Vol. 686 No. 3
23 Deputy James Reilly asked the Minister for Health and Children her plans to roll out a national colorectal cancer screening programme in view of the fate of the cervical cancer vaccination, which was also recommended by the Health Information and Quality Authority; when the first phase of roll-out will be implemented; and if she will make a statement on the matter. [26719/09]
Approximately 2,000 new cases of colorectal cancer are diagnosed and around 950 deaths occur from this disease each year in Ireland. Due to our ageing population and the long period in people's lives over which risk factors are built up, we can expect an increase in the numbers of colorectal cancer cases in the coming years. The national cancer registry has projected that approximately 3,400 new cases of colorectal cancer will be diagnosed per annum by 2020.
As with many cancers, early detection and treatment is one of the most effective measures of avoiding premature death. This is the reason population based screening programmes are so important and it explains why the national cervical screening programme was accorded a higher priority than the HPV vaccine programme. CervicalCheck is being implemented at a full year cost of €43 million. There are between 250 to 300 new cases of cervical cancer per year and 70 to 100 deaths. The successful implementation of CervicalCheck will result in a reduction of up to 80% in deaths from this disease.
On 17 June, two reports were published on screening for colorectal cancer. The first was a report by the national cancer screening service board on the development of a national colorectal cancer screening programme. The second was a health technology assessment carried out by the Health Information and Quality Authority. Both reports confirm that a properly organised screening programme would have huge public health benefits and that population based colorectal cancer screening would be highly cost effective. Notwithstanding the current budgetary situation, I am anxious to introduce such a programme at the earliest opportunity. Accordingly, I have requested HIQA to explore ways of delivering a high quality colorectal cancer screening programme within existing cancer screening resources and based on the range of advice contained in the two expert reports. That work will be overseen by an expert advisory group comprising representatives of key stakeholders, including my Department, the national cancer screening service, the HSE national cancer control programme, the National Hospitals Office, the Irish Cancer Society and clinicians.
HIQA's report is to be provided to me by the end of September and I will decide how to proceed when I examine it. The national cancer screening service has advised that based on previous experience it would take in excess of two years to proceed from policy and funding approval to the commencement of a national screening programme.
The Minister's figures are correct. We have been told that we could save more than 340 lives annually by rolling out screening for colorectal cancer. However, I am concerned that she has delayed implementation of the programme even though HIQA has advised that it provides value for money and the national cancer screening service wants to proceed with it.
Cervical screening was first introduced as a pilot project in late 1999 and early 2000 but ten years passed before it was rolled out nationally. The national roll-out of BreastCheck has been similarly protracted. Colorectal cancer screening, which has been costed at approximately €15 million, should be available sooner rather than later. What price is put on lives? When will the Minister make screening available?
Deputy Reilly will have to become accustomed to the reality that not every new service or initiative can come with a new price tag. Given that additional moneys will not be available for health services for the foreseeable future, it is a question of reprioritising resources.
The programme recommended to me had an upfront capital cost of €14 million but I want to see it done within existing capital infrastructure. The programme envisaged that doctors would perform colonoscopies but within Cork University Hospital nurses are already performing such procedures. The most effective programme involves sending individual kits to the population being screened, of whom about 6%, or 11,000 people, would require follow up colonoscopies. At present, we conduct 50,000 colonoscopies nationally.
I have met representatives of the Irish Cancer Society, which like me regards this issue as a priority. If we have to make choices, this will have to be next. The society has generously offered to provide funding from its private voluntary fundraising activities for the initial roll-out of the programme.
Screening programmes are substantially more expensive here than across the Border or in other countries because of the fees paid to professionals. In an environment where money is extremely limited, we have to explore the most innovative ways of introducing new programmes.
The big cost arises not from colonoscopies but from screening through fecal occult blood tests. I have no problem with finding money from within existing services given the huge level of waste that obtains. This has to be a priority and should be introduced sooner rather than later.
Last December, the Minister indicated that she wanted to see colonoscopies being performed within one month of referral. In April, however, the HSE revealed waiting lists of two years and more for colonoscopies in certain areas. I again ask her when we can expect the roll-out of this programme, irrespective of how it is funded. The money can be found, even if it has to come from the existing health budget of €16 billion.
Every week a new priority is identified. Last week it was Crumlin and the previous week it was orthodontics. Everything has to be an exception or involve additional moneys.
