Dáil Éireann díospóireacht -
Thursday, 7 Feb 2019

Vol. 979 No. 1

Saincheisteanna Tráthúla - Topical Issue Debate

Airport Development Projects

Deputy Mary Butler

Waterford Airport has been without any commercial flights since mid-2016. I know the Minister is very familiar with this matter. The lack of international and national connections is a huge challenge. Extending the runway is crucial for the viability of Waterford Airport in the long term and in the context of any commercial future for the airport. Right now, Waterford's runway is only capable of handling smaller, turboprop aircraft, which are diminishing in numbers and struggling to retain their place in a highly competitive marketplace. The airport's board says a longer, wider runway would allow the hub to cater for more commonly used aircraft such as the Boeing 737, favoured by Ryanair, and the Airbus A320, the most common plane in the Aer Lingus fleet. The future of Waterford Airport has been hanging in the balance since June 2016, when the Belgian parent of the VLM airline went bankrupt, bringing an abrupt end to its only scheduled services to London Luton Airport. Waterford Airport currently hosts an Irish Coast Guard helicopter and is available for use by private jets.

The development of the runway extension at Waterford Airport is key to the region so that viable routes can be explored. I accept that the aviation industry is extremely tough and the airport has seen its fair share of setbacks in recent years. However, the delivery of funding to pay for the extension of the runway to allow larger aircraft use the airport, offering longer distance services to mainland Europe, would ensure the future of the airport and secure the many local jobs that are dependent on it being fully operational.

The North Quays in Waterford is the site of a proposed €350 million regeneration project which can only be described as a game-changer for Waterford. The south east needs a regional city of consequence and that city must be Waterford. A viable working airport is crucial to strengthen the city and the region. Waterford could act as a release valve for the overcrowding in Dublin, and it could act as a counterbalance to the capital in the context of issues such as overheating, rehousing, transport congestion and education.

I acknowledge that on foot of requests made by the airport and the Minister's colleague, the Minister of State, Deputy Halligan, and to ensure there was no disruption to the coast guard's search and rescue service, the Minister sanctioned the provision of €750,000 in grant funding to the airport last year. Two payments of €375,000 were made to the airport in January and December. These were exceptional payments and were provided to allow time for appropriate consideration of the issues arising at Waterford Airport. I submitted a parliamentary question on the matter last October and welcomed the reply that the Minister had brought to Cabinet an independent report on the extension of Waterford Airport runway. This was a very positive move. I am also pleased that submissions from Waterford Airport, Waterford City and County Council and local private investors were included in the review by Ernst & Young, EY, commissioned by the Minister. A planning application has been made for an extension to the runway. The current length of 1,400 m would be extended to 2,200 m and the width would be increased from 30 m to 45 m. This runway extension is vital to secure the future of Waterford Airport.

Minister for Transport, Tourism and Sport (Deputy Shane Ross)

I thank the Deputy for raising this issue. I appreciate its importance to the south east, and to all the public representatives and people there. I appreciate the energy Waterford Airport could inject into that region if it was a working and successful project.

Before I update the House, I think it might be useful to provide some background information on the issue. Many Deputies here today will be familiar with Waterford Airport, which has been operating in the south east of the country since the mid-1980s. While passenger numbers reached a peak of more than 140,000 in 2008, there was a steady decline in numbers thereafter with fewer than 35,000 travelling through the airport in 2015. In fact, since June 2016, as the Deputy stated, no scheduled air services have operated at Waterford Airport. In terms of Exchequer support, no capital funding grants have been provided to the airport since that time and grant aid towards operational funding ceased from 2017. This is because the schemes operated under the regional airports programme relate to the provision of scheduled air services. Unfortunately, despite best efforts and numerous attempts, the airport has not been able to secure new scheduled air services since the last operator ceased services in 2016.

This has, as one would expect, given rise to financial challenges at the airport. On foot of these challenges, the airport submitted requests to my Department for a minimal level of subvention, which would allow the airport to continue its operations in 2018 as it considered its future. After informing the Government of the situation, I made a decision to provide €375,000 to the airport in January 2018. I provided a further payment of €375,000 in December. That is the €750,000 to which the Deputy refers. These payments were justified. They were an exceptional measure and were made to ensure that there would be no disruption to the search and rescue service that operates from there. They were also provided to allow time for a full and extensive consideration of future options for Waterford Airport.

