Hundreds of decent people from County Monaghan again braved the cold and inconvenience to make yet another trek to Leinster House to ask the Government to maintain crucial services at Monaghan General Hospital. Deputy Connolly has championed the community in County Monaghan time and again on this issue, to great effect. We want the Taoiseach to clarify exactly where the Government stands on the hospital's services because there is, on the face of it, a total contradiction between what the Tánaiste says will happen in the next two years and what was said today by representatives of the Taoiseach's party. The Tánaiste is promising that within two years the high care unit in the hospital will be closed, in addition to the medical services ward, which is open 24 hours per day, seven days per week. It was promised that the opening hours of the accident and emergency unit which has operated 24 hours a day, seven days per week, would be pared back to 12 hours per day and that there would be a similar paring back of X-ray facilities.

A Fianna Fáil Senator said to the people of County Monaghan outside the gates of Leinster House today that the Taoiseach was in full agreement with him that all current services should be maintained at the hospital.

Fair play to him.

The Teamwork report, commissioned by the HSE, is supposed to be driving this process but it states no services should be removed from local hospitals until better services are in their place. However, the downgrading of Monaghan General Hospital within two years will mean acute patients will be pushed off to the hospitals in Cavan and Drogheda which currently account for 20% of the national trolley count and are already overwhelmed according to the stated evidence of their dedicated staff.

The Taoiseach should not reply by stating the regional centres of medical excellence are the alternative. There is no contradiction between local hospitals, where day surgical procedures and minor and intermediate surgery are carried out, and centres of excellence for more serious procedures. More significantly, no date has ever been set for establishing centres of medical excellence. It will happen in the dim and distant future. Within two years, if the Tánaiste's writ runs, all the aforesaid services will be lost from Monaghan General Hospital. She has already in place an implementation group to try to put this into effect.

Is the Deputy referring to me or the Tánaiste?

That is not the Tánaiste.

I should have referred to the Minister for Health and Children, Deputy Harney. Does the Taoiseach stand for the agenda of the Minister or for the absolutely reasonable demands of the people of County Monaghan?

Hear, hear.

That is one question to which the Deputy will not get an answer.

The Ceann Comhairle is very familiar with this issue. Deputy Higgins's quotation was correct in that I agree with my Senator colleague who stated we should not close any of the services in Monaghan General Hospital until we provide better services in the region. That is what he said and that is the position.

I met the Monaghan action group, the staff and some of the general practitioners from Monaghan General Hospital. They identified a number of services that they wanted to keep. The HSE representatives, whom I met recently, said they were prepared to keep them open until a better service could be agreed. I hope senior members of the HSE can agree on these issues which have been discussed backwards and forwards.

Approximately 15 patients per annum who tend to be extremely ill would be minded better and more safely in Drogheda than in the high dependency unit. There are too few patients to deal with in the latter unit. The clinicians and specialist staff have been clear on this; they have said this is the better way to deal with the issue. They made this clear at a number of meetings and I have read what they said.

On the longer term issue for the region, citizens should have available to them top quality health services that meet their needs within their own region. There is a short-term plan and a longer-term one. I have seen the papers produced by both sides and hope there will be a meeting of minds to reach agreement on the issue. An enormous effort has been made by everybody. Everybody involved means well but the HSE has set out clearly in the documents I have seen the services it will keep in Monaghan until a better service is made available elsewhere in the region.

That is not what happened.

It has set down the services it believes it will keep in the longer term.

The people were told something different on the night——

They have been stealing services——

The Deputy should allow the Taoiseach to continue.

It is a period of several years.

Reference was made to a period of two years, after which the services will be removed.

Deputy Connolly should note that it is Deputy Joe Higgins's question.

I have talked to Professor Drumm and senior individuals in the HSE and they have said clearly and put it in writing, having attended the meetings in Monaghan, that the existing services will not be closed until a better service is available.

The Minister is telling us something different.

I am not.

She told us something different on——

Deputy Connolly will have to find another way to raise the matter.

I have no other way.

If the Deputy wants to continue to raise it now, he knows the choice he faces.

I know Deputy Connolly has been arguing the point for a long time. HSE officials attended meetings in Monaghan and met the Oireachtas Members. They have said they will not close any service until they provide a better one elsewhere in the region.

That is untrue.

That is what they have said.

They have already closed services.

I can only quote what they have said.

They have given an undertaking on foot of that position. It is only where there is an issue of safety, in respect of which I mentioned the 15 patients per annum who pass through the high dependency unit, that patients will be treated elsewhere. I honestly believe——

In one bed.

——that everybody, on both sides, rather than having a go at each other, albeit through legitimate protest, would be far better off if they set down to discuss what both sides are saying to try to reach agreement on the matter. The more it is talked up, the more difficulties will be created, and the problem will not be resolved. The Teamwork Management Services report, commissioned by the HSE, outlines the long-term position, but it also outlines the short-term position. It should at least be possible for those concerned to agree on what both sides are saying and the medium and long-term strategies.

On which side is the Taoiseach?

I honestly believe that if there were calmness——

We have tried.

The objective is to ensure a quality, safe health service will be provided for the people of County Monaghan. This is what it should be about and I hope it is.

That is what we want.

If each side calmed down and listened to what the other was saying, we should be able to reach a solution. I have read the statements of both sides and they are not that far apart.

The problem is that for several years the Taoiseach has backed and facilitated the extreme right-wing ideology of the Minister for Health and Children, Deputy Harney, and her party, the Progressive Democrats, in crucial areas of the health service. He has even done so by not restoring the thousands of beds ruthlessly cut from the system in the 1980s and by allowing cowboys — speculators and builders — to treat health care as a product on the market by building private hospitals.

It is very difficult to obfuscate about the situation at Monaghan General Hospital and get away with it. The Taoiseach may say with regard to mental health services for children that he cannot do the work immediately but these services exist in Monaghan County Hospital for the community of County Monaghan. Therefore it is easy to be very clear on what will happen in the next two years.

I would like the Taoiseach to state in his final reply whether in two years time the high care unit, the seven day, 24 hour medical services ward, the seven day, 24 hour accident and emergency unit and the extra facilities will be there and fully functioning to provide the service that is needed in County Monaghan. The Taoiseach could be very specific about that and clear up what is on the face of it a complete conflict between what the Minister for Health and Children is saying and what the Taoiseach was quoted as standing for at the meeting today.

It is important that the Taoiseach is clear on this matter for this community and for communities around the country because this is a pilot project. If the Minister for Health and Children gets away with what she clearly has in mind with the cutbacks, the same will come to hospitals around the country. A great deal is at stake. The Taoiseach needs to be very clear, and state in black and white the position of the Government of which he is head. He can resolve this issue in the next minute, to everybody's satisfaction.

I will be very clear. I emphasise again that no service will be changed in Monaghan before a better service replaces it and any change will be planned well in advance. The change will be for the good of the patients in Monaghan.

That is not clear at all.

On a point of order.

The Taoiseach is out of touch.

That is not what the Minister for Health and Children told Oireachtas Members on 9 November, and county council members.

There are other ways in which the Deputy can raise that matter and the Chair will facilitate him in that.

I have absolutely no other way to raise this point. The Minister for Health and Children told us a completely different story on 9 November.

Deputy Connolly is being disorderly. It appears to the Chair that the Deputy wants to leave the House and if that is what he wants, the Chair will facilitate him.

The Minister told every Oireachtas Member from Cavan-Monaghan that these services are going in two years. I ask my colleagues to stand with me. I have no option.