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Dáil Éireann díospóireacht -
Tuesday, 13 May 2003

Vol. 566 No. 3

Adjournment Debate. - Hospital Services.

I thank the Ceann Comhairle for allowing me to raise this important issue and the Minister of State for attending to reply. I hope it is the right one.

The medical service is in a serious and traumatic position, not just in Monaghan General Hospital but also nationally. It is because of the recent announcement at national level that I was forced to raise this issue once again. It is only six to seven weeks to the anniversary of the removal of Monaghan General Hospital from an on-call position. We were promised by the Minister at that stage that he would get something done as quickly as possible. Some of my colleagues said to the media that the on-call service would reopen in a few days. I did not believe it could at the time and genuinely did not believe the Minister was saying that to me but I certainly did not believe for one second that he would allow it to remain closed for almost a year.

I was one of those who welcomed the appointment of Mr. Kevin Bonner as an independent outside consultant. I sought it from more than 18 months ago until now. It scares me that this has continued for so long and we have no indication yet when his report will be published and the new structures put in place.

As far as young doctors are concerned, 1 July is D-Day which is approaching again with no positive decisions worked out. I welcome that the nurses' union, through the work of nurse Catherine Quigley, obtained a positive decision at its meeting in Galway when she made a proposal that Monaghan General Hospital be reopened. It is good to see some of the unions and others coming behind the people of Monaghan on this issue. However, when one sees personnel in hospitals such as St. Vincent's making it clear that, with their difficulties, they should not admit any patients from the country, one realises the seriousness of the situation for a constituency such as mine, Cavan-Monaghan, and especially for Monaghan with its hospital which is no longer on-call.

The staff in Monaghan General Hospital are doing a good job in as much as they are allowed to and can do an excellent one if given the opportunity. The theatre is brand new and modern. The personnel are half idle because they are not allowed do the work. Monaghan patients are being sent to God knows where to be treated. That is all right to some extent when the Mater, St. Vincent's, St. James's, Beaumont and others admit patients but if they decide not to, where will the waiting lists be?

I cannot help mentioning a strategy document brought forward in 1999. It reminds me of one we received on Monaghan General Hospital in 1997 when we were promised everything and that all issues would be brought forward. This country has come through the Celtic tiger since and nothing has happened. The strategy document to which I referred comes from the Isle of Man where a group of us, through the British-Irish Inter-Parliamentary Body, went last week. The difference is that this document which was a proposal in 1999 is now a reality. It is a 314 bed, ultra-modern hospital with six theatres providing a service for 76,000 people, and has been funded and paid for. There is a bank loan against it but investments made by the health board over the years will pay for it. There will be a brand new hospital in July 2003 with no debts, and a full complement of staff has already been allocated.

What are we doing wrong in this country? I represent a population of 110,000 to 120,000 people. We pay our taxes – the Border region pays more than its fair due because people come across the Border in droves to buy petrol and other products. We are putting a lot more into the Exchequer than the population figure would suggest. If the Isle of Man can be successful in this regard, a small country run by the people themselves, I believe we must re-examine the structure of our health boards and the way our country is run to ensure that we have a proper health service. It was stated there was a problem on the Isle of Man – some people were waiting for hip replacements for up to six months. They can do hip replacements in their hospital so why can the taxpayers of Cavan-Monaghan not have a service like that?

On behalf of my colleague, the Minister for Health and Children, Deputy Martin, I welcome the opportunity to clarify the latest position in relation to Monaghan General Hospital. I point out to Deputy Crawford that responsibility for the provision of services at Monaghan General Hospital rests with the North Eastern Health Board.

That is what is wrong.

It is a matter for the board to determine the nature and level of service provision at the hospital, consistent with the board's commitment to the provision of a high quality, efficient and cost-effective service across the north-eastern region. The Deputy will be aware that Mr. Kevin Bonner, management consultant and former Secretary General of the Department of Enterprise, Trade and Employment, has been commissioned to advise, inter alia, on an appropriate management structure for Monaghan hospital and to assist the board in implementing this structure. He is also working with the board to facilitate the resolution of outstanding issues pertaining to the provision of services at the hospital, including emergency services. It is anticipated that Mr. Bonner's report will be finalised in the coming weeks.

The recommendations of his report will assist in determining the future configuration of services under the Cavan-Monaghan Hospital Group. The Minister is assured by the North Eastern Health Board of its continuing commitment to the future provision and development of services at Monaghan hospital. The Minister considers it essential that all parties involved play their part to resolve the present difficulties and to assure the future delivery of services at the hospital as an integral part of the existing Cavan-Monaghan Hospital Group. The Minister is advised that in working towards a resolution to the current difficulties at Monaghan hospital, the board is being guided by professional clinical advice. The board has advised that in the solution to these difficulties regard will need to be had to advice from professional bodies, including the Royal College of Physicians in Ireland, the Royal College of Surgeons in Ireland, the College of Anaesthetists, the Medical Council and Comhairle na n-Ospidéal.

The board's overriding objective is to ensure the provision of safe and sustainable hospital services at Monaghan as part of the Cavan-Monaghan Hospital Group. My officials are working closely with the ERHA and the DATHS and have entered into a process to try to resolve the difficulties that we are facing in this area this year.

The Dáil adjourned at 8.55 p.m. until 12.30 p.m. on Wednesday, 14 May 2003.

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