In respect of that consideration and the detailed analysis that would be required, the Department procured the services of EY, the independent consultants, in early 2018. During the course of this analysis, Waterford Airport submitted a proposal to my Department for Exchequer support in respect of a project to expand the runway at the airport to accommodate large commercial passenger jets. The airport is also intending to raise money from three local authorities - Waterford, Kilkenny and Wexford - and from private investors. EY was asked to assess this proposal as part of its review.

The airport contends that the failure to maintain passenger services is embedded in the limitations of its runway, particularly in terms of length, which cannot handle larger jet aircraft. Following completion of the EY review, my Department sought additional information from the airport in respect of private investor commitment, interest from jet carriers and the future ownership and shareholding position of the airport company. Then, in October last, I brought the matter to Government for the purposes of updating my Cabinet colleagues and also to inform them of my intention to provide a copy of the EY report to the board of Waterford Airport. The airport was invited to respond to EY's findings and to provide any additional information that might strengthen its position in respect of the runway proposal. That response, received from the airport last week, is being reviewed by my Department and will be assessed against national aviation and transport policy objectives, as well as broader Government policies such as Project Ireland 2040 and the national planning framework. Once I have fully considered the matter, it is my intention to revert to Government for a decision in the coming weeks.

Deputy Mary Butler

I thank the Minister for his comprehensive reply. Funding will be required from the State, local government and private investors. However, I believe a positive response from the Government and from the Minister will spur on other interested parties and ensure that the developments needed are delivered. It is imperative that support from the Government for the extension is delivered. If the Government could commit to the €5 million requested, there would be matched funding from private investors of €5 million and matched funding of a further €3 million from the local authorities in Waterford, Kilkenny and Wexford. I welcome the Minister of State's comments to the effect that he received a response from the airport last week which is being reviewed by his Department and which will be assessed against national aviation and transport policy objectives, as well as broader Government policies. I hope we will have a timely reply on that.

I reiterate some of the comments I made earlier.

The development of this runway is absolutely essential. Waterford city is on the crest of a wave currently. There are huge opportunities in Waterford to make it the capital city of the south east. There is no doubt that if the airport could access this runway we would end up with a range of additional businesses and opportunities. I believe the airport would reduce its dependency on Government support in the long run, and its potential to attract additional investment and employment opportunities to the area would be enhanced.

I hope to welcome the Minister's decision on the airport at Waterford as soon as possible.

Deputy Shane Ross

It is everybody's wish for Waterford Airport to be a functioning, commercial and viable airport. That is our objective. We have to take many things into account when making a decision on this, including the long-term outlook, not just the short term. We have to look at the Government's regional policy and decide on that basis whether investment is worthwhile or not. We also have to take into account the somewhat unique situation where there are private investors in county councils who volunteer to produce money to put into an airport of that size and who take risks with their investments. We must also consider that county councils have great faith in the benefits this would bring to the region. However, we cannot take imprudent decisions which will not, in the considered view of independent reviewers, ourselves and of experts, offer benefits to the region. We do not want to create a white elephant.

We have pondered this issue for a long time and have shown good faith in the project by providing €375,000 on two occasions. We do not want to close the airport and will give it every chance to succeed. However, we will take a decision on a very sensible and prudent basis in the coming weeks.

Electric Vehicles

Deputy Noel Rock

New figures show that electric vehicle registrations increased significantly in January, with a total of 811 cars sold. That represents a massive increase of 680% on January 2018. The Society of the Irish Motor Industry, SIMI, said that the January figure is more than the total of sales for 2017, and in fact is over 60% of the total for the whole of last year. It is quite clear that this sector is growing, not only internationally but domestically. It is equally clear that, in terms of personal vehicle usage, electric vehicles are the way of the future. I am sure the Minister, and indeed the House, would agree with that statement. However, it is equally clear, based on recent reports and discussions I have had with people, that there is some concern around some of the incentives being put in place. For example, the tolling discounts which were put in place to incentivise the uptake of electric vehicles, have lead to some confusion among existing owners of electric vehicles. Indeed, there is a complete lack of knowledge among prospective purchasers of electric vehicles.