This is an important issue. The home kits will cost approximately €4.5 million but that is not the biggest element of the programme's cost. Between 75% and 80% of colonoscopies are performed within one month in respect of urgent cases. Professor Drumm has established a group to make that a reality for all cases. Challenges arise in two hospitals, Tallaght and Letterkenny. The group appointed by the professor will report directly to him on the issue. The two year waiting list to which the Deputy referred was for repeat colonoscopies rather than urgent referrals. We are making significant improvements and when I receive the report from HIQA at the end of September I will be in a position to make a decision.
24 Deputy Jan O’Sullivan asked the Minister for Health and Children the proposed co-located hospitals which will qualify for tax relief; the projected amount of that relief; if she has been informed as to the timeframe within which these hospitals will be operational; the number of private hospital beds which will be provided in co-located hospitals; if it is intended that health insurers will be charged the full cost of treating private patients in co-located hospitals; the way public hospitals’ budgets will be adjusted to compensate for the funding they currently receive for treating private patients; and if she will make a statement on the matter. [26456/09]
The Finance Act 2009 provides that the schemes of capital allowances for private hospitals and certain other health facilities will be terminated, subject to transitional arrangements for projects already in development. Provided that a co-located private hospital project conforms to the requirements of these transitional arrangements and otherwise satisfies the general requirements of the scheme of capital allowances, the tax relief will apply. The value of the tax relief in each case will depend on the level of qualifying capital expenditure.
The HSE estimates that from the start of building, the overall construction and commissioning period for the projects will be about 28 to 36 months. To date, project agreements have been signed on four co-located private hospitals involving a total of 976 inpatient and day case beds and of these, planning permission has been granted in respect of the Beaumont, Limerick and Cork projects. Preferred bidders have been approved for two other projects.
The HSE estimates that the loss of private health insurance income to the hospitals in respect of the six projects would be about €100 million, or an average of €16 million per hospital. This is in the context of their combined current budgets this year of €1.322 billion in public funding. This loss of income will be mitigated in part through income from the lease of lands and a potential share of profits from the co-located facilities. The question of the net impact on the budgets of participating public hospitals will be examined at an appropriate juncture.
Net losses of income are factored into the overall cost-benefit and value-for-money analysis for each project. It always has been an essential requirement that each co-location project demonstrates clear value for money to the taxpayer. The prices charged by private co-located hospitals in respect of private patients will be a matter for the hospitals concerned.
This project was announced four years ago, in July 2005, on the basis that it was a fast way of getting 1,000 extra beds into the system. Does the Minister accept that the project has been a failure from that point of view? We are four years on but not a single bed has been provided. Not a single brick has been laid for these co-located hospitals. Will the Minister consider abandoning the project at this stage, as it has not fulfilled its original intention? One of the criteria was that the HSE must be satisfied that all co-location proposals represent better value for money than building, commissioning and operating beds in the traditional way. More than 1,000 public beds are currently closed in Irish hospitals because of cutbacks. Would it not make more sense to provide funding to the public system to open those beds, rather than going through the whole process of building more beds at this particularly difficult economic period? According to what the Minister has just said, it will be 31 December 2013 before we can expect all these beds to be provided despite the fact that four years ago we expected they would all be provided by 2010.
The answer to that is "No". Among the reasons for the delay was the fact that planning applications were opposed and appealed to An Bord Pleanála, mainly by a former Deputy who is now a member of the European Parliament.
And by the Minister's Cabinet colleague from Cork.
No, I do not think he was involved in an appeal to An Bord Pleanála. He may have had issues concerning location. At around 1.30 p.m. Deputy O'Sullivan said her party wants to keep the VHI — which provides private health insurance and guarantees people preferential access to public hospitals and super-dooper hospitals — in State ownership, yet when we try to reduce the level of private activity in public hospitals by building these facilities there are also objections.
The representatives of St. James's Hospital came to me recently to make the case for the co-located facility. I invite the Deputies opposite to meet them and hear the compelling case they made. They said it would make such sense for their public hospital to have this facility provided. Perhaps the Joint Committee on Health and Children would consider inviting them in. There is no other plan. There is no public money available.
Why not use the 1,000 beds that were closed?
That would be a lot more expensive. The reality is that when we put private patients into public hospitals, we pay for all the staff and all the diagnostics, yet only insured patients or those who can pay themselves can get into those beds. The State is paying all the overhead costs, including staffing, so that does not make sense.
No, it does not. It would mean changing the whole system.
