The future organisation of our acute hospitals is a major policy issue for the Government. It is essential that all hospitals provide care in the right way, at the right location, and in a manner that ensures a safe, high quality service for all.
The Government is committed to securing and further developing the role of our smaller hospitals which will see them provide more, not fewer services. The challenge is to make sure that they provide services, which can safely be delivered in these settings, in order to maximise the benefit to patients. All hospitals, irrespective of size, as well as associated GP and community services, must work together in an integrated way. There have already been very significant developments recently in health care delivery, particularly in the context of shifts to day surgery and ambulatory care, and the centralisation of low volume high complexity care into larger centres. In this context, it is necessary that we redefine the role of the smaller hospitals so that they continue to play a central part of the Irish Health care system.
The Framework for Smaller Hospitals defines the role of the smaller hospitals. It outlines the need for smaller hospitals and larger hospitals to operate together. The Framework outlines the wide range of services that can be provided within the smaller hospital. It defines the need for the smaller hospital to be supported within a group of hospitals in terms of education and training, continuous professional development, the sustainable recruitment of high quality clinical staff and the safe management of patients who present with varying levels of complexity. It also sets out to address the categories of services that should transfer from the larger to the smaller hospitals and vice versa within a Hospital Group so that services are delivered in the most appropriate hospital.
Work is in progress on developing a detailed plan for service enhancements in each of the nine smaller hospitals that are covered by the Smaller Hospitals Framework. These plans are based on detailed local analysis of the services in place and what can be provided in the future.
I am determined to ensure that as many services as possible can be provided safely and appropriately in smaller, local hospitals. On this basis, the organisation of hospital services nationally, regionally and locally will be informed by the ongoing development of the HSE Clinical Programmes. With this in mind the Framework will set out what services can and should be delivered safely by these hospitals in the interest of better outcomes for patients.
The Smaller Hospitals Framework is currently being examined in the context of the overall reorganisation of the health services. The HSE is in the final stages of a consultation process to help inform the details of the service changes. This consultation process has sought feedback from all stakeholders, including local communities and health professionals in each hospital who deliver the service, and their feedback will be captured as input to the change process. Until this process has been fully completed I do not think that it is appropriate to comment on individual hospitals at this time.
It is my intention to publish the Framework when this process has been completed.