I wish to ask the Minister two quick questions, both of which are related to his commitment to increase the number of beds in the system. I presume he would regard the Coombe Hospital as a centre of excellence and one where, to quote him, it is safe to provide maternity services. What does he have to say to a young Dublin woman who went there recently to deliver her first baby who did not have a bed but was put in a wheelchair for seven and a half hours after giving birth? Would he regard this as being consistent with the commitment to have sufficient beds in the system? He talked about a commitment to provide beds but is there not an inconsistency in providing money last year for 265 additional beds only to have 250 of them closed yesterday? Is it an efficient use of resources to provide beds and then not fund them?

The Minister said he did not want to use the word "downgrade" but he spoke of the reconfiguration of services based on size rather than catchment area which gives rise to the issue of accessibility. He said he will not interfere in regard to the Royal College of Surgeons and the provision of supports because there will not be two consultants in some of the smaller hospitals to support accident and emergency services. In light of the fact that this year's budget is not based on last year's outturn and from the points made by the Minister it appears evident to many of the smaller hospitals that they are threatened with downgrading.

I am not aware of the individual case referred to by the Deputy in terms of the Coombe Hospital which has provided excellent services.

The service was excellent but the person would like to have had a bed.

I will check on that individual case with the Coombe Hospital, now that it has been raised in the House. We are aware that maternity hospitals have been under considerable pressure in Dublin for a variety of reasons over recent years. The Coombe Hospital has always discharged its functions in an excellent manner and the quality of service provided by it and, indeed, the other maternity hospitals in Dublin has been quite exceptional in many instances.

In terms of bed capacity, we must remember that the entire system is not ERHA-based. The 502 beds to which I referred are in operation. I can give specific information of where the various boards made proposals to us and we provided ring-fenced funding for this which was followed up this year in the budget. It is not true that 250 beds were closed yesterday.

They were announced. Some of them were closed.

There was an announcement that it was intended to close 250 beds and, as I said in reply to an earlier question, meetings are under way to try to ascertain the full nature of that situation and to discuss the difficulties that have been flagged by the Dublin academic teaching hospitals.

In terms of Deputy Naughten's question, the reconfiguration is not on the basis of the size of hospitals, it is on the basis of quality and health outcomes – what is best for the patient in terms of giving the right service and what particular hospitals can do best in their appropriate circumstances. It is also dictated by factors such as the consultant and junior doctor issue that I mentioned earlier. We are all aware that there is a European Union directive which is putting pressure on the Government to reduce the working week of junior doctors to 48 hours per week by 2009, which is in turn putting pressure on the system here. That is creating its own imperative for change and combined with the need to provide a more consultant-provided service is dictating the pace of the reforms that will emerge. The fundamental principles underlying the change relate to quality and patient safety.

There is still a question mark over Portiuncula Hospital and Roscommon County Hospital.