Dáil Éireann Debate, Thursday - 20 April 2023
13. Deputy Éamon Ó Cuív asked the Minister for Health the steps he is taking to ensure more speedy delivery of capital projects by the HSE; the policy changes he is introducing to ensure this; and if he will make a statement on the matter. [18202/23]
View answerJust in time, JIT, díreach in am. The question is very simple. The Government and the Minister have the money but we are not getting delivery of big and small health projects as speedily as we need it. We can go into this in more detail in the supplementary questions. What has been done to speed up procedures so that we can get necessary health facilities in place? The old barriers are gone but if we eliminate old barriers, we always seem to arrive at a new one.
I fully agree with the premise of the Deputy's question.
Before getting into what we are doing to speed it up, it is important to state that in spite of an extremely cumbersome process that leads us to being able to put new infrastructure in place, the Government has over the past three years expanded infrastructure and added critical care beds, diagnostics and primary care centres at a rate that has not been seen since, and likely long before, the HSE was founded. We need to give credit, dare I say, "to Government" for allocating the money, to all of the Oireachtas for supporting the allocation of that money, and to the Department and the HSE and their partners because there has been a substantial increase in infrastructure. Nonetheless, it takes far too long to build infrastructure in this country.
I am happy to be able to share that, working with the Taoiseach, the Tánaiste, the Ministers, Deputies Michael McGrath and Donohoe, we have recently agreed some important changes. We have agreed that the limit where the public spending code - the public spending code being this extraordinarily detailed 17-step process - kicks in be moved from €100 million to €200 million. That means that most bed projects in the country will no longer have to go through the code. That will speed projects up.
Second, in the Deputy's own region and in the Leas-Cheann Comhairle's region, there is a massive investment planned for Galway. We are looking at putting in the eight-storey emergency department, ED, women's health block. The Deputy will be aware we are sanctioning detailed design now for the cancer centre for the region. We are looking at putting in place the new laboratories. We are looking at putting in place the new elective hospital. I am working with Government for these very large projects to reduce the number of steps required. The key number of steps required for many of these, the smaller projects, has been brought down from five to three and then we will be looking at the bigger projects to see how they can be accelerated as well.
I am reasonably happy that the four big projects are going ahead. I have a specific question on that. Is the limit of €100 million per individual project? Will the elective hospital be taken as one project, the ED as another and the cancer and the laboratories as another or is it a cumulative €200 million between the four projects put together even though they will not be physically conjoined together?
One Taoiseach said that it is the little things that catch you, and we have that syndrome. I can name for the Minister some health centres, an ambulance base and a community nursing unit, CNU, that seem to be going on forever and not getting built. These are small projects. These should be done in a matter of two or three years. There is no big principle involved in them. We are promised them. They are needed but they are not happening. Is there anything that can be done to speed up these small projects that are not held up by any Government guideline but just need to get done?
In answer to the Deputy's first question, each of those projects is a separate project in terms of the €100 million versus €200 million. It will not come as a surprise to any of us that several of those projects will cost well in excess of the €200 million but, critically, even where they will, and where the public spending code to date has five separate approval stages and I have had to bring memorandum after memorandum to Government, for example, on the elective hospitals, much to the frustration of everyone in government, it has been agreed with the Ministers, Deputies Donohoe and Michael McGrath, that the five stages is brought down to three. That will help with all of those projects.
When it comes to the smaller projects, be that an ambulance base or a primary care centre, or, indeed, another project we did not mention to go into Galway, which is another bed block the hospital needs as well, that might well fall under the €200 million. That might well be the kind of one I am looking to bring in if I can get agreement on the 1,500 rapid-build beds.
To give an example of what we face in practice on the ground, there was a health centre planned and planning permission for Inishbofin in the 2000s. It never happened. They are trying to move site but it is going on forever. More than two years ago, the Minister might remember the need for the ambulance base in Connemara. We got the ambulance and we got the staff within four months. They were to convert an old health centre into an ambulance base. We seem to be running into all sorts of problems even though it is within a 60 km/h zone, or a village zoning, with everything from parking space to planning and whatever.
On the CNU, the Minister has heard the saga of Clifden hospital, which the Minister of State, Deputy Butler, will be more than familiar with, and St. Anne's. We were promised repeatedly - the Leas-Cheann Comhairle knows all about this - a new community nursing home unit. The reality is it has not even gone to planning yet.
Much as I would like the Deputy to go on, we are over time.
These are the kinds of issues. I could give the Minister a list. I note the Leas-Cheann Comhairle is absolutely dying for me to go on because she is as interested in this subject as I am.
I am, but I have to keep the time.
I will not delay the Leas-Cheann Comhairle but I would say that we need a rapid way of dealing with these problems. It might also need issues such as planning and so on to be fast-tracked where there is an obvious need for health reasons.
I also want to raise a serious situation in my own constituency, where construction work continues to be halted on a multimillion euro primary care centre in Ballyhaunis, County Mayo. Construction work was halted in early 2022. I have written to the senior HSE management in community healthcare west. Management outlined that it remains on hold as the landlord agrees costs to completion with the contractor and his subcontractors. This is totally unacceptable. This centre was due to be opened in early 2021. The community in Ballyhaunis requires essential services that these fantastic primary care centres provide and it is in no man's land with regard to when construction will recommence. I have written to the Minister about this matter. I ask him to intervene and provide reassurance to the people in Ballyhaunis that this primary care centre will go back into construction and that it can be fully completed.
I will add to what previous speakers have said. In particular, where new building projects are happening, the Minister needs to insist that accommodation is co-located with major new builds for nurses and doctors who work in a hospital environment. I recently tabled a parliamentary question to ascertain where there was old nursing accommodation that is not being used in each hospital group. There is a little of it. Some is being transformed for office space. Where it exists, we need to seize the opportunity to reconvert it and retrofit it for nurses to use. The Minister's counterpart, the Tánaiste, yesterday told the Department of Defence that there was to be no more getting rid of old barrack accommodation because we have a housing crisis. The same needs to happen in the health service. When new build projects get under way, they must be co-located in hospital environments.
Notwithstanding all those interventions, the Minister has one minute to respond.
I will try to give each 20 seconds. Regarding Galway and the smaller projects, I fully agree that is an issue in Galway and right across the country. It takes us too long. A few things need to happen. Capital allocation needs to be sufficient and, second, there needs to be much more efficient processing of these. I could not agree more. We are working with the HSE. I am engaged directly with the chief executive on exactly that.
Let me get Deputy Dillon an update on Ballyhaunis. If I need to intervene, I absolutely will. I know we have discussed this matter here previously. I acknowledge that Deputy Dillon has been advocating on this for some time. The primary care centres being built across the country are a huge good news story. I am opening three tomorrow in counties Sligo and Donegal. They are transformational for the local communities. I will revert on Ballyhaunis.
On the question of accommodation, I agree. Healthcare services and hospitals have previously had accommodation blocks for nurses. There is room for that. It is something we can look at. I have spoken to individual hospital chief executives who already have their eye on various pieces of land or existing property they would like to retrofit for exactly that reason.
We are going to run out of time. I hope to squeeze in three questions, with Deputies' co-operation. I ask Deputy Ó Murchú for his co-operation.
