asked the Minister for Health if he will make a statement on the future role of the County Hospital, Tullamore, County Offaly, in the light of the recent hospital plan announced by the Government; and the general effect the plan will have on this hospital.

Tullamore Hospital will continue in its present role for some years to come until the necessary additional accommodation is provided at the centres to be developed as acute general hospitals. It will then continue in existence as a community hospital with a role of great importance in the health services. The details of this role will be discussed with the health board.

Is the Minister aware that on Thursday last more than 8,000 people participated in a demonstration in Tullamore regarding the forthcoming closure of Tullamore Hospital as a surgical hospital? I take it from the reply given by the Minister that this hospital will be turned into a community hospital; in my opinion, it will be better known as an old folks' home.

That is what the Deputy would like.

It will not be regarded as an old folks' home. So far as the demonstration was concerned I was not aware of it but I take the Deputy's word on the matter.

Is the Minister aware that in the south-eastern region there will be four general hospitals? The population in this area is 320,000 while in the midland region, which has a population of 178,000, there will be no general hospital whatever. Could the Minister explain that?

I can explain it by reason of the fact that it was the Mid-Western Health Board who decided that there would be these hospitals and that they would be located as I proposed.

Will the Minister indicate the considerations that were responsible for his departing from the very firm recommendation in the FitzGerald Report that Tullamore would be the general hospital for the region?

The FitzGerald Report made certain recommendations. It included Tullamore as one of the sites for a major general hospital but I decided I would consult Comhairle na nOspidéal who laid down the guidelines which I am sure are well known to the Deputy. These guidelines were proposed by Comhairle na nOspidéal. All the various health bodies, from An Comhairle downwards, were consulted. The eventual decision by the Mid-Western Health Board was that there would be a hospital at Portlaoise and another at Mullingar.

We are all aware that consultations take place on these matters. The Minister knows that the FitzGerald Report clearly and positively recommended that Tullamore be the general hospital for this region. Can the Minister assure the House that he decided on medical grounds to downgrade Tullamore from being a general hospital to being a mere community hospital, or was he influenced, as is widely suspected, by political motives in this decision?

So far as I was concerned I had made up my mind some time ago. I submitted the proposals to the Government who approved them. As far as the FitzGerald Report is concerned, I do not think anyone is happy with it apart from those towns where the FitzGerald Committee proposed that hospitals be sited. To say the least, when the FitzGerald Report was issued there was no enthusiasm for it from any side of the House. I believe that the FitzGerald Report recommended too few hospitals and I still believe there should be greater facilities at shorter distances for people who need urgent hospital attention.

Would I be right in stating that according to the latest issue of the Medical Journal, Comhairle na nOspidéal were not consulted——

Not consulted about what?

By the Minister in relation to his recent announcement on hospitalisation.

Whether they were consulted or not—well, it does make a difference because Comhairle na nOspidéal are held in high regard—but it was Comhairle na nOspidéal that laid down the guidelines whereby there would be a catchment area of 100,000 and the distance from a hospital would be no more than 30 miles approximately.

Further arising——

I have allowed a lot of latitude on this question. This must be a final supplementary.

I think the Ceann Comhairle will admit that in the opinion of the people of Offaly and the people of the whole region this is a very important matter——

The Chair has given latitude in that regard.

I should like to know if the Minister's decision in regard to the Midland region is open to negotiation of any kind or is it final? Is it a final plan?

That is the final plan as recommended by me and approved by the Government. I believe the area will be well served in the proposals that have been made and the decisions that have been made in relation to Portlaoise and Mullingar. Neither the Deputy nor anybody in Tullamore should assume that there is this awful downgrading that the Deputy describes. It will be deemed to be a community hospital and its functions will be decided in discussions between the health board and the Department of Health.

In other words——

The answer is that there is no question of Tullamore being without a hospital——

Much as the Deputy would like to see it close down completely it will still be there.

I want to say to Deputy Flanagan——

A question please, Deputy.

——that I attended meetings both in Portlaoise and in Offaly and I did not try to be on the two bandwagons like the Deputy, who fell off. I have great respect for the Deputy but I want to tell him that he got a sweet pill.

The Minister knows my attitude. I was in Tullamore when the Deputy was on the bandwagon.

Order. There are very many questions on the Order Paper and we must move on to other questions. Deputy Connolly may ask one final supplementary.

