Dáil Éireann díospóireacht -
Thursday, 11 May 2023

Vol. 1038 No. 2

Saincheisteanna Tráthúla - Topical Issue Debate

Road Safety

Deputy Michael Moynihan

I welcome the opportunity to raise the issue of road safety in the town of Charleville, County Cork, a town that will be known to the Cathaoirleach Gníomhach. This has been a major concern for a long time. Unfortunately, several people in the town have died while crossing the road there. I extend our deepest sympathies to those bereaved because of the tragic loss of people on the street in Charleville. The town is at the heart of Munster and is a very busy market town. Many people are employed around it and there is also great activity in it. It is on the N20 road between Cork and Limerick, so there is a phenomenal level of traffic going through the town daily.

I raise this issue of road safety in the context of ongoing developments concerning the advancement of the N20 and the motorway project. This must be prioritised and treated as an urgent issue. We understand and accept, though, the reality that completion of this project is some time away. In the meantime, road safety issues will have to be taken into account in Charleville. I have been working with Councillor Ian Doyle on this matter and he has a motion to discuss this issue before the northern committee of the county council next week as well.

I am trying to get across the real dangers concerning road safety issues in the town of Charleville. People are crossing the street and risking their lives daily, as has happened very recently. Representatives of Transport Infrastructure Ireland, TII, the local authority and the Department of Transport must prioritise this matter to ensure remedial work is done immediately to try to alleviate these dangers and make sure addressing road safety issues in the town of Charleville is paramount.

As we wait for the bypass to be completed, the Department, the local authority and TII must consider an intermediary measure to try to develop some way to have heavy goods vehicles bypass the town centre. In the long term, this would also lead to the development of lands on the Limerick side of Charleville. For those people driving from Cork to Limerick, it would be on the right-hand side of the town. I refer to examining the possibility of putting in a link or relief road. The roads are getting busier and economic activity in the town and along the route to it is increasing with every passing day. While the priority is to ensure the bypass happens, in the meantime we must also ensure that measures are taken to protect people's lives and improve road safety in Charleville.

The frightening thing about this is that people there are losing their lives. The N20 is probably one of the most dangerous routes in the country at this stage. It is a serious issue. We want the Minister, the Department of Transport, TII and the local authority to collaborate to find a solution in the short term that will ensure road safety issues are addressed and people are able to go about their business in Charleville while being assured of their safety. This means the immediate installation of a relief or link road on the right-hand side of the town, as people are going from Cork to Limerick. I ask this because we will be waiting for five years, and possibly more, for the major infrastructure in the shape of the bypass to happen. I ask the Minister of State to take this issue back to the Department as a matter of urgency. Many issues are raised here but this is one of life and death and concerns a situation where people have lost their lives on the streets of Charleville. There are very few other towns in the country we could say that about.

Minister of State at the Department of the Taoiseach (Deputy Peter Burke)

I thank Deputy Michael Moynihan for raising this important issue, which I am answering on behalf of the Minister for Transport, Deputy Eamon Ryan, who unfortunately is unable to attend.

The Minister for Transport has responsibility for overall policy and Exchequer funding for the national roads programme. Once funding arrangements have been put in place with TII, under the Roads Acts 1993 to 2015, and in line with the national development plan, NDP, the planning, design, improvement and upgrading of individual national roads is a matter for TIl, in conjunction with the local authorities concerned. Ultimately, TII delivers the national roads programme in line with Project Ireland 2040, the national planning framework and the NDP.

Approximately €491 million of Exchequer capital funds have been provided for national roads through TII to local authorities in 2023. These allocations were announced by the Department of Transport and TIl on 16 February 2023. A major priority in the NDP, in line with the Department’s investment hierarchy, is to maintain the quality and safety of the existing national road network. The NDP foresees an Exchequer allocation of approximately €2.9 billion for the protection and renewal of existing national roads over the ten years to 2030, allocated fairly evenly across the decade.