I want to see people admitted to our public hospitals on the basis of medical need. Although it does not concern a member of Deputy O'Sullivan's party, it is ironic to see that I am being criticised in a County Louth newspaper by a public representative because a doctor who signed a public-only contract will not get a fee for private patients. That public representative of the Sinn Féin party calls it "ludicrous" that there will not be preferential access for these private patients. There is a mishmash of hypocrisy in all of this.
Most of it is emanating from the Minister.
All our current hospitals are co-located. Some 20% of the beds within them are ring-fenced for private patients only and I do not think that is acceptable.
I will allow a brief supplementary question from Deputy Jan O'Sullivan.
The Minister knows very well that the Labour Party policy is that there should be no two-tier health system and everybody should be treated the same way. We should not have private beds in any public hospital, nor should we have the kind of system we have at the moment. It is disingenuous to state, on the one hand, that I am saying the VHI should stay in public ownership, while, on the other, the Minister is somehow suggesting that because of that I support private beds in public hospitals. Has the Minister considered how she will end the two-tier health system whereby we have private and public patients?
A major contribution to that is the new consultant contract where there will be a one-for-all list of diagnostics and there will not be preferential treatment. Under the Deputy's model of supporting private health insurance——
That is not my model.
——whether it is public or private, a VHI member has preferential access to public hospitals and super-dooper hospitals.
Not the system we currently have.
The Deputy wants to preserve that in State ownership, but I do not understand the strategic reason. They have preferential access to super-dooper clinics as well as private and public hospitals.
We want a universal health system.
The new consultant contract greatly improves matters, as we will see. It has only been in operation for a few weeks and there have already been complaints in Louth because of the one-for-all access. Co-location means that one will have virtually no private preferential access to public hospitals which have a co-located facility.
Because all the private patients will be in super-dooper private clinics.
In this city we have two co-located hospitals, the Mater and St. Vincent's. The St. Vincent's project, which was commented upon by a member of Deputy Jan O'Sullivan's party on the radio recently, is not even part of the co-location. St. Vincent's is a not-for-profit, private institution, which provides an outstanding service. It is building its own new co-located facility, which has nothing to do with this whatsoever, yet that was thrown in here. We need to inform ourselves of the facts.
We are very well informed.
The facts are that we need a lot of investment in our public hospitals. We are moving to an environment where more single rooms are required for hygiene and infection control. There is a huge capital expenditure involved. The tax regime we have had in place both for private hospitals and nursing homes has been very beneficial in delivering capital.
25 Deputy James Reilly asked the Minister for Health and Children if her attention has been drawn to the fact that 133 terminally ill patients are seeking access to hospice care and are being forced to wait days for inpatient, home care and day care services; and if she will make a statement on the matter. [26720/09]
I apologise for the fact that the Minister of State, Deputy Áine Brady, cannot be here to respond to this question.
There is no doubt that when people are diagnosed with a terminal illness or when they are in the last stages of their treatment, it is so important that they receive the appropriate care in an appropriate setting. This is important not only for patients, but also for their families.
Last year, 2,655 people were treated in specialist inpatient palliative care units. Some 7,575 people received home-based specialist care. Some 729 people received intermediate palliative care and a further 1,865 received day care services.
I am aware of a recent newspaper article in which the Irish Hospice Foundation suggested that 133 patients were awaiting hospice care. The Department and the HSE work closely with the Irish Hospice Foundation to develop these services. Historically, there have been parts of the country where inpatient palliative care services are underdeveloped and other areas of the country where the services are well developed.
The aim of the Government is to develop these services by prioritising areas in the country such as the Louth-Drogheda in the north-east, Laois-Offaly in the midlands and Waterford in the south-east for the capital development of specialist inpatient units, and other areas where the home-care service is underdeveloped, including Wicklow, Laois-Offaly and Longford-Westmeath.
Additional inpatient palliative care beds have been opened in the past few years in existing hospices, including six in Blackrock and an additional ten beds opened in Milford Hospice, Limerick, in 2006. The Department is also working with the HSE to open four beds in the Athlone hospice later this year.
The provision of appropriate end-of-life care has been, and continues to be, a priority for the Government.
The Irish Hospice Foundation's figures do not suggest, but show, that there is a palliative care shortage of 610 and a bed deficit of 237. It points out that the palliative care budget needs to be doubled to meet this shortage. I find this poignant because money was allocated by the Oireachtas to palliative care in the past. We found out subsequently, however, that the HSE siphoned that money off to use in other areas. Since that time the Minister has given us an undertaking that this cannot happen again, which I welcome. The reality, however, is that people now have to queue to die. It is something none of us could have envisaged in the past. They cannot get into an appropriate service for the last days of their lives. What does the Minister or Minister of State propose to address this matter? In particular, why are we now means testing terminally-ill patients for medical cards? This is something that was not done in the past.
