Nithe i dtosach suíonna - Commencement Matters

Credit Unions

I wish to share time with Senator Ahearn. I propose that he takes one minute of my time.

Is that agreed? Agreed. I welcome the Minister of State to the House.

The Minister of State and I have had a good discussion about this matter and, as he will be aware, credit unions are the bedrock of many local communities. Members save, members borrow and credit unions are the peoples' bank in many cases. I am a former supervisor of my own credit union in Bishopstown. At this time of the year a lot of credit unions hold their annual general meeting, AGM, and we have passed legislation to provide for virtual AGMs, which we all welcome.

Many people rely on the dividend payment. I know in some cases it is a small amount. The number of outcomes in terms of dividends is significant. Each share equals a dividend and the Central Bank, I am led to believe from ongoing representations I have received from people, has called for a prudent approach to be taken. The payment of the dividend and the members' rebate has been put into abeyance because of a letter from the Central Bank in September. It wrote to credit unions outlining the uncertainties relating to Brexit and Covid and mentioned that it did not want to see any distribution by way of dividend or loan interest rebate in credit unions' 2020 final accounts.

The AGMs have not been allowed; they are now virtual. The payment of dividends is important. They are small amounts such as €100, €200 or €300, and in many cases, they are used at this time of year. It prevents people from having to go to moneylenders and we know the consequences of that. I ask that the Minister, the Central Bank and the Irish League of Credit Unions, ILCU, work to ensure that members can receive dividends.

It is very upsetting that the Central Bank sent out a letter to credit unions not to pay out their dividends. I encourage the Minister of State to support the credit unions to make dividend payments to their customers. The credit union in Clonmel had a fantastic year. It has a surplus of had €3.6 million with a dividend of €1.7 million to be shared by members, equating to approximately €200 or €300 each. That money is spent locally. Credit unions only exist because of the support of their members and the community. It is really important and sacrosanct that the dividend be paid to members, especially this year more than most. I urge the Minister of State to support that.

I thank both Senators for raising this issue. The Government recognises the important role credit unions play in society as a volunteer co-operative in the area of financial institutions. In the current environment, credit unions are appropriately focusing on the health and well-being of their volunteers and staff, and on continuing to serve the needs of their members. Credit unions are important at local and national level given the community presences they have across the country.

In accordance with the Credit Union Act 1997, credit unions need the approval of their members at an AGM to pay dividends. In the rules set by members at local level, most credit unions cannot pay a loan interest rebate without having first paid a dividend. I stress these are rules brought in by members in individual credit unions. There is no Government rule to say that this should be the case, but some credit unions have instituted such a rule at local level.

Due to the Covid-19 pandemic, credit unions have not been able to hold physical AGMs as is normal while virtual AGMs were not permitted under the Credit Union Act 1997. It is for this reason that the Government progressed priority legislation, the Finance (Miscellaneous Provisions) Bill 2020, to allow for virtual AGMs, among other matters. When I say virtual AGMs, it all depends on the Covid restrictions. When AGMs come to be held early in the new year there could be a physical meeting combined with a virtual meeting. It could be a blended meeting. It might be somebody on an iPhone or a laptop, or it might be somebody phoning in depending on the mechanisms the individual credit union puts in place. It does not have to be virtually held; it can be partly held by virtual means and partly held by physical means, depending on the Covid restrictions.

The Bill completed all Stages in the Seanad on 30 November 2020 and completed all stages in the Dáil last Friday. The Bill is currently with the President for signing. Once signed by the President and enacted, the legislation will take immediate effect and credit unions will be able to convene an AGM to seek whatever approval may be required from members in respect of paying dividends and a loan interest rebate. In addition to the removal of the legislative barrier to holding an AGM credit union boards will have to determine whether their financial situation warrants a distribution. The Senators will be aware of the financial challenges facing the sector in recent years, which have been exacerbated by the pandemic.

