Hospital Services

Tuesday, 15 February 2022

Questions (65, 78, 156, 179)

Thomas Gould

Question:

65. Deputy Thomas Gould asked the Minister for Health the status of the elective hospital in Cork. [7942/22]

78. Deputy Colm Burke asked the Minister for Health when it is proposed to announce the site of the proposed elective hospital in Cork; if a site been identified; when planning will be applied for and construction work will commence; and if he will make a statement on the matter. [7678/22]

View answer

David Stanton

Question:

156. Deputy David Stanton asked the Minister for Health if he will report on the progress made to date on the development of a new elective hospital in Cork; and if he will make a statement on the matter. [7720/22]

View answer

David Cullinane

Question:

179. Deputy David Cullinane asked the Minister for Health when he will progress elective centres; and if he will make a statement on the matter. [7846/22]

View answer

Oral answers (17 contributions)

Deputy Thomas Gould

I am asking the Minister for an update on the proposed new elective hospital for Cork and, in particular, whether a site has been chosen. Government Deputies are claiming a site has been chosen. I do not know about it and, more importantly, the constituents of Cork do not know about it. Will the Minister update us?

Deputy Stephen Donnelly

I propose to take Questions Nos. 65, 78, 156 and 179 together. I thank Deputy Gould for the question. Similar questions were tabled by Deputies Colm Burke, Stanton and Cullinane. This reply addresses all of those questions.

The development of new elective care capacity is a big commitment of the programme for Government. Last December, I brought a memo to Government and secured agreement on a new national elective ambulatory care strategy that will transform the way in which day cases, scheduled procedures, surgeries, diagnostics and outpatient services can be better arranged to ensure greater capacity in the future and help to tackle waiting lists through the development of dedicated, stand-alone elective hospitals in Cork, Galway and Dublin.

Initial proposals, as set out in a strategic assessment report, had been to develop elective day-case hospitals only. However, extensive consultations with stakeholders, particularly in Cork and Galway, indicated support for incorporating inpatient care in the new elective facilities. In other words, the proposal that came to me from the team was firmly of the view that it should be day-case services only. There was a lot of interaction around the House from Deputy Gould and others, Deputies from Galway and Cork, who said there is a strong desire for inpatient, overnight facilities in these elective hospitals as well so they could do more complex work.

We are doing it two phases. Phase 1 will be day case, outpatients and diagnostics, and phase 2 will be inpatients. Critically, however, the business case, on which we will be signing off, includes both phases and all the design work so that when phase 2 comes on, it will be part of an integrated system.

I am sorry, Acting Chairman; I am not sure of the time.

Acting Chairman (Deputy Marc Ó Cathasaigh)

The Minister does not have to take all of it. He would have that much if he wished.

Deputy Thomas Gould

I still did not get an answer. Has a site been chosen? That is the question people in Cork want to know. Before the most recent local elections, there was an announcement there would be an announcement where the site would be. There were announcements before the by-election and the most recent general election. That was two years ago and we still do not have a definite site. For the people I represent in Cork North-Central, I am looking for that hospital to be located on the north side of the city. A report in October stated the Cabinet would include the site and that it was discussed. I am asking the Minister a straight question. Has a site been finalised? Where is it? If not, why has it not been done?

Deputy Colm Burke

I agree with my colleague from Cork North-Central with regard to an elective hospital for Cork. The South/South West Hospital Group made a presentation to the HSE more than three years ago. An advertisement was put in place almost 12 months ago now looking for sites to be identified and here we are. Even if we identify a site in the morning, we have to get a design team in to design it, go through a planning process and get contractors in to get the job done.

It is now time to identify the site. I am not aware of any announcement or promises that a site was identified already, but my understanding is the work has been done. Why can we not now take the next step of identifying this site and get on with the planning process?

One of the places that is available to the HSE and where it actually owns the land already is Sarsfieldscourt. It has more than 100 acres where the elective hospital can be built block by block. I seriously believe we are talking about an elective hospital not only for Cork but also for Munster. There is a huge undercapacity in the health service, whether it is in Limerick, Kerry, Waterford or Cork. I ask that this now be given priority.

Deputy Stephen Donnelly

I thank both Deputies. The first thing to state very clearly is this is being prioritised and moved forward. I brought a memo to Government recently. We got agreement on the elective hospitals, including for Cork. One of the asks, and this is why I said it earlier, was that the proposal that came to me from the group that reviewed this had a very material change to it. As I said, the proposal I got was for day case only. Through extensive consultation at a political and clinical level, we changed that. It is a very material change. The business case, therefore, had to be updated.

I am delighted to be able to share with the Deputies that this preliminary business case has come back into the Department. It came back in on Monday morning and is now being assessed by Department officials. That will then go to the Department of Public Expenditure and Reform. We will see what it has to say but it is hoped it will sign off on it and then we can move very quickly into design and tender. We have to get going on this. The State is not good at building hospitals quickly. In fact, we are very bad at it. We obviously have to go through all the processes in terms of protecting public money, but we have got to move on this.