I want to say that as far as the people in the midland region are concerned this is the worst decision that could be made since the year of the famine.

Next question please.

I should like, with your permission, a Cheann Comhairle, to raise this matter on the Adjournment.

I shall communicate with the Deputy on the matter.

I appreciate that possibly the Deputy has not been able to treat the case in as detailed a fashion as he might be able to do when the debate on the general hospital plan will be taken in a short time when I introduce a supplementary estimate for that purpose.

3.

asked the Minister for Health when he will be in a position to approve recent plans submitted by the Midland Health Board for continued improvement in facilities at the County Hospital, Tullamore, County Offaly.

Various proposals for the improvement of facilities at the County Hospital, Tullamore, have been submitted by the Midland Health Board. These will be considered in the light of the general hospital plan and the health board's priorities but I cannot at present indicate when it may be possible to proceed with such of the improvements as may be agreed.

It seems now that they will not be approved in view of the downgrading of the hospital.

No, that is not so. There are various proposals from the eight health boards throughout the country. There are a number of proposals from practically every health board and these include a number from the Midland Health Board area. Certain of these proposals are not regarded as top priority—I do not say that they are discounted entirely. The order of priority has been described to me by the health boards—for example, establishment of a day hospital—that is not scrapped: provision for new stores, a new mortuary and autopsy room; a health centre; extension of x-ray department and the provision of a day care centre. The Deputy need not assume, as he seems to do, that no more improvements will be carried out at Tullamore hospital. That is entirely wrong.

Question No. 4.

I am sure the Deputy is disappointed now to hear that.

Deputy Haughey.

Deputy Connolly would like to have a story to go back to the lads with. He painted the picture all wrong.

The Deputy will have to digest it because he has got the pill.

I know the Deputy does not like this but he should bring back a copy of the Minister's remarks. The position is not at all as he painted it.

Order; Deputy Haughey.

The Minister is aware from the number of questions put down to him from time to time that there is serious overcrowding in Tullamore hospital at present and for some considerable time. If he is not prepared to sanction these proposals which are before him for the hospital, can he give us any indication as to how these patients who are at present in overcrowded conditions will be catered for? Is it the intention that they be sent to Portlaoise or Mullingar or what will the outcome be? Further, in view of the present position with this downgrading—and no matter what Deputy Flanagan says, it is downgrading of Tullamore—will there be any major, first-class general hospital in this region if Tullamore will not be such a hospital?

I have told the Deputy that there will be hospitals in Portlaoise and Mullingar.

Will they be major, regional hospitals?

We are now getting back to the previous question.

As far as overcrowding is concerned I do not know if Deputy Haughey is conversant with the position that——

I have seen it.

Wait a moment—for years and years, not alone in Tullamore but in various hospitals all over the country—I am sure he found that himself in the election campaign, in County Mayo—as far as I can gather from my visits around the country there has been overcrowding in all these hospitals for very many years and there was not a hell of a lot of money spent in attempting to——

There was plenty of money spent on Tullamore.

——provide extra beds in these hospitals. I find myself in the position that I have a backlog of things that must be done in the Department of Health and which appear to me to have been neglected for very many years.

Not in Tullamore. We spent a £1/2 million there.

Question No. 4.

We provided the money.

I am on the health board; the Deputy is not. I know the facts; the Deputy does not.

Deputy Flanagan is muzzled now.

I am a member of the health board.

Order. Let the interruptions cease.

Why does Deputy Haughey not go into the Dublin hospitals and see what is happening? I have known a case where a girl——

Let the interruptions cease on both sides of the House.

——tried five hospitals to have an X-ray carried out and she cannot be X-rayed until 14th December.

Order.

We will look after Offaly. The Deputies opposite should keep to Dublin.

You have let them down.

Is the Minister aware that we are discussing Tullamore hospital?

Order.

If that is Deputy Connolly's and Deputy Power's contribution they are welcome to it.

Is the Ceann Comhairle going to sit there and let Deputy Flanagan ignore his orders and flout the Standing Orders of this House?

The Chair is seeking to restore order. I must ask Deputies to have regard to the large number of questions and allow the Chair to make some progress and also to have regard to the order and decorum that should prevail in the House.

The Chair might address his remarks to where they should be addressed to the Parliamentary Secretary, Deputy Flanagan.

