asked the Minister for Health if he will define the necessary level of services for the local community which a county hospital should provide.
Ceisteanna—Questions. Oral Answers. - County Hospital Community Services.
1.
In my reply to a question by the Deputy on 6 April 1978 (Official Report Volume 305, columns 242 and 243) I outlined the various levels at which acute general hospital services would be provided as follows:
On the first level, community specialities such as general medicine, general surgery, obstetrics, gynaecology and paediatrics will be provided in general hospitals to cater for the immediate catchment area of the hospital.
On the second level, regional specialties such as orthopaedics, ENT ophthalmology and urology will be provided in a number of larger hospitals.
On the third level, services of a highly specialised nature will be provided in a very limited number of centres, mainly in Dublin and Cork.
The services to be provided in each general hospital, including county hospitals will be determined in consultation with the local health board taking into account the over-all organisation of general hospital services in each health board area and having regard to the requirements of the catchment population of each hospital.
Did I understand the Minister to say that at the first level in the county hospitals services in obstetrics, gynaecology, and paediatrics will be provided?
Yes.
In how many county hospitals are those services being provided?
It is a long list. I will supply the information to the Deputy.
As the Minister is aware, in certain county hospitals the intention is to phase out those services. He is aware of the particular hospital to which I am referring.
What particular hospital is the Deputy referring to?
It has been exercising our minds and using the time of the House in the past week. Is it not clear that the situation, as Comhairle na nOspidéal appear to want it, would result in the lack of those services at Roscommon County Hospital?
The Deputy is not informed on the position. The situation is that the Comhairle na nOspidéal proposals and the federation proposals envisage what many people regard as a satisfactory level of maternity services in Roscommon hospital.
Would the Minister accept that a service which did not include the services of specialist staff would be acceptable as first-level services as defined in Government policy?
I do not understand the question.
Is the Minister suggesting that, in the first-level services which he outlined in his reply, an acceptable level of service would be a service which did not include the full-time service of consultant staff?
The provision of services in county hospitals is primarily a matter for the health board in each case, having regard to the general structure of the service in the area. Each area has to be considered on the elements involved in its own situation. If I may come back to Roscommon hospital, I want to assert that the federation arrangements were worked out between the health board and Portiuncula under the chairmanship of an officer of my Department. As far as those participating in the talks were concerned, the arrangements were satisfactory and had the approval of Comhairle na nOspidéal. Excellent medical opinion was of the view that the level of service to be provided in Roscommon was completely adequate for the purpose and represented a good solution to the problem. For some reason best known to themselves, the Western Health Board decided not to adopt those proposals. The Deputy need not continue to flog this issue any further at this stage because Comhairle na nOspidéal are meeting the Western Health Board to discuss the situation further. At that meeting a solution may emerge. If a solution does not emerge, I have indicated that I am prepared to meet the Western Health Board after that meeting to discuss the situation further. If the Deputy were being responsible he would be prepared to accept the situation as it stands and let us see if some rational and sensible solution can be worked out.