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Dáil Éireann díospóireacht -
Thursday, 30 Apr 1998

Vol. 490 No. 4

Ceisteanna — Questions. Priority Questions. - Hospital Funding.

Alan Shatter

Ceist:

1 Mr. Shatter asked the Minister for Health and Children whether he will sanction additional funding for Tallaght hospital, Dublin 24, to ensure essential works are carried out to facilitate the opening of the hospital on 21 June 1998; if the operating theatres in the hospital will be fully and adequately equipped and the computer facilities properly functioning at the date of opening; and if he will give a guarantee that the hospital upon opening will fully meet the needs of the patients for whom it was constructed. [10388/98]

The new hospital at Tallaght is the largest project in the history of our health services. It has been built to a standard on a par with the finest acute teaching hospitals in western Europe. A process of continuous consultation with the user groups who will be providing the services at the new hospital has informed the planning and commissioning of the hospital.

At the start of the commissioning phase of the hospital earlier this year a range of adjustments and some additional works were identified by users. This is not unusual in a project of this size. These works were confirmed by senior management as necessary for a variety of reasons, including adjustments necessitated by improved health and safety standards. The funding required for the completion of these essential additional works, which have been agreed as necessary to facilitate the opening of the hospital on 21 June, is being made available and the hospital is agreed on the arrangements to do this.

It has been agreed with the hospital management for some time that the first task in commissioning the new hospital is to transfer existing services, including the psychiatric services from St. Loman's hospital, to Tallaght and to immediately bring on stream at the new hospital those enhanced facilities which are necessary for the functioning of a major acute hospital. These new facilities include on-site laboratory services, more sophisticated theatres, state of the art sterile services, a "best of breed" information system-information technology system and an ultra modern filmless radiology system known as PACS — Picture Archiving Communication System.

The hospital management is confident that on 21 June all these facilities will be available to the degree necessary to open the hospital and to provide the projected required services similar to those currently being provided at the base hospitals and at St. Loman's. Enormous efforts have been and are being made by very committed people including the staff of the transferring hospitals, construction staff and suppliers to ensure this excellent health facility is made available as soon as possible to the people it is designed to serve.

I appreciate the dedication and commitment to the project by all concerned but particularly the dedication of the chairman of the Tallaght hospital board, Professor Richard Conroy, and the members of that board who have given so generously of their time and expertise in a voluntary capacity to bring this complex project to fruition. The work of the Tallaght hospital board is now in its final stages and its functions will be continued by the board of the Adelaide and Meath hospitals, Dublin, incorporating the board of the National Children's Hospital, currently chaired by Mrs. Rosemary French. I equally appreciate the tremendous achievements of this board since its inception less than two years ago. Not only has the task of integrating and preparing the base hospitals for the move been addressed but it has been done in a spirit of partnership and dedication in the interests of patients.

I share the Deputy's concern that the hospital upon opening should fully meet the needs of the patients for whom it was constructed. While I would be amenable to very temporary and short-term alternative use of a small number of facilities, I and my Department will insist that the hospital will be utilised to meet the needs of the patients for whom it was constructed.

Did the Minister visit the hospital?

Not yet.

Is the Minister saying what he knows about the hospital is based on briefings he received, that despite the fact that this is the largest hospital project in the history of the State, which has cost the State £130 million to date, he has not yet taken the initiative, after ten months in office, to visit the hospital to assess the needs to enable it to operate?

I met the boards of the hospitals involved. An official in the Department is involved on an ongoing basis and briefs me regularly. I agreed with the board to visit the hospital at an opportune time. I do not wish to interfere with the very important and urgent work that is proceeding to ensure the date for opening is met. Regardless of when I visit the hospital, it will not change the challenges that exist.

Is the Minister aware the hospital has been available for some months to be visited by groups and individuals with interests in it? Will he acknowledge the hospital, which is less than 30 minutes drive from his office, is easily accessible to him and it will be regarded as extraordinary by the public that the Minister for Health and Children did not visit the largest, most expensive hospital development in the history of the State prior to its opening? Is the Minister aware there is substantial concern that the hospital is under-funded and will be understaffed, and that because of his failure to allocate the necessary expenditure required, on the day the hospital opens a substantial portion of it will not be used? Will the Minister clarify the current budget allocation for the hospital?

The overall cost of the hospital will be probably in the region of £140 million. I visited many hospitals during my term in office and they would like to have access to the resources this hospital has obtained. To suggest that problems pertaining to the opening of a hospital, such as those experienced in Beaumont and other hospitals, will not be experienced here would be to simplify the position to too great an extent. Increased allocations to the hospital will be made on the basis of ensuring that health and safety regulations are met.

Funding for the schedule of alterations and additional works essential for the opening of the hospital amounts to £1.746 million. That funding is being provided as a result of additional capital funding of £664,000, revenue funding transfer of £135,000, transfer from the equipping budget to the main capital budget of £700,000 and a contribution from the National Children's Hospital of £247,000, totalling £1.746 million required. Funding is being made available to provide for issues raised by people involved in the opening of the hospital.