Each year, TIl carries out a collision analysis of the entire national road network. The purpose of this exercise is to identify locations that have high concentrations of collisions. It does not, however, include the subsequent process to devise proposals to identify road safety interventions. This is the responsibility of the relevant local authority, as the road authority for the area in the first instance. Regarding safety issues in Charleville, a high-collision location was identified through the network safety analysis undertaken in 2019, and this information was forwarded to Cork County Council for its consideration. TII is aware that the county council is considering improvements at two locations in Charleville, at the New Line junction and the filling station at the southern end of the town. TIl is committed to working with the county council to see what safety measures can be identified in the short term to improve road safety in Charleville.

Deputy Michael Moynihan

I thank the Minister of State for the reply. The two last paragraphs in the script were the important ones. TII identified a high-collision location in the town through the network safety analysis undertaken in 2019. This is not just about collisions but about life and death. People are losing their lives on the main street in Charleville. I do not want to exaggerate the issue, but it has happened and is happening. We must ensure urgency is brought to bear on this issue.

Can we get representatives of TII and the local authority together as a matter of extreme urgency to resolve this issue and to try to make Charleville safer in the short term, as well as to examine a medium-term solution for the town? This approach can be twofold. It can address further development in Charleville in the longer term, as well as the short-term priority of a solution to try to resolve the current issues. I ask that TII, the Department and Cork County Council meet urgently. Will the Minister of State ask the Minister for Transport to organise this meeting urgently?

As public representatives, we can input into this matter. It is greatly important, however, that this matter is addressed with serious urgency. Does the Minister of State have information regarding ongoing discussions between TII and Cork County Council? If so, I ask him to make any such information available to me, which I would appreciate. If he does not have the information to hand, I ask him if he could make it available to us as a matter of urgency. Councillor Ian Doyle and I have been working on this issue and it is an urgent priority. We need a short- and medium-term solution to this matter. The long-term solution will come with the bypass in time to come.

Deputy Peter Burke

Deputy Michael Moynihan clearly articulated in his response the importance of these improvement works and, indeed, the State's obligation to ensure the safety of our road network is up to specification to ensure we mitigate any collisions and have adequate safety processes in place. I will raise the Deputy's concerns with the Minister for Transport and ask that TII provide an update concerning its discussions with Cork County Council.

I understand the priority and urgency attached to it because it is important in our road network that we protect life and ensure that the infrastructure is up to date and as safe as possible. I will undertake to revert to the Minister for Transport on the Deputy's behalf.

Primary Care Centres

Deputy Dessie Ellis

It is more than ten years since Finglas was promised a primary care centre. A comprehensive study by the HSE and other services was carried out. It identified the urgent need to deliver a primary care centre in the north and west of Finglas. At the time, Finglas was the top priority on the list, ahead of Cabra and Blanchardstown primary care centres, which were built a couple of years ago. We were also told there was no issue with regard to funding.

A site was identified and received permission from Dublin City Council, but on appeal to An Bord Pleanála the project was shot down for various reasons. A couple of years later, another site was identified, known as the Church of the Annunciation site. It was planned to build approximately 100 senior citizen accommodation units wrapped around a new church – the old church is to be demolished – as well as a Tusla building and new primary care centre.

Finglas has a large urban population of approximately 32,000 people at present. The population has started to increase only in recent years. In north and west Finglas, the population is one of the oldest in Europe and well above the national average. There has not been a GP in the area for more than 20 years. A new primary care centre is needed to deal with minor injuries and provide social care, mental health, GP and other services for the local community. This will also help to alleviate pressure on local hospitals such as Connolly, the Mater and Beaumont.

On the Church of the Annunciation site, an area was identified for this project well over five years ago. However, planners were not happy with accessibility. Since then, negotiations have been entered into with the City of Dublin Education and Training Board, CDETB, which runs the two schools, Coláiste Eoin and Coláiste Íde, on land attached to the side. Agreement has now been reached, but the land has still not been transferred. We were also told this would be concluded in the second quarter of this year. Part of the agreement would also include a provision for an all-weather pitch for the schools.