I certainly cannot compete with that nonsense about queuing to die. I am not into the quotes——
The Minister of State should say that to the 132 patients who are currently waiting for services.
I will come to that. Each week there is a tear jerker. I will respond to the Deputy's assertions, but I will not be saying things like "queuing to die". I did not want to mention this in my initial response. I wonder about the 133 patients. The HSE cannot substantiate this figure, and I wonder about creating this impression and I am worried about families that have to read this sort of stuff. It is not the case——
They can never substantiate the numbers on trolleys either.
Allow the Minister of State to respond.
The Deputy may laugh and sneer, but I am just presenting the facts. For those who are genuinely concerned about this, funding is ring-fenced and has been committed already. I will not go into the detail for the record, but it is important to look at the yearly funding from 2004 to 2008. Nobody should suggest that we are trying to park the huge demand for funding. The additional funding has doubled each year from €1.2 million in 2004 to an extra €3 million in 2008. I can also show the levels of funding by way of commitments to hospice funding. The monthly average number of people receiving palliative care treatment for the past year was 286, which is again an increase. Therefore, I cannot accept the Deputy's claims. An average of 133 people received immediate palliative care, and a further 291 received day-care services. Funding has been increased, funding is ring-fenced, and I do not buy for a second the claim that people are queuing to die.
I do not accept HSE figures regarding trolleys, and I would have much more faith in Irish Hospital Foundation figures than I would have in HSE figures. The Minister of State alludes to funding figures between 2004 and 2008, but this was the same period in which the HSE siphoned off funds for other areas of activity. Again, that is sleight of hand and misrepresentation. The Minister of State did not answer my question as to why terminally-ill patients are currently being means tested for medical cards.
I apologise for not answering that question. It slipped my mind because I was so carried away with the initial statement made by the Deputy. Everybody over a particular figure is means tested for a medical card. As the Deputy knows well, once medical evidence is presented to the HSE, that is taken into account.
26 Deputy Jan O’Sullivan asked the Minister for Health and Children her policy position on the allocation of resources to publicly funded hospitals; her views on whether there is a need to change the way in which money is allocated on the basis of historical patterns rather than work done, efficiency and response to the needs of the cohort for which the hospital provides service; if she will ensure that an assessment is carried out on Our Lady’s Children’s Hospital, Crumlin, so that the extra demands on its services as the primary tertiary children’s hospital here are adequately funded; and if she will make a statement on the matter. [26457/09]
The purpose of health policy is to achieve the best health status and health outcomes for the whole population. We are succeeding in Ireland in many respects. Life expectancy is now at the highest level it has ever been. Infant mortality is one of the lowest in the world. Survival from many cancers is improving. Death rates from cardiac disease are falling.
We are now allocating €16 billion in current funding across three health Votes. Even if there was scope to increase this, it would be vital that we allocate resources so that the clear focus and the economic incentives created are about achieving the best health status and health outcomes for people, within affordable limits. Many health care systems are seeking to achieve this. It is not about changing the funding basis from tax-based funding to insurance-based funding. It is about how resources are allocated. There is certainly every reason we should avoid changing to a system dominated by fee-per-item payments to doctors and hospitals, where simply more activities, such as tests, investigations and surgeries, get more money for the providers. This system has a cost dynamic that can bankrupt either insurers or the State or both, and worst of all, can result in worse health outcomes for patients. However, I do want to move away from the tradition in our country of allocating resources to public hospitals on the basis of incrementally adjusted historical block budgets.
I want to allocate resources to support the best outcomes for patients, in a way that would avoid unnecessary hospitalisation, reduce the lengths of stay in hospital, manage chronic conditions in the community, and reward better preventive primary care. This is what we mean when we talk about making money follow the patient. For this reason, I established an expert group on resource allocation and financing in the health sector in April this year to do the complex, detailed work required. This group is being chaired by Professor Frances Ruane, director of the ESRI. It includes many independent experts who will bring their experience and judgment to bear on how to achieve the objectives I have set in practical ways. The group is to report to me and the Minister for Finance by April 2010.
