Dáil Éireann - Volume 571 - 02 October, 2003
Mr. Crawford Mr. Crawford
Mr. Crawford: I thank the Ceann Comhairle for the opportunity to again raise this important matter on the Adjournment. I assume the Minister for Education and Science is responding. I am disappointed that none of the Ministers with responsibility for health can be here to respond. However, the Minister for Education and Science is in the North-Eastern Health Board area and our nearest county and, perhaps, he will convey the message to the Minister.
As one of those who had asked for an independent person outside the health board structure to look at the situation in Monaghan General Hospital I had looked forward to the Bonner report. Where stands the Bonner report? Has any of it been implemented? Is there a process in place to ensure it is implemented in full? I saw this exercise as a start to stabilise Monaghan Gen eral Hospital. It is now 15 months since Monaghan General Hospital was taken off call. Is Mr. Kevin Bonner still involved? Mr. Bonner assured the North Eastern Health Board and the general public, through the media, attending that meeting that he was confident funding would be made available to honour his report. He was appointed by the Minister for Health and Children, Deputy Martin, and had discussions with the Department of Health and Children and other personnel as well as the chief executive and members of the North Eastern Health Board.
Monaghan General Hospital is providing a good service to those who know the way in. Patients can go in by car, on foot or on a bicycle but not by ambulance. The father of Denis Taylor, the famous snooker player, was operated on in Monaghan General Hospital as part of a cross-Border co-operation project. Yet patients from this island have been sent to Manchester at enormous cost to the nation for similar surgery which could have been carried out by eminent surgeons in Monaghan General Hospital. Two of these surgeons were appointed when my colleague, Deputy Noonan, was Minister for Health and Children. The surgeon, Mr. Moloney, retired and was replaced by two surgeons, Mr. McAleese and Mr. McMullan.
The Bonner report does not go anywhere near delivering what I or others would desire for Monaghan General Hospital, its excellent staff and its patients. The restructuring suggested would be a major start. Some €3.8 million to be spent on a treatment room and a further €10 million, as proposed in the report, for 2004 would be a first real step of commitment to Monaghan General Hospital. The Minister has a budget of €9.2 million to deal with the problems including Monaghan General Hospital and Cavan General Hospital or have them treated as equal partners under the Cavan-Monaghan hospital arrangement.
I believe the overall budget is not the problem, and this belief is supported by none other than Professor Niamh Brennan. A recent newspaper report stated:
In the past, commentators have referred to a black hole in the health service. The problems found through her report were not so much a black hole, rather there are so many holes in our health services that it is more akin to a colander or a sieve.
Professor Brennan was appointed by the Minister to produce a report and she has made it clear that she believes her report's recommendations will only be implemented by an independent person who is outside the health board.
We have had an independent person in Monaghan who is outside the health board, but nine months after his appointment we have seen no improvements. In his final summary he said that  the proposals provide a sound basis for Monaghan to continue providing excellent patient care, which complements services being provided elsewhere. It is vital that all the consultants in Cavan-Monaghan agree and actively support these proposals and participate in the preparation and implementation of the necessary protocols. I would like to see that happening.
There has been cross-party support for Monaghan General Hospital within our council chamber and I was part of that. It has not worked and I am pleading with the Minister. The Hanly report will come out in the next 24 hours or so but we always seem to be one report away from a decision. The Minister appointed Mr. Kevin Bonner and it is on his report that the Minister and the health board must deliver.
Mr. N. Dempsey Mr. N. Dempsey
Mr. N. Dempsey: On behalf of my colleague, 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 services in Monaghan General Hospital rests with the North-Eastern Health Board, not the Minister. It is a matter for the board to determine—
Mr. Crawford Mr. Crawford
Mr. Crawford: Is the Minister in charge at all?
Mr. N. Dempsey Mr. N. Dempsey
Mr. N. Dempsey: —the nature and level of service provision at the hospital consistent with the board's commitment to the provision of a highly qualified, efficient and cost-effective service across the north eastern region.
As the Deputy outlined, Kevin Bonner, management consultant and former Secretary General of the Department of Enterprise and Employment, was commissioned to advise, inter alia, on an appropriate management structure for Monaghan General Hospital and to assist the board in implementing this structure. He also worked with the board to facilitate the resolution of any outstanding issues pertaining to the provision of services at the hospital, including emergency services. On 25 July 2003 the Minister for Health and Children published the report from Mr. Bonner on the hospital. The Minister indicated at that time his acceptance of the main recommendation of the report that Monaghan General Hospital should continue to play a vital role in the delivery of acute hospital services to the local community within the Cavan-Monaghan hospital group. The Minister also accepted that additional services be developed at the hospital to the benefit of the local community. In particular the Minister welcomed the proposals in the report aimed at strengthening the management capacity of the hospital within the Cavan-Monaghan group. The central involvement of consultant staff with this new structure is a very significant development which should enhance the ability of the group to deliver high quality services.
 Mr. Bonner recognised in his report that the pattern of acute hospital service is changing world-wide and that Monaghan hospital's best guarantee for the future is to participate in and accept those changes which will ensure its future viability. In this context the report's recommendations in relation to the range and configuration of acute services to be delivered within the Cavan-Monaghan hospital group are being considered by the North Eastern Health Board. The forthcoming national task force on medical staffing – the Hanly report referred to by the Deputy – will further inform decisions in this regard. The task force was asked to make recommendations on how best to organise hospital medical staffing within the hospital system, having regard to the requirements of the European working time directive to reduce the average weekly working hours of non-consultant hospital doctors and the recommendations of the forum on medical manpower. The report of the task force on medical staffing is due to be published shortly.
In accordance with the recommendations in the Bonner report, the Minister made additional capital funding available to the North Eastern  Health Board under the national development plan. This will allow the board to address urgent capital needs at Monaghan General Hospital in such areas as equipment replacement, refurbishment, fire precaution and other health and safety measures.
A project team under the national development plan has also been established at each hospital in the region, including Monaghan General Hospital. The initial responsibility of the project team is to identify service requirements and to prepare a planning brief for the preparation of an outlying development control plan in respect of the hospital site. The preparation of these briefs is now at an advanced stage.
The Minister is assured by the North Eastern Health Board of its continuing commitment to the future provision and development of services at Monaghan General Hospital. The Minister considers it essential that all parties involved play their part to resolve the present difficulties and to ensure the future delivery of services at the hospital as an integral part of the existing Cavan-Monaghan hospital group.
The Dáil adjourned at 5.25 p.m. until 2.30 p.m. on Tuesday, 7 October 2003.
Dáil Éireann 571 Hospital Services.