Vol. 649 No. 2
83 Deputy Charles Flanagan asked the Minister for Health and Children the reason the Health Service Executive is undertaking a cost-benefit analysis to determine whether it would be cheaper to redevelop the Central Mental Hospital on its existing site; if the Central Mental hospital will go ahead at the Thornton site; and if she will make a statement on the matter. [9384/08]
144 Deputy Ruairí Quinn asked the Minister for Health and Children if she will review the decision to transfer the Central Mental Hospital from Dundrum to Thornton Hall; and if she will make a statement on the matter. [9310/08]
I propose to take Questions Nos. 83 and 144 together.
The Government decision in May 2006 to approve the development of a new national forensic mental health facility at Thornton Hall, County Dublin, also required that a cost-benefit analysis be carried out. Department of Finance guidelines require that all projects over €30 million are subject to a cost-benefit analysis. This cost-benefit analysis is currently being undertaken and is expected to be completed by the end of March.
The new hospital facility will provide a therapeutic, forensic psychiatric service to the highest international standards in a state-of–the-art building. The decision to relocate the Central Mental Hospital is consistent with A Vision for Change, the report of the expert group on mental health policy, which recommends that the Central Mental Hospital should be replaced or remodelled to allow it to provide care and treatment in a modern, up-to-date humane setting and that capacity should be maximised.
The redevelopment of the Central Mental Hospital will constitute a separate capital development project independent of the prison complex to replace Mountjoy Prison and will be owned and managed by the Health Service Executive. The new hospital will be built on its own campus and will retain its identity as a distinct therapeutic health facility with a separate entrance and address to the prison complex.
I am glad to hear a cost-benefit analysis is being done. Was a cost-benefit analysis done before the site was bought, given the extraordinary sum which was paid for it? I had hoped the Minister and the Minister of State would have taken on board the concerns of the professionals involved in the service, outside professionals and voluntary groups and their dismay at the thought that psychiatrically ill patients would be placed on a site beside a penal institution and would be stigmatised as criminals when their problem is one of mental heath.
I had hoped the Minister of State would say the Government was considering leaving it at the site in Drundrum where there is ample land and where there would still be land left over to provide money for the HSE. We would hope that money would be ring-fenced for psychiatric services. What was the initial cost of this project? Was the original plan a mere fig leaf for the Government to justify the extraordinary sum paid for the prison site?
I do not have the figure with me but I will get it for the Deputy.
I presume the Minister of State is aware of a wide group of interests which have come together to oppose the moving of the site. Views have been expressed by organisations such as GROW, Aware, the Irish Civil Rights Commission, various unions, Amnesty International, Bodywhys, the Central Mental Hospital carers group, etc. All of them are strongly opposed to moving the Central Mental Hospital from Dundrum.
Is the Minister of State aware that Jim Power, chief economist of Friends First, of all people, has done an economic analysis suggesting that of the 34 acres in Dundrum, it would be possible to sell some of the land and redevelop the site in a cost effective manner? Will the proposal to move the Central Mental Hospital be reconsidered in view of these widespread concerns and the alternative economic analysis of the situation?
The Deputy will agree that the current location of the Central Mental Hospital, which was opened in 1850, is not suitable for a modern forensic psychiatric service.
Is the Minister of State talking about the building or the site?
I am talking about the building. The need to develop a new Central Mental Hospital is the responsibility of the HSE. A project team is progressing the development of the new hospital which will have a complement of 120 as distinct from 85 beds as at present. I should add that additional funding was provided in 2007 to enable the development of West Lodge, which is a high support community based residence in Lucan for six patients. The facility has been opened and patients have been placed there on a temporary basis pending finalisation of the formal approval of the relocation by the Department of Justice, Equality and Law Reform.
The list a previous speaker read out of organisations and voices opposed to the proposition of siting the Central Mental Hospital on the same site as the new so-called super prison to be located at Thornton Hall is not exhaustive. Without question, one could add to that list the Mental Health Commission, the clinical director of the Central Mental Hospital, the families and carers of the patients in the hospital and the Human Rights Commission, to name but a small number of additional voices which have roundly rejected the proposition. What is it that outweighs the concerns voiced by these eminent organisations and has the Department locked into proceeding with this proposal to co-locate the Central Mental Hospital's new facility adjacent to a super-prison? What information is guiding this obstinacy on the part of the Department of Health and Children with regard to what is, in the view of the greater number of Members of this House, including those on the Government benches, and all of the people concerned, an ill thought out and deeply wounding proposal?
