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Ó Caoláin secures Dáil debate on Monaghan General Hospital

24 September, 2008

Sinn Féin Health Spokesperson Caoimhghín Ó Caoláin TD has initiated a debate in the Dáil on plans by the Health Service Executive to remove all acute care from Monaghan General Hospital and to downgrade it essentially to a Minor Injuries Unit.

Speaking during the debate this evening Deputy Ó Caoláin said the plan for the destruction of Monaghan General Hospital must be opposed in the strongest possible manner by the entire community

He said, "The Health Service Executive confirmed in a letter to me two weeks ago its plans to remove all acute care from Monaghan General Hospital and to downgrade it essentially to a Minor Injuries Unit.

"The HSE has confirmed the death sentence for Monaghan General Hospital. And in Reply to my Dáil Question today the Minister also confirms that sentence.

"The Minister and the HSE confirm the ongoing implementation of the so-called 'Transformation' report which I revealed in April. The HSE is denuding Monaghan of services and working towards a deadline that, if adhered to, will mean that by Christmas 2008 Monaghan General Hospital as we have known it for some years, will no longer be a hospital.

"When read carefully the HSE letter, entitled 'Developments in Cavan & Monaghan Hospital Group Services' and dated 3 September 2008, reveals a number of inconsistencies, raising huge concern about future patient care. It speaks of having specific measures 'in place and bedded down prior to or in parallel with the transfer of acute care to Cavan' by the end of November. I note that those words are repeated in the Minister's PQ reply today. But what does 'in parallel with' actually mean?

"The HSE says it is committed to the enhancement of ambulance services, including an additional 24-hour emergency ambulance at Monaghan Ambulance Station, bringing the number of ambulances from 2 to 3. Will we be faced with a situation where acute care is removed from Monaghan before the extra ambulance is provided? How long would such a gap in services be allowed to continue? We have seen in the past where the HSE commits 'in principle' to provide new services but we wait months or years to see them delivered.

"There are currently 3,000 acute medical admissions to Monaghan General Hospital per annum. By the end of November this service will have to be provided by Cavan General Hospital which already has to cater for 5,000 acute medical admissions per annum and has 160% bed occupancy. This is to be done under this plan without a single extra bed being provided in Cavan.

"The plan for the destruction of Monaghan General Hospital must be opposed in the strongest possible manner by the entire community and every elected representative, including the Fianna Fáil TDs for Cavan-Monaghan, must be called to account." ENDS


DÁIL QUESTION addressed to the Minister for Health and Children (Ms. Harney (Dublin Mid-West)) by Deputy Caoimhghín Ó Caoláin for WRITTEN ANSWER on 24/09/2008

* To ask the Minister for Health and Children if she will intervene to halt the Health Service Executive plan to end acute inpatient care at Monaghan General Hospital by the end of November 2008, closing Monaghan's 50 inpatient beds, its six critical care beds and transferring all inpatient and critical care to Cavan General Hospital without increasing bed numbers in Cavan; and if she will make a statement on the matter.

Caoimhghín Ó Caoláin T.D.


The Teamwork Report, prepared for the Health Service Executive (HSE), clearly indicated that the service configuration in the North East region was unsustainable. It recommended a reconfiguration of hospital services across the existing five hospital sites in order to ensure the highest level of patient safety. The Report also identified a significant future role for all five hospital sites in the provision of acute hospital services.

The Report has helped to inform the approach being adopted by the HSE in implementing its Transformation Programme. The Programme involves widespread and fundamental change and is designed to build a health system that is in line with the model of care emerging internationally. The overriding aim, which I fully support, is the need to improve safety and achieve better standards of care for patients in the region.

As part of the reconfiguration of acute hospital services in the North East the HSE is planning to transfer acute inpatient services from Monaghan to Cavan. The transfer is scheduled to take place later this year. The HSE is working to ensure that the necessary capacity is in place prior to or in parallel with the transfer date in order to ensure a smooth transition.

For example a Medical Assessment Unit is being established at Cavan to help manage the anticipated increase in activity. The average length of stay for inpatients is to be reduced in line with best practice. The discharge planning process will also be improved. Alternatives to acute inpatient care will be required through the planned provision of additional packages of care in the Cavan/Monaghan community care area together with an increase in capacity at Monaghan. Enhancements in pre-hospital care in the Cavan/Monaghan area will also be required.

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