Written Answers. - Hospital Services.
Liz McManus
Question:
237
Ms McManus
asked the
Minister for Health and Children
the national specialities, if any, approved in hospitals (details supplied); and the level of non-capital expenditure in 1999 compared with 1998 for those specialities.
[6815/99]
Liz McManus
Question:
240
Ms McManus
asked the
Minister for Health and Children
the regional specialities, if any, approved in hospitals (details supplied); and the level of non-capital expenditure in 1999 compared with 1998 which pertains solely to each of those regional specialities.
[6818/99]
I propose to take Questions Nos. 237 and 240 together.
Comhairle na nOspidéal was established under the Health Act, 1970 (No. 1 of 1970). Its statutory functions are defined under section 41(1) of that Act and include the regulation of the number and type of consultant appointments to hospitals, the provision of advice to the Minister on matters relating to the organisation and operation of hospital services and the preparation and publication of reports relating to hospital services.
In January 1977, a joint working group of the Department of Health and Comhairle na nOspidéal produced a discussion document on the development of specialist services in Dublin. Following this, a final report was published in July 1980 which set out the designations of specialities within the Dublin hospitals in terms of regional, hospital and service units. This report would still be used by Comhairle na nOspidéal as a reference point in considering implications for consultant appointments to Dublin hospital services. However, both Comhairle and the Department would also take into account factors such as developments in medical technology, changing demographics and increasing specialisation in medical practice.
With regard to the Deputy's question regarding national specialities, as I stated in my reply of 2 March 1999, there are a number of formally designated national speciality services within individual hospitals in Dublin. These would include the National Cardiac Surgery Unit at the Mater Hospital, the National Liver Transplant Centre at St. Vincent's Hospital and the National Neurosurgery Centre at Beaumont Hospital, by way of example. In addition, some of the major acute providers offer services which are considered as national specialities by virtue of the degree of specialist expertise which has been developed within the relevant hospitals by individual consultants or the specialties concerned.
National and regional specialties are provided as part of the individual hospital's overall services and as such are resourced within the hospital's total annual determination. The development of these centres of particular expertise is often due to the existence within the hospital involved of a range of complementary skills and technologies. It would not be possible to provide a breakdown of allocations to individual national and regional specialities.
In the context of the proposed establishment of the new Eastern Regional Health Authority, there are a number of critical issues which fall to be considered regarding future arrangements for the formal designation of and funding arrangements for national specialty services. My Department has indicated to the chief executive officers of the major hospitals that this issue is currently under detailed consideration within the Department. We will be discussing the matter further with the hospitals and health boards in due course.
The basis for the designation of national and regional specialities must also be seen within the context of my Department's policy objectives for regional self sufficiency in the delivery of acute services. The health strategy "Shaping a Healthier Future" identified a number of priorities in this regard including the achievement of self sufficiency in regional specialties within each health board area and the provision of a small number of highly specialised tertiary or supra-regional units which would service much wider catchment areas and concentrate resources nationally to best effect. My Department is conscious of the need to continue to improve efficiencies in the delivery of acute services, both at regional and national level and to ensure that the patient interest is served at all times. The recently announced proposals for the establishment of joint structures for both the paediatric and maternity services serve as an example of a departmental initiative in this area. My Department is considering the scope for developing other collaborative networks within the acute sector with the aim of improving service provision at local, regional and national levels.