The people of Finglas are angry that the new primary care centre identified more than ten years ago by the HSE as urgent has not been given the priority and attention required. The people are concerned that the provision of funding for the project has not been clarified by the HSE and the Minister for Health. Can the Minister of State provide assurances that funding is available and that there will be no further delays?

I have been dealing with this issue since the project's inception. It is unacceptable that it has not been addressed. I was recently told a design team had been appointed and that the transfer of land would be sorted. This was one of the pillars associated with Sláintecare. The roll-out of primary care centres across the country was something the Minister made an awful lot of fuss about.

The people of Finglas have been badly let down, in particular the elderly who are looking forward to the services to be provided, including services that would help them with their daily lives such as getting therapy and other such things. We now need a commitment to deliver and not prevaricate any longer. Let us move this forward.

Deputy Peter Burke

I thank Deputy Ellis for giving me the opportunity to update the House on behalf of the Minister, Deputy Donnelly, who is unfortunately unavailable.

One of the objectives of the programme for Government is to deliver increased levels of integrated healthcare with service delivery reoriented towards general practice, primary care and community-based services to enable a home first approach. Primary care centres play an essential role in the delivery of that objective and significant progress has been made in the delivery of these centres nationally. These centres support the delivery of integrated care by facilitating closer co-ordination and co-operation between health professionals from across different disciplines. They also provide a single point of access to services for the individual and can serve as a resource more broadly for the community.

There are currently 167 primary care centres in operation throughout the country, with a further 13 under construction. The Finglas primary care centre will be located on a block of land between Cappagh Road, Cardiffsbridge Road, Wellmount Avenue and Fergal’s Lane. These lands offer an opportunity to provide and enhance facilities for the local community in Finglas. The vision for the whole site is to provide a new church and parish centre, housing provision, new sporting facilities for the CDETB, local schools and, of course, the new primary care centre.

The stakeholders involved have been the Dublin archdiocese, Dublin City Council, the HSE, the CDETB, local schools and the public. Fruitful stakeholder engagement has led to agreements between Dublin City Council, the HSE and CDETB on the preferred option for all parties in regard to access and land ownership.

Finglas has long been identified as a priority location for the development of a primary care centre due to the population level, care requirements for the community and the HSE Sláintecare programme, which will provide care for patients closer to their homes. Finglas primary care centre is included in the capital programme for 2023. A design team has been engaged for the project. The preliminary design stage 1 report is expected to be completed by end of quarter 2 this year. The legal process to transfer the land is in progress and the HSE is engaging with all parties to complete the necessary property transactions. It is anticipated this process will be concluded in the second half of 2023, which will facilitate further progress through design and planning stages of the project, including the submission of the planning application.

On completion of the legal process to transfer the land, the HSE will be able to give a further update on the status of the primary care centre in Finglas. More than 50,000 people will be serviced by this primary care centre. The site’s location will provide for more easily accessible pathways to care for people currently residing in the area and new residents who will move into the proposed housing development.

Deputy Dessie Ellis

As the Minister of State said, this is a fantastic place. The Church of Annunciation has been there for many years. It will be pulled down. The site is very large. It is in the heart of Finglas. I do not know why we cannot decide that this project can move ahead much more quickly. The Minister of State referred to the second quarter of this year. We are in the second quarter of this year. We are talking about a design team but we do not even have that.

I always thought there were prototypes, and visited one elsewhere in the country built by the HSE. Whether or not those prototypes are suitable for this site, is having to go through a design team absolutely necessary? Surely a prototype could be adopted for the site, which is quite large.

The Minister of State is correct about the population in north and west Finglas being older. Many people in the area, including my mother, have passed away and have not been able to avail of this centre because this has been going on for ten years. We were number one on the list, well ahead of many primary care centres the Minister of State mentioned. We ran into a bit of trouble, but that should not have stopped us. We should have moved ahead. I need a commitment that this will be done, and I want to know how long it will take and whether the funding is in place. It should not be the case that when the design is completed, we will see about the funding. I want to hear whether the funding is there.

