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Dáil Éireann díospóireacht -
Thursday, 26 Mar 1992

Vol. 417 No. 7

Ceisteanna—Questions. Oral Answers. - Tallaght Hospital Project.

Pat Rabbitte

Ceist:

7 Mr. Rabbitte asked the Minister for Health if he has received the report of the working group representative of the Adelaide Hospital, the Meath Hospital and the National Childrens' Hospital which was established to reach agreement on an appropriate management structure for the new Tallaght Hospital; if it is intended to publish the report; if he has yet met with the group or plans to do so; and if he will make a statement on the matter.

Pat Rabbitte

Ceist:

35 Mr. Rabbitte asked the Minister for Health if he will outline the latest position regarding the proposed Tallaght Hospital; if a date has been set for the issuing of tenders or the commencement of construction; if he will further outline the alternative forms of finance for the hospital he is now considering; if, in regard to his statement in Dáil Éireann on 19 December 1991, he has had his promised meeting with the board of Tallaght hospital local interest groups; if so, if he will give details of the outcome of any such meetings; and if he will make a statement on the matter.

Donal Carey

Ceist:

61 Mr. Carey asked the Minister for Health if he will outline the present status of his plans for Tallaght Hospital, Dublin 24; and the expected commencement date of the project.

Pádraic McCormack

Ceist:

93 Mr. McCormack asked the Minister for Health if he will outline whether resources have been set aside within the 1992 capital allocation to allow the Tallaght Hospital project to proceed when the report of the Kennedy Group on the project becomes available in mid-year; and if he will make a statement on the matter.

Mervyn Taylor

Ceist:

113 Mr. Taylor asked the Minister for Health if he will give details of the meetings he held and the discussions which took place recently with Tallaght organisations to discuss the matter of the Tallaght Regional Hospital; if he will outline the information given to the groups and the changes which were announced regarding the development of the proposal for the Tallaght Regional Hospital; and if he will make a statement on the matter.

Bernard Allen

Ceist:

144 Mr. Allen asked the Minister for Health if he will make a statement on recent reports (details supplied) that a total revamping of the Tallaght Hospital project with a smaller 350 bed hospital funded by local authority funds is accurate; and if he will make a statement on the matter.

Richard Bruton

Ceist:

149 Mr. R. Bruton asked the Minister for Health if he will outline the estimated cost of (a) an outpatient facility only for Tallaght (b) a 350 bed hospital in Tallaght and (c) the original proposed plan for Tallaght.

Mervyn Taylor

Ceist:

157 Mr. Taylor asked the Minister for Health if he will make a statement regarding his recently announced proposed changes in the plans for the Tallaght Hospital in Dublin 24 outlining his exact amended proposals specifying the proposed amended catchment area for the revised hospital; and if he will make a statement on the matter.

Mervyn Taylor

Ceist:

159 Mr. Taylor asked the Minister for Health if he will make a statement on the initiatives he is taking to progress the Tallaght Hospital project in the context of statements made in a radio programme on 24 February 1992; and if he will make a statement on the matter.

I propose to take Questions Nos. 7, 35, 61, 93, 113, 144, 149, 157, and 159 together. That will give some indication of the interest in this issue and in my reply.

I have met separately with the Tallaght Hospital Board, the Tallaght Community Council and the Tallaght Regional Hospital Action Group for discussions regarding the proposed hospital project. At those meetings I reiterated the Government's commitment to the Tallaght Hospital project. It was explained that all possible funding options were being actively explored and that in this context the Dublin Hospital Advisory Group had been asked to examine the hospital needs of the area and to make recommendations on the functions, scope and scale of the proposed hospital and on possible methods of funding. The Dublin Hospital Advisory Group are currently examining these needs.

When the hospital was originally planned in the early 1980s the number of beds was based on the planning norms of the time. However, in the last ten years there has been a dramatic change in acute hospital practice, with developments in diagnostic techniques, the introduction of day surgery and new and improved treatment regimes, all leading to a significantly reduced length of stay for patients attending general hospitals. Therefore, the large number of beds originally planned would not appear to be necessary at this time.

The question of interim services in the Tallaght area will be considered in the light of the group's recommendations, which I expect to receive shortly.

Deputies will be aware that the estimated cost of the original Tallaght Hospital project was £118. It is not possible at this stage to provide estimated costings for a revised project or an out-patient facility, pending the recommendations of the Dublin Hospital Advisory Group.

The Working Group, representative of the Meath Hospital, Adelaide Hospital and National Children's Hospital, was an ad hoc committee which was set up to consider a management structure for the Tallaght Hospital and it is not intended to publish the group's report. However, I have received the report and I am actively considering the matter at present.

I wish the Minister for Health well in his new appointment.

A colleague from my constituency, Minister Flood, is in the House and I am sure that he would testify to the number of occasions on which I have raised this issue with the Minister's predecessors.

When does the Minister consider that he will be able to announce the outline of his plans for what is apparently now to be a scaled-down hospital? The only question about which the people of the most populous region in the country are concerned is when construction will start on whatever shape of hospital is to be provided — and we can argue about that matter another time. Those in Tallaght, Clondalkin and the surrounding region want to know when construction is likely to begin.

