Denis Naughten (Roscommon-South Leitrim, Fine Gael)
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Question 174: To ask the Minister for Health the impact to the provision of acute services in County Roscommon of the redesignation of up to 20 acute medical beds at Roscommon County Hospital as step-down rehabilitation beds; the reason other acute hospitals servicing County Roscommon have failed to transfer back to Roscommon County Hospital non-critical acute medical patients from the county even after being requested to do so by local consultants on foot of its accident and emergency department being taken off call; and if he will make a statement on the matter. [28981/11]

James Reilly (Dublin North, Fine Gael)
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The HSE plan implementing the changes to the Emergency Department Service at Roscommon County Hospital came into effect in July. The Urgent Care Centre now in place at Roscommon operates from 8am to 8pm seven days a week and is provided by non-consultant hospital doctors (NCHDs) with clinical governance provided by an Emergency Medicine Consultant at Galway. In addition there is a Medical Assessment Unit at the Hospital and an out of hours GP service is in operation. An enhanced ambulance service has been put in place.

The changes at Roscommon were necessitated by the serious patient safety concerns of the HSE and of the Health Information and Quality Authority in relation to the accident and emergency service at Roscommon following the publication of the Authority's Report on Mallow Hospital in April 2011. This was compounded because of NCHD recruitment difficulties.

Roscommon County Hospital has a clear future and will continue to provide acute hospital care for the population of the Roscommon area. It will do this as part of a wider network of acute hospitals across the Western area and it will be supported by the other hospitals in the region.

I believe that smaller hospitals can and should provide as wide as possible a range of services, close to the local community. The key concern is that they are safe. A framework for the development of smaller hospitals is being prepared. The HSE has been asked to work up detailed draft proposals in this regard which will take account of the results of consultation with stakeholders.

The framework will specify what services will be transferred to smaller hospitals. Too often the focus has been on taking away services from smaller hospitals rather than on the services that they can provide.

I am pleased that services at Roscommon have recently been enhanced with the establishment of outreach plastic surgical services at the hospital. This is the first of a number of service enhancements at Roscommon. The issue of locating a satellite service centre of the National Rehabilitation Hospital at Roscommon is also actively being examined in the context of enhancing the hospital's role. I fully support the role of smaller hospitals like Roscommon in providing for patients whose care no longer requires them to be treated in larger centres. The transfer of patients back from surrounding hospitals occurs when the patient's acute care is complete, and by agreement with the patient, the referring consultant and the receiving consultant.