I propose to take Questions Nos. 693 and 698 together.
In July 2000, Comhairle na nOspidéal made a number of recommendations on the future organisation and delivery of respiratory and tuberculosis services. Comhairle recognised the valuable role which Peamount Hospital has played for many years. However, in line with major advances in medical treatment, it recommended that the optimal in-patient care of patients with respiratory diseases, including tuberculosis, is more appropriate to acute general hospitals, staffed by consultant respiratory physicians and other consultants supported by an array of investigative facilities.
Peamount Hospital was not regarded by Comhairle na nOspidéal as an appropriate location for the treatment of TB patients, especially those requiring ventilation and specialised treatment for other symptoms, such as heart disease, HIV, etc., who may present with TB. Comhairle na nOspidéal subsequently appointed a committee to advance the implementation of the 2000 report. The report of this committee, which endorsed the recommendations in the earlier report, was adopted by Comhairle in April 2003. Specifically it recommended that Peamount Hospital should play an active role in the provision of a range of non-acute support services, including pulmonary rehabilitation, within the South Western Area Health Board. It also recommended that patients who have been treated in St. James's Hospital and other major acute hospitals, and who require on-going rehabilitative care, could be transferred to Peamount Hospital for completion of their care.
I understand that in addition to the Comhairle advices on this issue, the board of Peamount Hospital has developed a strategic plan for the next five years. The hospital employed external support to assist them in this process and to advise of developments in the wider health care environment. The strategy adopted by the board proposes considerable enhancement of existing services and development of new services in the areas of rehabilitation and continuing care of older people, persons with intellectual disabilities and adults with neurological or pulmonary illness. The hospital will now develop a transitional plan to transfer acute services in a planned way, and following consultation, to an appropriate location in an acute general hospital.
Services in the hospital such as phlebotomy and X-ray will continue to be available to the local community; indeed much of the discussion to date has related to how Peamount can more effectively meet the primary care needs of the local population. After discussion with local GPs, it is clear that key concerns are in relation to the management of older people with chest infections and respiratory difficulties. The Eastern Regional Health Authority is in continuing discussion with Peamount in regard to how these services will be maintained. This will be supported by the appointment of a consultant geriatrician to Tallaght Hospital, with two sessions per week specifically committed to Peamount.
The authority is also working with Peamount to ensure that rehabilitation facilities will continue to be available for people with TB who have chronic lifestyles and are at risk of being unable to maintain their treatment programme without supervision. A joint consultant post in rehabilitation medicine is also being established between the National Rehabilitation Hospital and Peamount.
Existing day and residential services for older people, people with intellectual and physical disabilities will continue to be provided. I would like to assure the Deputy that the direction which Peamount is now taking will see it developing its overall role and its support for acute hospitals, general practitioners and the community of the surrounding area and is in line with its commitment to the provision of the highest quality of care to existing and future patients. The implications for the acute respiratory services currently provided at the hospital are being assessed, following which it is understood there will be further consultation with a range of relevant parties. The authority will participate fully in this process to ensure that the interests of, and potential benefits to, patients of the region are fully realised. The industrial relations issue referred to by the Deputy is a matter for the board of Peamount Hospital and, accordingly, I do not propose to comment on the matter.