I accept that the Central Mental Hospital's new facility will be adjacent to the prison being built to replace Mountjoy. However, it is important to stress that the project relating to the former is stand alone in nature. The new facility will, therefore, have a separate entrance to the prison. There will also be separate road access. From an organisational point of view, it will be operated by the HSE and not the Irish Prison Service. It is incorrect to state otherwise.
It will have a separate entrance. That is absolutely wonderful.
The Minister of State has experience as a physician. Does he not agree with the advice that was offered by a number of experts — including some from Australia and New Zealand — in recent times in respect of this matter to the effect that locating a therapeutic hospital beside a custodial establishment is the wrong way to proceed? The experts to whom I refer also referred to the inevitability of the culture of and approach taken by the hospital becoming more custodial rather than therapeutic in nature. A hospital is a place of recovery, not one of control. It was stated that where such co-location has occurred in other countries, members of staff from custodial institutions have been used to contain difficulties that arise in the adjacent hospitals. It is inevitable that the latter will happen and this will lead to the Central Mental Hospital being stigmatised.
I must point out that the Mater Hospital, a medical institution of world renown, is located adjacent to Mountjoy Prison.
That is a completely different situation. We are discussing a forensic hospital.
Will the Minister of State clarify the position?
We must proceed to the next question.
84 Deputy Tom Sheahan asked the Minister for Health and Children if she will request the Health Service Executive to provide interpretive services in hospitals for aurally impaired citizens, because there are no such services at present, in view of the fact that the HSE has agreed to extend interpretive services for non-nationals in hospitals; and if she will make a statement on the matter. [9427/08]
The HSE has provided access to interpretation services for aurally impaired citizens in hospitals. A survey carried out in June 2007 among all hospital groups found that, when required, interpretation services are provided directly by contracting the services of approved sign language practitioners; a number of hospitals have identified staff members with a knowledge of medical terminology who can use sign language; a number of sign language interpreters have been trained to work in hospitals; and arrangements have also been made with the National Association of the Deaf to provide interpretation services, when required and if available.
The HSE is obliged, under the provisions of the Disability Act 2005, to make its services accessible to people with disabilities, in as far as is practicable. In general, responsibility for ensuring that health services are accessible rests with local service providers. The sectoral plan prepared by the Department of Health and Children under the provisions of the Disability Act contains a range of measures to be taken by the HSE in this regard, including the designation of access officers, as set out in Part 3 of the Disability Act.
The Minister of State's reply is completely unsatisfactory. It is completely unacceptable that in 2008 we are dependent on volunteers and volunteer staff members to be available, on a haphazard basis, to assist in interpreting for people with hearing difficulties. Surely there are not so many hospitals that we cannot appoint to them properly accredited people to act as interpreters. The services of such interpreters could be shared among hospitals. Surely we should have properly appointed officers in place and we should not be dependent on volunteers or the goodwill of staff.
Under the one year review of the sectoral plan, which was set down in the Disability Act 2005, the HSE has committed to put in place access officers who will develop and deliver an appropriate training programme. This will ensure consistency across the health system in 2008. The key actions and timeframes relating to these access officers are the appointment of a national specialist in accessibility by the HSE by March of this year; the putting in place of a plan for the designation of access officers by September; and the commencement of the designation of said officers will take place by the end of the year.
I understand that the national assistant director with responsibility for disability currently chairs a group, the function of which is to provide support and advice and monitor compliance with the legislation. The post of national specialist in accessibility is currently being processed by the Public Appointments Service.
The Minister is reading out gobbledegook provided by officials at the Department of Health and Children. What is an access officer? We want interpreters to be appointed in order that patients might have their consultations and clinical examinations carried out in a meaningful fashion in order that people will not be misinformed and to avoid misunderstandings. Will the Minister of State indicate the nature of an access officer's job? It seems that such officers will be responsible for arranging certain things but a commitment has not been given in the context of appointing interpreters.