How exactly is this scheme being advertised? A journalist from The Irish Times contacted Transport Infrastructure Ireland, TII, to get some clarity around how this scheme operates, only to be given incorrect information. While that is itself is not a problem - people make mistakes and we cannot necessarily blame one individual - it goes to show that there is a lack of clarity and consistency around the application of this scheme. The story, from Mr. Neill Briscoe, reads:

[Another] issue, possibly [more] worryingly, seems to be confusion in the ranks over exactly how the discount system should work. A representative from the TII told The Irish Times that: "Please note that if people were travelling during peak hours there were no discounts".

That, however, according to the journalist and the regulations, is incorrect. The Department's official rules for the scheme say: "At peak times the discount is reduced from 75% to 50% on the M50, and from 50% to 25% for petrol hybrid electric vehicles". Consequently, there is a discount at peak times, despite TII saying otherwise.

If TII does not know how this operates, how can the public be expected to know? Is this issue recognised within the Minister's Department? Does the Department have a plan to expand this scheme or to clarify it? It is quite clear that this is the way of the future, and that the number of users of this technology is going to go up and up. Some clarity and consistency on this matter would be most welcome. I have spoken to a number of people within the community, and the good news is that the majority - some 60% - of the more than 150 users who were polled on this are happy with the scheme. However, there is a significant minority who are confused by the inconsistencies of the scheme. There are currently five different toll tag operators who apply discounts. Some apply them in a live manner, at the moment a car passes through the tolls. Some apply them by way of a backlog, rebating moneys monthly based on arrears accrued. It is clear that among the toll tag operators, TII and the Department there is a complete lack of clarity and consistency. I would like to hear the Minister's views on this, his plans for the scheme for the future and his own feeling about electric vehicles generally.

Deputy Shane Ross

I am glad the Deputy has acknowledged the great success of electric vehicles in general, even though he has specific, interesting criticisms about the way it is operating.

To give some background on the issue for the benefit of the House, this scheme was developed through the low emission vehicle task force, an interdepartmental group which aims to accelerate the take-up of low-carbon technologies in the road transport sector, and forms part of a wider suite of incentives aimed at supporting the national transition towards lower emitting vehicles. The reduced tolling regime was introduced to encourage private car commuters who regularly use tolled roads to consider switching to electric vehicles. It is estimated that there are approximately 400,000 heavy toll users in Ireland, and so reduced tolls act as a meaningful incentive for a large number of vehicle owners. I was happy to announce the launch of the scheme in July 2018, which is administered by TII on behalf of my Department. Under the scheme, battery electric vehicles and plug-in hybrid electric vehicles qualify for 50% and 25% toll reduction respectively, up to a maximum annual threshold of €500 for private vehicles and €1,000 for commercial vehicles. Greater off-peak reductions also apply to the M50 toll.

Information for electric vehicle owners on the simple and straightforward registration process is available online through the TII website and at eToll.ie. Vehicles participating in the scheme must be registered and approved by one of four toll service providers. All eligible vehicles require a toll tag to avail of the scheme. Since its introduction the electric vehicle toll scheme has proven very successful, with over 52% of all electric vehicles in the national fleet registered to avail of the incentive. That amounts to over 4,000 successful registrations. Based on the significant increase in electric vehicle sales in 2019, I expect the numbers availing of the incentive to rise further.

I am aware of a media article to which the Deputy referred and the concerns regarding the operation of the scheme. As advised in my recent response to a parliamentary question from Deputy Munster on Tuesday last, I understand that, to date, neither TII nor the individual toll service providers who operate the scheme have received any information, concerns or complaints from customers regarding the operation of scheme. If any electric vehicle owner is having issues registering for the scheme I would encourage them to contact TII directly and the matter will be investigated as a matter of urgency.

