Does the Minister acknowledge that changes in training rules being implemented by the Royal College of Surgeons in Ireland as signalled by the Irish Medical Organisation have been in the offing for some considerable time? What steps is the Minister taking to ensure that current provision of accident and emergency services throughout the hospital network in the State will continue unaffected by these changes and that people in communities and all of us traversing the country have a guarantee that those accident and emergency services will remain in place?

The situation in the Monaghan and the North-Eastern Health Board region has been referred to on a number of occasions this afternoon. The hospital in my community in County Monaghan has remained off call for almost 12 months. Ambulances responding to accidents in our immediate community cannot deliver patients to Monaghan General Hospital but are obliged under diktat of the health board to bring those patients a considerable distance to other hospitals at some considerable risk, as we have only too sadly recorded in our community. What is the Minister doing to ensure the restoration of Monaghan General Hospital to on-call status? Will he ensure that accident and emergency services and, indeed, the level of maternity care that our community both demands and deserves, are provided there.

I do not interfere with the protocols issued by the Royal College of Surgeons in terms of accrediting hospitals for training purposes, in particular training for non-consultant hospital doctors, the quality of that training and so forth. The key principle of the Hanly report is to move to a consultant-provided service as opposed to a consultant-led one which is what we have at the moment. We are currently too dependent on doctors in training which is giving rise to the annual or biannual problems in many hospitals around the country in regard to whether they will have junior doctors, they will get accreditation and so on. We need to transform that situation and the ultimate way to do that is to move from a system that is too dependent on doctors in training to one which is consultant-provided. In essence there would be more consultants and a trade-off between the number of consultants and junior doctors that currently exists.

Jointly with the North-Eastern Health Board, we appointed Mr. Kevin Bonner to carry out a full report on the issues around the Monaghan situation. I do not intend to intervene in the way the North-Eastern Health Board discharges its duty in terms of protocols for major accidents. It is common sense and a basic principle in terms of accidents, as Deputy Twomey alluded to earlier, that anyone involved in a serious accident should be stabilised at the nearest hospital. He or she can then be moved on to the correct centre where proper effective interventions can take place in terms of multidisciplinary teams of consultants on standby. That is established practice and that has happened for years without any hue and cry.

We are talking about now.

It is interesting that when I announced the appointment of additional accident and emergency consultants three years ago everyone started roaring and shouting about accident and emergency consultants, but they had nothing before that and many hospitals had never even contemplated having them. As soon as we announced an increase in the number every area in the country wanted one.

The Minister says he will not intervene or interfere but I argue that it is long past the time he did both.

I am sorry but the Deputy will have to find another forum to argue his case.