I propose to take Questions Nos. 105 and 114 together.
The Framework for Smaller Hospitals lists the services that are appropriate to a smaller hospital. The future growth in healthcare will be in the services such as ambulatory care (including chronic disease management and day surgery), diagnostics and rehabilitation which will be based in smaller hospitals. As a result of these emerging models of healthcare delivery, and the ageing population, the total volume of activity of the smaller hospitals will grow substantially and no smaller hospital will close as a result of either the Hospital Groups Report or the Framework for Smaller Hospitals. This increase in volume is particularly evidenced in Roscommon where day case discharges have increased by 26% from 3,798 in 2010 to 5,127 in 2012.
Hospital groups will be required to submit a strategic plan within one year of formation which will outline their plans for future services within the group area, including those to be delivered in each smaller hospital. In the case of Loughlinstown hospital, its future role will be developed in consultation with the Dublin East Hospital Group of which it is a member. Smaller hospitals will play a crucial role in the delivery of services and when groups are established, services can be exchanged between sites. This will result in the enhancement of activity in smaller hospitals and will allow them to focus on the provision of care that is safe and appropriate.
The implementation of the Framework for these smaller hospitals has largely been completed around the country and the objective is to complete the remaining necessary changes dependent on required capacity being available in the regions and hospital groups concerned.