The remit of access officers is clearly set out in Part 3 of the Disability Act 2005. I am sure the Deputy can, like any other Members, seek out that information.
That is very useful.
85 Deputy Pádraic McCormack asked the Minister for Health and Children her views on the recent comments by the Irish Hospital Consultants Association that the new consultants contract is deficient in many areas and does not reflect the agreement announced in January 2008; the aspects of the agreement reached in January 2008 that were omitted from the proposed contract; if a revised contract will be presented to the consultants; when she expects the Health Service Executive to begin recruiting consultants; and if she will make a statement on the matter. [9398/08]
148 Deputy Eamon Gilmore asked the Minister for Health and Children the position with regard to agreement on the consultants’ contract; and if she will make a statement on the matter. [9325/08]
I propose to take Questions Nos. 85 and 148 together.
Negotiations between health service employers and the Irish Hospital Consultants Association, IHCA, on new contractual arrangements for medical consultants came to a successful conclusion on 24 January 2008. While the Irish Medical Organisation, IMO, withdrew from the talks on 22 January 2008, it engaged in subsequent dialogue with Mr. Connaughton, who had facilitated the agreement. Mr. Connaughton issued a final document on 1 February 2008 setting out the agreed position and his recommendations on a number of issues.
All parties agreed that Mr. Connaughton be invited to draft the formal employment contract and that a composite document summarising the key elements of the agreement be prepared and forwarded to him at the earliest opportunity. It was clearly understood — and agreed — by the employers, the IMO and the IHCA that this document would be a summary of the agreement rather than a formal contract.
On 22 February, a revised composite document, based on the various documents and recommendations issued by Mr. Connaughton during the course of the negotiations, was circulated to the IHCA and IMO. The national council of the IHCA considered this document on 23 February but deferred a decision on it until the end of March. We are satisfied that the document reflected the main areas of agreement under various headings. However, there is ongoing contact between the parties to clarify certain aspects.
As far as health service employers are concerned, the only substantive issue outstanding is the rate of salary applicable to academic consultants who sign up to the new contractual arrangements. This is the subject of ongoing contact between the sides. In the meantime, we need to proceed with the process of recruiting new consultants. I have already engaged in discussions with the HSE in this regard. The delay in filling posts in critical areas such as cancer care, neurology, rheumatology, respiratory care and mental health is having a detrimental effect on the development of much-needed services.
The Minister announced the agreement on the contract, to great fanfare, a couple of months ago. What has happened in the interim? Why is the IHCA of the view that nothing meaningful has occurred? Is it possible that a new contract will not come into being in 2008 and that the HSE will not, therefore, employ any new consultants, thus avoiding the €300 million shortfall it faces in the context of funding? Many people are coming to the view that this is the strategy.
How many new consultant posts will be filled this year? I would like the Minister to provide a definite number in that regard. She may, if she so wishes, provide written information at a later date in respect of the nature of the specialties to which these new posts will apply.
I do not accept that there are many issues outstanding. The agreement was reached and announced in good faith and was signed off on by Mr. Connaughton. As the Deputy is aware, we do not have agreement with the IMO. There were a number of issues in respect of which tidying up exercises were required. One of these related to academic consultants and another to emergency consultants and the current group thereof. We are satisfied that the composite document circulated recently to both organisations reflects the agreement that was reached. There has to be a contract, which is different from, although it encompasses, the agreement. Close to 100 consultants will probably be recruited but I do not know when they will all be in place. We have advertised for 68 and Professor Drumm announced 100 plus as a result of performance in accident and emergency departments.
There is funding for only 20.
The Deputy misunderstands. These posts are not being funded by additional revenue. The idea is that we suppress junior posts to create senior ones. All bodies acknowledge that we need 6,000 hospital doctors, 4,000 consultants and 2,000 juniors. We have 4,000 juniors and 2,000 consultants. The Deputy knows from his own experience that suppressing the cost of many of the non-consultant doctors will more than meet the cost of appointing consultants. The intention is that the additional resources, such as they are, will mainly come from the suppression of junior posts rather than additionality.
