Martin Ferris (Kerry North-West Limerick, Sinn Fein)
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Question 19: To ask the Minister for Health the action he will take to address the overcrowding and threats to patient safety that led nurses to take industrial action in the Mid-Western Regional Hospital, County Limerick; and if he will make a statement on the matter. [26388/11]

James Reilly (Dublin North, Fine Gael)
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I do not believe that any useful purpose is served by this industrial action. I am concerned that a further stoppage has happened today and would urge the INMO to reflect on the impact which these actions have on the general public.

I also find it hard to reconcile the fact that the nursing unions are taking this industrial action, given that they are parties to the Public Service Agreement, particularly as the agreement focuses on the need to deliver services in the changed circumstances which we now find ourselves in and with co-operation between management and unions. The shared focus of all those working in the health service should be on safeguarding front-line care in the face of the continuing very serious economic situation. The Mid-Western Regional Hospital Limerick was €16.2m over budget at the end of July 2011. Accordingly, it has had to take measures to reduce its spending, including a prohibition on staff overtime and on hiring agency staff.

As in all areas of the economy and the public service, we must focus on solutions, including efficiency, flexibility and innovative working, to allow us to maintain our public services in the face of economic crisis.

Industrial action by any group will simply exacerbate our country's problems and, in the case of nurses, may negatively affect patient care.

In recent months I have established the Special Delivery Unit (SDU), under the leadership of Dr Martin Connor. The SDU is working to unblock access to acute services by improving the flow of patients through the system. It is focusing initially on emergency departments and will be working to support hospitals in addressing excessive waiting times for admission to hospital. The SDU is due to submit a report to me on Limerick on Thursday. I look forward to the cooperation of all health service staff with the work of the SDU, which is aimed at ensuring that patients receive a safe and appropriate service when they present at our acute hospitals. In the case of Limerick, it is vital that we focus on solutions, including the introduction of new rosters and the redeployment of nurses to areas of greatest need in the hospital. New rosters become even more important in light of the need to maintain and improve services in a financially constrained context.

In relation to pressures in the emergency department, it is clear that risk issues arising from overcrowding should be regarded as a problem for the entire hospital to deal with. Hospital management cannot accede to a demand that no extra beds should be put up in wards. This is provided for in the escalation policy and represents a lesser risk than allowing an unsafe build-up of trolleys in the ED.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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Question 20: To ask the Minister for Health if any assessment has been done as to the likely impact on the accident and emergency at St. Vincent's Hospital, Dublin, as a result of the proposed downgrading of the 24 hour accident and emergency at St. Columcille's Hospital, Loughlinstown, County Dublin; and if he will make a statement on the matter. [26374/11]

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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Question 38: To ask the Minister for Health if the budgets, staffing levels and bed numbers currently in place for St. Columcille's Hospital, Loughlinstown and St. Vincent's Hospital, Dublin, will remain the same or see reductions following the proposed re-configuration of accident and emergency services; and if he will make a statement on the matter. [26375/11]

Joan Collins (Dublin South Central, People Before Profit Alliance)
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Question 42: To ask the Minister for Health if he will provide details and dates of all the planned downgrading of the 24 hour accident and emergency at St. Columcille's Hospital, Loughlinstown, County Dublin; the date on which this proposal is due to be implemented; and if he will make a statement on the matter. [26428/11]

Joan Collins (Dublin South Central, People Before Profit Alliance)
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Question 44: To ask the Minister for Health the plans that are in place in terms of staffing and budgets at St. Vincent's Hospital, accident and emergency, in view of the threatened downgrading of the 24 hour accident and emergency at St. Columcille's Hospital, Loughlinstown, County Dublin; and if he will make a statement on the matter. [26376/11]

James Reilly (Dublin North, Fine Gael)
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I propose to take Questions Nos. 20, 38, 42 and 44 together. Acute hospital services in the HSE Dublin South / Wicklow Area, are provided through a collaborative arrangement across three sites, St. Vincent's University Hospital (SVUH), St. Michael's Hospital (SMH) and St. Columcille's Hospital (SCH).

The configuration of services in the area has been under continued review and reorganisation for some time in the interest of improving access and quality of service to the local population.

The HSE is currently carrying out a collaborative study and consultation process across the three sites.

The issues raised by the Deputies will be considered within this context.