Hospital Facilities

Dáil Éireann Debate, Thursday - 8 December 2022

Thursday, 8 December 2022

Ceisteanna (10)

Catherine Connolly

Ceist:

10. Deputy Catherine Connolly asked the Minister for Health further to parliamentary Question No. 314 of 24 November 2022 and the national development plan commitment to deliver a cancer care centre, with appropriate infrastructure, at University Hospital Galway, if the HSE's national capital and property steering committee has commenced its review of the project; the expected timeline for the steering committee to make its decision on the proposed cancer care centre; the details of any planned interim cancer care infrastructural improvements for the hospital, particularly in view of the fact that the 2019 options appraisal for model 4 hospital services identified the existing facilities as "in urgent need of replacement"; and if he will make a statement on the matter. [61359/22]

Freagraí ó Béal (9 píosaí cainte)

Deputy Catherine Connolly

I welcome the news of a new elective hospital yesterday. I hope it is the start and part of the overall new hospital that is needed but in due course, we might get clarification on that. My question is one of five seeking clarification on the situation in Galway and concerns a cancer care centre. I wish to know precisely what the position is with that. I ask this question in the context that there were 51 people on trolleys yesterday in Galway, most of whom were in the accident and emergency department, and in the context of the options appraisal.

Deputy Stephen Donnelly

I thank the Deputy for her comments on the elective hospital. The national cancer centre is being looked at. I have had meetings on it in the past few weeks. It is an important project. As the Deputy rightly says, it is one of several significant investments in healthcare in Galway. We had agreement yesterday on the elective hospital. A proposal, which I support, is in for a seven-storey emergency and women and infants' block, which is actually the size of a small hospital. It is a huge piece. I have been discussing with the hospital team the need to upgrade the laboratories. The hospital also has a proposal in for additional bed blocks.

An ambitious proposal is being developed for a cancer care centre in Galway. The project would cost significantly in excess of €100 million so we will go through the public spending code and the HSE capital projects manual and approvals protocol. The strategic assessment report, which is one of the important stages, is being reviewed internally in the HSE. It is intended that this report will then be submitted to the national capital and property steering committee as soon as possible. If that is approved, it will be sent to me for consideration.

The Government is committed to ensuring the continued improvement of cancer services at University Hospital Galway and the region. As the Deputy will be aware, an important new service, a radiation oncology facility, will come on line in the coming months. This is a state-of-the-art facility with several linear accelerators and will be cost €56 million. It is only one thing that is needed but it will be an important additional service for patients in the region.

Deputy Catherine Connolly

That was the options appraisal. I have a small library in my office related to Galway. "Not fit for purpose" is the comment from former Taoisigh and Ministers. A letter from the hospital's consultants and doctors to all Deputies and Senators, dated 1 November, told us about the state of the hospital. They tell us the main hospital was built in 1956, while Merlin Park was built in 1954. They told us that 95% of Merlin Park and 64% of University Hospital Galway is not satisfactory, unacceptable and not fit for purpose. Given this context and years of asking for a brand-new hospital, not an elective hospital but a brand-new one, as identified in the options appraisal, there is now confusion regarding this.

Regarding cancer care, the region has between 800,000 and 1 million people. I am concerned that we are going backwards. I am very familiar with these gates. I do not wish to be familiar with them but I must be. We are at gate zero. On the last occasion, the report told us that the national capital and property steering committee was reviewing the matter. The Minister's reply today tells us it is being reviewed internally. Will the Minister clarify this inconsistency?

Deputy Stephen Donnelly

The proposal is being progressed and is working its way through the various stages. The public spending code is a very laborious process. It was put in place after the cost overruns at the national children's hospital. There is a balance to be struck between managing the costs in the public interest and trying to build facilities as quickly as possible.