On 4 September, credit unions received a letter from the Central Bank outlining that it expects credit unions to take a prudent approach to their reserve management, given the risk and uncertainty regarding the economic outlook. It expects priority to be given to the maintenance of building up reserves over the payment of any distribution to members. The Central Bank is independent of the Department of Finance, the Minister for Finance and the Government. They are independent regulators and, therefore, I am not in a position to say to the Central Bank precisely what it should do on that matter.

The Central Bank stated that it did not expect that proposed distributions, dividends or loan interest rebate, would feature for the 2020 financial year, which was the end of September. Where a credit union may be considering the potential for a proposed distribution, however, they are expected to contact the Central Bank at an early stage to clearly outline the rationale for proposing this course of action.

Senator Ahearn mentioned the surplus of €3.6 million in Clonmel credit union last year.

Not all credit unions actually made a surplus last year. Some credit unions might have made a small surplus but relative to their assets would not be considered substantial. The Clonmel credit union is proposing a dividend of €1.7 million. The Central Bank has issued the letter across the board to all credit unions. If a credit union wants to consider that, it will have to take it up on a case-by-case basis directly with the Central Bank.

I thank the Minister of State for his reply. I hope the credit union movement, which is supportive of and immersed in local communities, continues to sponsor local organisations. There is a hardship welfare fund available. I also hope the credit union movement will not move away from that ethos and neither will it be allowed to move away by the Government and the Central Bank. It is about accessibility and community. I take the Minister of State's final point about surpluses.

I thank the Minister of State for his reply. Obviously there is a separation of power, rightly so, between himself and the Central Bank. It is important the Government supports credit unions and that they continue to support their local communities. That is the bedrock on which credit unions are founded.

I thank the Minister of State for his reply.

As I already said, the Central Bank is independent in its role but I hope it is aware of this debate and takes it into consideration. It will not change its view on the matter but, at least, it will hear what is being said about it.

The various credit unions should contact the Central Bank where they feel they need to make these payments. They can propose a mixture of a small dividend, large interest rebate, or 50:50 or whatever the local arrangements historically have been. If the credit union is satisfied that the Central Bank will allow that happen, notwithstanding the fact an AGM might not happen for several weeks, at least people will know the amount of a payment to expect in due course. Perhaps on an individual, member-by-member basis, if the case arises, arrangements can be made with the credit union in the full knowledge that if a payment is approved, how much it will be and when it will be received. Perhaps some local measures can come into play to assist the cash flow position of individual members if the need arises between now and Christmas.

Third Level Education

I am raising the need to address the issue around higher education funding being potentially lost to students who withdraw from their courses and the knock-on consequences that this will have not only for free fees - a term I use lightly - but also for their access to Student Universal Support Ireland, SUSI, grants.

There is a certain point, usually at the end of October, by which students must withdraw from their courses or serve notice that they do not wish to continue their learning if they want to be able to access learning the following year, still be able to get free fees and the like. I am concerned about this because this has been an extraordinary year. Students have had to adapt to new learning styles, as lecturers have had to adapt to new teaching styles. We have all had to adapt to a whole new system. I am concerned about the impact this will have on students, their interaction and the sense of the course they are undertaking. This is through no fault of their own. Neither is it through any fault of their lecturers, the support staff in the educational institutions or the State. The coronavirus happened and we have to make the best of it. There is an opportunity, however, to do something about it.

I do not need to go into too much about the consequences of dropping out from a course. There is no shame in dropping out of a course if it is not the right course for one. The knock-on consequences, however, for those who feel they have to drop out because of financial reasons or because the course was not right for them often mean they are not able to continue on with their learning. It is important that students have been able to leave courses before October which would not have a knock-on consequence for their education.

However, I have spoken to some people in the past while who just do not know. That is because they have not been able to get a sense of their course, themselves, their space or being, all of the things with which we are all trying to grapple too. These people are concerned about the consequences of either staying in a course that is wrong for them or staying in a course they simply should not be in and out of which they will not get any value. This also means there is a knock-on cost to the State and wider society. These people feel that if they bite the bullet and drop out, they will then lock themselves out of coming back next year to do a different course. They will also lock themselves out of being able to access the SUSI grant and other supports. There are also students for whom circumstances are changing dramatically. We still have coronavirus, people getting sick and knock-on consequences for families.

