Pa Daly
Question:89. Deputy Pa Daly asked the Minister for Health when oncology services in University Hospital Kerry will have a permanent location. [6697/23]
View answerThursday, 16 February 2023
Questions (89)
Oral answers (6 contributions)
When a patient has been diagnosed with cancer and their life is in turmoil, the first thing they need is a bit of stability. Oncology patients who have to attend University Hospital Kerry have been at various stages in the palliative care unit, then there was a proposal to send them to a private hospital and they are currently in the day ward. What plans does the Minister have to give oncology services a permanent home?
I acknowledge that the current situation for cancer services and the location of those at University Hospital Kerry is not sustainable and is not what anybody wants to see. I visited the hospital just last month and discussed this with the senior management in the hospital. The priority is that every patient in Kerry receives the best possible care in the right environment. The solution to this is the new oncology unit, which will greatly increase capacity at the hospital. The project is going through the various capital stages. I am happy to say it completed appraisal last year, the design team has been appointed and the project is being advanced this year. I have made it clear to the Department, the HSE and the team in Kerry that this is a priority.
The chemotherapy services operate on a hub and spoke model nationally, providing patients with treatment closer to the home where that is appropriate, including in Kerry. Over the course of the cancer strategy, there has been an increase in the number of patients receiving chemotherapy. The developments are taking place under the strategy, which has received significant investment in recent years, with €20 million in new development funding and capital funding for exactly this situation. We do not want a situation where chemotherapy services are being delivered while displacing other parts of the patient service. As the Deputy referenced in his opening remarks, they are currently co-located with palliative care, as they have been in the other places, and I am told there has been a knock-on effect, for example, on day case procedures as well.
The focus here is on progressing the new unit as quickly as possible. It has been approved and the design team is in place. What I want to see now is a rapid conclusion of that as we move to build. As I discussed with the team when I was there, we would also like to take a modular build approach, which we know can put these facilities in place a lot quicker than the traditional approach that has been used.
I have also been in contact with the new general manager and I wish her well in her endeavours over the next few years. However, while I hear what the Minister is saying in regard to capital stages and the design team, the Minister still has not given a date as to when he expects the new permanent unit to be completed. He is right in referencing palliative care but, from 1 March, I understand that, quite rightly, patients have to leave the palliative care section and move somewhere else. Unbelievably, there was a proposal to move them to a private hospital on the other side of town, which would have involved a €50,000 investment by the private hospital and a €2 million investment by the HSE. At least someone saw sense and decided that moving patients to the other side of town and that type of spending was not a good idea, to put it mildly, while only a fraction of the cost was paid, which is a familiar theme across healthcare, where the public has been subsidising the private. It is now in the day surgery space and, as the Minister mentioned, 20 operations have been cancelled.
We need to get this sorted as quickly as possible. The new unit is going to make a big difference. It will have 14-day treatment cubicles, two treatment isolation rooms and seven outpatient consultation rooms, so it is going to make a big difference in terms of the experience that patients have and, indeed, that clinicians have in providing what is world-class oncology treatment to patients. I am advised that to facilitate palliative care being reinstated, the Department has been told by the HSE that the oncology services will move for a period of four months to facilitate the reconfiguration of the palliative care unit and to provide adequate interim capacity but, ultimately, the solution is to finalise this design and then crack on.
I appreciate the Deputy’s very reasonable question, which is whether we have a date for when the new services will be in place. That cannot be answered until we have the final design because, obviously, the design that is come up with will, to some extent, determine how long the build will take.
Can the Minister even give a year as to when he expects this to be open? He mentioned the problem with day surgery. The problem in the last three or four years has been that whenever there is a surge, whether due to Covid or otherwise, elective day surgeries are the first to be cancelled. On any given day, University Hospital Kerry cannot guarantee that an elective surgery will actually take place because it does not have the beds or it is using the day wards as surge capacity for the emergency department. They are the low hanging fruit; they are the ones that are always getting cancelled.
What plan does the Minister have to deal with this? He mentioned rapid modular builds such as the ones that were built in Clonmel and Limerick. One of those needs to be put in place, at the very least. We have a problem with ratcheting up hospital capacity. One of the solutions was community recovery beds. It was said two or three years ago that an extra 70 would solve the problem with regard to step-down beds. A new building is being constructed in Killarney but, unfortunately, there is not one extra bed there.
We are looking at modular builds. My view is that the capital process is not working; the capital process is broken. There are internal processes within the HSE and processes between the Department of Health and the Department of Public Expenditure, National Development Plan Delivery and Reform. There are far too many layers and far too many people who can say “No” who need to say “Yes”. As an example, I was checking in recently on a very modest project that I sanctioned a year and a half ago which still has not happened. I got a note to say it had been through four separate committees and was working its way to the board for a review, on a piece of healthcare infrastructure that should have taken a matter of months to sanction. I am working with the Department of Health, the HSE and across Government to call this out. The current process is not working for patients or for our healthcare professionals, so we need to substantially overhaul it to be able to make these decisions quicker - either yes or no – and then drive on with the build. As I said, we are looking at modular build approaches right across the board in terms of surgical hubs and new bed blocks. The Deputy rightly referenced that University Hospital Limerick put in its new oncology suite in four months during Covid.