I would like to see these things moving a lot quicker. I do not think we are good at putting in place healthcare infrastructure quickly enough. When it gets put in place it tends to be of a very high quality and capacity, but I share the Deputy's frustration. However, the project is moving forward and it is worth noting that a lot of investment is going into the hospital, for example, in the radiation and oncology building, as I said. There is a new 12-bed cardiothoracic ward, in which have made a €5 million investment. I met the team there recently, and the ward is making a big difference to patient waiting lists. It is true that projects of this scale unfortunately take a very long time and I think they probably take too long, but it is only one of several very big healthcare investments that are being made in Galway and the hospital.

Deputy Catherine Connolly

There are 150 acres at Merlin Park University Hospital. A site has been identified for a new hospital within that. I welcome the fact that we are progressing with the development of an elective hospital. On 24 November I was told that the Saolta University Healthcare Group has made a capital submission to the national capital and property steering committee. Today, we have learned that it is not with the steering committee, and that it is with the HSE for an internal view. I appreciate that the Minister has a difficult job. Like other Deputies, I have taken the trouble to put questions to the Minister for Public Expenditure and Reform. We have not even got to gate zero in the process. One question is undermining the other question. It is extremely difficult for the Minister to be on top of the stages of the process from gate 1 to gate 5 or 6, or whatever it is. We are not making progress. If we were, we would not have received a letter from the consultants appealing to all Deputies to act on a cross-party basis to do something about this issue. I have many other questions, but I will keep within the time limit.

Deputy Stephen Donnelly

I am more than happy to look at whether there is a discrepancy in the answers that the Deputy has received. The update I have received is that the submission will be going to the property steering committee shortly. I am more than happy to look at that. Importantly, I reiterate that I have met the clinicians and I have visited Galway a few times. I was there recently and we talked about various capital investments. I have met colleagues from around the House to discuss the issue. I fully acknowledge the strength of the case for a regional cancer centre. University Hospital Galway has one of the eight national cancer centres, and as has quite rightly been pointed out, there is a deficit in the capacity available for cancer care. It is something that we are very aware of and we are looking at. We will prioritise it.

Acting Chairman (Deputy Aengus Ó Snodaigh)

Apologies, I meant to bring in Deputy Conway-Walsh before the Minister responded.

Deputy Rose Conway-Walsh

I appreciate the fact that the Minister has met with the clinicians. He will know that the clinicians have done a huge amount of work on this. They are really busy people, but they have an expertise and they really care about what is happening in the region. The truth is, as the clinicians have pointed out, if you live in that region and you are accessing the cancer services there, it is not the same as accessing them in another part of the country. We need to bring equity and fairness to the situation there. That is why the centre is so important. What concerns me is the number of hours that are lost because the beds are not available for the cancer patients. I do not know if any evaluations or studies have been done on the number of hours that are lost when there are consultants there but no beds are available to bring the patients in. Appointments are cancelled, sometimes at the last minute, because there are no basic beds there for patients.

Deputy Stephen Donnelly

There are two sides to this. I would agree with Deputy Conway-Walsh's comments and indeed, those from the clinicians and the hospital that we need more beds and facilities. However, there is an awful lot more that they could be doing with what they already have. For example, the last time I met with the team not long ago, they said that they needed more diagnostic suites and theatres. I asked how often they run the diagnostic and theatre services. Broadly, those services are run from 9 a.m. to 5 p.m., Monday to Friday. The first thing we need is not more theatres, but more theatre nurses to run the theatres that are in place for longer. In fact, it is one of the core points in the new consultant contract. We have to get away from running theatres, diagnostic suites and outpatient clinics from 9 a.m. to 5 p.m. or 9 a.m. to 6 p.m., Monday to Friday. It does not work for patients. Yes, we need more investment, but we must also put the question back to the hospitals and the clinics. Theatre and diagnostic services need to be available outside the hours of 9 a.m. to 5 p.m., Monday to Friday, and patients need to be discharged at the weekend, which typically does not happen, to free up more of those beds. That needs to happen as well as the additional investment.