As it is an exceptional year, I am asking for exceptional leniency and understanding for the circumstances in which students may find themselves at the end of 2020 and in 2021 with their education. I have always said, both inside and outside Leinster House, that education is the great leveller. Both the Minister of State and the Minister, Deputy Harris, have also spoken about how education is a great leveller and that we need to work more on easing access to it. I am pleading with the Minister of State for understanding and leniency that we do not lock anyone out due to circumstances beyond his or her control this year and for exceptional understanding for exceptional circumstances.

I thank Senator Hoey for raising this important matter.

Under the Department's free fees schemes, the Exchequer provides funding toward the tuition fee costs of eligible undergraduate higher education students with students paying the student contribution. The student contribution applies to all students on an annual basis who are eligible under the free fees scheme. The current rate is €3,000 per annum. Currently, 60,000 students had all or part of their student contribution paid on their behalf by the State via the student grant scheme.

To satisfy the terms and conditions of the SUSI and free fees schemes regarding progression, a student must be moving from year to year within a course, having successfully completed the previous year, or be transferring from one course to another where the award for the subsequent course is of a higher level than the previous course.

Under the progression-previous academic attainment criteria of the schemes, a grant or funding will not be paid to a student for a repeat period of study on the same course, or for a different course at the same level. The objective of this policy is to help as many students as possible to obtain one qualification at each level of study. However, once an equivalent period of study has been completed on the new course, the student may be eligible for student grant assistance or free fees funding for the remainder of the course.

Typically students are not supported for a repeat period of study under the free fees initiative. However, in exceptional circumstances or where a student receives a leaving certificate uplifted offer from their original CAO application following an appeal, an exception may be allowed.

The student contribution applies to all students on an annual basis who benefit under the free fees scheme. If the student receives an uplifted place and, subsequently, switches courses during the academic year, they will only pay one student contribution. If a student leaves the current course mid-year, they may be eligible for a partial refund of the contribution from the higher education institution. Students should discuss this with their institution in the first instance.

In addition, under the student grant scheme of 2020, SUSI has discretion to award a grant for a repeat period of study in exceptional circumstances which impacted on a student completing a particular period of study or undertaking exams. SUSI treats each application for repeat funding on a case-by-case basis. It is a matter for the individual student to demonstrate to the satisfaction of the awarding authority that there were exceptional circumstances.

If a student leaves their course, normal rules apply and the student will not continue to receive a student grant payment. Students must inform SUSI that they are no longer attending their course.

My Department is acutely aware of the needs of students. The student assistance fund provides financial assistance to students experiencing financial difficulties while attending third level. Students can be assisted towards the rent, childcare costs, transport costs and books or class materials. The total allocation for the fund in 2020 and 2021 is €18.2 million.

Additionally, in response to Covid-19, a once-off fund of €1.9 million for access and support services was provided as part of the July stimulus package in 2020 for higher education institutions.

This funding has been ring-fenced to meet the wider demands of vulnerable students and target groups. The funding will be used to support activities such as: support learner and student access; engagement or re-engagement activities; retention; progression and positive learning experiences; student success measures; the recruitment of temporary staff to support access services; student advisory support; enhanced orientation programmes; outreach; and pre-entry work.

I thank the Minister of State for that. He indicated that an exception may be allowed. He also stated that a student who leaves a course mid-year may be eligible for a partial refund of contribution from the relevant higher education institution. Would that effectively set students who would not be eligible for a SUSI grant back to point zero? I note that SUSI has discretion to award a grant for a repeat period of study in exceptional circumstances. Will the Department be advising SUSI to consider circumstances related to Covid-19 as exceptional? Do we just have to hope it will address matters on a case-by-case basis? Will the Department be stating this year has been exceptional owing to Covid and that this could have had a major impact on students' experience?

