I am surprised that Deputy Luke ‘Ming' Flanagan is not present. He seems to believe that when he is speaking, everyone must be in the Chamber. He must not have a monitor in his office like the rest of us do. While we might not be sitting in the Chamber, we are aware of proceedings.
Adjournment Debate
Telecommunications Services
There are always more of us present, though.
It is whoever got the most votes.
I thank the Acting Chairman for affording me the opportunity to raise this important issue. There is no doubt that one of the greatest issues facing society is the high level of unemployment and the urgent need for the Government and Opposition to work tirelessly together to implement policies and initiatives that will facilitate job creation. I acknowledge the Government's commitment to laying a jobs initiative before the House in the next month, but one of the most important factors in job creation is infrastructure and, without critical infrastructure, we will not be able to attract inward investment to an area. Who in their right mind will start up a business without the necessary infrastructure? Without doubt, broadband is a critical piece of infrastructure.
Looking at the Department's website I saw a press release from December 2010 welcoming the €223 million spent on the national broadband scheme. According to the website, the service has a minimum download speed of 1.6Mbps and a maximum of 6.8Mbps with a contention ratio of 22:1. It has been made available for 235,000 premises across every county in Ireland, creating 170 jobs in the process. Built into the contract is a provision that speeds will be increased to a maximum of 10Mbps by October 2012. This is most welcome but what about the areas outside the national broadband scheme or within that are just not been served?
I question the accuracy of the Department figure of 99% coverage through the country and would ask the Minister if the number of new sites established under the scheme has reached the target of over 400 stated previously on the website, and, if not, how many new sites have been completed and are functioning correctly at present. How many of those are masts supporting antennae in new locations? In my own constituency, there are numerous black spots, including Abbeyshrule and Ballynacargy, which is home to me and a Cabinet member. The village still has no adequate broadband and the Eircom exchange is not even enabled to provide broadband service. Other villages affected include Ballymore, Ballinalack, Ballinamuck in Longford, Cloughan and Coralstown, Coole, Collinstown, Dysart, Dring, Fore, Forgony and Gaybrook. Kenagh, where the recent electoral count was held, had a connection so bad that we found it hard to get out the news that I was elected.
As I said already, broadband is not a luxury but a necessity for both business development and households. We live in an age where more people are using the Internet to carry out daily tasks such as online shopping and banking. Students are using it as a research tool and firms need it to carry out their daily business. I know a case in Dring, County Longford, where a local bookmaker running a number of businesses from home has no broadband and cannot properly function. A friend who is a solicitor contacted me recently because after building a new house in my home village, she is unable to get any broadband or work from home, thus causing severe problems for her family life.
Despite the large-scale investment in the provision of broadband over the past number of years, areas remain without an adequate service. I understand the previous Government before leaving office had committed €18 million for a new rural scheme to ensure outstanding areas would be serviced. I conclude by asking if this scheme will proceed and, if so, how can the areas I listed qualify? Are there plans to discuss with Eircom its obligation to ensure that exchanges are broadband-enabled and whether the subsidy of ongoing charges for satellite service provided under the national broadband scheme will be maintained after the current contract ends in July 2014?
I would appreciate it if I did not get a history lesson on why this or that cannot be done because of what happened in the past 14 years. I have been here five weeks and I would like to know what will happen in future. I do not live in the past; I live in the present. I want to work towards a better future.
I thank the Deputy opposite for his noble words. I am reminded of the line from the poem, "i mBaile na Muc, Dé Sathairn, chailleamar an lá". Sibhse a chaill an toghchán deireanach. Cháin an Teachta cúrsaí leathanbhanda na tíre agus dúirt sé nach bhfuil leathanbhanda ag daoine ina cheantar féin. Ta súil agam go dtuigeann an Teachta gur ar a phairtí atá an milleán faoi sin.
I welcome very much what the Deputy has said about identifying the issues and the needs concerning broadband in his area. It is an important issue and in the past five weeks I have spent as much time as possible on the matter. The Deputy is correct in that it is unacceptable for people, whether living in his village or mine, not to have a proper broadband service. The history lesson takes in the Deputy's party; it is a history of a failure to deliver broadband or the services which people want. The difference between us is that this Government is committed to NewERA, which is a massive investment in broadband. Together with private enterprise, State and semi-State agencies, it will ensure that the Deputy's village and the other townlands mentioned will have a proper broadband service.
