The terms of reference and the scope of the capacity review did not include the costing of additional capacity. The analysis has established two extremes that define the indicative range and scale of potential capacity needs up to 2031 and the level of reforms involved. The key findings and recommendations of the report recognise this and outline further work required, including:
-assessing the optimum reform strategy that takes account of workforce, the whole life cost of services, eligibility arrangements and their impact on implementing reforms, the feasibility of delivering infrastructure, and impact on operational services in the timeframe. It would also need to take account of the wider implications arising from major reconfigurations of services across hospitals;
- consideration of the Capacity Review in the context of the forthcoming National Development Plan; and
- an important next step noted in the report is to consider how additional capacity should be planned and delivered at a regional level based on population need.
As the Deputy will appreciate, costing is an important and complex process in its own right. For example, it is important to state that there is no one cost for a hospital bed. The cost is dependent on the nature of the bed, such as inpatient, daycase, critical care, the specialty and where the bed will be delivered, for example, an existing hospital, an extension, or a new development. Therefore, the steps I mentioned will be examined in the context of both the forthcoming National Development Plan and the Sláintecare Implementation Plan.
As a final point, I would just reiterate what I have stated previously, that adding additional capacity cannot be the only answer. In tandem with this, we need fundamental reform of our health system - with significant development of the primary and community care system. Sláintecare provides the blueprint for this.