services at national, regional and local level are provided in a clinically appropriate and efficient manner. In particular, I want to ensure that services are provided safely and in the setting most appropriate to patients' needs.

I have made it clear previously that I intended to consider the current provision of orthopaedic services in St Mary's fully before any move went ahead. I also had to take into account the unprecedented economic and financial situation the country is facing and the requirement to reduce public spending in line with the EU/IMF programme. In order to fully consider the issues involved in the proposed changes to the delivery of regional orthopaedic services in Cork and Kerry, I have recently held discussions with the Health Service Executive, including senior clinicians, and with local representatives.

I have now reflected and considered the matter and it is my view that, on balance, the move of orthopaedic services should go ahead as planned. The relocation of services to the South Infirmary Victoria University Hospital will provide a range of improvements in the facilities for, and the efficiency of, elective surgery for the people of Cork and Kerry, including the recommencement of paediatric orthopaedic services in Cork and an increased level of elective surgery.

I have also made it clear that health services should continue to be provided at the St Mary's campus, including the planned Urgent Care Centre and outpatient services linked to the Mercy University Hospital along with other services. There is also potential, in line with my determination to develop primary care services, for a primary care centre, which I have asked the HSE to examine. This could provide much needed services to the area, which is one of particular social disadvantage. However I am making no commitment in this respect and I would want to be assured of the position of the relevant General Practitioners before taking any further action.

It is essential that there be a full engagement with the staff of St Mary's in relation to their relocation and also to address any clinical or other concerns that they have. I have asked the HSE South to begin this process immediately.

Olivia Mitchell (Dublin South, Fine Gael)
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Question 510: To ask the Minister for Health the reasoning behind the decision to stop maternity hospitals facilitating mothers who wish to have their cord blood stem cell procured for future possible use; and if he will make a statement on the matter. [17463/11]

James Reilly (Dublin North, Fine Gael)
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Cord blood is a source of stem cells, which have proven therapeutic benefit for a number of conditions, principally the treatment of blood conditions. Stem cells may also be obtained from bone marrow. It is important to note that many potential benefits of stem cells are at very early investigative stages and will require substantiation through clinical trials.

Ireland does not currently have a public cord blood bank. At present, when clinically indicated by a consultant overseeing care, collection of cord blood for donation to an identified family member in high risk families is facilitated by HSE hospitals in collaboration with the Irish Blood Transfusion Service. In addition, where an identified clinical need arises, Ireland has access to cord blood stem cells through international stem cell banks and registries and this is also arranged by the Irish Blood Transfusion Service.

Collection of cord blood for private use in low risk families is not provided publicly in Ireland. While recognising that science in this area is evolving, the HSE sought and considered expert professional clinical opinion as well as legal advice in relation to this matter. As a result, it has determined that staff at hospitals operated or funded by the HSE should not undertake the procurement of cord blood for commercial entities. The HSE must ensure that evidence-based, safe, effective and high quality care is provided to patients and their families. In addition, the contracting of staff employed at hospitals operated or funded by the HSE, to undertake the collection of cord blood on behalf of commercial companies, was outside the cover provided under the Clinical Indemnity Scheme.

Any hospital wishing to accommodate staff directly employed by third party commercial entities to undertake the procurement of cord blood at hospitals operated or funded by the HSE must therefore ensure that all appropriate arrangements are in place within the context of a robust clinical governance framework to control risks associated with the service. A contract, or service level agreement, should be in place between the third party commercial entity and the hospital concerned. Policies, procedures and guidelines are required to govern how the service is provided. Hospitals and their maternity service teams face significant challenges in ensuring a robust clinical governance framework to support a safe and high quality maternity care system. My Department will keep the emergence of clinical benefits of cord blood banking under constant review. While the HSE's primary objective is to ensure that there is a safe and high quality maternity service it should correct this anomaly that has not allowed the banking of cord blood cells in cases where patients are anxious for this to happen and are prepared to fund the cost so that no additional cost is borne by the hospital.