Responsibility for the provision of services at Letterkenny General Hospital rests with the North Western Health Board. I gave approval in July 2003 to the board to proceed with the planning of an extension to the accident and emergency unit at the hospital. The board and its design team are carrying out an option appraisal to determine the preferred option for the location of the facility on the hospital site. The detailed design process will commence on satisfactory completion of the option appraisal. Approval to go to tender will be granted by my Department following receipt of a satisfactory proposal from the board within the approved budget costs.