Deputy Peter Burke

I thank the Deputy for his response and his concern for his constituents and the wider Finglas area. As quite clearly stated in the reply, the design team has been engaged. It is now working on the design of the site. According to the reply, it will encompass huge change for the locality in terms of the dynamics of the site and what is included. The Minister said the ownership issue will be resolved quickly this year. As Deputy Ellis rightly pointed out, we are into the second quarter of the year and I hope it will be next month. Both of the issues should be moving on. It is also included in the capital programme for 2023. The budget line is there for it.

I accept and understand Deputy Ellis's frustration on the capacity to deliver infrastructural projects such as this. It can be very frustrating when going through the process of design, tender and procurement. As Deputy Ellis rightly pointed out, others have got there. From reading the reply, I know this is a significant site and I will relate to the Minister for Health Deputy Ellis's concerns about the timelines. I hope they will be stuck to.

Social Welfare Eligibility

Deputy Éamon Ó Cuív

Gabhaim buíochas leis an Aire Stáit as ucht teacht anseo agus gabhaim buíochas leis an Aire. Fuair mé glaoch gutháin uaithi ag rá nach mbeadh sí ar fáil tráthnóna agus thoiligh mé dul ar aghaidh leis seo. Tá áthas orm an deis a fháil an cheist thábhachtach seo a thógáil leis an Aire Stáit. As the Minister of State knows, the Government made a good decision recently to make a payment of €200 to each person in receipt of a long-term primary payment. However, a mistake has been made. I will focus on pensioners but it applies to all who receive it. In cases where an adult dependant is on the payment only €200 was paid and not €400. We should outline why this is unfair. Two people have two costs. As the Minister of State is very well aware from his constituency work, if people going on the pension come to him he will assess what is the best option for them. For many women, and more so than for men, because they tend to have traditionally taken more time out for caring, they have gap year contribution records. Man or woman, there are four ways to assess the best option for a recipient of a pension. For couples the best option is that both get a full contributory pension. This is by far the best option. However, if a full contribution pension is not possible, four other options come into play. For the person without the good record the first option is the non-contributory pension. Within the contributory pension are the second and third options. These are the total contributions system and the average system. The fourth option is that of the dependent adult, which is means-tested. We would always advise people to take whatever option is better but nobody ever foresaw that there would be discrimination between the choices. In the event of people choosing the dependent adult option, even though they had an underlying right to a pension in their own right, they are discriminated against. I believe this is an oversight.

I would like to point out that the costs are not that great. A total of 2,983 qualified adult dependants are paid on the non-contributory pension. There are 54,510 on the contributory pension. If we multiply this by €200 we get approximately €11 million, which in the greater scheme of what this costs is very small. A total of 10%, give or take, of contributory pensioners have a qualified adult as do 3% of non-contributory pensioners. I am sure this was a mistake and an oversight. There is no significant cost factor involved. I am sure it would not be a big job to amend the statutory instrument to cover somebody having chosen in good faith the dependent adult option to get €400 like everybody else in a situation where two adults are dependent on a payment from social welfare.

Deputy Peter Burke

I thank Deputy Ó Cuív for raising this issue. I apologise on behalf of the Minister for Social Protection. The Government is acutely aware of the effect that high energy prices and the cost of living are having on families, businesses and the most vulnerable. In recognition of these pressures, only last September, budget 2023 delivered the largest social protection budget in the history of the State. In addition to the substantial package of supports provided as part of the budget, earlier this year the Government announced a €470 million spring package of measures to help social protection recipients, including families, pensioners, carers and people with disabilities.

The spring cost-of-living bonus is one of the range of measures put in place. It is one lump sum payment of €200 for each eligible person who has an entitlement to a primary payment in their own right. The €200 lump sum payment was paid in the week commencing 24 April to 1.2 million people in receipt of long-term social welfare payments at a cost of approximately €250 million. Those receiving more than one qualifying social welfare payment receive only one €200 lump sum payment. Each eligible primary recipient of a social welfare payment receives €200, regardless of the number of qualified adult or child dependants, if any, or other social welfare payments. Qualified adults do not have an entitlement to cost-of-living bonuses, including the spring bonus, in their own right.