When I came into office I thought that I should see the groups concerned immediately to know what their exact thoughts were. I then met the Tallaght Hospital Board. I felt that 11 years was a long time for considering the construction of the Tallaght hospital. The discussions concerned the possibility that the Government would not be able to provide £118 million. It was also suggested, by virtue of the fact that such advances have been made in hospitals, that we should consider a more realistically sized hospital. Until five years ago there were no day surgeries and we did not have the keyhole surgery that is now available. For example, a patient who would normally have spent 14 to 18 days in hospital after a gall bladder operation can now be released after three days. We are now looking at a completely different picture. I did not lay down any rules but I put it to the Tallaght Hospital Board that they might perhaps consider a more realistically sized hospital. The opinion in America now is that smaller hospitals are much more cost effective, more personal and provide better care than the huge hospitals.

I visited all hospitals in Dublin. When meeting the Meath Hospital Board I suggested that, as proof of sincerity, interim arrangements should be made if there were to be a hospital. I suggested to the board that they come back to me in two weeks with proposals for the provision of outpatient services there on an interim basis. The suggestion was also made for a first aid ambulance service that could provide basic care and treatment for minor ailments and could also take people to the nearest casualty hospital. The area is so far out of the city that mothers who try to bring their children in on buses, for example, are faced with great inconvenience. That is one proposal that should be considered to prove to the people that we are serious about what we are saying. I would welcome the provision of such a service in the centre, near the centre or perhaps even on the site. I gave the board two weeks to come forward with proposals and I am sorry for looking for their ideas in such a short time.

I also met the Kennedy Group and Dr. David Kennedy. I suggested to Dr. Kennedy that he could perhaps speed up his deliberations on this issue and come back to me with his ideas before July or August. I suggested that he might come back to me with proposals for alternative methods of funding by the end of April.

I also met financiers from the United States who had indicated an interest in the project. They seemed enthusiastic and I suggested that they meet the chairman of the Tallaght Hospital Board.

Those are the measures that I have taken in this regard in my four weeks as Minister.

May I ask——

I must call Deputy Bruton who has tabled a related question.

If it is not unacceptable to talk about a first aid station for a population of hundreds of thousands of people, at a time when the Minister has £40 million at his disposal this year for hospital capital projects, would he not agree that this flurry of meetings in which he is engaging misses the central question of why he will not allocate money to the project? Would he not agree that the board of Tallaght hospital have taken into account the new norms in bed ratios and day surgery in designing their most recent plans?

No, they have not. There have been various figures trotted out about the size of the hospital. I would ask the Deputy to realise that I am endeavouring to do something about it. It may be the Deputy's duty to criticise no matter what I do. I might point out I have been four weeks in the Department and I am not there to perform miracles; certainly I cannot perform the miracle of the five loaves and two fishes. But I can assure the Deputy I will consistently work very hard to see that hospital erected; that is the commitment I have given them.

Deputy Rabbittee will be aware of the various figures. For example, originally it was to contain 750 beds, then they decided to reduce that to 650 and they have examined various other figures. I suggested around 350 to 400 beds. Perhaps that is not an ideal figure but let us ascertain whether we can get a good hospital record. I am not talking about a first aid station as such. I am talking about a first aid ambulance station. That does not mean there will be merely a St. John Ambulance man located there. It does not mean that. It means we will provide some form of service for minor casualties so that an ambulance would be on standby wherever immediate therapy is necessitated. That is what I thought we might provide, if the people accept this proposal and if we get the requisite funds. It is as an interim measure so that people could be taken to the nearest hospital. If Deputy Rabbitte has other recommendations, better suggestions, I gladly invite him to my office when I will give them sympathetic consideration.

What about allocating the £40 million the Minister has already?

It has already been allocated to ongoing commitments. I wish those funds were available.

What are the Minister's priorities?

We cannot discontinue current commitments.

Does the Minister accept that modern developments in the delivery of acute services about which he has spoken, may, in some people's minds, be seen as a pretext for not relocating the Adelaide Hospital in Tallaght? Does he agree that the loss of the Adelaide ethos and tradition to the Tallaght Regional Hospital would be regrettable? Furthermore, is he aware of the fears that may be provoked in the minds of many people in the region when he talks about private financiers in the United States or wherever else? Does he accept that what we do not need in Tallaght is a Blackrock Private Clinic-type institution? Finally, why is he not publishing the work of the Kennedy Advisory Group? When does he propose to respond legislatively to the recommendations of the Kennedy report which, as I understand it, cannot be implemented without legislation being brought before this House?

First, I will look at that and communicate with the Deputy. I am very conscious of the special ethos of the Adelaide Hospital. I did suggest to the Adelaide Hospital — and I am not laying down laws — that they might consider remaining where they are and where they are providing a vital medical service in the inner city area. We have lost a lot of hospitals in this area, including Mercer's, Baggot Street, Sir Patrick Dun's and Steevens. We might find the inner city area depleted or devoid of hospital care. From the time I was very young we always went to the Adelaide Hospital. Indeed, I have great regard for and sentimental attachment to that hospital. It was a suggestion I hoped they would consider. But, if they are committed to Tallaght, then I will ensure that the ethos of the Adelaide Hospital is preserved there. I would want to do so, as I think we all would.

What about alternative funding?

I should say we would not want, and I would not allow, a Blackrock Clinic type of hospital there in the first place. This will be a public hospital providing first-class, quality care. There may be some suggestion that if there were not a large number of beds one would lose out on attendant technology. Our job is to provide a first-class quality public hospital, no private hospitals. That is very important as we have sufficient of the latter.

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