Seanad Éireann debate -
Monday, 24 Nov 2003

Vol. 174 No. 16

Adjournment Matter. - Hanly Report.

Mr. Bannon

I am pleased to welcome the Tánaiste to the House to take this important matter on health facilities in the midlands, particularly the status of stage 2B of Mullingar Hospital.

A nationwide campaign against the Hanly report is now being planned by hospital action groups to oppose plans to centralise acute hospital services. The level of opposition to the report has been outlined by the chairwoman of the Irish Medical Organisation consultant committee and other prominent specialists. It has sparked opposition not just from the Opposition, but there has been strong opposition to the report from within the Government parties. It is heartening to know that even there the total impracticality of much of the report is recognised.

My concern is with the situation at Mullingar Regional Hospital and how the report, including report No. 149, which the Department of Health and Children plans to publish after the local elections, will affect this vital facility for the Midland Health Board area. Its future status has supposedly been assured under phase 2B of the midland region's hospitals. The people of this area need assurances that the development of Mullingar Hospital will go ahead despite the report. Mullingar Hospital has 203 beds and the number is to increase to 311 under phase 2B. There are 25 consultants attached to the hospital and 202 full-time nursing personnel. There were 1,850 births in the hospital in 2002, with upwards of 1,900 forecast for this year. The accident and emergency department treated 29,000 patients in 2002 and this figure is expected to increase to more than 30,000 this year. In-patient numbers for 2002 were more than 13,000.

The Government promised that €57 million was ring-fenced for the development of the hospital. The shell was opened in 1997 by the former Minister for Health, Deputy Noonan. The control plan was signed off by the members late last year and I understand it is going to the Department of Health and Children next week. More than 40% of all accident and emergency cases in the Midland Health Board area are treated in Mullingar Hospital. It is totally impractical to think that, despite Government assurances for its expansion and development, this medical hub for the midlands could conceivably be downgraded to local cottage hospital status. Let us not pull any punches here. The real issue here relates to people's lives. Proximity and quality of service are of paramount importance in medical emergencies.

Mullingar is the only acute hospital from Sligo to Dublin on the N4 route. The downgrading of the accident and emergency department in the hospital would have the effect of reducing the service to 150,000 people currently living in the Longford-Westmeath catchment area. It would mean ambulances by-passing Mullingar Hospital and driving a further 45 minutes to bring patients to Tullamore Regional Hospital.

What is the future of the maternity unit and its staff at Mullingar? As we have already learned to our cost, the lack of maternity services at local hospitals can lead to the tragic loss of life.

Under the national spatial strategy, the three hub towns of Mullingar, Tullamore and Athlone will see their population increase to 60,000 each. This will mean that Mullingar Hospital will eventually serve a catchment area of 300,000 people. The implementation of the proposals of the spatial strategy and the redeployment of people without the necessary basis of good and readily available medical care would be tantamount to madness, but the elimination of these facilities, which are already in place and due for expansion, would be a disaster for the area.

The rationalisation and concentration of services may be a good idea in some specialities, but vital maternity and accident and emergency departments, where time is of the essence in life-threatening situations, should not be among these. The removal of maternity, accident and emergency and other services from Mullingar would be dangerous and morally wrong. I ask the Tánaiste for a commitment to complete phase 2B of this essential development plan for the midlands. I hope she will give me assurances on the future of the Midland Regional Hospital in the Mullingar area. It is vitally important to get positive answers this evening and to send a message of assurance to the people of the Longford-Westmeath catchment area.

Tánaiste and Minister for Enterprise, Trade and Employment (Ms Harney)

I am speaking on behalf of my colleague, the Minister for Health and Children, Deputy Martin, who is unavailable.

There are no plans at present to alter the services provided by the Midland Regional Hospital at Mullingar. The report of the national task force on medical staffing, the Hanly report, deals with the reorganisation of acute hospital services in two regions, the East Coast Area Health Board and the Mid-Western Health Board. A second report will consider the role of acute hospital services in the rest of the country, taking account of the principles set out in the Hanly report. It is anticipated the Midland Regional Hospital at Mullingar will be examined in this context.

The Hanly report addresses the need to improve patient care, reform medical education and training, and support the continued provision of safe, high quality acute hospital care 24 hours a day, seven days a week. The report sets out the measures needed to comply with the EU working time directive by reducing the working hours of junior doctors and introducing a consultant-provided service. No viable alternative has been advanced.

Implementation of the principles set out in the Hanly report will mean a better service for patients. It involves harnessing the contribution of all our hospitals and providing a wider range of appropriate services and procedures in local hospitals. The report states that a full range of acute hospital services should be available within each region, so that patients should not have to travel outside other than for specialised supra-regional or national specialty services.

The Hanly report recommends investment in local hospitals to provide more services for patients, including elective medical and surgical procedures, out-patient services, pre- and post-natal maternity services and better access to diagnostic facilities.

Implementation of the Hanly report, in conjunction with the development of acute bed capacity and appropriate resourcing and reform of ambulance services, will mean hospital services are provided in the most appropriate setting. It will ensure that all patients, wherever they live, have equitable and rapid access to high quality emergency care.

The next phase of the development of Mullingar Hospital, phase 2B, was approved in July 2001. The design team has recently completed its work on the development control plan. Some minor amendments are being made to the plan and, following its acceptance by the Midland Health Board, it will be submitted to the Department of Health and Children for approval. The phase 2 development has been costed at approximately €57 million at 2001 prices, and is designed to increase the number of beds at the hospital from 198 to 311. The project is scheduled for completion in April 2008. There are no plans at present to alter the services provided by the Midland Regional Hospital at Mullingar. A group is being established to consider the role of acute hospital services outside the east coast area and the mid west region, taking account of the principles set out in the Hanly report. The Midland Regional Hospital at Mullingar will be examined in this context.

Mr. Bannon

I am not too happy with the statement from the Minister for Health and Children, Deputy Martin. I do not like the reference to "no plans at present to alter the services provided by the Midland Regional Hospital at Mullingar". I hope the Tánaiste will seek greater reassurance for us from the Minister for Health and Children with regard to this facility. It is important for the midland area. We want this hospital upgraded and improved upon and the facilities, as outlined in phase 2B, to be given to the people of this area.

The Seanad adjourned at 6.05 p.m. until 2 p.m. on Tuesday, 25 November 2003.