A note from Department officials has been circulated but I am happy to debate the key question of the rural broadband scheme in the time we have. It is my intention in the next number of weeks to announce a new rural broadband scheme to reach those locations with no broadband whatever. Depending on terrain, there may or may not be a broadband service. With business and enterprise, the Government must work with everybody to have an efficient and effective broadband service around the country so that everybody can compete.
The European target is that by 2020 there should be a 30Mbps broadband service in as many places as possible. In the circulated response there is mention of three towns in the Deputy's constituency that have a metropolitan area network. These are working but I point out — as I am sure the Deputy will — that we need everybody that can have a service in a metropolitan area network to avail of it. I hope to work with the Deputy and our colleagues in the House to bring that about. I am working with my Department officials on that plan as it is very important for us to have connectivity around the country and in metropolitan area networks to meet obvious needs.
If the fibre optic cable is in the ground, it should not be forever unused, as it was under the previous Government. We want to use the equipment fully. The Deputy can read the rest of the circulated response but I hope he found this contribution helpful.
Departmental Agencies
The Government must urgently review the proposed closure of the Kinsealy research centre and its relocation to a much smaller facility at Ashtown, County Dublin. The important Teagasc facility at Kinsealy plays a critical role, as the Minister of State knows, in the horticulture and agrifood sector in Fingal and the north county. Serious issues have been raised about the high cost of closing the facility. Many constituents and Teagasc workers have argued that the proposal to close the centre will incur a significant net cost to the State at a time when we can least afford the burden of any extra or unnecessary costs.
It has also been alleged that extraordinary costly mistakes have been made by Teagasc during this episode. For example, it is alleged that property consultants missed the key submission date to the Fingal county development plan in what was an extraordinary lapse. For these reasons I have contacted the Comptroller and Auditor General, Mr. John Buckley, to ask him to request that the Teagasc internal auditors submit an immediate report responding to these allegations. I also asked him to carry out a full cost-benefit analysis on the closure and relocation of the centre to Ashtown. On 12 April I received a letter from the Comptroller and Auditor General stating that he "has asked the audit group completing the financial audit of Teagasc to make preliminary inquiries" and that he will "review the outcome as soon as they have been made". It would be extraordinarily premature for Teagasc to move ahead with the closure of Kinsealy given the involvement of the Comptroller and Auditor General and the prospect of a report being published on serious auditing of financial matters surrounding the proposed closure.
As the Minister for Health and Children, Deputy Reilly, knows, the Kinsealy Teagasc centre is a vital agricultural and horticultural research station for north County Dublin and its wider environs. Fingal has a strong farming tradition and the horticultural sector here is critical to local, mid-Leinster and national economies. For example, I understand very important research was developed at the centre relating to the valuable mushroom production sector in some of the northern counties.
Some 85 people are now employed at the Kinsealy centre, and it has an important mandate for ensuring that the long-term competitiveness and dynamism of Irish horticulture continues. I understand the Kinsealy centre also has close research links with scientific staff at the world-class Botanic Gardens in Glasnevin.
In late 2009, just before Christmas, staff at the Kinsealy centre were shocked to discover that there were plans afoot to shut their research station down and relocate staff to Ashtown and other Teagasc facilities across the country. As the Minister of State knows, it is a big site of 100 acres plus. It was then that constituents who are also Teagasc staff first came to meet me to express concerns about the closure. Several were rightly fearful that they would be forced to move across the county or the country even though they and their families had deep roots in Fingal, in the Minister's constituency and mine, and throughout the north county. I continually pursued the former Minister for Agriculture, Fisheries and Food, Deputy Brendan Smith, on this matter, and was disappointed with the performance of the outgoing Minister of State with responsibility for horticulture, Trevor Sargent of the Green Party who, despite representing the area, seemed to do little or nothing for the welfare of these workers and the important work they do for our country.
During the 30th Dáil, as the Acting Chairman knows, I was a member of the Committee of Public Accounts, and I asked the committee to examine the value for money to the State of the potential closure of the Kinsealy centre. I understand the clerk of the committee contacted Professor Gerry Boyle, the director of Teagasc, at the Carlow headquarters and asked him to provide details of any cost-benefit analysis undertaken before the closure plans were developed. As far as I understand, Professor Boyle and the Teagasc senior management team have never provided this information to the committee or to the Comptroller and Auditor General. Can the Minister indicate whether he has seen the details of any cost-benefit analysis? What are the costs and benefits of relocating from Kinsealy to Ashtown? What is the economic justification for closing down such a vital and historic facility in modern Irish agriculture?
