asked the Minister for Health if he will make a general statement on the type of services which it is proposed to carry out and the system of staffing which is proposed in the White Paper on the Health Services in the community health centres which will replace some county hospitals; and if he will give the name of hospitals which will be so affected.

82.

asked the Minister for Health if he is aware of the great concern and anxiety prevailing in County Westmeath consequent on the proposal contained in the reorganisational plan, which if implemented, will have the effect of down grading Mullingar County Hospital; and if he will now allay the fears of the people and give an assurance that a centre of the extent and importance of Mullingar and its vast hinterland will not lose this most efficient and necessary medical and surgical unit.

83.

asked the Minister for Health if he is aware of the great concern and anxiety prevailing in County Roscommon consequent on the proposal contained in the reorganisational plan, which if implemented, will have the effect of down grading Roscommon County Hospital; and if he will allay the fears of the people and give an assurance that a centre of the extent and importance of Roscommon and its vast hinterland will not lose this most efficient and necessary medical, maternity, and surgical unit.

With your permission, a Cheann Comhairle, I propose to take Questions Nos. 81, 82 and 83 together.

I presume the Deputies are referring to the report of the Consultative Council on the General Hospital Services.

The Council has recommended that a number of existing county hospitals should be retained and developed to become General Hospitals and that the remaining county hospitals should have their rôle changed to what was described as Community Health Centres. This designation is somewhat misleading. The centres would continue to be hospitals and would provide inpatient services for normal maternity patients, for certain kinds of medical cases and for geriatric patients. In addition, they would have a wide range of well-developed consultant out-patient services, including radiology and pathology. Detailed recommendations were not made about the staffing of the Centres but it was proposed that general practitioners would have access to them and it is an important part of the plan that they would be visited regularly by consultants in different specialties from the nearest General or Regional Hospital.

The county hospitals which according to the recommendations of the Consultative Council might eventually become Community Health Centres are those at Bantry, Cashel, Clonmel, Dundalk, Ennis, Kilkenny, Longford, Mallow, Manorhamilton, Monaghan, Mullingar, Naas, Navan, Nenagh, Portlaoise, Roscommon and Wexford.

While I have accepted in principle the plan of reorganisation which has been drawn up by the Consultative Council, the detailed recommendations in relation to individual hospitals will have to be carefully examined in consultation with the various interests concerned before final decisions are made.

I asked the Minister last week if he would make a general statement if I put down this question and I am grateful to him for having done so. Would he not agree that the plan he proposes is one which it would hardly be possible to operate before the turn of the century in view of the fact that it means spending millions in Dublin to enlarge the hospitals so that they will be able to take patients? In addition, the proposal which he now makes about these community centres—which are badly named I agree—and about the district medical officers having access to them is a slight variation from what was originally stated, which was that the district medical officers would be responsible for looking after their patients. Would he explain how it is proposed that district medical officers could do this work in view of the fact that many of them are already overworked in their own areas and some of them, in fact, have two dispensary districts?

What I am sure about is that the conclusions in the report are right and if representatives of Fine Gael and Labour or whatever other Parties there are are big enough to put this into practice it will be for the great benefit of the people of Ireland.

Would the Minister not agree that this is not a question of politics at all?

I hope not.

It is a question of the health of our people and it is unfair of the Minister to say that Fine Gael and Labour——

I was not trying to be unfair.

I cannot speak for Fine Gael but as far as the Labour Party are concerned we are interested in one thing only and that is the health of the people and the best hospital treatment for them but we are not sure that making a succession of statements from the Department of Health, which may be well intentioned, without putting a time table on them is the best way of dealing with this matter. While the Minister has given us a good deal of information I hope in the spring to ask him for some further information.

As chairman of the Cork Health Authority I want to support what Deputy Tully has said. The Labour Party are interested only in the health of the people. As far as the reorganisation of the hospitals in Cork is concerned I am not in agreement with the report and I would ask the Minister to discuss the matter with the Cork Health Authority before any final decision is reached.

I did not intend to slight the Fine Gael or Labour Parties when I said this——

(Cavan): If the Minister had said the representatives of Fianna Fáil, Fine Gael and Labour——

I am quite sure that the principles enshrined in the report are right and that if we can put them through it will have to be at a higher level.

It will possibly be the turn of the century before many of the things, particularly this question of the change in the type of hospital, will be reached as far as money is concerned.

I hope not.

(Cavan): May I take it that the Minister and the Government have accepted the recommendations of the commission regarding the location of the central hospitals?

I can only repeat that I think the report is a very good one.

(Cavan): I would be interested to know if the Government have yet accepted the recommendation concerning the location of these central hospitals.

You are wondering whether Cavan is getting one.

We accept the report in principle.

(Cavan): I take it that “in principle” means that it is accepted, that the location of these central hospitals has been accepted as the correct location?

But can be changed.

I did not say that.

May we take it as far as Mullingar Hospital is concerned that major surgery will cease if this report is adopted by the Government?

Yes.

(Cavan): There seems to be some doubt as to the acceptance of the report. Will the Minister and the Government see to it that the only thing which is taken into consideration in deciding on the location of the hospitals is the welfare of the patients and the convenience of their relatives?

The welfare of the patients, not the convenience of the relatives.

(Cavan): I would ask the Minister to accept that very often, if not all the time, the convenience of the relatives and the welfare of the patients are inseparable and synonymous.