In the meantime, I fully support the work being done by the HSE in conjunction with the three Dublin children's hospitals. The real challenge in paediatrics is to maximise the efficient use of all our health care capacity, both in Dublin and across the country. The paediatric services in Crumlin, Temple Street and Tallaght need to be increasingly working in a co-ordinated, shared and efficient fashion to prepare for the eventual merging of the three institutions in 2014 into one national paediatric hospital. In the meantime, the HSE is actively pursuing ways in which services across the three hospitals can best be co-ordinated, in order to avoid unnecessary duplication and to achieve savings that can be put back into patient care.
I welcome the fact that the Minister accepts that we need to move away from the historical pattern of providing a small increase or decrease to hospitals every year, irrespective of the demands put on them. In measuring outcome, surely Our Lady's Children's Hospital in Crumlin must measure up well. The Minister is talking about taking action that will give children a better outcome for the future. In many cases, pain and suffering will be avoided because of early intervention. Yet through no fault of their own, as the birth rate has gone up, the rate of serious illness among children that can be treated has also gone up, and the demands on the hospital have gone up. In the last four years, day activity has gone up by 30%, outpatient activity has gone up by 23%, and theatre procedures have gone up by 34%.
While the Minister may be right in stating that savings can be made through co-operation among the three hospitals, there needs to be intervention among children in order to address the fact that waiting lists are growing due to increased demand for the most important sector of our population, namely, children with serious illnesses.
The Deputy is correct and we have substantially increased the budget in Crumlin by 39% since 2004. However, I believe that many initiatives can be taken and are being taken by the hospital, such as the decision by the board last week not to have any further ward closures this summer. That is to be welcomed, and it was done without any additional money. There is no system in the world with an unlimited source on which we can continually draw.
I am not saying that.
Everybody must be allocated a budget. The reduction in the allocation to Crumlin was less than many other places. Professor Drumm will be addressing the health committee next week on the children's hospitals, specifically regarding the issues on Crumlin. He is familiar with them, having been a clinician there for many years. There is a 17,000 day overtime bill in Crumlin. By the end of this year, we hope to move to a single surgical department between the three children's hospitals, with seven surgeons. That will greatly cut down on on-call overtime and so on. We hope to move to a single, clinical critical care department between Temple Street and Crumlin. Professor Des Bowen from Canada has been brought in to help with this. All of these initiatives can greatly reduce overheads in the hospital and direct more activity to patient care.
That is all very well for the future, but children are currently waiting for unacceptable lengths of time with very serious conditions such as scoliosis, which is generally not dealt with by the National Treatment Purchase Fund. Will the Minister find some measure in the meantime which accepts the kind of models on value for money, but which also accepts that the demands on the children's hospital in Crumlin have greatly increased in recent years?
I accept that, but the resources allocated to Crumlin have also increased. There was an 18% increase in medical staff and there are also more day cases, which is much less expensive for a hospital than overnight stays. We are hoping to arrive at a situation in Ireland where about 85% of surgery will be done on a day-case basis. We are at about 62% at the moment. Professor Drumm will address all of these issues. I do not believe seriously-ill children cannot be treated within the budget framework for Crumlin hospital in 2009.
One size fits all does not work in this case.
27 Deputy Alan Shatter asked the Minister for Health and Children her views on whether it is satisfactory that a patient suffering from cystic fibrosis, in need of medical care due to their condition, was admitted to St. Vincent’s University Hospital, Dublin, on 23 June 2009 and placed in a small room with five other patients all suffering chronic illness; if her attention has been drawn to the inadequate conditions around the bed of the patient; her further views on whether it is appropriate that a cystic fibrosis patient be so treated and placed at a risk of infection; the action she will take to ensure that appropriate facilities are available to all cystic fibrosis patients who require inpatient treatment; the progress made to date with regard to the long promised new hospital wing; and if she will make a statement on the matter. [26656/09]
More than 50% of adults with cystic fibrosis in the State attend St. Vincent's University Hospital for their treatment due to the expertise established there. The hospital is also designated as the national referral centre for all other hospitals providing treatment for people with cystic fibrosis.
St. Vincent's hospital is undergoing a process of complete redevelopment. The new ambulatory day care centre opened in 2006 provides dedicated ambulatory care facilities for people with cystic fibrosis. A new ward, St. Christopher's, comprising eight single en-suite rooms was opened at the hospital in August 2008 — these rooms are occupied only by people with cystic fibrosis.
