David Cullinane
Question:8. Deputy David Cullinane asked the Minister for Health when he will publish a multi-annual investment plan to address the capacity deficit in hospitals; and if he will make a statement on the matter. [40790/23]
View answerThursday, 21 September 2023
Questions (8)
Oral answers (6 contributions)
We need a multi-annual plan for the health services. We know there is a crisis in emergency departments, with people waiting too long. There are almost 900,000 people or more on waiting lists when one includes diagnostic waiting times, acute hospitals and community waiting lists. There are problems in children's healthcare. A multi-annual plan is needed. I have been calling for one for some time. What plans does the Government have to put such a plan in place?
The health service is currently experiencing its largest multi-annual capacity growth since the HSE was established. This is based off a number of multi-annual strategies. Since 2020, we have opened 1,019 acute beds nationally. This is expected to reach 1,204 acute beds by the end of 2023 - an additional 185 beds over the current position and well ahead of the 2018 capacity review target. The objective of the HSE's 2023 national service plan is to bring critical care capacity to 352 beds, an additional 94 beds since 2020.
Progress is being made on new elective hospitals in Cork, Dublin and Galway. Approval in principle at gate 1 of the public spending code was given to the sites at Galway and Cork at the end of 2022. The HSE is progressing the development of elective surgical hubs as quickly as possible and considering all options to expedite the delivery of these units in south Dublin, north Dublin, Galway, Cork, Waterford and Limerick. The first of these, in south Dublin, is expected to be operational before year end and the rest following next year.
As well as this infrastructural investment, there has been a net growth in workforce of 21,910 whole-time equivalents, WTEs, an increase of 18% since 2020. In July 2023, the total workforce of the HSE stood at 141,722 WTEs.
Health and social care workforce planning is a top priority for Government. The Department is developing a health and social care workforce strategy and action plan and a planning projection model. Initial workforce planning projections are due to be completed in quarter 3 of 2023. The Department and the HSE are planning a refresh of capacity targets in the 2018 health service capacity review. This will cover both infrastructure and workforce to ensure we are developing the right level of capacity and plans to meet the needs of the population.
I have met with dozens of hospital managers, front-line healthcare staff and advocate groups in recent months. They all talk about plans they have submitted for new beds in hospitals, surgical theatre capacity and diagnostic capacity, all of which are necessary to reduce wait times in hospitals. The same can be said in mental health, where there are many buildings that are simply not fit for purpose. We need a long-term investment plan. We need a decongregation plan for people with disabilities. All of these areas, however, do not have multi-annual plans.
I need to ask a more fundamental question relating to what is actually going on in the Department of Health. So far this morning, the Government has been unable to give us a completion date for the national children's hospital. For whatever reason, we just cannot get it. We have no idea what the cost overrun in the Department of Health will be. Despite the fact that there is an ongoing debate, discussion or row - call it what you want - between the Department of Health and the HSE, nobody in government is prepared to tell us what that cost overrun will be, and we have all these crises in healthcare. The Minister needs to get a grip with his Department and what is going on. It is not good enough that on days like today, when it is our opportunity to put fundamental questions to the Government and the Minister for Health, we are provided with no answers, almost right across the board.
To reiterate, there is a significant amount happening in this space within the Department. We have had the largest expansion of the workforce since the inception of the HSE, with more than 21,000 WTEs added since 2020, while 1,019 acute beds have been opened nationally since 2020 and a total target of 1,204 beds will be delivered by the end of the year. Delivery is an absolute priority for the Government and I know the Minister, Deputy Donnelly, and his officials are exploring all available opportunities to improve the pace of delivery of capital health projects. In March this year, there were changes to the public spending code which will help the delivery of the national development plan that was introduced to streamline that process and make it more efficient. The Deputy can rest assured that work is also under way through the Estimates process in the upcoming budget. Many discussions are happening with me, the Minister of State, Deputy Butler, and the Minister, Deputy Donnelly, in respect of securing the funding that will be necessary to meet the increased demand within the health service.
While I respect the Ministers of State who are present and we all understand why the Minister for Health travelled, I again make the point to the Leas-Cheann Comhairle that a real crisis has unfolded at Temple Street hospital but there have been no statements on the matter this week in the Dáil. I asked questions on one of the most important issues facing the Department, that is, to get the national children's hospital delivered. The Government has a completion date but it will not share it. We are being told there will be updates and there has to be validation. It seems that time stops when it comes to the children's hospital but what goes on are cost overruns, lack of accountability and the fact that this Chamber, the Oireachtas and the public still cannot be given a completion date. That is absolutely bonkers. There is potentially €1 billion or more of a cost overrun in a Department and there is a row between the HSE and the Department of Health but we cannot be given the figure and the Minister cannot tell us it. It seems the Minister is asleep at the wheel on crucial issues in his Department and that is simply not good enough.
I cannot accept the Deputy's statements regarding the work that is happening within the Department. There are, and always have been, challenges in the health system. People are living longer and there is increased demand, which is fantastic. We need to be able to meet those demands and that will require extra funding through the budgetary process.
The Minister will address the Dáil next Tuesday on the issue of scoliosis. He has given that commitment. He had to travel to the United Nations and could not be here but he has given his commitment to address the Dáil next week.
On the children's hospital, I have answered that question previously. There are ongoing negotiations and discussions between the board and BAM, and that has to be bottomed out. Huge pressure is being applied with regard to the delivery of that critical hospital for the children of Ireland for today but also to the future. Yes there are challenges but the Deputy can be assured that the Minister, Deputy Donnelly, and his team are working to expedite these projects as quickly as possible.