John Perry
Question:6 Mr. Perry asked the Minister for Health and Children if he will guarantee that all health service development projects included in the national development plan will go ahead in the period 2000 to 2006. [19386/01]
Other Questions. - Health Service Projects.
The capital programme for the health services under the national development plan represents a major initiative by the Government to radically improve the infrastructure of our service. My Department has overall strategic responsibility for the national development plan to develop the health service infrastructure in a co-ordinated and effective manner. However, the prioritisation and delivery of individual capital projects at local level is primarily a matter for the health boards.
A sum of £2 billion was provided at the launch of the plan for the health service nationally for the period 2000 to 2006. As 2000 was the first year of the national development plan for the health services, transitional arrangements applied in relation to capital funding for health boards to ensure existing commitments were met while allowing scope for various new approvals throughout the country. As regards 2001 to 2006, capital funding was indicated to health boards for each of those years for various care programmes, such as disability services, child care, acute hospitals, etc. The actual funding available each year to individual health boards will depend on a number of factors, including adjustments in respect of various issues, such as inflation, changing service priorities, technological developments, new clinical practices, progress on the delivery of specific projects and market capacity in the construction industry.
Health boards have developed plans under the national development plan for the years 2001 to 2006 in line with the indicative funding levels notified to them by my Department at the commencement of the plan. The health board plans are expected to evolve over the period of the plan in line with prevailing service, financial and operational circumstances. It is, therefore, not possible at this stage to project the progress on individual projects proposed under the national development plan.
Is the Minister satisfied with the 15% inflationary figure attached to each development in the plan? Given that 100 developments are planned for the north-west, is he satisfied that the programme management has the capability to deliver the plan? Is he satisfied with the significant gap which exists between the allocation of funding and the development plan adopted by the health board, particularly in relation to the strategy for the elderly which has not yet been put in place? I am concerned that the information and communication technology plan, particularly in terms of general practitioner and hospital technology, is not in place. The strategy for the elderly should be in place at this stage.
The Deputy wants to know if we can guarantee that every project will go ahead. In the context of the reply I gave, we cannot guarantee that in every health board area because there is a range of planning issues, etc. Inflation, particularly over the lifetime of the plan, is causing me and health boards concern. It was significant in 2000. The St. Vincent's Hospital project, for example, was significantly above the original estimate. Admittedly, we included £25 million extra for theatre modernisation, namely, new theatres. Apart from that, however, there was still a significant increase in the estimate. That matter will be under continuous review. We will examine the entire capital projections in the context of the forthcoming health strategy.
As regards information technology—
The Minister's minute has concluded. I call Deputy McManus.
How long do I have to reply?
The Minister had one minute to reply to the supplementary. There are three Deputies offering. I will call them and then the Minister for a final reply.
Does the Minister accept it is not sufficient to say he has worries and concerns? It is clear that miscalculations have been made in terms of costs. We all need to know if the Minister is talking about the deferral or the scrapping of projects. The Minister may be aware that a senior civil servant in the Department has already been quoted as saying that hard decisions may have to be made. Is it time the Minister came clean about the fact that the cost estimates for the capital projects he was planning under this plan are wrong? He needs to indicate now what he intends to do and where he will make changes or cutbacks to the capital programme. People depend on these projects and it is important they are not led up the garden path in terms of what can be achieved within the timeframe of the plan.
Is the Minister aware of an article written in the Irish Medical Times on 22 June this year which states that by 2002 it appears increasingly unlikely that the £2 billion allocated to health projects will be anywhere near enough to meet the costs and that when one factors in the amount other projects will cost under the national development plan, health boards will have to put strong cases to ensure the health service does not come second to the Bertie bowl or Luas? That sums it up.
Who said that?
That was written in the Irish Medical Times.
I call Deputy Crawford.
May I finish? The same article deals with the nub of the subject.
The Deputy is aware it is not appropriate to quote on Question Time. I call Deputy Crawford.
Does the Minister agree that political indecision and poor planning has caused inflation to run riot and the effect of that is that planning for health services, which are much needed, will be set back by many years?
I may not be able to call Deputy Crawford and I would not like that to happen.
I have been advised that plans about specific projects were submitted by the North Eastern Health Board to the Minister last January.
The Deputy should ask a question.
The health board suggests the decision rests with the Minister. I ask the Minister to ensure that Monaghan General Hospital receives priority as quickly as possible.
It will be difficult to answer all those questions in one minute. We are reviewing the capital requirements in the context of the health strategy. The national development plan represented a trebling of the resources provided in the previous seven years. It is the first major capital investment in health by any Government almost since the foundation of the health service. That should be acknowledged in the House. Major projects are now under way as a result of that, such as St. Vincent's Hospital, James Connolly Memorial Hospital, Beaumont Hospital, Cork University Hospital, Galway University Hospital and other hospitals throughout the country, such as that in Portlaoise.
The Minister is a great man to flatter himself.
Huge projects are taking place which were not even dreamed of two or three years ago. That is the reality.
The other issue is that other health boards have come forward with other projects, notwithstanding their own prioritisation within the national development plan. Many Members of this House have also come forward with projects they want considered. Even in the interim period, we provided for projects that were not included in the national development plan. Demands are now being made on us in terms of interim projects while we are waiting for some of the major projects to be built, which will invariably take time. There is not an accident and emergency department in the country which is not planned for refurbishment and modernisation but, unfortunately, because of the design, planning, tendering, etc. process, it could take three or four years before many of them are built. We have a lot of interim work to do to alleviate immediate pressures on the services and the system. The health strategy will set out the framework for the modernisation of the health infrastructure and the requirements to do that—
Indecision, poor Government.
—but in the meantime we are going ahead with many other projects.
Ceist a seacht.
Indecision.
We have made decisions.
Does that mean the Monaghan project is in doubt?
I did not get a chance to deal with Monaghan.
Question No. 7 has been called.
It would embarrass the Deputies from Monaghan if the Minister spoke about it.
Deputy Mitchell, we want to try to get through as many questions as possible. The purpose of Question Time is to allow Members elicit information from the Minister.
It is difficult to get it.
When is "Answer Time"? We are not getting any answers.
The Deputy is getting a lot of answers today.
It is all questions and no answers.