Maintaining the success of the scheme is important as we continue to encourage more and more people to switch to electric vehicles. As such, TII has already begun a review of the scheme. The electric vehicle customer experience will, of course, form an integral part of this review process. The transition to electric vehicles is fundamental to decarbonising the private car fleet. As such a generous range of incentives have been put in place to encourage their uptake. Incentives include purchase grants, vehicle road tax, VRT, relief, favourable benefit-in-kind rates, low motor tax and an extensive public charging network.

I am pleased to see the positive impact that such incentives are having on uptake rates. We are beginning to see a marked increase in electric vehicle sales, to which the Deputy referred. In January alone, a total of 811 new full battery electric vehicles were registered. This compares with 104 vehicles for the same period last year. Similarly, plug-in hybrid sales are increasing, with 301 new vehicles sold in January compared with 109 last year. Electric vehicles accounted for over 3.4% of all new car sales to date in 2019. This upward trend is one I hope to see continue as EVs become a common alternative to conventionally fuelled cars.

In the short term incentives, including the reduced tolling regime we are speaking of today, play a vital role in guiding consumer choice towards lower emitting alternatives. This is a necessary step change as we move towards decarbonising the transport sector.

Deputy Noel Rock

I thank the Minister for his answer. One point that jumped out at me was his comment that, since its introduction, the electric vehicle toll scheme has proven "very successful" – those were the Minister's words – with over 52% of all electric vehicles in the national fleet registered to avail of the incentive. This is free money, an incentive, yet only 52% of the people who are early converters have applied to the scheme. Generally speaking, these people are well connected in a small tight-knit community. Only 52% or one in every two of them has registered for a scheme that is meant to incentivise the public at large to convert to electric vehicles, turn doubters into believers and get more people buying electric vehicles. Does the fact that only half of the existing owners of electric vehicles have converted not indicate, as I outlined in my original statement, that there is a clear issue with the clarity, consistency in applicability, effectiveness and usefulness of the scheme? It seems to be generating a potentially large expense without doing what it sets out to do. People are converting to electric vehicles in greater numbers. However, as the Minister outlined, several challenges face us, especially in terms of charging infrastructure. Does he believe the scheme, in which only one in two existing vehicles owners participate, is operating as a true incentive?

Deputy Shane Ross

I thank the Deputy for asking the question a second time. If I did not adequately respond the first time, I will repeat myself and add a little. I do not know the answer to Deputy Rock's question and nor does the Deputy as otherwise he would not be asking it.

Deputy Noel Rock

The Minister is here to answer it.

Deputy Shane Ross

I put it to the Deputy that it is possible that the scheme is not being properly marketed, but it could also be inertia – I do not know.

Deputy Rock started by saying the scheme was not working property and read from an article in The Irish Times. The Deputy seems to disregard that those operating the scheme have received no complaints. Is it not strange that the operators of a scheme that is apparently not working have had no complaints from Transport Infrastructure Ireland? To date, neither TII nor the individual service providers who operate the scheme have received any information, concerns or complaints from customers regarding the operation of the scheme. If 48% of people who qualify are not applying, it could be inertia or it could be a matter of the scheme not being properly advertised. To respond to the possibility that the Deputy is right, I will convey his remarks to TII.

General Practitioner Services

Deputy Dara Calleary

I thank the Ceann Comhairle and his staff for allowing me to raise this issue this evening. Being a Galway man, the Minister of State is probably familiar with Kiltane and Bangor Erris, which is at the centre of the parish. There has been an excellent general practitioner serving that community for some years now. The superb staff there give a very good service. It was difficult to fill the vacancy when it arose some years ago but the GP has worked hard and built confidence with the community and he is providing a good service. We understand from the HSE that he has been offered another position in the west of Ireland and intends to take that up. As the Minister of State can imagine, members of the community are concerned that they will be left without GP services. There is an information deficit about what may happen at the end of February when the GP is due to take up the new position.

This raises the wider issue of rural GP services. I note Deputy Harty is here with us. The Minster of State did not make it out to the GP protest outside the House yesterday but he will have heard the frustrations of GPs, old and young, on resourcing. This is a broader issue which I raised during Priority Questions with the Minister for Rural and Community Development, Deputy Ring, some weeks ago. It is not right that the Department of Rural and Community Development is giving everything to try to maintain services. The Minister of State at the Department of Health has to step up to the mark as well.

