I join Deputy Kenny in extending Christmas good wishes to all Members of the House, the staff and the members of the media who are present. While we can sincerely make these wishes, for some families this will be a Christmas that will be all too painful and one which they wish they would not have to face. How many more deaths will it take before the Taoiseach will personally intervene in what I can only describe as the scandalous, reckless and life-threatening downgrading of Monaghan General Hospital?

The Taoiseach is aware of the justified anger and outrage throughout the country at the tragic loss of little Bronagh Livingstone's life. He is also very much aware of the great courage of her mother, father and family. Despite their immediate grief, hurt and loss, they have gone before the nation and given a full account of their tragedy and the tragedy that faces the community which I and others have represented for some years. Will the Taoiseach join me in paying tribute to the Livingstone family for their courage and public spiritedness in seeking to ensure this tragedy will not visit another family? Does the Taoiseach realise that what happened in Monaghan has already happened in this terrible year within the North-Eastern Health Board region, where another child was lost during delivery en route between Dundalk and Drogheda, having been turned away from the Louth hospital at Dundalk? Will the Taoiseach advise us—

Your time has concluded.

I will conclude with this. What is happening at Monaghan and Dundalk is but a template that will be visited on other hospitals throughout the country. This is not just a local or regional issue but one that requires the active challenge of people throughout the 26 counties and on an island wide basis. I am anxious to hear the Taoiseach's response to these questions.

The Minister for Health and Children made our position clear last week. I take the opportunity to restate my personal sympathy to the mother and family concerned. It is a tragic period for the Livingstone family and the Government commiserates fully with them. The Minister for Health and Children will meet members of the family today. Although the Minister might not like me to say so, there is no Minister for Health and Children that would understand the tragic loss of a child more than he would and that is very much reflected in his reports to Government on this topic in recent days.

In his professional capacity, the Minister for Health and Children immediately instructed the North-Eastern Health Board to carry out a full review of the incident and provide him with a detailed report of the circumstances surrounding the case. An external review group independent of the board has been established to evaluate the health board's report. The House probably already knows the membership of the group, which comprises Dr. Seán Daly, Master of the Coombe Women's Hospital, Maureen Lynott, Project Director of the National Treatment Purchase Fund and Bridget Boyd, Clinic and Midwifery Manager of the neo-natal unit at the Coombe Women's Hospital.

The board's report was completed on 16 December and the findings are being evaluated by the review group at present. The review group's report will be completed as a matter of urgency for presentation to the Minister and he intends to publish the findings by Friday. I hope we can establish the full circumstances of this so we can learn from it. There are protocols and regulations in place and we understand the difficulties in Monaghan. The full facts will be put in the public domain. That does not take away from the tragedy for the Livingstone family with which I completely empathise.

The Taoiseach knows this is not the only loss of life this year that can be argued to be attributable to the decision to downgrade and remove services from Monaghan General Hospital. There was also the tragic death of Christina Nutts earlier this year. In his response, I have not noted an indication on his part to make a direct intervention despite repeated appeals to him throughout the year. It is imperative for him to do so.

Who determines policy in relation to the delivery of health care and acute hospital services in particular? Is this done by the Minister, the Department and the Government or the bureaucrats and the unaccountable professional bodies who act like tsars within our health service? Is the Taoiseach prepared to take on these outside bodies that dictate the reality of the daily delivery of the health service?

Your time has concluded.

On numerous occasions here, we have heard the response that this is a matter primarily for the North-Eastern Health Board. Is the Taoiseach aware that at yesterday's meeting of the North-Eastern Health Board the members were gagged and refused the opportunity to address the most important and pressing matter facing the people of the north eastern region and the country today? How does the Taoiseach view that decision yesterday?

We spent considerable time this year talking about Monaghan General Hospital. I have been in the hospital this year and some of the issues the Deputy mentioned—

It is the first I have heard of it. Can the Taoiseach tell us the date?

I was there and I was very disappointed the Deputy did not turn up when I met the staff there.

The Deputy is obviously not in touch as much as he thinks.

The hospital was taken off call on 2 July 2002, in response to medical advice from the consultants based at Monaghan General Hospital and the medical adviser of the North-Eastern Health Board as the hospital was unable to provide a 24-hour anaesthetist service due to various difficulties as the Deputy is aware. If following a tragedy in any hospital, the Minister or Government had decided to ignore the professional advice of the consultants, the Royal College of Surgeons in Ireland, the Royal College of Physicians of Ireland and the College of Anaesthetists, there would be uproar in this House. No Government can do that.

The obstetricians, gynaecologists, anaesthetists and all the others have given their professional advice. Although it has created difficulties, the Minister for Health and Children along with his officials and members of the North-Eastern Health Board have given enormous time to this. Maybe Deputy Ó Caoláin thinks they are all bureaucrats and know nothing, but I would not ignore the advice of the Royal College of Surgeons in Ireland, the Royal College of Physicians of Ireland and the College of Anaesthetists. If I did so I would be held accountable in this House as being totally irresponsible or leading an irresponsible Government.

The Minister will continue to work on this in every way he can. I could give a list of all the additional posts, consultants and facilities he has provided for Monaghan General Hospital. I have no doubt this will continue. The Minister has approved consultants in dermatology and general medicine and done a number of other things. He will continue to deal with the difficulties there and I will remain in touch with him on those issues.

A reduction in the number of junior doctors at the hospital has just been announced.