There is disorder on both sides of the House.

We are talking about Tullamore Hospital and I want to ask the Minister if he is aware that this is one hospital which has been kept up to date and on which a great deal of money has been spent and that any overcrowding in this hospital is a matter of very recent times? He is now the Minister for Health and there is absolutely no point in his telling us what happened years ago. He has the responsibility. Is he going to face up to the responsibility, sanction these plans for approval and enable this serious overcrowding in Tullamore to be done away with?

Yes. Not alone will I concern myself about Tullamore but I will concern myself about every other hospital in the country.

Tullamore will do for the moment.

Wait now. There are more towns in Ireland than Tullamore.

Just for the moment.

The Parliamentary Secretary has been shouting. If I did it I would be outside the gate.

Has the Deputy a supplementary question to put?

May I ask the Minister, is it a question of having no money on hands for repairs to hospitals?

I have plenty of money.

You told the party conference that you could not borrow any more.

I have plenty of money but, like many Ministers, I could do with 20 times more to make up the back-log that was neglected by Fianna Fáil.

The Public Accounts Committee had a bit of trouble in finding some of the money when the Deputy was in power. You squandered the money. It could not be accounted for. Never forget that. If we had it now, we could put it to more use.

Could I ask Deputy Flanagan, please, to cease interrupting?

He has his voice back again.

He cannot go into Tullamore anymore.

4.

asked the Minister for Health the total amount of money spent on Tullamore Hospital, County Offaly for each of the years 1970 to 1975, inclusive; and if he will give details of the expenditure.

I presume that the Deputy is referring to capital expenditure on this hospital. The amounts of such expenditure for the years in question were: 1970, £13,000; 1971, £160,000; 1972, £125,000; 1973, £59,000; 1974, £99,000; 1975, £14,000. This expenditure covered the cost of a new 100-bed geriatric unit, which was opened in December, 1973, an extension to the X-ray department, recently completed and X-ray equipment.

Proving our point.

Not proving your point. It seems that there was a major scheme going on over a particular period of years, the provision of a geriatric home. That took the bulk of the money.

It seems that there has been a vast amount of finance spent on that hospital. Will that all go to waste? As the Minister is aware, there is a cloud over the hospital now and it will be difficult to hold staff in the hospital never mind replace them.

The Deputy was complaining some few minutes ago that this would deteriorate, I think he said, into a geriatric unit. As a matter of fact, the bulk of the money I have described— over £100,000—I have not the exact figure——

The £14,000 in 1975 is the key figure.

I am talking about the geriatric hospital, not talking about total expenditure. I should like to remind the Deputy also of the revenue expenditure in the same county hospital which in 1970-71 was £267,863; in 1971-72, £305,430; in 1972-73, £415,083; in 1973-74, £606,392, for nine-months in 1974, £695,000 and 1975—I am still talking about the Tullamore Hospital—it was £1,200,000.

Bring that down to them and show it to them.

The Parliamentary Secretary was on the two bandwagons. He has got his voice back. May I ask just one more supplementary? Is this plan which the Minister has announced in regard to the midland region final or is it open to negotiation in any shape or form?

The Deputy has already asked that question. We cannot have repetition.

I might not have got the Minister right with the interruption.

The Deputy is not listening. He does not want to hear the facts.

The Parliamentary Secretary does not want to hear them. He fell off the bandwagon and he is on a soft tyre now. Is it open to negotiation?

The Deputy has already asked that question.

It is not open to negotiation.

In any shape or form?

It is not open to negotiation. Decisions had to be made and decisions were made, something the Deputy's party avoided.

Next question.

No, we did not. Did we not announce the geriatric home and you changed the guidelines?

The FitzGerald Report was announced. Was it accepted by the Fianna Fáil Party?

It was.

It was not.

Next question.

It was, in principle.

When in trouble, grab your principles.

You changed the guidelines.

Comhairle na nOspidéal changed the guidelines.

Will the Chair be obeyed? I have called the next question on a number of occasions.

And everywhere there was a Labour TD you fixed them up.

Order. I have called the next question on a number of occasions.

Has the Deputy no regard for the feelings of Deputy Paddy Lalor?

He is well able to look after himself, as Deputy Oliver J. knows well.

I will look after both of you at the right time.

What about Deputy McDonald?

He is safe enough.

Question No. 5.