I want to address the model 2 hospitals and the part they play in the health service. These are hospitals which do not provide emergency services. Model 2 hospitals resulted from the reconfiguration of the hospital system several years ago into centres of excellence as proclaimed by Mary Harney, thus taking acute services away from many county and regional hospitals. In return, the model 2 hospitals were to be developed to provide services such as acute medical assessment units, day care services and outpatient services and act as diagnostic centres to include scans in order that patients would access services close to their homes and within their own regions. Model 2 hospitals, therefore, were to provide services that would be complementary to those provided in the regional hospitals and relieve footfall in them, particularly in emergency departments.

The development of hospital groups was to drive this development forward. Model 2 hospitals are being starved of funding, finances and staff, and they are not being supported by both lay and medical management within the hospital groups.

Ennis General Hospital is the only hospital in the Mid Western Hospital Group that provides a medical assessment unit service seven days per week, yet the management of the group is proposing to close the unit and reduce the seven-day service to a five-day service. This has much more to do with medical politics than the delivery of care to patients. Effectively, it is a failure of the group to deploy resources properly. Considering that the Mid Western Hospital Group is unable to open its own medical assessment unit on weekdays, not to mind weekends, it defies logic that it would now propose to close the only seven-day medical assessment unit within the region, namely, that in Ennis. This will curtail services within the hospital in Ennis but it will also transfer considerable pressure to the accident and emergency services in Limerick because the patients who would occupy the medical assessment unit beds will now end up in the regional hospital in Limerick. Medical assessment units are part of the integration of the primary and secondary care elements of our health service, and discontinuing them will break that continuity.

Sláintecare addresses these issues and provides solutions. It demands that there be accountability and responsibility for decisions. Decisions should be made not for medical or political reasons but for patient care. Will the Taoiseach ensure that the existing services in Ennis will be maintained on a seven-day basis and that all model 2 hospitals will be expanded to provide medical assessment facilities on a seven-day basis nationally?

It is not quite correct to say model 2 hospitals are being starved of funding. I may be wrong about this but I believe every hospital, be it a model 3 or model 2 hospital, saw its budget increase last year and the year before. Therefore, the Deputy's statement is probably incorrect. I would imagine that the Minister, Deputy Harris, can provide the numbers to back me up.

I have never been fully comfortable with the idea of crudely dividing hospitals into model 3 and model 2 categories because different hospitals have different roles in different places. The hospital in Roscommon may have a very different role from the hospitals in Ennis or Nenagh, although they are all model 2 hospitals. Roscommon hospital, as the Deputy knows, has never been busier. It has seen major additions to its functions and patient numbers in recent years.

Ultimately, the whole point of establishing hospital groups was to give hospital groups autonomy and give them decision-making power regarding how best to deploy resources in their regions between the community and the hospitals, and among the hospitals. As the Deputy knows, Sláintecare refers very much to ensuring autonomy and ensuring decisions are made at local and regional levels and do not come from the Minister's office or the Taoiseach's office.

As the Taoiseach quite rightly says, the difficulty is not uniquely related to the Mid West Hospital Group. Roscommon has been striving to extend the opening period of its medical assessment unit from five days per week to seven days per week. The Minister for Communications, Climate Action and Environment, Deputy Naughten, has been pursuing this since he entered government. Unfortunately, he has not been successful so far.

Medical assessment units and model 2 hospitals are critical to health care delivery. Not only do they deliver medical assessment services but they also deliver day care, theatre services and diagnostic services. In Ennis, the theatre is idle for in excess of 50% of the time it is manned. The CT scanner there is operated for three hours per day on a five-day week basis. Therefore, it is operated for 15 hours per week. It does not work at weekends. This is a complete waste of resources. Model 2 hospitals have the capacity to develop and take pressure from our acute services. They have the capacity to supply services that are essential to patients without their having to go to accident and emergency services, which would clog them up and add to trolley queues.

I am informed by the Minister for Health that funding has now been extended to Roscommon hospital to extend the period of service of its medical assessment unit from five days per week to seven days per week. I imagine there will be a lag period in making that happen as staff are recruited and rosters are changed but that is very much under way.

The Deputy is absolutely correct. Model 2 hospitals and hospitals that do not have emergency departments can play a very effective role in providing for elective surgery and day cases, access to diagnostics and giving GPs direct access to these hospitals through medical assessment units. The fact that they do not have emergency departments means that they can plan care much better because they do not have to deal with the unpredictability as to whether 30 or 40 patients will need to be admitted from the emergency department on a given day. They can plan their work much more than hospitals that have emergency departments. Ultimately, decisions on resource allocations should not be directed by my office or the Minister. That is very much in line with the recommendations made in the Sláintecare report which states such decisions should be dealt with by the HSE and the hospital groups.