Some medical newspapers report that there is a problem with the detail of the 80-20 mix for consultants. Will the Minister clarify whether that is a problem? Is the Minister saying that there will be money to appoint extra consultants this year?
The move from 4,000 non-consultant hospital doctors to 4,000 consultants should be cost-neutral. This has been the subject of discussion for many years. It is not a question of keeping the 4,000 non-consultants and having 4,000 consultants as well. The Health Service Executive will receive an additional €1.1 billion during 2008.
There are transitional arrangements for the incumbents agreed over a three year period. The 80-20 mix will no longer be designated by beds but rather by volume so a consultant will be entitled to see one fee-paying patient in a public hospital for every four public patients he or she sees. That is very different from the situation in many hospitals today.
The Minister said agreement was reached in January.Why is the matter now being revised again and why is the Minister saying it may be the end of March before we reach an agreement? The Minister does not sound as confident as usual that this matter is settled. The negotiations started almost five years ago and the Minister announced a deal. Is the HSE stalling agreements and why would it do this and not appoint consultants? When will the consultants be appointed and by what process? Will there be a public advertisement and will they have to give notice where they are now? Will it be another year before they are appointed? What is the time scale for the appointment of the necessary consultants if this agreement is reached at the end of March?
We would have reached agreement with the consultants a long time ago if we had simply agreed with everything that everybody sought but there is give and take in negotiation. It was no different here and access to public hospitals for public patients was crucial to negotiating a new contract so that there would be one for equality of access to diagnostics, outpatients and so on. That is extremely important in facilities funded by the taxpayer in a society where we are all entitled to coverage.
It takes time to recruit consultants. It is a global search although many of the senior registrars will qualify for many of the appointments. We are seeking to bring the best doctors to Ireland, many will be our own people who work in Canada, the United States, the United Kingdom and elsewhere. For them to disengage from their existing employment and come here can take upwards of a year.
The HSE is not trying to revise anything. Mr. Connaughton, the chairman of the talks, announced the agreement. He was an independent chairman whom both sides respected highly. As in all agreements, when it comes to dotting the i's and crossing the t's problems arise. These mainly concern the academic consultants. We have offered a salary of €265,000 but consultants want €310,000. We have suggested referring the matter to the review group on higher pay because of that difference.
So there is no agreement.
The Minister has indicated that she regards the scandalous delays of up to 18 months in diagnostic procedures for cancer, including colonoscopy, as unacceptable. She has also cited the new consultants' contract as a means to address the situation. Will the Minister advise the House on how exactly that will be done, where the new consultants will be deployed and how that will impact on the scandalous waiting time?
I dealt with this earlier today. It is a matter of great concern, especially for cancer care, and Professor Keane is in discussions with the professional organisations, particularly the Irish College of General Practitioners, about the form of referral so that we can separate what would be broadly called urgent from routine cases. There are protocols and best practice models in place in many jurisdictions, including Canada, that we will put in place here. The intention is that people will be diagnosed within a two-week timeframe. They can get early diagnosis and treatment. That will be done for the main cancers at the eight centres.
We have all acknowledged that the best health care system is one in which consultants deliver the service, not just lead the team. That requires doubling the number of consultants. This year we will begin to recruit those additional consultants, including in cancer care.
If there are 6,000 hospital doctors comprising 2,000 consultants and 4,000 non-consultant hospital doctors, which will change to 4,000 consultants, the pay equivalents do not stack up. Junior hospital doctors cost so much only because of the inordinate overtime they do, up to 100 hours per week. I doubt that is envisaged in the new consultant contract, so it will never be a 1:1 or even 1:2 ratio. Will the Minister explain what ratio she is working off because, as I pointed out, there is funding for only 20 consultants although she talks about appointing 100?
Part of the new contract includes longer working days and cover for 24 hours a day, seven days a week, where required. We will not be funding the substantial overtime bills that we fund at the moment. These have arisen because of the manner in which we have employed consultants in the past. It is often the case that because consultants work across several different sites ward rounds are done in the evening and the team has to stay back on overtime to accompany the consultant so there are many such issues to be resolved.