For all these reasons, the Minister should insist on an immediate moratorium on all plans by Teagasc to shut down the Kinsealy centre until the outcome of the investigation by the Committee of Public Accounts and the Comptroller and Auditor General is known. I understand that a decision some time ago to close the Teagasc facility in Naas, County Kildare, was ultimately reversed, and I ask the Minister to ensure, similarly, that the proposal for our Kinsealy station is reversed.
I thank Deputy Broughan for bringing this matter to our attention.
I was hoping the Minister, Deputy Reilly, would respond to this debate.
I only have two other matters to respond to.
I apologise for the absence of the Minister of State at the Department of Agriculture, Fisheries and Food, Deputy Shane McEntee, who has asked me to take this matter on his behalf.
I am pleased to be given this opportunity to deal with the issues raised by Deputy Broughan. I would like to clarify the position with regard to the respective responsibilities of Teagasc and the Department of Agriculture, Fisheries and Food. Under the Act establishing Teagasc, the Agriculture (Research, Training and Advice) Act 1988, Teagasc has statutory responsibility for the provision of education, advisory and research services to the agriculture sector. It develops its programmes, services and activities in conjunction with its clients and partners, overseen by an authority that is representative of the main stakeholder groups in the agrifood sector. It is a matter for Teagasc and its board to prioritise activities in the delivery of these services and to allocate its resources in accordance with these priorities.
As far as my Department is concerned, ministerial responsibility is confined to matters of policy in accordance with the Act, and the Minister does not interfere in the day-to-day operations of Teagasc. Accordingly, decisions relating to the future of the Kinsealy centre or any other research centres or advisory offices are operational matters for the Teagasc authority to consider. It would not be appropriate, therefore, for me to interfere in decisions made by the Teagasc authority about the Kinsealy centre.
I am aware that the Teagasc authority approved a major change programme in 2009, reorganising and refocusing the organisation to meet the significant challenges that lie ahead. The programme provided for rationalisation measures across the organisation, including changes in the advisory office network and research centres, the disposal of surplus land and staff reductions. The agreed actions were seen as the first step in an ongoing process of change. The programme was updated in May 2010 to incorporate additional rationalisation measures to the end of 2012.
As part of this change strategy, Teagasc decided to move the activities and staff based in Kinsealy to other locations, with the majority transferring to the Teagasc campus in Ashtown. I understand that Teagasc took the decision to close the Kinsealy centre for a number of reasons. It currently has four centres in the greater Dublin area — Grange, Botanic Gardens, Ashtown and Kinsealy — and Teagasc has concluded that it does not make economic sense to maintain all of these sites. Many of the facilities in Kinsealy are ageing and the move to Ashtown offsets the need to invest in these facilities. I understand Teagasc has developed excellent facilities in Ashtown following a €10 million investment programme in recent years. The move provides the opportunity to optimise the usage of this valuable centre. In addition, there are considerable savings in overhead costs and staff costs to be achieved from operating at one site. For example, Kinsealy education and research programmes can be delivered effectively from Ashtown and other Teagasc locations.
Teagasc has stressed that the decision to relocate horticulture services from Kinsealy will not have a negative impact on its support for the horticulture sector. It points out that most of the permanent staff located in Kinsealy are not involved in horticulture and could operate from other Teagasc centres. There are only three permanent horticulture and forestry researchers working in Kinsealy.
Teagasc has produced a comprehensive horticultural plan which outlines an alternative model for horticultural research that is less dependent on the traditional type of research infrastructure. Following preparation of the plan, Teagasc is satisfied that the needs of the programme can be adequately met by the facilities proposed for Ashtown and by conducting more research on producer sites. It plans to service the horticultural education programme from the new Teagasc facility in the Botanic Gardens and the training centre in Ashtown, with the addition of some new facilities. It is investing €2.5 million to upgrade educational facilities in the Botanic Gardens, and this will cater for many of the Kinsealy educational staff and students.
For strategic reasons, Teagasc considers it essential that it retains a presence in the Botanic Gardens. The Botanic Gardens brand is hugely important for the standing of the college and its courses. Teagasc plans to meet the needs of the forestry programme through a combination of new and existing facilities at Ashtown and through the exploitation of other Teagasc locations.