We are involved in transferring to Tallaght existing services from the four hospitals, including St. Loman's, enhancing some of those services and in time providing additional facilities which will come on stream in 1999. That always has been the plan for the hospital. There is an indication that because construction has not yet started on the private block, the opening date will be put back, but that is not the case. The extra beds required will be provided in either the Meath hospital or the Adelaide hospital on a short-term basis. We hope the Eastern Health Board will acquire the Meath hospital for the purpose of providing day care facilities for that part of the south inner city. The public-private mix can be accommodated. I am not prepared to allow, for example, vulnerable patients like those in St. Loman's Acute Psychiatric Hospital, not to be transferred to the hospital, as required and which is ministerial policy. That will happen.

I remind Deputy Shatter that unless we move on to Question No. 2, we will not be able to deal with Question No. 3.

This is a very important issue. I appreciate the Ceann Comhairle's concern and I will try to be brief. Instead of bluster, will the Minister acknowledge that he should have visited this hospital by now? Will he clarify the current annual budget designated by him for this hospital for 1998 because he has not answered that question?

The Deputy did not ask it.

I asked that question previously. How many operating theatres have been constructed in the hospital and how many will come on stream, start operating and be available to function when this hospital opens on 21 June? Will the Minister clarify whether the nursing services planning study, which indicated that this hospital requires an allocation of 300 additional nursing staff, will be implemented by him and the steps he intends to take in that regard?

The Deputy will be aware that there are more hospitals than Tallaght. I assure him Tallaght is the best and most modern hospital available.

The Minister has not seen it, so he does not know the problems.

I will answer the Deputy's question, but the bluster is coming from that side of the House. The Deputy asked whether additional funding will be sanctioned for Tallaght Hospital.

The Minister for Health and Children is talking about the largest hospital development in the State, which he has not visited.

I will visit Tallaght Hospital when it suits those who are doing urgent work there. The Deputy should not worry about my visitations.

Has anyone there said the Minister is not welcome?

Nobody has suggested I am not welcome. I would like to invite the Deputy and other spokesperson to join me.

I have already been to the hospital.

The Deputy could go again.

I ask the Minister to proceed to Question No. 2 as there is limited time for Priority Questions.

I was in Newcastlewest with Deputy Neville last week. Has the Deputy visited there? Does that suggest he does not have the same concern for Newcastlewest as he has for Tallaght?

I am asking the Minister about a new £130 million hospital which has teething troubles.

We cannot proceed in this manner. I ask the Deputy to allow the Minister to answer.

We will leave the bluster to that side of the House. Deputy Shatter asked whether I would sanction additional funding for Tallaght Hospital to ensure essential works are carried out to facilitate its opening on 21 June. I answered that question in the body of my main reply and £1.746 million will be provided to facilitate that. The Deputy asked if the operation theatres in the hospital will be fully and adequately equipped. The answer to that question is yes.

Will they be staffed and functioning?

The Deputy has asked questions which are being answered. He asked if the computer facilities will be properly functioning at the date of opening. The answer is yes. Deputy Shatter also asked if I will guarantee that the hospital, on opening, will fully meet the needs of the patients for whom it was constructed. As in line with the original plans, the existing services in the four hospitals will be transferred. It will include enhanced services in those existing services in the four hospitals being merged and transferred to Tallaght and there will be further increased services which will come on stream in 1999, as planned. That is a full and comprehensive answer to the question the Deputy asked.

What services will not come on stream on 21 June? Will the Minister indicate when he will make arrangements for the transfer of responsibility for the hospital from the planning board to the trustees, who will ultimately run the hospital?

I answered the question the Deputy tabled. If he has more questions to ask, he may table them and I will give a comprehensive answer.

The Minister does not know what is happening.

On meeting the needs of patients for whom the hospital was constructed, it is reasonable to assume the Deputy is referring to those additional facilities provided in the construction of the hospital which will not be brought on stream from day one but which will come on stream in 1999. These will include one theatre and theatre reception area, observation wards, adult accident and emergency, a segregated resuscitation unit, seven dialysis stations, four high dependency beds, three beds in the recovery area, an age related day hospital, any extension of the autopsy service, radiology and two ultrasound rooms.

In 1998, the hospital was allocated additional funds of £4 million to commission and open the hospital with the additional £1.746 million I mentioned, which was on last year's base to facilitate the commissioning process. These additional funds do not allow the hospital to open the above facilities, but it is hoped to bring them on stream next year. Another possible interpretation is that the hospital may be too small for some of the planned services to be provided, for example, the age related health care unit or the children's unit. My response is that the hospital, as constructed, has significant provision for expansion factors should the need arise.

The Deputy may refer to short-term inappropriate use of some sections of the hospital, for example, that the psychiatric or children's unit would be deferred to provide acute adult in patient facilities until the 76 bed private wing is completed late next year. I replied to the Deputy by saying that anything other than attaining 55 to 76 beds at either the Meath or the Adelaide Hospitals would be unacceptable to my Department.

What about the nursing services planning study?

I ask the Deputy to resume his seat.

The Minister's knowledge of what is happening in Tallaght is extraordinary.

The existing staff are being transferred.

We have been told in a study commissioned by the Minister's Department——

The Deputy should take his briefings from others, as well as Mr. Fitzpatrick.

Will the Minister proceed to Question No. 2?

We represent more than the hospital consultants on this matter.

On a point of order, the Minister has suggested I represent the hospital consultants.

The Deputy is being disorderly and making a point of order in an atmosphere of disorder is not in order.

The Deputy did not mention too many patients.

The Minister made an accusation. His approach to this matter is a dereliction of his duty as Minister.

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