I am not saying that the additional money will be a zero sum game for the Health Service Executive but the bulk of the additional resources will come from reducing the number of non-consultant hospital doctors, many of whom are qualified to be consultants, and enhancing the number of consultants.
86 Deputy Jack Wall asked the Minister for Health and Children if she has approved the Health Service Executive budget for 2008 and the addendum thereto; if she is satisfied that the proposals are adequate to address service needs; and if she will make a statement on the matter. [9323/08]
Under the Health Act 2004, the Health Service Executive, HSE, must prepare and submit a national service plan, NSP, each year in accordance with any directions from the Minister. The NSP must, among other things, indicate the type and volume of health and personal social services to be provided. The NSP for 2008 was submitted to me on 19 November 2007 by the chairman of the HSE board. In accordance with the Health Act 2004, I approved the plan on 10 December 2007 and it has been published.
In my letter of approval, I requested the board to pay particular attention in 2008 to the absolute necessity for the HSE to operate within the limits of its voted allocation in delivering, at minimum, the levels of service activity specified in the 2008 service plan. This means that the voted allocation, approved employment levels and service activities, within the HSE itself and in HSE funded agencies such as the major voluntary hospitals, must all be actively planned and prudently managed from the very start of the year.
Considerable additional funds, over and above those provided in the Estimates, are being made available to the HSE in 2008 as a result of the December budget day announcements. These additional funds are being provided for the further development of specific services in 2008, most notably services for older people, cancer services and services for persons with disabilities. At my request, the HSE has provided me with an addendum to the national service plan, detailing these additional services and enhancements. I approved this addendum on 20 February and it too is being published.
The HSE has been allocated almost €15 billion gross for 2008 in total current and capital expenditure, an increase of over €1.1 billion, or almost 9% when provision for the long-stay repayments scheme is excluded. I have emphasised to the HSE the need to secure greater value for money and cost effectiveness from its core funding. This is essential if the HSE is to meet its obligation to provide the best possible services within the funding made available to it.
Has the Minister any mechanism for ensuring that what happened, for example, with the money for A Vision for Change is not replicated with other moneys this year that have been specifically allocated for particular developments — in other words, money meant for a particular area actually being used to plug the holes in the HSE's budget? A Vision for Change, as raised by Deputy Neville, is of particular concern.
Is the Minister aware that unfilled positions are, in effect, saving the HSE money? Has she any way of ensuring positions will not be left unfilled in order to balance the budget? I raise this in the context of figures in the media at the weekend which showed that people were waiting up to a year and a half for colonoscopies, despite what was said after the sad death of Ms Susie Long, who had been waiting on a public list for this procedure but did not get it.
How will the Minister bring down those waiting lists if the HSE budget is so limited that it cannot even do what it did last year? I ask this because of the various pressures on money such as a rising birth rate, growing activity levels, medical inflation, national wage increases, etc.
A 9% increase is considerable. Ireland has been increasing current spending on health over the past decade faster than any country in the OECD, yet we have one of the youngest populations in the world. Only 11% of the population is over 65, as against 17% in the UK and 27% in Germany. The HSE has to manage its budget in accordance with the money voted for it by the Oireachtas. We cannot have over-runs. Money given for new developments, in particular, must be spent on them.
How will the Minister ensure that happens?
We have made it clear. The HSE has put procedures in place — I am sure we will discuss this in the morning at the Joint Committee on Health and Children — to ensure that moneys identified for mental health, A Vision for Change and disabilities are spent in those areas.
The employment ceiling is obviously important. Some 80% of HSE spending is on staff and, using full-time and wholetime equivalents, it employs 112,000 people directly or indirectly through the voluntary hospitals, which is a considerable resource. Last year, it employed an extra 4,000 people approximately and this year it will employ more people, but this will be justifiable in the delivery of new services.
