Dáil Éireann díospóireacht -
Tuesday, 12 May 1992

Vol. 419 No. 5

Adjournment Debate. - Castlebar (Mayo) Hospital Project.

Mr. Kenny

I thank the Ceann Comhairle for giving me the opportunity to raise this matter on the Adjournment. The urgent necessity for the Minister to authorise Phase II of the Castlebar General Hospital has been raised on a number of occasions in this Chamber and I hope this will be the last time any Deputy has to raise this issue. In wishing the Minister well in this onerous task, I should like to remind him that his three predecessors failed to authorise this work. It may well be that this is the last chance the people of Castlebar and County Mayo in general will have to see this work commenced.

I note and welcome the Minister's public announcement today of his commitment to funding for the Tallaght Hospital. Obviously this is a priority which must be welcomed. The commencement of work on Phase II of Castlebar General Hospital cannot and will not be commenced unless certain action is taken. The existing hospital is like a bird with one wing or a doctor's surgery without any implements. The hospital cannot operate effectively because the planning and design proposals dictated by the civil servants in the Minister's Department have not yet been implemented. The planning and design proposals for Phase II were drawn up to dovetail with the work on Phase I. Patients who are being treated in the older section of the hospital at present face the consequent risk of cross-infection. Indeed, sections of the older building could constitute a fire hazard. This creates practical difficulties for the nurses, doctors, staff, patients and their relatives. I wish to outline the action which needs to be taken to redress this problem.

I welcome the Minister's announcement that he intends to visit Louth County Hospital. I extend to him a formal invitation to visit Castlebar General Hospital. When he was Minister for Health, the former Deputy Barry Desmond, visited Castlebar General Hospital. Having seen at first hand the conditions in the old hospital, he allocated the necessary funds and authorised work on Phase 1 to proceed.

It is necessary to have a health service outside Dublin. I should like the Minister to authorise the planning and development work on the remaining section of phase I to proceed. This will take at least six months to complete, at no great cost to the Department. The people of Castlebar and the Western Health Board will more than readily accept the phasing in of work on Phase II over a two or three year period. I ask the Minister not to leave us in limbo for a further ten years. If the Department carry out cost analysis I believe they will find that the cost of Phase II against rationalising the existing structures in order to provide a decent service for the people of County Mayo, are more or less the same.

The promises and commitments given by the Minister's three predecessors received local and national coverage. The case for this work has already been made and accepted by the Department, and has never been denied. Indeed, the higher civil servants in the Department state regularly that the hospital cannot operate effectively or practically at present. I again issue a formal invitation to the Minister to visit Castlebar General Hospital. I ask him either on that occasion or beforehand, to please authorise the completion of the planning and development work on Phase I. We can then discuss allocating resources from the 1993, 1994 and 1995 capital programmes for Phase II. This development is much needed and I am sure the Minister will give it his urgent attention.

Minister for Health (Dr. O'Connell)

I am pleased to respond to the issue raised by Deputy Kenny. As the Deputy may be aware, the total development of Castlebar General Hospital was planned in accordance with the requirements of the development brief for construction under a single building contract. Tender documentation was prepared on that basis for the construction of four large hospital blocks, a core service area, major adaptations of the existing hospital block, an extension and upgrading of the existing maternity unit, a new morturary and a nurses home.

In the event, it was not possible to provide the necessary capital funds to proceed with the total development. However, the accommodation in the old hospital was very sub-standard and it was accepted that much of it had to be replaced. Accordingly, in 1983 the original plans were revised to allow phasing and to provide for a reduced scheme which would remedy the most serious defects of the hospital. I accept that conditions in the hospital must have been very bad when it was decided to move fast on this scheme.

It was decided to build two of the four blocks provided for in the plans together with the core service areas. Because the original development had been designed for construction under a single building contract, some areas had to be revised to allow acceptable operation of the reduced scheme. This phase of the development was commissioned in 1989-90 at a total cost, including building fees and equipment, of more than £11 million.

The accommodation provided in Phase 1 includes an outpatients department, kitchen, staff dining, stores, a radiology department, an operating department — four theatres — an intensive care unit and ward accommodation. I am sure the Deputy will agree that the completion of Phase 1 of this major development has resulted in a big improvement in hospital services for the people of Mayo.

I fully accept the need for the Phase 2 development. The intention is to proceed with it as soon as resources permit. This phase will involve building and connecting up to the new Phase 1 buildings two further blocks — ward accommodation, a new entrance, an administration department and an accident and emergency department, converting the existing hospital to provide a central sterile supply department, a physical medicine department, administration facilities, nurse changing-hostel accommodation, on-call staff accommodation and oratory; extending the obstetric unit and up-grading the existing unit; the provision of a new mortuary and the provision of a new nurses' home to replace the one demolished to allow Phase 1 to proceed.

As part of the Phase 2 development some modification will be necessary to areas of Phase 1 — making it much more expensive — so that the overall development can function as planned.

As I have said, I am anxious to proceed with this necessary work to complete the provision of an efficient and effective hospital facility at Castlebar. However, the total estimated cost of Phase 2 is in the region of £15 million and it will not be possible to accommodate a project of this size in the 1992 capital programme. The capital allocation available to me this year is severely limited and it will not be possible to provide other than for contractual obligations and other priority commitments. The scope for starting major new building projects will be extremely limited. Accordingly, the provision can only be made for the continuation of a number of major hospital projects currently under construction, a limited number of hospital improvement schemes at different locations, the purchase of urgent replacement equipment in a number of hospitals, a number of urgently required fire precaution and maintenance schemes, which amount to a considerable sum, and essential community developments in services for psychiatric patients, handicapped persons, the elderly and children.

Because of the urgent need to limit the national borrowing requirement, it will not be possible in 1992 to allocate capital resources to a number of major acute hospital developments, including Tallaght, as mentioned by Deputy Kenny, and the Phase 2 development at Castlebar. I would like to reiterate that the need for this major project is not in dispute, but the commencement of building work must be deferred until the public finances can support it. The Government are committed to ensuring that projects such as Phase 2 of Castlebar General Hospital should be commenced as soon as pressures ease on the national finances.

My priority is to ensure that the infrastructure of the existing hospital service is strengthened so that services can continue to be delivered in an effective and efficient manner and at a reasonable revenue cost. The Phase 2 development at Castlebar will contribute to the achievement of this objective and I can assure the Deputy that the needs of Castlebar will be taken fully into account in the formulation of my Department's capital programme for 1993 and subsequent years.

I promise Deputy Kenny that I will visit the hospital in the very near future because it is very difficult to know what the position is without seeing it first hand.