We should use Bangor Erris as a case study or pilot study. I reckon the time has come for the HSE to step in and provide surgeries and facilities in the same way that IDA Ireland provides advance factories. The HSE should provide, through a public service obligation, a subsidy towards the employment and retention of staff.

One of the reasons these communities are not as big as we would wish them to be is diminishing services. If we provided support in terms of premises and a subsidy towards the running costs of GP practices in rural areas, we would attract GP services to rural communities and retain them. People would be willing to apply to provide the service. I appeal to the Minister of State to use this situation as a potential case study and to engage with HSE officials in Mayo. They are trying their best to try to resolve this issue. We need to give certainty to the people of Bangor Erris and Kiltane in respect of the long-term provision of GP services in that proud community, which needs this service. For a small investment, the Minister of State would find that we could come up with a model that might help to resolve some of our issues about providing GP services throughout the country.

I appeal to the Minster of State to go back to his Tuam and Galway roots, champion this issue at Government and work with various Departments. Let us try to do this and keep the current doctor in Kiltane and Bangor Erris. Let us allow him to provide the kind of service that he wants to provide to those in a community who trust him greatly.

Minister of State at the Department of Health (Deputy Finian McGrath)

I thank Deputy Dara Calleary for raising this important issue. I assure the Deputy that I always go back to my Tuam and Galway roots. I also assure the House that the Government is committed to enhancing primary care services, including general practice services. This is central to the Government objective of delivering a high-quality, integrated and cost-effective health service. Our goal is to ensure that patients throughout the country continue to have access to GP services, and that general practice is sustainable in all areas into the future. It is imperative that existing GP services are retained and that the new general practice remains an attractive career option for newly qualified general practitioners.

The number of GPs on the Medical Council specialist register continues to increase. They have increased from 2,270 in 2010 to 3,723 as of 1 January 2019. The number of GPs holding General Medical Services, GMS, contracts has also risen from 2,098 in 2008 to almost 2,500 in 2019.

The Government is aware of workforce issues facing general practice, including the influence of demographic factors. In recent years, the Government has implemented a number of measures to improve recruitment and retention in general practice. GP training places have been increased from 120 in 2009 to 202 in 2019, an increase of almost 70% over this ten-year period. As stated in the programme for Government, the intention is to continue to achieve annual increases in the number of training places available.

Entry provisions to the GMS scheme have been changed to accommodate more flexible GMS contracts. The retirement age for GPs has been extended to 72 years. An enhanced support package for rural practices has been introduced with improved qualifying criteria and an increased financial allowance of €20,000 per annum. The Government is also committed to engaging with GP representatives on the development of modernised GP contractual arrangements - one of the points raised by Deputy Calleary.

A talks process is underway between the Department of Health, the HSE and the IMO. Discussions are ongoing in an effort to bring matters to a conclusion. Agreement on the delivery on a range of service improvements and contractual reforms has the potential to facilitate a substantial increase in the resourcing of general practice on a multiannual basis. The HSE is fully committed to ensuring GP services continue to be provided to people in Bangor Erris, County Mayo. The HSE has confirmed that it will immediately advertise the GMS panel concerned and will explore all options available to ensure GP services continue to be provided in the area into the future.

The current GP will continue to provide services until the end of March. The HSE will ensure locum arrangements are in place following this to ensure patients continue to have access to a GP service, pending the appointment of a GP to take over the panel permanently.

Deputy Dara Calleary

I welcome the clarification in relation to Bangor Erris. However, the Minister of State's response is completely removed from the reality on the ground. He spoke of increased places on GP training schemes. For the first time anyone can remember, there are vacancies on training schemes because people do not want to be GPs. It is no longer a desired option for so many people and those who do, do not want to be a GP in Ireland. GP practices are no longer viable in many areas, which the Minister of State would have heard yesterday. I know that there are communication difficulties in the Department of Health but surely the Minister of State must have heard the complaints. We hear this from younger doctors but one of the most disheartening things yesterday was to hear older doctors who have put their life and soul into building up practices and communities, now more or less broken and not recommending that people follow their path.

