As the Deputy is aware, health services must be provided in a challenging environment of demographic changes, increased public expectations, and financial and regulatory pressures from national and international bodies. Consideration is now focused on how the Irish healthcare system should be reformed to meet these challenges. With regard to hospitals, a key component of these considerations is the Casemix Index (CMI), i.e. the types and volumes of activities which are carried out by each individual hospital. When the matter of the potential redesignation of Letterkenny General Hospital to Regional status was considered in 2013, the Department formed the view that such a redesignation would be inequitable, when compared to similar general hospitals with higher CMIs.
The formation of Irish acute hospitals into Hospital Groups, each with its own governance and management, provides an optimum opportunity for hospital services to be configured to deliver high-quality, safe patient care in a cost-effective manner. Each Group will be required to submit a strategic plan which will outline the group's plan for future services in the group area. The issue raised by the Deputy can be further considered in the context of the development of such a plan for the West/Northwest Hospital Group. Such consideration will also take into account the various infrastructural and service developments which have taken place at Letterkenny General Hospital following the flood of July 2013.