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Healthcare Infrastructure Provision

Dáil Éireann Debate, Friday - 3 December 2021

Friday, 3 December 2021

Ceisteanna (106)

Thomas Gould

Ceist:

106. Deputy Thomas Gould asked the Minister for Health the status of the new elective hospital in Cork. [59419/21]

Amharc ar fhreagra

Freagraí ó Béal (20 píosaí cainte)

I ask the Minister what the status is of the new elective hospital in Cork.

We have skipped a question and are on to No. 106.

I apologise to the Deputy. He might bear with me. There are not as many people turning up on a Friday.

I thank the Deputy very much for his question. It is an essential one on an essential piece of infrastructure for Cork and indeed the entire region. The provision of additional elective care delivery capability in Cork, Galway and Dublin is, as the Deputy will be aware, stated Government policy. The purpose of elective care centres is to initially provide high volume, low- to medium-complexity procedures and a range of related diagnostic services as well. There will also be outpatient facilities. The range of specialties in the initial scope of the elective care centres-----

I apologise to the Minister but I am looking for the status. I am looking to see where we are.

The Deputy has put his question. Perhaps we can allow the Minister to give his answer. The Deputy will then have two further opportunities to come in.

It is recognised that the current elective care capacities do not meet current demand and there will be even greater demand for elective care services in the future. Incremental refinements to the current public hospital network will not, I think we can all agree, be sufficient to meet this demand by themselves. The electives proposal has guided the work of the elective hospitals oversight group, under the governance of the HSE and the Department of Health. The development of three elective care centres will require significant infrastructural investment and therefore the oversight group is following the process outlined in the updated public spending code. This sets out value for money requirements for the evaluation, planning and management of large public investment projects, that is, those costing in excess of €100 million. I think we can all agree these will be investments exceeding €100 million.

A preliminary business case for the new elective facilities, including in Cork, is currently being reviewed within the Department of Health. If it is technically compliant and approved by the Department of Public Expenditure and Reform, the preliminary business case, PBC, will then be further developed by that Department. If approved, it is envisaged a memorandum for Government will be brought by me, seeking approval to proceed to the next stage.

The Minister is saying he received a proposal in September. This is December and it still has not been approved. This is urgent. A site should be specifically set out in the PBC. Why is there a delay in announcing it? It should say where the potential site is. Where is the information for people? I ask that this hospital be based on the north side of Cork. The people of the north side have no hospital. Fianna Fáil closed down the North Infirmary. Fine Gael closed down St. Mary's Orthopaedic Hospital. I am asking for a full elective inpatient surgery hospital open 24-7 and not the part-time hospital that is being suggested. There are 75,000 people on waiting lists in Cork city and county.

We were promised this hospital before the general election, before the by-election, in 2018 and in 2017. We are being promised and promised. I am asking the Minister a straight question. When will there be an announcement regarding this hospital? Will it be located on the northside of Cork city?

I assure the Deputy that no one is proposing anything that would be described as a part-time hospital. He might elaborate on what he means so I can address concerns, if he has them, but I assure him that there is-----

What is being proposed is 8 a.m. to 8 p.m. from Monday to Friday.

The Deputy should allow the Minister to answer.

I assure the Deputy that no one is proposing a part-time hospital. To answer his exact question on when we will be able to announce where the hospital will be built, with details on its configuration, the number of operating theatres, the number of patients we hope to see, the timelines and so forth, I would like nothing more than to come to the Chamber and, indeed, meet representatives from the region, to give that information. However, following the national children's hospital situation, a review of large capital investment was done. It was agreed that there would be a multi-stage approach to this project to ensure value for money and to ensure it was done right. The downside is that it takes time. While I acknowledge the Deputy's frustration, and we are all frustrated by this, a set process has to be gone through to evaluate and approve the business case. We are moving through that as quickly as it can be done.

We know the figures in CUH and Mercy University Hospital are at crisis point. We have people on trolleys and waiting lists. This is not just about Cork wanting or needing a hospital. Hospital services are at crisis point in Cork. This hospital has to happen. It was proposed that it would be operational by 2024. There is no way I can see that happening. I am asking the Minister a direct question. Does he believe that this hospital will be operational by 2024? This is a commitment given by his Government, his party and Fine Gael, who all made a promise to the people of Cork. This is not about making election promises. This has been specifically identified under health needs as a requirement for the Cork area. This hospital is needed and the Minister knows it is needed, as do the HSE and the people of Cork. When will it be delivered? Will it be delivered on the northside? Will there be beds to go with it? We are talking about delivering elective hospitals, but we need a 24-7, seven days a week hospital, with the beds to support it.

This is a very important issue that the Joint Committee on Health should focus on in the new year. Its members should have a discussion on exactly what these elective-only hospitals should or should not be. I have an open mind on it, but my understanding is that elective-only hospitals will be for the regions and for addressing waiting lists for elective procedures. I support its location on the northside of Cork, as it makes sense. I spoke to Deputy Gould on this issue and we understand that these hospitals will be for people throughout the regions. I hope that these hospitals, in whatever form they come, will address the critical mass of elective care that needs to be done, will take it out of acute hospitals, if possible, and allow more complicated work to take place in the acute hospitals, which will continue. The debate about what elective hospitals are is an important one. We need to bring as many people with us as possible, which is done through consultation with those in the constituencies who might be affected and engagement with Members. Engagement with the Oireachtas health committee on this particular issue would also be helpful.

I wholeheartedly agree with Deputy Cullinane. There needs to be engagement with the health committee and elected representatives from the regions. To answer his question, these will be regional elective hospitals that will not just serve Cork city, County Cork or Galway city. They will be incredibly useful. I suggest to both Deputies that elected representatives from the regions and members of the health committee consider arranging a trip to one of these hospitals, which I would be very happy to facilitate. We have one such hospital, the Reeves Day Surgery Centre in Tallaght University Hospital, which has four operating theatres. It is modest by comparison with what we are looking at building in Cork, but it is going incredibly well. The Reeves centre has no inpatient facility. I am very aware that there are strong views in some parts of the clinical communities in Cork and Galway that there should be inpatient beds as part of this. That is actively under consideration and consultation.

I have very strong advice from the expert group that these hospitals should be day case only. It might be worthwhile if Professor Frank Keane comes in to talk to the health committee about that. All I ask of the Deputies is to keep an open mind until they have an opportunity to engage with the experts on the rationale for it. It is quite a compelling argument but no decisions have been made on that. I strongly recommend a trip to the Reeves centre to talk to the surgeons there about how useful they are finding it for medium and lower complexity work. Their lists are scheduled, they know they are coming in at 7 a.m. or 8 a.m. on a Monday and nothing stops that. The volume is going very well. In fact, more and more hospitals throughout Dublin are expressing interest in using it. I would be very happy to facilitate a trip to the Reeves centre in addition to broader consultation. Both Deputies are exactly correct. There has to be engagement with those in the Dublin, Galway and Cork regions so that this is received well and understood as the best possible response and solution.

Will it be delivered by 2024?

We are already well over time on this question.

A commitment was given to 2024. I am looking for an answer on that.

I am preaching to the converted, but I note we are fully half an hour ahead of our anticipated time. Questions are now being reached, which the Deputies who tabled them would have reasonably expected not to be reached, given the timeframe. Deputy Ó Murchú is first up. I will give the Minister of State a little time to get organised. We are skipping ahead to Question No. 112.

Questions Nos. 107 to 111, inclusive, replied to with Written Answers.
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