Further measures as part of the latest cost-of-living support package will include a €100 lump sum payment in respect of every child for whom child benefit is paid. An additional €100 payment will also be paid this year in respect of each child for whom the back-to-school clothing and footwear allowance is paid. There will be an extension of the hot school meals programme to all DEIS primary schools from September, benefiting 64,500 children. Together, these supports will provide more than €470 million in additional supports to households and families in need.

Since March last year, the Government has provided unprecedented supports to protect people and families as the cost of living has increased. These supports have included a mixture of lump sum payments, double payment weeks and weekly rate increases. The €2.2 billion social protection budget 2023 package included eight lump sum payments to a value of more than €1.3 billion. These comprised an autumn double payment, a double payment of child benefit, a €400 lump sum payment of fuel allowance, a €500 lump sum payment to families receiving working family payment, a €500 lump sum payment to people in receipt of disability allowance, blind pension or invalidity pension, a €200 lump sum payment to people in receipt of the living alone allowance, a €500 lump sum payment to carers, a Christmas bonus double payment of weekly social welfare and pension payments.

In addition, from January we have provided a €12 increase in weekly social welfare and pension rates, the largest increase to weekly payments since the mid-2000s. There has also been a significant expansion of the fuel allowance scheme with a particular focus on supporting older people over 70. There are also increased income thresholds for the working family payment so that more families can qualify. These measures are in addition to other measures introduced during 2022 to assist people and families with the cost of living. These include a major expansion of the hot school meals programme to 320 new DEIS schools, a €100 increase in the back to school clothing and footwear allowance, two fuel allowance lump sum payments of €125 in March 2022 and €100 in May 2022, a universal energy credit of €200 introduced in April 2022, followed by three further €200 energy credits, a reduction in student fees, a 25% reduction in childcare costs and a 20% reduction in public transport fees.

With regard to the qualification criteria for the State pension quoted by Deputy Ó Cuív for people on qualifying allowances, who may qualify anyway for part of the main payment, I will raise it with the Minister, Deputy Humphreys, and come back to him.

Deputy Éamon Ó Cuív

I thank the Minister of State kindly. To be quite honest, whoever in the Department wrote the reply must think I know nothing about social welfare. They have informed me about all the schemes that the Minister of State and I know about, and that every Deputy in the House knows about because we deal with them every week. It is a little bit patronising for the Department to dodge the issue. What did it say about the nub of this issue? It made a bald statement that qualified adults do not have an entitlement to cost-of-living bonuses, including the spring bonus, in their own right. "Yes" Minister and "No" Minister. Before Christmas there were double payments and someone with a qualified adult on their payment got paid.

The two points I am making here are about the cost of living. Is the Minister of State telling me that pensioners, invalidity pensioners, any of the people with disabilities and so on with a dependent adult did not face the same cost-of-living increases as everybody else? Of course they did. Is the Department suggesting that to me? In this case, some of these people might have had and probably had an underlying entitlement to a payment in their own right but they opted for the one because the Department carefully always claims it will give the one that is optimal for the individual. Having opted for the dependent adult, they have found that in this case they lose out. It is very simple.

I will not ask the Minister of State to waste his time going through another supplementary answer with a whole lot of further bumf. I ask him to go back and ask the Minister to review this on two bases: first, because, as I said, people have made choices on the basis of the best option; and second, and more importantly, couples in a household face the same increase in costs irrespective of whether it is primary payment on the dependent adult or two primary payments. The third issue here is that this will cost very little. If the Minister of State just stands up and says he will raise the transcript of this debate with the Minister he can sit down and we can go on to the next Topical Issue and we will save my good colleagues here a bit of time in the House.