Both Deputies asked about the site. The short answer is I have a recommendation on a site but no site has been agreed. A Government decision has not been taken on a particular site. That is what the business case is going to address. I have discussed the issue at length with many Deputies and colleagues here and with clinicians in Cork. As the Deputies will know, probably better than I do, there are very strongly held views on multiple different sites. It would not be appropriate for me just yet to say which site is likely the one on which I want a final recommendation based on inpatients and day cases. I would then very much like to share with the House the preferred site as quickly as possible.

Deputy Thomas Gould

The Minister said the site has been identified but he is not announcing it at the moment. He also made a point the State is not good at building hospitals. The Government is very good at closing them on the northside of Cork city, however. Fianna Fáil and Fine Gael closed the North Infirmary hospital and the orthopaedic hospital. We have sites like Sarsfieldscourt in Glanmire, the orthopaedic hospital in Gurranabraher and Our Lady’s Hospital in Shanakiel. There are numerous sites that are owned by the HSE which could be delivered. I had to fight tooth and nail for a year to get SouthDoc in Cork city reopened. That is how hard it is to get services on the northside of Cork city.

I am not sure if the Minister heard the reports today from Cork University Hospital. It has the highest numbers since records began of patients on trolleys in Cork. Cork city healthcare is in crisis at the moment. We do not have time for waiting and pushing things down the road. We need a site to be identified and it must be on the northside. I am sick and tired of one-tier development in Cork. We need balanced development, especially balanced healthcare.

Deputy Colm Burke

I agree we need long-term planning. One of the things about long-term planning is making sure we do not identify a small site and then say we do not have adequate space in five or ten years’ time. It is important we identify a site and get on with the planning process. The planning process is going to take us a minimum of 18 months. This is now a priority. There is not sufficient capacity. Even if we take into account a scenario where the HSE were to take over all the private hospitals in Cork in the morning, it would not have sufficient capacity. A huge amount of work now is going out of Cork to Dublin because there is not capacity in Cork. This should now be given priority and a decision taken at the earliest possible date.

The Minister admitted he has the report back in. I ask that his Department now gives priority to assessing that report but also that he gets his colleague in the Department of Public Expenditure and Reform also to make it a priority in that Department to deal with the issues regarding the public cost of this facility. It is a priority and needs a fast decision in order that we can get on with the job of building an elective hospital in Cork.

Deputy Pádraig O'Sullivan

I welcome the Minister's comments that there is progress on the case in identifying the site. It is heartening to see the business cases have been submitted to the Minister and that, as he said, they will undergo assessment with the Department of Public Expenditure and Reform. It is probably one of the few questions on which the three speakers from Cork North-Central will all agree. We want identification of the site as early as possible. We have all spoken in the House about our preference for it and its location.

I understand the Minister has to make a balanced decision about the best thing for patients, the public purse and whatever other criteria by which he will need to assess the overall decision. We are in a situation with waiting lists the way they are, and as Deputy Burke said, the waiting lists will not improve without the delivery of these hospitals throughout the country. I echo the frustration with the process up to now, but at the same time, I recognise the progress that has been made and that the Minister said those business cases are now in front of him. I ask him to expedite those appraisals as quickly as possible.

An Ceann Comhairle

I thank the Deputy. Are we finished with everyone? I believe this is the final response.

Deputy Stephen Donnelly

I thank the Deputies for their contributions. Two very important issues were raised, one of which is on the elective centre. It will be based in Cork, but remember, it is a regional hub. It will make a huge difference in terms of people being able to access care quickly, which ultimately is the mission in universal healthcare. That is what we are going to do. It will make a big difference.

The Deputies asked me very directly about the revised business case, which arrived back in my Department on Monday, and the need for it to be prioritised; yes, it will. The Department is prioritising it and I will be in discussions with the Minister, Deputy McGrath, who I know will look at and prioritise that as well.

We will get this through as quickly as it can happen and will then move on immediately to getting the planning process moving and the design done.

Regardless of that, there are not enough hospital beds, there is not enough acute capacity and there is not enough community capacity in Cork. We all know this and that it is not a small deficit but a very serious one. There are phenomenal clinical teams in community care, social care and hospital care in Cork. There are brilliant hospitals there. However, the health service in Cork is under enormous sustained pressure. The HSE recently intervened directly, as Deputies will be aware, and that had an impact, but it is not remotely enough. In parallel with our putting in place a regional elective centre based in Cork, we are also looking, as a matter of urgency, at how we can very quickly add more capacity there, including in diagnostics, beds, operating theatres, community-based care, home care options and so forth. The system is under unsustainable pressure and it needs serious investment. It is a very big priority for me to get moving on that and identify exactly what is needed. The funding is there and we will drive on.