I understand that Teagasc has carefully assessed the potential investment attributable to relocating from Kinsealy to Ashtown, and that this is estimated to be €4.8 million. The actual costs will depend on the outcome of any competitive tendering processes. Teagasc estimates that overhead savings of approximately €300,000 per annum can be achieved through moving to Ashtown. The amalgamation and streamlining of services at Ashtown is expected to yield further annual savings of approximately €240,000. In addition, savings on the upgrading of facilities and equipment are expected to be €200,000 per annum, or €1.4 million over seven years, on the assumption that the facilities in Kinsealy would have to be upgraded to bring them into line with those proposed for Ashtown.
Teagasc is satisfied that the closure of the Kinsealy campus will give rise to significant annual cost savings. It confidently expects a payback arising from relocation savings over an acceptable seven-year period. Teagasc is substantially dependent on taxpayer-funded resources to deliver on its statutory mandate. In the current economic circumstances, it has had to explore every conceivable option to minimise the Exchequer contribution. It embarked on an extensive rationalisation programme in 2009 to respond to these constraints in a manner that minimises any adverse impact on its services and programmes. The move from Kinsealy to Ashtown is consistent with the aims of the rationalisation programme to reduce organisational overheads and achieve greater efficiencies.
The Teagasc authority has concluded that the Kinsealy campus is no longer a strategic site for the organisation and that programmes and staff can be accommodated in Ashtown and other Teagasc sites. I reiterate that this is an operational matter for Teagasc. It is entirely within its rights to make this decision, and it would not be appropriate for the Minister of the day or the Department to interfere in the matter. I will bring the Deputy's comments to the attention of the Minister.
Cystic Fibrosis Services
On Wednesday morning, during Leaders' Questions, Deputy Finian McGrath sought clarification from the Taoiseach on the statement issued by the HSE last Wednesday week that the 34 promised isolation beds for cystic fibrosis patients in the new unit at St. Vincent's hospital were to be reduced to 20. This statement was issued by the Department after the "Prime Time" programme on Wednesday evening. I heard the Minister's response to Deputy McGrath, which was that late last Friday the Taoiseach, and possibly the Minister, met with Professor Charlie Gallagher and the CEO of the Cystic Fibrosis Association of Ireland and Mr. Philip Watt along with hospital and HSE officials. There was clarification on the issue, namely, that there would be a minimum of 20 and a maximum of 34 bed units, that two bed units would be available at all times to CF patients in the hospital and that these units, whether in rooms or wards, would be infection free.
The Minister must agree the whole saga has knocked the confidence of cystic fibrosis sufferers, their families and friends. Before the election, the Minister and the Taoiseach were around the CF issue like a rash. Only the week before last the Taoiseach received a very warm welcome at the Cystic Fibrosis Association of Ireland, CFAI, conference because of the commitments the Fine Gael Party had given towards a 34-bed unit at the new St. Vincent's unit. Since Wednesday I have spoken to people affected by this issue. They want more than a verbal clarification on the issue. In my experience, a verbal commitment is not worth the paper on which it is not written. Today I wish to have the Minister's commitment that a written statement will be drawn up with the agreement of the hospital, the HSE and the consultant, Professor Gallagher, with protocols put in place in respect of bed management and the two beds that are to be left infection free for CF patients. I also want clarification by 17 May of the commitment to 34 beds for CF patients. People believe this must be the case. We want a committed, unequivocal commitment from the Minister's Government, stating this will happen. That date is three weeks away and this allows time for the groups to meet.
I have spoken to people from the Cystic Fibrosis Association in the past 24 hours who want this, and they want it in writing. That is the only outcome that will calm them and revive the confidence of CF sufferers in this country who deserve to have these facilities copperfastened and in place. That should not be a problem for the Minister who had made a commitment before the election to these patients, as he now has. I know the matter can be dealt with and I wish to have the commitment today, in this Chamber, that there will be a written statement putting in place all protocols for this matter to be dealt with in the hospital and in order that we will not have to argue the toss when people arrive in accident and emergency departments in the future.
I thank the Deputy opposite for allowing me the opportunity to bring absolute clarity to this very important issue. I shall correct some of the statements made. Notwithstanding the Taoiseach's well-known interest in this area, he was not involved during the events of last week. It became apparent after the "Prime Time" programme that there was considerable lack of clarity and much concern for many people in respect of the number of beds available for the treatment of cystic fibrosis patients in the new unit. In order to address that we arranged to bring people together so that they could communicate. Let me be absolutely clear — there was communication between all interested parties and this was arranged by me and my Department in order to clarify the issue. Arising from that, a statement has been published on both the CFAI and the HSE websites, signed off by all parties. Therefore, there is no confusion.