We are aware of the difficulties students have been facing during the pandemic. We encourage any students who are struggling to cope with studying at home to contact their educational institutions or access officers in order that they can be informed of the wide range of services that are available to support them on their journey prior to making any decisions regarding a cessation of their studies.

In recognition of the challenges facing full-time third level students, the Government approved once-off funding of up to €50 million to provide financial assistance in this academic year. That resulted in a payment of €250 for SUSI students and a €250 credit for all EU full-time undergraduate and postgraduate students attending publicly funded higher education institutes. It will be allocated in the coming weeks. SUSI and the higher education institutions will be communicating with students shortly in this regard. That builds on the additional supports that I referred to, namely, the doubling of the student assistance fund, the €15 million technology fund for devices for students in further and higher education, and the €3 million euro provided as part of the July stimulus to support enhanced mental health services and well-being initiatives.

If the Senator communicates with me separately on some of the issues referred to in her supplementary question, I will get her a more definitive reply. I am just not in a position to give a reply on the issues now.

As early as yesterday, the Government approved a review of the entire SUSI system, to commence immediately. The system has not been reviewed in a number of years. The review will cover all aspects of the system, including criteria, payments and eligibility. It will be all-encompassing. All the stakeholders, including the student unions, will be consulted as part of it. I envisage that there will be an opportunity for public submissions to be made. Public representatives will be able to avail of this facility also. I hope that helps.

Medical Aids and Appliances

I thank the Minister of State, Deputy Butler, for coming to the House to address this issue. Over 1,000 people in Ireland require the use of artificial limbs every year. Many people will have heard Saoirse tell her story on the "The Late Late Toy Show" but there was also a piece on "Prime Time" last week with Louise Byrne. A number of stories were told in the programme, one of which was that of Darragh McDonald, a friend of mine from Gorey. He is a gold-medalist Paralympian. He told his story. In his case, because of the limbs he requires, the cost is in the order of €16,000 every two years. The Minister of State will also have heard the story of Darren Kelly, who spoke about his son Éanna, who needs two prosthetic legs, at a cost of €5,000 to €6,000 each per year. If one breaks, the total cost could be €15,000 in a year.

The only way those who require prosthetic limbs can apply for them is by getting a medical card. In many cases, they have to apply for a discretionary medical card. That process can take a long time. I am aware that the Minister of State shares some of my concerns about means testing in the case of permanent disability. Those who require prosthetic limbs need them for their entire lives. There is a problem in that families always have to apply for renewal. Even when this is approved, they have to wait a number of months for the limbs to become available. A growing child, in particular, may not be able to get around. "Prime Time" addressed the issue of the HSE and the postcode lottery that exists. There is a commitment to trying to resolve this but the difficulty is that there has not been an improvement in processing times.

It is a question of determining how we can allow those with a disability to play their full part in society. I am aware that the Minister of State is very committed to this. We must ensure those with a disability can reach or exceed their potential. We achieve this in so many other areas. With regard to getting people into higher education, we have the disability access route to education, DARE, scheme in place. We talk about trying to increase the number of people with a disability in the workplace but, with regard to prostheses, sufficient support is not made available. If we compare our health system with others across Europe, we note that we are clearly behind the curve.

For people like Saoirse, Darragh and Éanna, and thousands of others, I ask that we be innovative and consider putting in place a proper scheme, be it through guaranteed discretionary medical cards or tax deductions, whereby those relying on prostheses do not face a barrier and their families do not have to spend the whole time campaigning or fundraising. I ask the Minister of State to intervene with the HSE to take action on this.

I thank the Senator for raising this really important issue. He is quite right in that Saoirse stole all our hearts two weeks ago on the "The Late Late Toy Show". Also, he quite rightly stated that there are so many more affected, including Darragh and Éanna. The issue can be very problematic for parents and children because the latter grow so quickly at a young age. It is an important issue and I am glad the Deputy has raised it.