When this contract was last advertised it was difficult to fill because of the lack of supports. The Minister of State referred to the rural practice allowance, but it is not enough. We must look at this differently. By the time a premises is kitted out and staffed, €20,000 does not go far on a list of 500 people.

This must be looked at differently. This will have to be used as a pilot to put the facilities and services for GPs in place and give them an investment. Then we will fill the vacancies. There are vacancies in rural areas that cannot be filled, yet the Minister of State spoke of the numbers of GPs on the register increasing. That is no good to someone who cannot access a doctor because there is no doctor in his or her community.

Once again, I ask that the Government put together a package, using Bangor Erris as a pilot, to put the facilities in place and work with the existing GP. It might find that he is more than happy to stay there. I can assure the Minister of State that the community has enormous trust in both him and his staff and they want to keep him there.

Deputy Finian McGrath

I did hear the GPs yesterday and I meet GPs regularly. I am aware of the genuine issues that the Deputy raises.

I wish to reiterate the Government's commitment to ensure that patients throughout the country continue to have access to quality GP services. The Department of Health, together with the HSE and the Irish College of General Practitioners, are committed to working together to improve recruitment and retention in general practice in coming years.

I will put the Deputy's two proposals on the pilot study and working with GPs to the Minister, Deputy Harris.

The goal of the current phase of the GP contract talks is to reform and modernise the existing GMS contract. This will be key in making general practice a more attractive career to young doctors.

In the case of GP services in Bangor Erris, I wish to reassure the Deputy that the HSE is taking all necessary steps to ensure that a new GP is recruited as soon as possible and that the locum arrangements will be in place to ensure services to this community are retained while the recruitment process is underway.

Hospital Accommodation Provision

Deputy Michael Harty

This is a very important question for the mid-west, particularly in the context of the controversies that are raging in so many areas of our health service. There is disquiet and frustration in the mid-west that the regional hospital, University Hospital Limerick, is first or second in the number of people waiting on trolleys for admission on a daily basis.

There are two proposals to address this. One is to build a permanent 96-bed unit at the regional hospital in Limerick. To my knowledge, that has not got to design stage. The other is an interim proposal to build a 60-bed modular unit at Limerick to try to deal with the trolley crisis that faces the hospital each day. On 5 November the Minister for Health announced in Limerick that funding had been committed for this urgent 60-bed modular block at University Hospital Limerick. The unit is expected to cost €19.5 million. There is every expectation in the mid-west, in Clare, Limerick and north Tipperary, that this would be completed by the end of this year.

University Hospital Limerick suffers extreme overcrowding. This is the result of reconfiguration almost ten years ago where beds were closed in Ennis and Nenagh but no replacement beds were provided in the regional hospital in Limerick. Since then the population of the area has expanded. The population is not only growing but also ageing and we know that it is older people who occupy beds for prolonged periods. We need this 96-bed unit to be provided on a permanent basis, but it is also necessary for the 60-bed modular unit to be provided as urgently as possible. The 60-bed modular unit is not a permanent solution but it is an important element in dealing with overcrowding.

Recently, doubt has been cast over whether the promised money will be produced and whether it will continue to be part of the capital plan. Recently the Minister of State, Deputy Pat Breen, expressed on local radio the hope that the money would be available but he could not confirm that it would be. This has caused great frustration in the mid-west. Two issues must be dealt with. When will the capital plan for 2019 be announced? Can the Minister of State confirm that it will contain the building of the 60-bed modular unit? What is the current status of the contract? When will tendering be made and when will contracts be signed? Construction is expected to take 300 days. If we are to have that by the end of 2019, construction must start immediately. When will the first patient be admitted to that block?

Then there is the issue of the 96-bed permanent unit. When will the funding be made available through the capital plan for that permanent 96-bed unit? How much will this cost? There is great controversy over how building projects such as this are tendered, procured, designed and built. Can the Minister of State confirm a costing has been placed on this 96-bed unit? What is the current situation in relation to design and planning and when does the Government expect the work to begin?