The building of the new ward block at St.Vincent's hospital is a priority for me, as Minister for Health, for the Government and for the HSE. My commitment to cystic fibrosis is no less now than it was when I first stood in this Chamber as a new Deputy on the first Adjournment debate for which I called on the issue. The development of the new 100 bed unit being built at St. Vincent's hospital encompasses both inpatient and day care facilities for patients with cystic fibrosis. It represents a major improvement in the care of CF patients in Ireland. It is essential that all inpatients are cared for in single en suite rooms, by multidisciplinary teams with special training in cystic fibrosis.
The new unit will have 100 inpatient beds and ten day care beds and is due to be completed next year. Progress is being expedited as we speak. The new building, which I reiterate has single en suite rooms and isolation rooms, will play a vital role in the treatment of patients with cystic fibrosis and a range of other ailments.
It is Department of Health policy that there must be sufficient inpatient beds to treat all people with cystic fibrosis who require hospitalisation. Last week I arranged communication between the various stakeholders to ensure there was a common understanding about the precise arrangements related to cystic fibrosis patients in the new unit. It is important to emphasise the position was agreed with all the stakeholders. The number of cystic fibrosis inpatients at St Vincent's hospital and the resultant requirement for beds is expected to vary between 20 and 34. In this respect 20 inpatient beds is a minimum number not a maximum, and the number of beds with appropriately trained staff that can potentially accommodate 34 patients will be provided.
The Deputy must agree, as do people within CFAI and others, that if there is a situation where there are 22 patients in the hospital with cystic fibrosis and 12 beds in isolation rooms lying idle we could not in conscience tolerate a situation where a young, immunocompromised, terminally ill man on chemotherapy or a similarly immunocompromised mother in her 30s would be left on a trolley in the accident and emergency department. I do not believe any Member of this House would accept that nor do I believe anybody in CFAI was looking for it. What they want is an assurance that when somebody with cystic fibrosis is ill, he or she can have a bed in an isolation room with an en suite facility and be attended to by staff who are trained specifically in the care of cystic fibrosis. That has been confirmed.
It is important to note there is a much greater understanding now and that Professor Charles Gallagher, who is the leading light in cystic fibrosis treatment in this country and serves on the medical board of the CFAI, Mr. Philip Watt, on behalf of the CFAI, Mr. Nicky Jermyn, the chief executive of the hospital and Dr. Barry White, a clinical director of the HSE all got together via telephone to discuss this. They agreed an absolute and clear understanding, clear to the point where two of the parties were perfectly happy to post the same statement, signed by all four parties, on their respective websites.
I am very pleased to have the opportunity to clarify any misunderstanding and confusion, lack of clarity and communication. I remain totally committed to this very important project which will, in my view, improve services to patients with cystic fibrosis attending the hospital. It is my belief also this unit will go a very long way towards improving the quality of life and the life expectancy of patients with cystic fibrosis so that they will match the international norms of which we are aware, and we will no longer have to preside over the terrible situation where citizens of this country have a life expectancy that is ten years less than that of their cousins in Northern Ireland.
Hospital Services
I wish to share time with Deputy Neville. I welcome the Minister and thank him for taking the Adjournment debate. This is a very important issue in the part of the world the Deputy and I represent. I ask the Minister to intervene and personally review the recently announced decision of the HSE to close an operating theatre and surgical ward at Croom hospital.
I shall give some initial background. Croom hospital operates without a waiting list. Its policy is to treat patients on the basis of clinical need at the time of presenting. The Minister will be well aware that over the years the hospital has produced fantastic results in terms of its service as a centre of excellence to the people of the mid-western region. At the moment there is a suggestion that up to 30 specialist orthopaedic staff would be transferred from the Mid-Western Orthopaedic Regional Hospital, Croom to the Mid-Western Regional Maternity Hospital, Limerick and the general hospital. There is fear and concern among the staff that what is being suggested as a temporary arrangement between August and December could become a more prolonged issue, especially considering that up to eight weeks was taken out of Croom last year.
