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Dáil Éireann debate -
Thursday, 19 May 1977

Vol. 299 No. 9

Ceisteanna—Questions. Oral Answers. - Hospital Closures.


asked the Minister for Health if he will make a statement on the circumstances in which a decision is taken to close a hospital or terminate services in it.

Generally, a decision to close a hospital or to terminate services in it would be taken where the retention of the hospital or the continuance of the services was no longer the best way to meet the needs of the community which it serves. A further consideration would be the need to ensure the optimum use of available resources.

The complete closure of a hospital would, of course, be very rarely contemplated but changes of user where particular services are discontinued do take place, for example in relation to the conversion of tuberculosis hospitals for other purposes.

A health board may not close a hospital without the consent of the Minister and the Minister may not direct a health board to close a hospital without the holding of a public inquiry into the desirability of the discontinuance of the hospital.

Must the initial steps not come from either the Minister or the CEO?

That is not the position. First of all, I have explained the position in regard to the closure of hospitals. Comhairle na nOspidéal play a major part. They have to take into consideration the use made in a hospital of such things as maternity services. If it appears to an comhairle that services are not being availed of to the fullest extent in a hospital they have a right to decide whether a particular service would remain there.

The Minister has said that the needs of the community are the prior consideration. Would this not be a decision in the first place for the CEO and would it not then be necessary for the Minister to approve?

Perhaps in the initial stages it may be a matter for the CEO and the health board but in the final stages it is Comhairle na nOspidéal who decide which consultants should be assigned to a particular hospital. The matter of appointment of consultants is entirely in the hands of Comhairle na nOspidéal.

Does the Minister not agree that section 38 of the 1970 Act which deals with the maintenance of hospitals has reference to the health board, with the Minister's approval, and that there is not anything in it in regard to Comhairle na nOspidéal? Is that not the relevant section?

The Deputy must know that Comhairle na nOspidéal decide whether or not consultants will be assigned to a certain hospital. It may be that the health board or the CEO think differently but, ultimately, it is Comhairle na nOspidéal who decide what consultants, if any, will go into that hospital.

Would the Minister quote the statutory authority for that, how many Health Acts say that Comhairle na nOspidéal have the right to declare a hospital, or services in a hospital closed?

I am afraid I cannot quote directly from the Act now but if the Deputy would repeat his question next week I will be glad to give him the information.

It will come up on the next question.