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mick wallaceOn Tuesday May 31st, Deputy Mick Wallace asked Minister for Health James Reilly if he planned to maintain the 24 hour A&E service at Wexford General Hospital. The Minister’s prepared response was read and was followed by a statement on the future of mental health services in Wexford. You can view the full exchange between Mick and Minister Reilly here  Mick Wallace Question 40: To ask the Minister for Health and Children if maintaining the 24 hour accident and emergency service at Wexford General Hospital remains in the long-term plans of the health service; and if he will make a statement on the matter.
James Reilly (Minister, Department of Health; Dublin North, Fine Gael) 
The Government’s priority in regard to acute hospital services is to ensure a safe and high quality of care for patients which is provided at the most appropriate location. I am committed to ensuring that all care is provided at the lowest level of complexity, is safe, timely and efficient and is available as close to home as possible, consistent with safe practice. Wexford General Hospital has an important and permanent role to play in the south-east region. It will continue to operate as a vibrant, fully functioning acute hospital. Acute medicine will continue at the hospital with an emphasis on increasing day surgery in line with international trends. The hospital will continue to operate a 24-hour emergency department but, in common with all other hospitals, the scope and composition of the department will be developed having regard to advice of the national clinical programmes, the service standards required by HIQA and the related requirements of acute hospital licensing, legislation for which is in preparation. As for all acute services, we should look at the future of Wexford General Hospital in the wider context of hospital networks functioning as part of a co-ordinated system. One of the prerequisites for the introduction of universal health insurance is strong and efficient hospital networks which provide the appropriate treatment at the appropriate level of complexity to the patients in their area. These networks will provide the basis from which the independent hospital trusts can be established. I also believe there must be strong clinical leadership at the head of the development of hospital networks. The clinical programmes developed by the HSE to improve and standardise patient care throughout the system are being led by clinical directors. They will support and direct the development of hospital networks and the safe and effective provision of services. We can ensure a well functioning acute hospital service in the south-east region by using the Government’s approach to networks and clinical programmes and the future of Wexford General Hospital is assured within this system.
Mick Wallace
I am glad to hear that the Minister intends to maintain a 24-hour accident and emergency service, as well as maintain the general upkeep of the hospital. He stated before the election that we cannot afford to downgrade Wexford General Hospital because we do not have capacity elsewhere to take up the load. He will be aware that the psychiatric hospital in Enniscorthy, St. Senan’s, has been closed. Some 25% of the people in the north of County Wexford are using the unit in Newcastle, which I believe is very good, but the remaining 75% have been diverted to Waterford. 
The 2010 report of the Inspector of Mental Health Services was critical of the facilities in Waterford but nothing substantial was done to improve the facility since the report was published. Adding to the existing problems in Waterford, patients from Wexford now use the same facility. The acute mental health service in Waterford Regional Hospital is located in a basement overlooked by a carpark and there are no occupational or recreational facilities for patients. In recent weeks, 16 of its 40 beds have been occupied by Wexford patients. Will an acute mental health admission service be established in Wexford General Hospital given that Waterford is clearly not fit for purposes and that requiring patients from Wexford to use the same service is hardly a great idea? Wexford is crying out for an acute mental unit.
 
James Reilly (Minister, Department of Health; Dublin North, Fine Gael)
Wexford General Hospital is a separate issue to psychiatric services, which are being re-organised in the south east and Wexford in particular. As I noted in my original reply, it is important to site services as close to patients as possible and to this end the development of a community psychiatric service is well advanced. A crisis house will be open 24 hours per day, seven days per week and a psychiatric service will be made available in the community with the back-up of consultant psychiatrists. The local psychiatric teams have been engaged in the design and implementation of this service, which is only proper, and patients will receive a much better service than the one described by the Deputy. That is the way forward. I defer to the Minister of State, Deputy Kathleen Lynch, who has responsibility for this area but both consumers and providers of the service have indicated their preference for proceeding in the direction of more services and treatments in the community and less stigmatisation.
Mick Wallace
I agree that it will be great if services in the community are brought up to scratch but at present the people are going nuts in Wexford because they are demoralised about what is available in Waterford. Community facilities offer a way forward provided adequate facilities are put in place. James Reilly (Minister, Department of Health; Dublin North, Fine Gael)
I share the Deputy’s concern. The matter is being expedited and significant advances have been made to the point that services will be in place very shortly. This should be seen as progress rather than regress.
 

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