Ms Kate Killeen White:

As I said, there were well-documented challenges before Covid 19. Then came the pandemic, which we are still experiencing. That brought with it more challenges for infection prevention and control. When we were preparing for Covid-19 we decanted a number of our short-stay units to utilise them as Covid step-down units if required. Thankfully, we did end up in that position in this country. However, we did have a requirement for staff elsewhere, including testing and vaccination centres. We redeployed the staff from St. Brigid's Hospital to those alternative locations to deliver on the pandemic response. The issues at St. Brigid's presented before Covid. The pandemic hit and then we had more significant issues to deal with in the context of infection prevention and control requirements.

Regarding services in the local community, I acknowledge that we need to develop our services in our communities. That is what made this a very difficult decision. We are very familiar with Carrick-on-Suir and St. Brigid's and we know the hospital is in the heart of the community. Nevertheless, we are required to operate our services in line with infection prevention and control and safer and better health care standards. The HSE was not confident that St. Brigid's could resume short-stay services in line with the guidelines we were required to meet at the time to resume our services.

The HIQA reports indicated that there was only 76 cm of space between the beds in the two five-bed wards. Current advice generally recommends 1.2 m between beds and our health building notes recommend a bed space of 1.8 m. These were the challenges we had to overcome. As the Chair has pointed out, even with the reduced capacity, the showering facilities remained a challenge.

The question regarding what attempts were made is a fair one. Two issues needed to be considered in the context of St. Brigid's Hospital. Those were upgrading the existing buildings so that we could operate in line with the guidelines and infection prevention and control. We have to bear in mind that we were operating, and are still operating, in a global pandemic. Our primary focus continues to be to deliver safe services and ensure we can prevent transmission of Covid-19 and prevent transmission of hospital acquired infections. There were two major impediments to upgrading and extending the building. The first was the requirement to raise the floor levels by approximately 1 m. The advice we were given suggested we would have to demolish the existing building and build from the ground up. The second was the site within the area of St. Brigid's. Acquiring land to develop the building was a problem for us. I will ask my colleague, Mr. Ruane, to speak in more detail about the technical aspects.