The term "community-funded schemes" is a collective title for all of the many products, supports, supplies, appliances and aids that are provided through community services. A variety of products and services are provided under the schemes. The HSE provides a wide range of medical and surgical aids and appliances, such as prosthetic limbs, wheelchairs and walking aids, free of charge to medical card holders and people on the long-term illness, LTI, scheme. Assessment by a relevant health professional is required. The products and services play a key role in assisting and supporting service users to maintain everyday functioning and to remain living in their homes and local community. They also avoid the need for a hospital presentation or admission while facilitating early discharge from hospital back into the community.

Under the LTI scheme, patients receive, free of charge, drugs, medicines, and medical and surgical appliances directly related to the treatment of the diseases and disabilities covered by the scheme. People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family.

Prosthetic services are currently provided by a range of private providers, and the cost of prostheses for eligible service users is charged to the HSE. Clinical governance arrangements vary depending on the location where services are accessed. Each community healthcare organisation, CHO, operates standard processes for the allocation of funding for medical and surgical aids and appliances.

In terms of eligibility criteria, each application for a prosthesis within a CHO is assessed for medical card and long-term illness card patients by the local resource allocation group. A determination is made regarding approval based on priority and funding availability within local budgets.

At times, due to the demand for resources exceeding the available capacity, waiting lists may apply for some categories of items provided through the medical and surgical aids and appliances budget in a particular CHO. CHOs undertake a range of initiatives to ensure optimum use of resources.

As part of the HSE's service improvement programme for community funded schemes, a work stream has been dedicated to standardising provision of aids and appliances at national level. This work includes the establishment of a national approved list of items, national guidance for prioritisation and standardised provision across the entire country to help ensure that the quality and equity of access to the service is improved and that what is sometimes referred to as the postcode lottery becomes a thing of the past. While the availability of sufficient resources will undoubtedly remain a challenge for individual areas in meeting demands for these services, it is expected that there will be a significant reduction in the geographical variation that has previously existed. This does not speak to the issue the Senator raised about those who do not have medical cards and who have to fundraise. I will certainly give this consideration and address it with the HSE and the Minister.

I thank the Minister of State. It is welcome that the postcode lottery will be a thing of the past but it does not solve the bigger question. It is a crazy situation that families have to continue to apply for a discretionary medical card. These are permanent disabilities. As the Minister of State knows, they are not disabilities that will disappear. I ask that once a medical card is granted, it should be allowed to continue so it will give those families and parents certainty.

Where we have somebody who may exceed the income threshold for the medical card, and I am speaking about someone like Darragh who needs to spend €16,000 every two years, it requires a lot of income to be able to do this. We are not providing the incentive for people to go into the workplace if they know they are going to have to come up with this level of funding. We as a society want those with a disability to play their full part and we have to ensure we have a health system that is designed to support it. There needs to be a complete review not just of the postcode lottery but about how we can help each individual child and as they grow into adulthood that we can provide them with the necessary limbs that they are not put out of pocket to the extent they are at present and that they can continue to play a very strong role in our communities.

I thank the Senator for the practical and pragmatic way he has raised this matter. It is a serious issue for many families. As he has said, the spotlight in recent weeks on young children with prostheses has shown that it can be very problematic for many families who might not have access to a long-term illness card or a medical card. As Senator Byrne said, if they are trying to raise an extra €16,000 every two years it is a huge amount of money for any one family to come up with.

The HSE states there are many demands on community funded schemes but thousands of products and appliances are provided through the schemes each year and they provide a key role in assisting and supporting service users to live at home and maintain their day-to-day activities. The HSE endeavours to meet needs in an equitable way within available resources and, given the many demands, the HSE prioritises eligible patients with the greatest needs.

I welcome also the programme for the community funded schemes, the work stream that has developed to standardise provision of aids and appliances at national level and the fact we will finally try to move away from the postcode lottery, which is something we are so used to in all services. It is something that has to become a thing of the past. I thank the Senator for raising this matter and I will certainly take back to the HSE the issues he has specifically raised. We know there are supports out there but unfortunately not everyone is able to access them.