Will the Minister confirm she wrote to the chairman of the HSE, Mr. Liam Downey, as regards the executive's national service plan? In the course of that correspondence, did she express concern over shortfalls in services to be provided in 2008 under the plan, especially in the whole area of mental health, as Deputy O'Sullivan has indicated, as well as primary care? How is the service plan target to reduce inpatient numbers in 2008 reconciled with the failure to improve primary care? Does she not agree that without the promised roll-out of primary care centres, there will continue to be an inordinate demand on acute hospitals? Does she not accept that, as Minister, she must approve the service plan for the HSE each year? If she is as discomfited by what is being proposed, should she not have taken steps to reject the plan and put the responsibility back on the HSE to present an initiative in keeping with the Minister's alleged intent?
The Deputy has raised a number of issues. Clearly, the preferred health system is one in which more procedures are carried out at community and primary care levels, and 90% of health needs can be met in these areas. This year, primary care teams are being rolled out and additional staff recruited, particularly as regards therapies, to ensure we have the range of expertise at community and primary care levels to provide a service. We are moving from inpatient to day cases, and in particular outpatients. Professor Keane has commented on this move.
The Irish norm is unusual in his experience where, after a person receives cancer treatment, he or she continues to attend the treating consultant. Best practice in Canada and internationally, he has said, provides that patients come back only in a rare number of cases. Follow-up treatment should be provided through the general practitioner. As a result of this practice, many people never get to see a consultant in the first place. Much of what we are trying to do is to change the way that outpatient and other services are provided.
As regards the plan——
Do we have enough general practitioners?
We have 2,500 general practitioners, who provide a very good service. People in the UK can wait for up to four or five days to see a GP, while in Ireland it is a same-day service, and a good one. As the Deputy knows, we are training more and more doctors. As I said in a different forum, health care professionals, like others, always do well in a well developed society. The reason we took such a strong view on the pharmacy issue was to save €100 million, so that it could be put into areas such as primary care and targeted at many of the other concerns raised by the Deputy.
The Minister said she approved the budget on 10 December and that the HSE had to work within its allocation and manage programmes prudently. That is the key to the whole problem. Who is responsible for prudently managing the budgets? Deputy Jan O'Sullivan said unfilled positions sometimes saved money. Unfilled positions sometimes cost hospitals a good deal of money. For example, at University College Hospital, Galway, a nurse cannot be appointed to the dermatology unit. Last year, some 30 dermatological patients were admitted to the hospital, at least 20 of whom could have been dealt with if a nurse had been appointed. They spent an average of five nights in hospital, equivalent to 100 bed nights, the expense of which could have been saved if a nurse had been appointed. When the manager of the hospital is asked about this, she refers the issue to the Health Service Executive.
Who is responsible for such problems in the Health Service Executive because it never gets back to the person concerned? A good deal of money is being wasted in hospital units. Talk of prudent management is a joke.
I must refer to the Minister's comments on general practice. It is a great shame, given that she mentioned the good work done by GPs, that the funding for GP training this year was pulled and the 75 extra places so badly needed to train doctors of the future will not now be available.
In light of the PPARS debacle and the Comptroller and Auditor General's report for last year, which identified another €4.5 million alone in IT overspend, Mr. John Purcell questioned the value of the HSE's report because so many errors and information gaps were contained in it. Given today's FitzGerald report, which specifically mentions the lack of clarity of roles for senior management in the HSE and poor communications, does the Minister have confidence in the executive to deliver the service for which she has paid it almost €15 billion in an efficient, effective and timely fashion?
Bearing in mind that an inadequate €44.3 million is allocated to the Road Safety Authority and 338 people died in road accidents last year, how can the Minister justify the allocation of just €3.5 million to the National Office for Suicide Prevention when 500 people die by suicide? How can she justify not increasing the level of funding this year?
A very competitive proportion is allocated to each area, be it cancer care, mental illness care, including suicide prevention, or primary care. They are all very worthy causes. The reality is that we have increased funding for health care substantially. The increase the HSE received since it was established, that is, over €4 billion, is more than we spent running the entire service approximately 11 years ago. This puts the expenditure into perspective. If money alone could solve our problems, none of us would be here today talking about the health service. A programme of massive reform must accompany investment and that is why I, along with many Deputies, believed strongly for 20 years that a unified system with consistently enforced standards in respect of cancer care and quality——
There is no consistency. There are different rates.
——was not possible under the former health board regime.
