Vol. 572 No. 2
7 Mr. Quinn asked the Minister for Health and Children in regard to his announcement of 29 July 2003, the number of the promised 850 hospital beds under the proposed public private partnership now available; the hospitals in which they are available; the number in each case; and if he will make a statement on the matter. [22529/03]
The 850 additional community nursing unit, CNU, beds which I announced in July 2002 under the pilot public private partnership, PPP, will be provided in 17 new sites in the Eastern Regional Health Authority, ERHA, and Southern Health Board, SHB, areas. The ERHA proposes to develop nine CNUs, three in each of the area health boards. The proposed sites are in the following locations: Clonskeagh Hospital, Newcastle Hospital, County Wicklow, and Tivoli Road, Dún Laoghaire, in the East Coast Area Health Board; St. Joseph's Hospital, Raheny, St. Mary's Hospital, Phoenix Park, and in Swords in the Northern Area Health Board; St. Brigid's Hospital, Crooksling, Brú Chaoimhín, Cork Street and Cherry Orchard Hospital in the South-Western Area Health Board.
Will the Minister get on with the answer? We have this information.
It is intended that between 20 and 25 day care places will be provided in each location if the site is conducive to accommodating the service.
The Southern Health Board proposes to develop eight CNUs in the following locations: St. Finbarr's Hospital, Farranlea Road and Ballincollig in the Cork south Lee area; St. Stephen's Hospital, Glanmire, and St. Mary's Orthopaedic Hospital, Gurranbraher, in the Cork north Lee area; Mount Alvernia Hospital, Mallow in the north Cork area; Bantry in the west Cork area and Ballyard, Tralee in Kerry. These additional beds are currently not available, as the process of providing services under a PPP arrangement requires the health board or authority to abide by the Department of Finance guidance on PPPs, Interim Guidelines for the Provision of Infrastructure and Capital Investments through Public Private Partnerships, and the EU procurement legislation for projects of this size. There are a number of stages in the process which must be completed before these facilities will be provided. The first phase involved the preparation of a preliminary business case and the appointment of business advisers in respect of each of the projects.
The current phase of the project involves the preparation of a public sector benchmark, PSB, by the ERHA and the SHB, with the assistance of business advisers and the National Development Finance Agency. On completion of the PSB, it will be submitted to my Department which will examine the proposal before it is submitted for approval to the Department of Finance. It will analyse whether the PPP proposal offers value for money in comparison with the most efficient form of public procurement. If approved by the Department of Finance, the next stage for the ERHA and the SHB will be to advertise in the official journal of the European Union for consortia to design, build, finance and partially operate the facilities. It is expected that a preferred bidder will be selected by the end of 2004 and the facilities to become operational on a phased basis during 2006-07.
The Minister gave exactly the same reply to this question as he gave on 24 June.
Cut and paste.
Indeed. It highlights the problem that nothing is happening in the Department of Health and Children when the Minister can recite the exact same answer that he gave in June, except for one interesting point that requires clarification. It was stated in the answer on 24 June that public sector benchmarks would be sub mitted for approval to the Department of Finance, through the Department of Health and Children, during the summer. The Minister said that still has not happened.
Yes.
We need to know why, then, in a process that is proceeding at a snail's pace, even the commitments that have been made have not been lived up to.
If Deputy McManus asks a question in June about a process she knows from the answer in June is due to come into operation in 2006, there is little point—
That was not in the answer – 2006 was not mentioned.
I have put it in because we all know the process in terms of PPPs.
Will the Minister answer my question?
I am answering the question. I want to take on this attitude that when a PPP is devised but the answer does not change dramatically in two or three months there is something wrong – there is not.
It has not changed.
Of course it has not because there is a process to be followed. I cannot leapfrog over—
What about the benchmarks?
The Department has them but they are not just rubber-stamped and handed on, they are examined to see if they make sense.
The Minister said that in June.
If the Department has queries with particular submissions it has an obligation to the taxpayers and the Oireachtas to go back and check them before sending them on to the Department of Finance.
What are the queries?
Otherwise people end up before the Committee of Public Accounts, where the Deputy's colleagues would attack the Department for not doing its job properly. The idea that we rubber-stamp something and send it on is rubbish.
Maybe the Minister will tell us what the problems are.
There are detailed technical issues.
Are they secret?
Does the Minister agree that the PPP process is wasting huge amounts of the time of talented bureaucrats, both in the promoting companies and the public sector, and that the adversarial approach that exists by virtue of the relationship between the promoting company, the health boards, the Department of Health and Children and the Department of Finance, is not conducive to the speedy and cost effective delivery of an improved service? Would he be better off doing this on the basis of simple public sector promotion?
In 2001 the Government promised an additional 709 acute hospital beds and the Department's report in June indicated that 303 extra beds had been created for patients at that time. Will the Minister confirm that information? How does that tally with the situation where in the last week of September, the Eastern Regional Health Authority closed 184 beds, of which only 11 were private beds, with 173 being public beds?
This is another example of the two-tier system and the critical imbalance in favour of those who can afford to pay as opposed to those dependent on the public health system. Should the Minister not concentrate on increasing beds in that sector instead of looking now and again at public private partnerships?
When I was Minister for Education and Science, I decided to seek involvement in the first public private partnership in education and it delivered five secondary schools in a most expeditious and efficient manner. Those schools are now open and people should visit them to see their high specification. When the opportunity came up to try a pilot health project under the public private partnership initiative under the NDP, I decided again to have a go and see if we could involve help, particularly in the context of community nursing units.
The ESRI will be advising that public private partnerships should continue to form part of the overall infrastructural agenda for the next five years for efficiency purposes, from design to completion of building. In the initial phase there is a lot of work involved with public procurement and the EU. I accept that can be protracted but there is now an official in the Department who focuses on that and does nothing else, and a review of the processing of PPPs is under way. The traditional procurement process is ongoing for other community nursing units.
We have a particular problem in the two regions from which the PPPs have come in terms of historical under-provision of community nursing units. The judgment is that if we can successfully execute these PPPs, we will bring on board a significant number of beds in key areas where there has been under-provision leading to problems in accident and emergency wards in the eastern region, overcrowding and the long stay situation in Dublin hospitals.
Deputy Ó Caoláin's question relates to a separate issue, acute beds. We have commissioned over 560 beds as a result of the bed capacity initiative, even though the health strategy called for 450, with another 200 in the private sector. The treatment purchase fund spending has introduced a further 200 on a rolling basis since its introduction and more than 7,000 patients have been treated under that scheme.
The closure of 184 beds is a disgrace, particularly when only 11 of them were in the private sector. It demonstrates what PPP really stands for – private plunder of public health resources – and the Minister is perpetuating it.
The Deputy would know all about plundering.
The PPPs have nothing to do with acute beds.