Maternity Services

I thank the Minister of State for coming to the House to respond to my Commencement matter, which calls on the Minister for Health and the Department to commit to providing €2.5 million in funding for the Rotunda Hospital on Parnell Square in Dublin. For those who are not aware, the Rotunda Hospital is the world's oldest maternity hospital. It is the country's busiest maternity hospital. It delivers on average 8,000 babies a year. One in every six babies in the country is born at the Rotunda Hospital and one in every four neonatal babies is born in the Rotunda Hospital. It is not just a local hospital for me or the women in central Dublin, it is a hospital that serves women from throughout the country. Some of the most vulnerable of patients and the most complex of pregnancies are enabled and supported in the Rotunda Hospital.

It dates back to 1745 and as well as being a very busy maternity hospital delivering babies and caring for mothers, it receives 500 gynaecological referrals every month. A woman only gets referred for a gynaecological appointment after her routine appointment has thrown up some anomaly. There are more than 3,500 women on the waiting list for basic female health services. Far too many of them have been waiting for more than 12 months for an appointment. To my mind, and in the mind of the Government, it should be totally unacceptable that women in Dublin today would be waiting more than 12 months for a gynaecological appointment.

According to HIQA, the Rotunda Hospital building and infrastructure is overcrowded, out of date and not fit for purpose. Essentially, it delivers 21st century health services in 18th century facilities. Going back to 2018, I brought the then Fianna Fáil spokesperson for health, the now Minister, Deputy Stephen Donnelly, to the Rotunda Hospital. Following our visit and lobbying by others, the then Minister, Deputy Harris, commissioned an independent report. KPMG completed that report and I understand it has been delivered to the Minister. The report examined nine different options to help deal with the overcrowding, lack of space, poor infrastructure and high risk of infection. It concluded the best option is the development of a new critical care wing on the west side of Parnell Square.

There is a one-storey outpatient department at present. The proposal is to demolish this and replace it with a fit-for-purpose critical care wing in a four storey building over a basement. It is considered the most cost-benefit advantageous solution with a 2:1 ratio. It would provide the greatest range of benefits and is consistent with the long-term plans for the Rotunda. To move the project forward next year will only cost an investment of €2.5 million. It is a very modest investment not just in the women, babies and mothers but also the 1,000 staff who work in the Rotunda Hospital. I was lucky enough to have my three babies in the Rotunda Hospital. Given the care provided to everybody when they walk in the door by the amazing security man, cleaners, doctors, nurses and midwives they deserve to be provided with fit for purpose facilities. The mothers and babies of Ireland deserve it too. I hope the Minister of State can give us some good news on this request.

The Rotunda Hospital is also very important to me as my two sons were born there and my wife trained as a midwife there. It is very important.

Many people are interested in this Commencement matter. As Senator Fitzpatrick has quite rightly said, the Rotunda Hospital is the world's oldest and Ireland's busiest maternity hospital, with the phenomenal number of 8,000 babies being delivered every year. I thank her for raising the issue and giving me the opportunity to outline to the House on behalf of the Minister, Deputy Stephen Donnelly, the position on the Rotunda Hospital.

Project Ireland 2040 provides €10.9 billion for health capital developments throughout the country, including funding to support implementation of the national maternity strategy. Co-location of maternity services with adult services provides mothers with access to a full range of medical and support services should the need arise. The availability of these services helps ensure the delivery of an optimum, safe service, particularly for high risk mothers and babies.

Work on the co-location of the Rotunda Hospital with Connolly Hospital Blanchardstown, in line with health policy, is progressing. The programme for Government includes a commitment to "Progress the planning, tender and design stages for the relocation of the Coombe Hospital to St James's, the Rotunda Hospital to Connolly, and Limerick University Maternity Hospital to University Hospital Limerick." A master plan has been prepared for the Connolly campus in support of the co-location of the Rotunda Hospital.