Deputy Peter Burke

I am happy to undertake to do that on behalf of Deputy Ó Cuív.

Deputy Éamon Ó Cuív

I thank the Minister of State.

Hospital Services

Deputy Marian Harkin

Do we get extra time here or do we just keep going?

Just over six months ago 50 consultants from Sligo University Hospital wrote to the Minister for Health to highlight the severe pressure being experienced at Sligo University Hospital. Just one sentence from that letter basically says it all. It sates, "We have never seen the demand on our services so high nor the morale of our staff so low." According to the consultants there, Sligo University Hospital routinely has hospital bed occupancy over 110%, often with 30, 40 or 50 admitted patients without a bed. They say this is an everyday occurrence. For the record, today there are 45 patients on trolleys at Sligo University Hospital and that is in the middle of May. It is the third highest in the country.

Sligo University Hospital is almost always in the top five - or the worst, whichever way we want to look at it - when it comes to numbers on trolleys and today it is in the top three. Unfortunately, the critical situation at Sligo University Hospital is simply a microcosm of what is happening in the entire Saolta region comprising Donegal, Sligo, Leitrim, Roscommon, Mayo and Galway. The Irish Hospital Consultants Association has issued a statement this week which follows a similar statement last year, except this year the statement is worse. This time we have a statement from a national organisation, not just from the consultants at Sligo University Hospital. They have said that patient health in the west and north west is at risk due to excessive delays to care. They are singling out that region, the Saolta region, and this is what they are saying.

They quote a raft of statistics to make their argument and some of those statistics are really frightening. They look at the overall picture concerning waiting lists, trolley numbers and new hospital beds or the lack thereof. I just want to quote a few of them to put them on the record. They say public hospitals in the Saolta Region Health Care Group have unmanageable waiting lists with more than 131,000 people waiting for care. Waiting lists for outpatient appointments, inpatient, day-case treatments and procedures in the region have increased by 3% since the start of the year and by 42% since 2015.

The Government's €443 million waiting list action plan has set a target to reduce by 10% waiting lists for appointments for outpatient, inpatient and day-case treatments and procedures this year. However, what has happened in the Saolta area? They have increased by 3%. This is happening because we do not have the beds and because appointments and operations are routinely cancelled. I am fed up coming in here speaking about Sligo University Hospital. We now see there is a wider picture in the whole region. Unless significant investment is put into the Saolta region in terms of both beds and employment of consultants, we will have these statements from the Irish Hospital Consultants Association and they are getting worse year on year.

Deputy Peter Burke

I welcome the opportunity to address the House on this extremely important issue. The Minister for Health sends his apologies. I and the Government acknowledge that waiting times for many hospital procedures and appointments are unacceptably long and we are acutely aware of the great distress this causes patients and their families. Our waiting lists were far too long before the pandemic but have worsened as a direct result of Covid-19. The Government has adopted a twin track approach of investment and reform to deal with the issue.

On 7 March, the Minister for Health published the 2023 waiting list action plan, which is the next stage of a new multi-annual approach to sustainably reduce and reform hospital waiting lists. For 2023, funding totalling €443 million is being allocated to tackle waiting lists, with €363 million of this being allocated to the 2023 waiting list action plan, to implement longer term reforms and provide additional public and private activity to clear backlogs exacerbated during the pandemic. The remaining €80 million of the €443 million is being targeted at various measures to alleviate community and primary care waiting lists.

Through this plan, we are fast-tracking the development of new elective surgical hubs in Cork, Dublin, Galway, Limerick and Waterford. Based on the successful Reeves Centre at Tallaght University Hospital, these will have a short-term impact on waiting times. For longer term investment, last December the Government approved the preliminary business cases and preferred sites for elective hospitals in Cork and Galway. The HSE expects to be able to submit business cases with a recommendation to Government to go to tender by the final quarter of this year.