It is not happening under the current one.
On the question on confidence, the HSE is a new organisation and it is not perfect. It is the largest in the country and employs one third of all staff in the public sector. Many of the staff who work in the hospital sector work in voluntary hospitals that are not owned or controlled by the State. I accept they would not be able to function without the resources of the State.
A report on one particular hospital in Dublin, in which the HSE conducted a study, identified that 65 acute beds could be freed up, at no extra cost, if the hospital changed the way in which it went about its business. That is the kind of approach I support.
Deputy McCormack should note that there are 2,600 staff in Galway hospital and they comprise a considerable resource.
It needs a dermatology nurse.
The number has doubled in a relatively short period. I read a story about a patient who fell out of a bed, supposedly because there was nobody on hand to assist. I do not accept a lot of that but that is not to say hospitals could not do with more staff. There has been a considerable investment in resources in the acute hospitals in recent years.
Why can we not get a dermatology nurse?
Please, Deputy.
The Minister wants to make progress.
87 Deputy Michael Noonan asked the Minister for Health and Children where the proposed acute psychiatric unit to replace St. Ita’s psychiatric hospital, Portrane, will be located; and if she will make a statement on the matter. [9412/08]
145 Deputy Aengus Ó Snodaigh asked the Minister for Health and Children when the long-promised psychiatric unit at Beaumont Hospital, Dublin, will be delivered; and if she will make a statement on the matter. [9284/08]
I propose to answer Questions Nos. 87 and 145 together.
The development of an acute psychiatric unit at Beaumont Hospital to replace the facility at St. Ita's, Portrane, is included in the HSE's national capital plan for the period 2006 to 2010. A project team has agreed the staffing and operational aspects of the unit.
During 2007, with a view to optimising the location of the range of capital projects planned for the Beaumont campus, a development control plan process was initiated. The draft development control plan has now identified an alternative site for the development of the acute psychiatric unit. It will be necessary for the project team to revisit the design and layout of the unit in the context of the new site. However, this will also afford the opportunity to the project team to review the design in the light of the recommendations in A Vision for Change, the report of the expert group on mental health policy.
I thank the Minister for that response, which is clearly straight out of God knows what. The reality is that Beaumont Hospital was built 24 years ago and a psychiatric outpatient and inpatient unit was to be located therein. The proposed unit was taken over to contain the overflow of patients from medical and surgical beds and, subsequently, when that problem was resolved, it was used to store equipment. In 2004, planning permission was sought and obtained for the psychiatric outpatient and inpatient unit. The project went to tender in 2005.
I remind the Minister of State that there are 23 women in an open ward in St. Ita's Hospital with one shower, one bathroom and one toilet, bearing in mind that it is 2008.
How much was spent on the original planning application and tendering process for the psychiatric unit? How much was spent on architects' fees and legal fees? Can the Minister confirm that the unit is now being moved to accommodate the co-located private hospital in Beaumont? It is impinging on the site.
We must remember that the unit to be developed at Beaumont Hospital has been promised since the 1980s, yet an archaic and antiquated facility continues to operate at Portrane. Will the Minister of State indicate whether the identified site is on the site identified for the Minister's precious so-called co-located private hospital arrangement? What is the position on the proposal to develop the psychiatric unit at Beaumont Hospital? Will work commence thereon or will the whole project be cancelled and become a victim of the Minister's privatisation policy?
I did not hear the Minister of State say where the proposed acute psychiatric unit will be. We did not get an answer.
We do not have it.
To reply to Deputy Jan O'Sullivan's question, a site has been identified.
The Minister of State already said that. Where is it?
On the Beaumont campus. A review of the location of capital projects on the Beaumont campus was commenced in 2007——
Why did the original project not proceed? Why the change?
The site has been identified, the design has been approved and the staffing and operational aspects have been agreed, but in light of the development control plan, the campus had to be considered in its entirety.
Has the co-location proposal resulted in the movement of the proposed psychiatric unit from the site originally intended?
It was a matter for the board to examine the overall development of the campus.
"Yes" is the answer.
"Yes" is the answer.
This was done in the development control plan of 2007.
Written Answers follow Adjournment Debate.