In the short term, it is acknowledged that there is a need to address the highest infrastructural risk and capacity issues at the existing hospital on Parnell Square on a prioritised and interim basis pending development of the new hospital in the medium term. The Rotunda Hospital has proposed the development of a critical care wing to address its identified key clinical risks. There has been engagement between the Department of Health, the HSE and the Rotunda to clarify the scope and extent of the development needed at the Rotunda to resolve patient safety risks arising from infrastructural challenges at the hospital. In the context of the long-term objective of relocating the Rotunda, however, any infrastructural development on the site should be confined to the minimum necessary requirements and designed only to address the priority patient safety risks.

In 2020, €4.6 million was provided by the HSE to the Rotunda Hospital to address capacity and infrastructural needs in the foetal assessment unit, neonatal intensive care unit, emergency theatre and delivery suites. Given the age and condition of the original hospital buildings, however, other issues remain. In this regard, additional funding of €100,000 has been provided by the HSE to the Rotunda to prepare a strategic assessment report and preliminary business case in support of the proposed critical care wing, as required under the public spending code. These reports have recently been submitted to the HSE and are under consideration. A projected €250,000 will be allocated in 2021 to assist further in progressing proposals to address areas of critical risk in the existing hospital buildings.

I appreciate the Minister of State's reply, but I am disappointed. I cannot be satisfied with it. I do not mean that personally where the Minister of State is concerned, but this saga has been ongoing for years. I believe the first proposal to move the Rotunda dates back to the 1990s. The women of Dublin and the women of Ireland deserve better. There was a planned move in 2007. In 2015, an announcement was made by the then Minister to the effect that the three maternity hospitals were going to be relocated. The other maternity hospitals have received significant investment and I accept that the HSE has given some funding to the Rotunda, but there was no point in spending €100,000 on a strategic assessment if we were not going to act on it now.

The Government's spend is €10.9 billion. That is a great investment in health services, but the women of Ireland deserve some of that. This is a modest, pragmatic and sound investment proposal. The total cost of creating a critical care wing in the Rotunda would be €61 million. The Connolly proposal is over €500 million. What will be the period involved? Will it be 15, 20 or 30 years? I implore the Minister of State to speak with the Minister. I would like him to meet the master of the Rotunda. If the Minister of State could attend that meeting as well, it would be great. It is important that we not ignore the risks facing not only the mothers, babies and families every day, but also the staff. It is unfair to put staff into these risky situations. It is also unfair on the mothers and babies who are relying on the Rotunda for their health services.

I thank the Deputy for her subsequent statement. In 2020, €4.6 million was provided by the HSE to the Rotunda Hospital to address capacity and infrastructural needs. Given the age and condition of the original hospital, additional funding of €100,000 has been provided by the HSE to the Rotunda to prepare a strategic assessment report and preliminary business case in support of the proposed critical care wing, as required under the public spending code. A projected €250,000 will be allocated in 2021 to assist further in progressing proposals to address areas of critical risk in the existing hospital buildings.

The proposed interim upgrade works are intended to address the key clinical risks and capacity concerns identified by the hospital prior to its co-location with Connolly Hospital Blanchardstown in line with programme for Government commitments. All capital development proposals must progress through a number of approved stages in line with the public spending code, including detailed appraisal, planning, design and procurement, before a firm timeline or funding requirements can be established. Approval must be received for each stage to ensure that the proposal delivers value for money and remains affordable and that sufficient moneys are available to fund the project to completion, including equipping and commissioning costs.

The delivery of capital projects is a dynamic process and subject to a number of key considerations, including service prioritisation, classification of scope, determination of affordability and the successful completion of the various capital project approval stages, which can impact on the timeline for delivery. However, I will bring the Senator's concerns to the Minister. I suggest that she write to him. There has been a previous visit. It is the oldest hospital in the world and the busiest in Ireland, with more than 8,000 babies delivered per year, and that is aside from the gynaecological work that is done in the hospital. This matter is of major concern to the Senator and many other people, including me.

I thank the Minister of State for her engagement with Senators.

Sitting suspended at 2.17 p.m. and resumed at 2.45 p.m.