Croom is a centre of excellence. I realise there are budgetary constraints within the HSE but Croom is not part of this in the sense that it has the capability to deal with all national treatment purchase fund, NTPF, hip procedures for the country were it required by the HSE. It also has the capability to take on two extra operating theatres if the HSE so desired and this is preferable to closing down one of them, albeit as a temporary arrangement. We are concerned about it and the staff are concerned. Ultimately, those concerned are those who could potentially wind up on waiting lists in an unnecessary fashion given that Croom does not have a history of waiting lists. I petition the Minister on a personal basis to intervene in this matter, to review the situation and to call on the HSE to address it.
I welcome the debate and I thank Deputy O'Donovan for raising the issue. The closure of two theatres and one ward will impact seriously on the orthopaedic health service, further delay necessary elective surgery and will seriously impact on the quality of the service to patients. I understand consultations are taking place between hospital consultants and the management of the HSE. I understand the consultants have put forward proposals to introduce savings that will not include the closure of the theatres. It is important that the management are encouraged in every possible way to enter the discussions in a positive fashion and that the proposals, which I believe can overcome the proposed closures, should be taken into account. Once the people at the coalface are involved, the solutions often impact less on the patients. Hopefully, this will be successful.
Croom is a highly efficient hospital and enjoys a high degree of admiration for its quality of care in the mid-west. Its staff have a high level of commitment to service and care for the patients treated there. My immediate family has had experience of that treatment and care in Croom hospital. People have the highest regard for the services there. Hopefully, the Minister will encourage in every way the discussions taking place at the moment such that they will be successful. I support Deputy O'Donovan's call for any intervention by the Minister to ensure that the closure does not take place. That much is necessary for the region.
I thank Deputy Patrick O'Donovan for raising this important matter which, I realise, is of particular concern to him and his constituency colleague, Deputy Dan Neville. The Government's key priority in dealing with serious budget pressures on the health services is to minimise the effect on services for patients to the greatest degree possible.
The Mid-Western Regional Orthopaedic Hospital, Croom provides elective orthopaedic services for the mid-west area. The hospital currently has 50 inpatient beds and nine day beds. I acknowledge that in excess of 1,700 inpatients were treated at the hospital last year and almost 3,000 day-case procedures were carried out. This is a hospital we value and it provides good care. Croom hospital currently performs well on waiting time targets for elective surgery and the HSE's intention is to continue to meet the waiting time threshold for access to elective surgery for public patients. I will ensure that waiting time performance in Croom, and in all other hospitals, will be monitored intensively throughout the year and bed capacity adjusted accordingly to address any change in performance.
In common with all agencies, the HSE is facing significant financial pressures. This increases the importance of delivering more within a given level of resources. In this regard, the mid-west hospital group has a requirement to operate within budget and must manage resources accordingly. A budget break-even plan is in place to ensure the group remains within its approved expenditure levels. This plan is based on achieving the overall activity targets set out in the annual service plan and the right balance between emergency and elective activity within the resources available for this year. However, I am not prepared to accept a situation where services are cut back suddenly to meet a spending target, however important it is to keep within budget. Recently, I made it clear that there should be no withdrawal or curtailment of services by the HSE without my first being briefed. In each case I am keen to satisfy myself that any change in provision of service is both appropriate and justifiable. My first priority is to protect services for patients. Accordingly, I have instructed the HSE to give me a comprehensive briefing on all aspects of the issue in Croom hospital before it makes any change to the agreed level of service.
The HSE has assured me that the measures proposed will not affect emergency or orthopaedic trauma activity and will enable savings to be made in staff overtime, agency and non-pay costs for the remainder of the year amounting to €2 million. It has also indicated that 37 inpatient beds and nine day beds will continue to be available for elective surgery under the proposal. However, there will be no changes until I have been fully briefed about the proposals and their implications for patients.
I assure the House that I envisage Croom orthopaedic hospital as a vital part of the health services infrastructure of the mid-west. I am committed to ensuring acute hospital services at national, regional and local level are provided in a clinically appropriate and efficient manner. In particular, I am keen to ensure that as many services as possible can be provided safely in smaller local hospitals, nearer to patients' homes, communities and friends. The recovery from operative procedures is influenced by having the support of one's family and friends near to hand. This is the context in which any proposals on spending and services in Croom orthopaedic hospital will be examined.
In short, there will not be any changes until we have reviewed the implications for patients, waiting lists and for the budget. The Deputies may rest assured that they will have an opportunity to return and make further representations when further deliberation is carried out and a result obtained.
The Dáil adjourned at 5.30 p.m. until 2.30 p.m. on Tuesday, 3 May 2011.