John Dolan (Independent) | Oireachtas source

That is a hint to me. I welcome and thank the witnesses and my colleagues for the detailed scrutiny and questioning. At a public level, and especially at the level of families who have children with serious chronic conditions and the many organisations and other interests that support them, this is a frightening scenario. I do not say this to be difficult but it is. They feel this is a runaway horse. Whether or not it is, it is the feeling people have in their guts about it. It is important to make this statement.

Ms Conroy stated several times there are lessons to be learned and this is very helpful. It is important these lessons are put in the public domain as quickly as possible so we can have a good open discussion and consideration of them. This is one challenge I am putting to the witnesses. One learning might be for us to be forensic outside the project building element. Ms Duffy made reference to staffing capacity and planning and this is one example. The cost of the capital project will be what it will be, and certain decisions have been made. I know it is an awful political statement but we are where we are. None of us likes where we are.

We also need to start looking at how the hospital, which is not just a building on a piece of ground, will link with, for example, a local GP in Clare, people and families, and how it will be able do more and have support. There are issues outside of health with regard to the conditions in which people live, such as housing, their incomes and their remoteness or closeness to services, support and education. I strongly underline this.

More specifically, I want to discuss Mr. Desmond's opening statement. When dealing with the capital plans he stated seven projects are on the move at present. I will take one, the redevelopment of the National Rehabilitation Hospital in Dún Laoghaire, as an example. Since I started working in the Irish Wheelchair Association as a young fellow in 1980, I have constantly heard about capacity and development issues. Ten or 15 years ago there was talk of having another unit in Cork. Last year, we had bed closures. I cannot remember the detail but in the middle of last year there were also issues with a consultant on the children's side. There are people in that hospital, and I have met some of them, who are there not because they need to be there but because they cannot be at home. In recent times the best thing we have been able to do is put them into a less acute residential or nursing setting rather than have them at home. I am simply making the point. We get best value when we look at what is happening around and outside as well as at the dysfunctions and issues. I am interested in any comment or remark on this.

How will planning identify where the problems are? All of us are familiar with the HSE stating it will be in a position to look at the support needs of a person when he or she gets a house while the local authority states that until the HSE is able to tell it the support package is in place it will not move on the housing side. This is happening today and will happen tomorrow as well as having happened yesterday. It is not just history. Many issues impact on this. We will have retrospective consideration of these matters if we do not look at parallel issues now.

With regard to the governance structure of the hospital, I want to underline the fact it is about what happens outside as well as within the operation. It is not the actual eye of the discussion we are have this morning but it is about value for money and getting the best bang for our buck for the people and families who need the services. I would welcome any remark from our witnesses on this and I welcome the fact the committee will specifically look at this issue.