Cathal Crowe (Clare, Fianna Fail)

We all obsess about the numbers of beds available and how quickly someone progresses from triage to accident and emergency and into the ward system. That is rightly where the focus should be. The point I would make is that it is a complex site down there. Every time you go to build a 96-bed block, you have the rigours of planning. You could have objections. You could have a judicial review, though you would hope not. You then have to build in a site where there is a huge amount of activity happening. Car parks have to be excavated. It is not just a matter of digging down foundations. Each facility must be tanked. Electrics, services, water, sewerage and a lift system must be included. It would make sense when you are building 96 beds and going up five storeys to continue to ten storeys and build 200 beds and five ward systems. That would make more sense than the current model. I would buy into the witnesses' recommendations. I am positive towards them. I cosigned a letter on behalf of TDs and Senators in the region. I am supportive of all of this. I just see a flaw in the report being that the status quo of delivering hospital wards and beds in UHL at the moment is that you go in for 96 beds, build it as a stand-alone unit, link it by a corridor to something else and put on a load-bearing roof so that more can be added in the future. That is unsustainable. Each time we try to add on a bit, it becomes like Legoland. It takes three years and ends up costing far more than €200 million. The cap is a slowing down mechanism. It is designed to achieve better cost efficiency but by the time you have built a new block, you have far exceeded the cap.

Presumably HIQA had a draft report and then the Minister gave a direction that it should stitch in the ESRI report because the two needed to be married.