Vol. 569 No. 3
84 Mr. Connolly asked the Minister for Health and Children the action he proposes to take in respect of the Cavan-Monaghan hospital; and the implications that this will have for hospital services in Cavan and Monaghan, and for the recruitment processes on both the hospital site and for the possibility of the Monaghan site coming back on call. [17764/03]
Responsibility for the provision of services within the Cavan-Monaghan hospital group rests with the North-Eastern Health Board.
Arising from the report of the independent review panel into the circumstances surrounding the death of baby Bronagh Livingstone, in December 2002, I appointed Mr. Kevin Bonner, management consultant and former Secretary General of the Department of Enterprise, Trade and Employment, to recommend an appropriate management structure for Monaghan Hospital, which operates within the Cavan-Monaghan hospital group, and to assist the North-Eastern Health Board in implementing the structure. I am aware that Mr. Bonner has been working closely with the board and relevant parties to facilitate a resolution to outstanding issues pertaining to the provision of services at Monaghan Hospital, with particular reference to emergency services. It is anticipated that Mr. Bonner's report will be finalised shortly.
As regards training posts, my Department is advised by the North-Eastern Health Board that it has been informed by the Royal College of Surgeons in Ireland that the RCSI council, on the advice of its basic surgical training committee, is to cease recognition of five posts in the department of surgery, Cavan General Hospital, for basic surgical training with effect from 30 June 2003. It was brought to the attention of the BST committee of the RCSI, through hospital inspectors' reports and through the regular counselling sessions for all trainees on the BST scheme, that interpersonal problems at the level of consultant surgeon in the unit were creating an environment that is not conducive to training.
The health board further advises that a group was set up by the BST committee to interview the Cavan trainees. The interviews highlighted a number of serious concerns. The chief executive officer of the North-Eastern Health Board is currently examining and considering a number of concerns and complaints relating to the unit which have been brought separately to his attention by the consultant surgeons.
I am informed that the chief executive officer sought the advice and guidance of the Royal College of Surgeons in Ireland regarding clinical issues raised. The response of the RCSI is currently being considered by the chief executive officer with a view to restoring recognition of the basic surgical training posts.
The North-Eastern Health Board advertised for fully registered candidates for the five posts in the department of surgery at Cavan General Hospital. Interviews have now taken place and a sufficient number of fully-registered candidates were selected to fill the available posts. The health board hopes, therefore, that all posts will be filled and services will continue as heretofore.
As regards Monaghan General Hospital, my Department is advised by the board that there are currently no vacant NCHD posts in the department of surgery at the hospital.
Will the Bonner report be superseded by the three reports, two of which are at hand and one of which is coming on stream, and, if so, what are the implications for Bonner? Bonner has stated that the report has cost implications but the difficulty is that he cannot get a meeting with the Department of Health and Children to discuss the implications. Monaghan General Hospital is now one year off call or, more importantly, off ambulance call. There is the ridiculous situation where an ambulance can pull out from Monaghan General Hospital, collect a patient, but not take the patient back to Monaghan General Hospital, instead the patient must be taken to Drogheda, Dublin or wherever. If this situation is to persist at the hospital, will the Mini ster address the issue? Lives have been lost in transit. Lives have also been saved because people can arrive at Monaghan General Hospital by car and be admitted to the accident and emergency department. They can walk in wounded and be treated at Monaghan General Hospital. When will the Minister allow Monaghan General Hospital back on call? The off-call status has had a negative effect on the rest of the North-Eastern Health Board. At Cavan General Hospital, the increased numbers at its accident and emergency department, has had a negative effect on its elective surgery performance. During the past 12 months elective surgery has had to be cancelled at Cavan General Hospital. In Our Lady of Lourdes Hospital there is a similar problem where there are ongoing industrial relations problems because nurses cannot attend to patients with head injuries for a two-hour period. This is making a complete nonsense of the golden hour rule in medicine, that the sooner the patient is treated the better the outcome.
What will the Minister say to parents in Monaghan who have a child with an asthmatic attack, or a parent or relative who suffers a heart attack, or someone suffering a haemorrhage? Should they drive for two hours and arrive with a corpse? Last night on "Questions and Answers" the Minister said that people should be stabilised first. That is the type of service which should be provided to the people of Monaghan and to 22 other towns like Monaghan. When will Monaghan have an on-call service again?
There is a significant history to this issue. The North-Eastern Health Board tabled proposals last September which were not accepted by all parties concerned. I appointed Mr. Bonnar to deal not only with the management structure at Monaghan Hospital, which is necessary as I communicated to the board, but also to try to resolve the outstanding issues and to engage in a process with all the parties involved in the catchment area of Monaghan Hospital to see if we could bring about a consensus in terms of the way forward vis-à-vis the provision of services, not least emergency cover.
Mr. Bonnar has not reported to me yet although I understand he will do so shortly. We will facilitate the presentation of that report. His report will be in the context of the forthcoming Hanley report to which the Deputy's question appeared to allude. I expect the report will have some relationship to what is likely to come down the tracks and will fit into that template.
Is the Minister aware that the St. Paul Consultancy Group, an independent international body, was commissioned to do an eight-day report at a cost of over €60,000? One of the core statements in that report was that the chief executive officer's proposed reconfiguration in the north-east was not workable. These reports and the Hanly report propose something similar. What concerns does the Minister have about that?
The work of the Hanly group will be informed by best international practice in these matters.
