Alan Kelly (Tipperary, Labour) | Oireachtas source

I welcome the delegation, which is slightly smaller this time. We have more Ministers on this occasion. I hope this delegation will be the same one that will be in front of us in a few months time. I am sure all the Ministers would agree with that. Given the times we live in, I wish them the best of luck. The situation in accident and emergency departments has improved recently but one would expect it to improve given the time of year. Is there a way in which we can change the pathways system regarding those who are being crammed into accident and emergency departments in Tier 1 hospitals and better use the under-utilised minor injury units across the country? There are people who end up in accident and emergency departments in Tier 1 who should not end up there. There are other options. It is creating a dynamic in those hospitals that is debilitating from a capacity perspective. I am most familiar with the midwest. There are minor injury units in three locations yet the situation in Limerick, which I visited recently, is terrible. Is there not a way in which we could use these units better because the capacity there is not being used and it would help?

I will ask a number of questions about capital because I am a bit confused. The Minister announced an investment in respect of a new accident and emergency department for Galway in the past week or so but I would have expected that this would have been announced as part of a capital plan that is meant to come out in a few months time. However, it was pre-announced. I am sure the Minister of State, Deputy Finian McGrath, will take an interest in this. Where are we in respect of the proposed new accident and emergency department for Beaumont Hospital? Will this be part of the capital plan? It is something that has been projected numerous times.

The Minister visited Limerick. All I will say is that there is an expectation regarding an accident and emergency department because I will not be unfair to the Minister and say that there was a promise or put words in his mouth. The CEO of the HSE confirmed to me that this accident and emergency department is to be opened in the last quarter of this year. There is an expectation among the clinicians, staff, management and the general public that it will be opened before the summer. Will this happen? I have a response from the chief executive of the University of Limerick Hospitals Group, Colette Cowan, who said it can be opened but will need €2.7 million. As we all know, the accident and emergency crisis in Limerick is probably the worst in the country. I am sure the Chairman agrees with this. Can this figure of €2.7 million be found? The recruitment process is ongoing. It would be very much appreciated if it could be because it would alleviate certain significant issues that exist there. One end of the county I represent uses Limerick while the other end uses South Tipperary General Hospital. Ratio-wise, they are probably the worst two in the country in terms of overcrowding in accident and emergency departments.

This brings me to South Tipperary General Hospital in Clonmel. I know there has been a lot of political talk about potential avenues regarding accommodation. What stage is this at? A national tender that has been put out. I expect that this will be part of the future capital plan as well. It must be prioritised. The situation is incredible. Will we ensure that it can be part of the capital plan upfront and built in the coming years or are we going to go through some temporary offering for a long time from which we may not get the results?

I would like some clarity on that.

In fairness, Mr. O'Brien and the Minister acknowledged the staff and management. I have my own issues, as have a number of members, with the Health Service Executive, HSE, management but there are some brilliant people working in the HSE. Some of them took grave offence to some of the comments made recently by the Department, Ministers and the HSE. Generalisations do not tend to work, so I am glad that was clarified.

With regard to the waiting lists, the Minister and Mr. O'Brien went into considerable detail on that, and my colleagues will have many questions so I will not take up all the time, but how can we be certain that the figures outlined here are correct following the experience we have had in recent months?

Regarding the national maternity strategy, of which I am a huge supporter, are we on track as regards funding that? We must bear in mind that there is a capital requirement with regard to planning the new maternity hospital. There are four hospitals - three in Dublin and one in Limerick - and there is a capital requirement €1.5 million in 2017 which is not being provided for. That suggests to me that in year 2, we are already behind. This is an excellent strategy, which this committee examined in detail, but if that funding cannot be found for the design of the new maternity hospital, what will be the position?

With regard to the children's hospital, which will come up in detail from my colleagues' questions, when will the Minister have the report that will tell him how in the name of God we ended up with the costs that have been outlined? The original cost was €450 million. It increased to €650 million and now, by all accounts, it is €1.2 billion. He might not have all the answers now but he has told me previously in correspondence that he will have them. When will the Minister have that report, which is referenced in the document he provided? I am sure all of us would like to find out about it.

I have some final questions. A review is ongoing of ambulance services across the country. It started in the mid-west. What is the purpose of that review? The Minister wrote to me stating that there will be no cuts in the mid-west, and I thank him for that, but what is the overall purpose of the review?

As it was one of the first issues I raised with the Minister on his appointment and my being appointed to this role, I am delighted about what has been done with regard to scoliosis in the recent past. There was a national outcry following the "Prime Time" programme, and rightly so. Many of us had been dealing with this issue for some time. I am delighted with the changes that are happening and the funding that has been found. My only issue is the reason it was not happening anyway. There is a concern that if the pressure builds up, consultants and clinicians can be found, theatres can be opened and money can be found. If that is the case, people will ask why it can be found for that area and not for somewhere else. I agree with what is happening.

That brings me on to the issue of Orkambi. What is the position on that? What is the position on Respreeza for alpha-1 patients? There are 21 people on that drug on a trial basis and they are worried that at the end of this month or early next month they will be taken off it. What is the position on both Orkambi and Respreeza because there are 40 more patients waiting to go on the latter? I understand 13 other countries are using this drug so why are we not signing off on it?

An issue in which I take a personal interest is e-health. I support the changes that are happening. A number of us sit on the Committee on the Future of Healthcare. I believe the issue with regard to IT systems across the health care service is chronic. I presume the various projects that have been outlined are being piloted in different hospitals and across various disciplines but a public service card is being produced separately to that by the Department of Public Expenditure and Reform, which is something of which I am a huge supporter. If this public service card is to be used effectively for everything in terms of one's interaction with Government services, and eventually will go to consumer services into the future, will somebody please tell me that under the e-health initiative the patient number will correlate with the PPS number and that they will be interoperable? If they are not, it will be one of the most stupid initiatives of all time.