The Saolta University Health Care Group’s six hospitals serve a significant portion of the population, covering more than 830,000 people. The Government’s commitment to the group can be seen in the increase in the combined budget of the hospitals and group to €999 million in 2022, up €194 million since 2018. Budgets 2021 and 2022 in particular have provided significant amounts of funding for a large-scale permanent expansion of the health service workforce and investment in capital projects. For example, staffing in Sligo University Hospital at the end of December 2022 was at 1,907 whole-time equivalents, an increase of 70 from the end of 2021. For Letterkenny University Hospital, Saolta has advised staff numbers have increased by 323.94 whole-time equivalents from 1,768.68 to 2,092.62 whole-time equivalents by the end of 2022. For Galway University Hospitals, comprising both the Merlin Park and University Hospital Galway campuses, by end of February 2023, there were 4,286 whole-time equivalents, an increase of 13% since December 2020. In the past five years to March 2023 overall consultant numbers have increased by 104.

Resources have been also allocated to provide increases in bed capacity, with Saolta reporting 11 beds opened in Sligo University Hospital since 2020, 32 beds opened in University Hospital Galway and 28 beds opened in Letterkenny. A range of strategically important capital projects are in train across the region. Some projects have been recently delivered, such as the €56 million radiation oncology facility at Galway, and treatment of patients commenced on 19 April 2023.

Other major developments are at various earlier stages in the capital process, with projects to deliver extra capacity and services advancing at a number of hospitals. For example, a new 50-bed ward at Portiuncula University Hospital is currently under construction. These investments show the commitment of the Department and the HSE in improving service delivery and meeting the needs of patients and the population in the west and north-west region.

Deputy Marian Harkin

The Minister of State quoted many figures. One was the €443 million to cut waiting lists by 10%, yet since the beginning of the year, as I said a few minutes ago, waiting lists have increased by 3% in the Saolta region. Some 3,400 people have been added to the main hospital waiting lists in the region since the start of the year because the shortage of beds is so severe that severely ill patients are admitted and essential surgical and other care has to be cancelled. The Irish Hospital Consultants Association is not just speaking about an overall picture. It is saying, quite clearly, that patient care and patient health in the west and the north west is at risk due to these excessive delays to care. It is worse in the Saolta region than it is anywhere else. The Minister of State quoted statistics about beds. I can only quote what is in front of me from the Irish Hospital Consultants Association. It says just 69 additional inpatient beds have been opened over the past three years at all hospitals in the Saolta group and that amounts to 7% of the national total. We have 16% of the population. According to the IHCA, we are not even getting half the number of beds that we should be getting.

When I raised this issue with the Minister last November, I specifically raised Sligo University Hospital. He talked about looking at progressing the emergency department modular unit, the ICU isolation rooms and the 42-bed ward block extension. Where is this work now? It was at a very early stage last November. Unless we see immediate progress here, we will keep getting these statements from the IHCA. In truth, people in the west and north west are getting worse care than anywhere else in the country. It is simple as that. That is what they are telling us. It is not me saying it. I am just relaying their words.

Deputy Peter Burke

I thank the Deputy for raising this issue. As has been acknowledged, many patients wait for an unacceptably long period. While significant work continues to positively impact waiting times and improve pathways to elective care, acute hospitals are still impacted by operational challenges arising from the pandemic. For the Saolta group, geography is a major challenge, as the population is dispersed and mostly rural, with approximately one sixth of the national population spread across one third of the land area of the State.

To address these issues, in addition to the waiting list action plan funding, significant increases in budgets have been allocated to hospitals in the group, including an increase in Sligo University Hospital's budget from €145 million in 2019 to €175 million in 2023. Galway has seen its budget in the same period increase by more than €70 million, to €441.7 million, and Letterkenny has risen from €142.7 million to €177.8 million in 2023. The Government recognises the importance of investment and is committed, with the HSE, the hospital group and individual hospitals, to ongoing investment in the strategic development of services in a challenging and geographically dispersed area. Through investment and reform, this Government is working to sustainably reform hospital waiting lists and to reduce times and waiting times, which will deliver improved access to care for patients throughout the north, north west, and the whole State.