Deputy Finian McGrath

I thank the Deputy for raising this important issue. I am very well aware of the situation in University Hospital Limerick and have direct experience from a family point of view.

I welcome the opportunity to update the House on the capital development projects at University Hospital Limerick, UHL. UHL is a model 4 hospital and provides major surgery, cancer care treatment and emergency care in the region, as well as a range of other medical, diagnostic and therapy services. All critical care services are located here and it has one of the busiest emergency departments in Ireland with annual attendances of approximately 65,000 presentations and the only 24-7 emergency service in the University Limerick hospital group. UHL is one of eight designated cancer centres.

A new emergency department opened at UHL in May 2017.

The new facility is triple the size of the old emergency department and immeasurably improves the experience of patients in terms of their comfort, privacy and dignity. The new emergency department is equipped with a computed tomography, CT, scanner, which is considered international best practice.

As the Deputy will be aware, there are two distinct proposals for the development of ward accommodation at UHL. The HSE is working towards appointing a design team for the 96-bed acute ward block there. The timeframe for the completion of the project will be informed by the work of the project team, which will be undertaken in conjunction with UHL and the HSE. The required capital allocation for the project is being reviewed in preparing the 2019 capital plan.

The Minister for Health recognises that hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged over the winter months. Increasing capacity is therefore a priority for the Government. Over the past 12 months an additional 240 beds have been opened, including 17 short-stay beds in UHL. The HSE's national service plan 2019 provides for a comprehensive capacity programme. This includes eight additional beds for UHL, five of which have already opened as part of the winter plan 2018-2019.

Last autumn, the Minister announced that a modular ward block would be built at UHL to provide interim accommodation. This 60-bed block will have three wards comprising 20 single-room occupancy with en suite facilities, two of which will be full isolation facilities and will provide care and treatment for patients from admission to discharge. The 60 single rooms will improve patient comfort, safety, privacy and dignity and assist with the management of infection control in the hospital. The additional 60 beds will also directly increase capacity, allowing patients access to an increased overall bedstock and improve patient flow across the hospital.

The Minister has set the construction of the UHL modular ward block as a priority. Following the publication of the national service plan for 2019, the HSE is currently finalising its capital plan or 2019 and funding will be provided to allow this important project to progress.

Deputy Michael Harty

When will the 60-bed modular unit be delivered? According to the Minister of State, capital funding will be made available. While we accept that, the capital plans for 2019 to 2021 are being reprofiled and we do not know whether that funding will be available. The 60-bed modular unit needs to be made available urgently. It cannot be put off until 2020 or 2021. I understand that it will be prioritised, but there are so many competing priorities in our health services that we are concerned this one will not be given sufficient priority to see it delivered in 2019, as promised by the Minister last November. We need clarity.

The mid-west has other urgent needs. For example, there was a proposal to build a 100-bed hospital to replace St. Joseph's Community Hospital's unit for elderly care on a greenfield site. What priority will that be given? It influences how people are discharged from our model 4 hospital in Limerick. That 100-bed unit was to be built and ready for occupation in 2021 as a priority, but we are now worried that it will be reprofiled off the priority list.

There is a plan to build two primary care centres in Ennis, which has never been lucky enough to get such a centre. When will they be delivered? There is also a proposal to move the outpatient department from Ennis general hospital to a new location. Will that be reprofiled and put on the long finger? The hospital is unfit for purpose. When will the upgrading of equipment and theatres in Ennis be delivered?

There are many more issues in the mid-west than just the 60-bed modular unit or the 96-bed permanent unit. When will they be prioritised and delivered?

Deputy Finian McGrath

I take the Deputy's point. I have been told that this development will be a priority. UHL is an integral part of the University Limerick Hospitals group, providing health services and care to the people of Limerick and the mid-west. The hospital provides quality patient care delivered safely by skilled and valued staff through the best use of available resources. This has been achieved through the commitment, hard work and professionalism of all its staff.

The Deputy discussed a number of other issues, including St. Joseph's Community Hospital and sick patients. I will raise them with the Minister. This Government is committed to developing services and infrastructure at UHL. Funding will be provided in 2019 for these projects.