Dáil Éireann Debate, Thursday - 2 December 2004
8 Mr. Connolly asked the Tánaiste and Minister for Health and Children if she will give consideration to the possibility of Monaghan General Hospital being used as a location for the delivery of the national treatment purchase fund service; and if she will make a statement on the matter. [31841/04]
Amharc ar fhreagra11 Mr. Healy asked the Tánaiste and Minister for Health and Children if Monaghan General Hospital will be used as a cross-Border centre for the provision of the national treatment purchase fund scheme on an all-Ireland basis; if NTPF funding will be retained in the island of Ireland; and if she will make a statement on the matter. [31855/04]
Amharc ar fhreagra116 Caoimhghín Ó Caoláin asked the Tánaiste and Minister for Health and Children the details of the report she has received arising from the recent visit of her officials to Monaghan General Hospital; the action she proposes to take; and if she will make a statement on the future for acute hospital services at Monaghan General Hospital. [31582/04]
Amharc ar fhreagra142 Dr. Twomey asked the Tánaiste and Minister for Health and Children the timescale for the major revamp of services at Monaghan General Hospital that include a CAT scanner and 24 hours a day, seven days a week medical cover; and if she will make a statement on the matter. [31913/04]
Amharc ar fhreagra143 Dr. Twomey asked the Tánaiste and Minister for Health and Children the emergency cases (details supplied) which will be treated at the enlarged emergency room at Monaghan General Hospital. [31914/04]
Amharc ar fhreagraI propose to take Questions Nos. 8, 11, 116, 142 and 143 together.
I requested my special adviser to visit Monaghan and Cavan on a fact-finding mission on my behalf. She met representatives of the North Eastern Health Board, the medical board of Monaghan General Hospital, the medical board of Cavan General Hospital, representatives of the County Monaghan community alliance and representatives of Monaghan General Hospital development committee. She also met members of the steering group which was established by the board to oversee the reconfiguration of services at Cavan and Monaghan hospitals. The purpose of the visit was to inform me of the position concerning the proposed reconfiguration of services within the group.
I have outlined to the House the range of developments in the hospital group arising from the report of the steering group. My Department has been advised by the board that it has established an implementation group to continue the various developments in the hospital group as a matter of priority. It is my intention to meet Members from Cavan and Monaghan next week. All options will be explored, including the use of Monaghan General Hospital as a location for the delivery of the NTPF services.
I welcome the additional €20 million for the national treatment purchase fund. It is working well, but I would like to see it delivered from Monaghan General Hospital. Has the Tánaiste read the recent report from the Royal College of Surgeons in Ireland? It openly questions the manner in which the health service reforms are being rolled out and states that it is counterproductive to the Hanly report. It further states that the centres of excellence should not be involved in doing elective, intermediate and minor level surgery. It quoted the example of Drogheda hospital and stated that such surgery could be carried out more effectively in Monaghan General Hospital and Cavan General Hospital. Is the Tánaiste concerned about the impact this will have on the training of junior doctors in major hospitals? The report also stated that a senior house officer sent to Monaghan and Cavan on a six-month contract would obtain more experience than in a high-tech Dublin hospital. These matters must be taken into consideration.
Question No. 11 questions the cost-effectiveness of sending people abroad to have non-complex surgery performed, such as intermediate and minor surgery, which could be carried out in our hospitals. The capacity exists and it would increase the volume of work in our hospitals. It would also be welcome as a money earner in our locality.
I am aware of the report by Professor Tanner in the Royal College of Surgeons in Ireland. I have taken advice from the Department and my special adviser has visited Cavan and Monaghan. The situation there is very unsatisfactory. It is not acceptable that a senior sister would almost break down in tears as she showed us the facilities that are not being used. We need to use all the health facilities we have in the most effective way possible and that is not happening.
The national treatment purchase fund was established as a last resort to deal with very long waiting lists and to try to find treatment for people in the private health care sector in Ireland or elsewhere. It has worked extraordinarily well. It may well be that there are possibilities for the fund to be used in facilities like those in Monaghan where there are excellent theatres. We need to explore all those options. Several Deputies have come to me with different suggestions and I would like to discuss all these matters together next week.
The report openly states that the smaller hospitals should be used and it questions whether the health service reforms are heading in the right direction.
I think the report suggests that Drogheda be the centre of excellence. We must use all the facilities to their best effect.
We want the regions to have autonomy. Many do not have certain specialist consultants, or only have one. No matter how good a specialist is, he or she cannot provide a service for a region. I strongly support the building of services at regional level. It is not about closing services down but about building them. Cavan-Monaghan Hospital, with hospitals in Drogheda, Dundalk and Navan, must be used in the most effective way possible for patients in each region or from outside, if appropriate. Using a little common sense, we should be able to resolve issues in a more satisfactory manner than has been the case to date.
On the subject of common sense, will there be a rethink on the Hanly report?
Do people understand what the report is about? A lot of people who speak to me about it have not read it.
People are not stupid.
What is happening in Cavan-Monaghan Hospital, before implementation of the Hanly report, is not good enough.
I thank the Tánaiste for sending her adviser and agreeing to meet us next week. I assure her I will enter discussions in a positive and constructive manner. She knows me long enough to know that is the case. However, we have had so many promises. Her predecessor as Minister, Deputy Martin, stood on the steps of Monaghan General Hospital and gave assurances that he would look after the problem. The hospital has been off-call since July two years ago. The Minister is here to discuss a question regarding the national treatment purchase fund. Much work could be done in Monaghan General Hospital under that scheme. The hospital was doing work from Northern Ireland before it was taken off-call. It has an extremely modern theatre——
The Deputy should conclude. He must put a question in a one minute time limit.
Will the Tánaiste do everything in her power to ensure the hospital is put back on-call in coming weeks and that maximum use will be made of the facilities available? It is not common sense to send people to Birmingham. Her predecessor refused to advise me as to how much it would cost, yet the theatre is lying empty in Monaghan General Hospital.
Facilities in Cavan and Monaghan hospitals and elsewhere in the region must be used to greatest effect. Many patients from the region end up in different places because facilities within the region are not used to full effect. This does not make sense from anybody's point of view. I give the Deputy that assurance and look forward to our discussions.
At a recent meeting in Monaghan General Hospital we were told protocols would be in place by the end of January whereby medical admissions by ambulance would be reaccepted. Is this still going ahead? During the course of the debate on our Private Members' motion I was under the impression there was a five day elective and selective surgery service. As the Tánaiste did not contradict me, I thought she had the same assumption. Health board officials in Cavan and Monaghan said there was no such thing, that there was a day surgery service which may extend a little beyond normal hours. When was the Tánaiste made aware that this was the case? This is the impression given to the people of Monaghan in all the discussions we have had in the House since the report was published last April-May. It now comes to light that this is not the case. It is nothing more than an extended day surgery service carried out by an individual surgeon who comes from Cavan General Hospital every day. I do not agree or disagree with the service but the impression given to the House was misleading.
One of the issues which arises is that, depending on who one speaks to, one gets a different answer. This is unsatisfactory with regard to Cavan-Monaghan Hospital and an issue I intend to address. There are badly needed procedures which could be carried out at Monaghan General Hospital. There is capacity to have people stay in overnight. Not all patients would be dealt with on a day case basis. Therefore, we must examine what we can do, how we can do it and how we can use the facility.
The people of Monaghan would prefer——
Most understand that in respect of elective and selective surgery, one deals with particular specialties. It has now emerged these are carried out on a day case basis.
We know the difference between five day surgery and day surgery. I was led to believe it was a five day service, which was misleading.