I am advised by the hospital that the patient in question was admitted under the cystic fibrosis team and moved to St. Christopher's as soon as a room became available. I have been informed by the HSE that cleaning is carried out twice a day on the ward to which the patient was initially admitted and also a deep clean is carried out once a week.
The next stage in the development of St. Vincent's hospital will involve the construction of a new ward block to replace existing accommodation. It is estimated that the construction, equipping and commissioning will take approximately 18 months and the new facility is to be operational as soon as possible in 2011. All of the rooms will be single and en-suite, significantly enhancing the hospital's capacity to provide appropriate isolation facilities for patients.
Over the past number of years, I have prioritised the development of services for people with cystic fibrosis with a total revenue investment of €6.78 million and complementary capital investment. The development and enhancement of specialist teams in a number of other hospitals, in particular Beaumont Hospital, Cork University Hospital, University College Hospital, Galway, Limerick Regional Hospital and Waterford Regional Hospital, means that some people with cystic fibrosis currently attending St. Vincent's may choose to attend another centre where this is closer to home and meets their needs. This should, in time, balance demand for accommodation for people with cystic fibrosis across a number of hospitals.
Is the Minister aware that the young man who is the subject of this question and who is 23 years of old and suffering from cystic fibrosis was admitted to a ward with five chronically ill elderly patients? Will she acknowledge that, because of the risk of cross-infection, it is an entirely inappropriate way in which to treat any cystic fibrosis patient who comes into hospital? Will she acknowledge it is unsatisfactory that this young man's family, who have already lost one son to cystic fibrosis, felt the need to sanitise the floor area around his bed and scrub down the bed frame because they found signs of blood on it? Will she acknowledge that is completely inappropriate and scandalous treatment of any cystic fibrosis patient?
Will the Minister acknowledge that it should not be necessary for a question of this nature to be raised by a patient? This question was tabled on Thursday of last week and the patient was moved into an isolation room on Friday. I do not believe that was a coincidence.
Will the Minister explain why she made an absolute commitment in this House in January 2008 that 14 new isolation rooms for cystic fibrosis patients would be established in St. Vincent's hospital by September 2008 but that, to date, only eight such rooms have been established?
I have been in touch with the hospital and the clinical nurse manager did the work the Deputy suggested was done by the family. She confirmed that. She also confirmed that she spoke to the patient on foot of the question tabled by Deputy Shatter, which was unusual — I would have thought it more appropriate that the question would have been raised and dealt with privately in the hospital — and that he had no complaint in regard to the matters the Deputy mentioned.
I accept the patient was in a room with other patients and, in an ideal situation, that should not be the case. That is why we are moving as quickly as we can to provide the additional facilities at St. Vincent's hospital. Notwithstanding the tight budgetary situation, we have found an innovative way for the facility to proceed with the Exchequer paying at the end of the project construction period rather than on a phased basis, which means it will be paid for at the start of 2011.
We have done an enormous amount over the past number of years for cystic fibrosis patients. When it met me recently, their association recognised that. However, I accept we still have quite a way to go to reach a situation where every patient will be directly admitted to a single room and, therefore, minimise the capacity for cross-infection.
When will the long promised new facility at St. Vincent's hospital go to tender? When will construction start because the date has been a moveable feast? In January 2008, the Minister informed the House it would be open by 2010 but in the recent debate in this House in April, she said 2011. Will she clarify when it will go to tender and when construction will start?
It is my information that two weeks ago, 34 cystic fibrosis patients were accommodated in St. Vincent's hospital, primarily in St. Christopher's ward, which includes the eight isolation units, and in St. Paul's ward, which has accommodation for 22 patients. It is my information that St. Paul's ward, which deals especially with respiratory patients, is scheduled to close today. Will the Minister clarify what facilities will be available to cystic fibrosis patients in the coming weeks if this ward closes as of today in accordance with the information received by me?
The delay arose because of dialogue between the architects nominated by the association, or the people involved in the cystic fibrosis community, and the architects and design team for St. Vincent's hospital. As I said in the House some time ago, that delayed it. I am not blaming anybody but I understand from the HSE that added to the timeframe. I am advised by the HSE that it will go to tender shortly.
Does "shortly" mean July or next October?
I do not know whether it means next week or the week after but contracts will be signed this year, the facility will be constructed next year and will be paid for at the start of 2011 and commissioned at that point. I am not aware of the plan to close St. Christopher's ward. I will have that matter checked and revert to the Deputy.
For the Minister's information, it is St. Paul's ward and not St. Christopher's ward.
