Ms Barbara Keogh Dunne:

Gabhaim buíochas le comhaltaí an choiste as an deis labhairt inniu. I am the chief executive at Tallaght University Hospital since July 2025. I am joined by my colleagues, Professor Anne-Marie Brady, chair of the hospital board; Dr. Peter Lavin, lead clinical director; Mr. Dermot Carter, chief financial officer; and Ms Sharon Larkin, director of HR. They join me to provide clarity on their respective areas of responsibility and expertise. It is our role to ensure we uphold the trust placed in us by patients, staff, the Department of Health, the HSE and the wider community.

Based on the briefing document already submitted to members, I will provide an overview of the scale of services we deliver, governance and funding structures in place, funding challenges and how we can provide assurances in relation to our regulatory, professional and statutory obligations. Supported by a workforce of over 4,000 staff, we work closely in partnership with the HSE, the National Treatment Purchase Fund, NTPF, community and other healthcare providers. Our mission is to deliver excellent patient-centred care, while continuously improving how we operate and use our public resources in line with our hospital strategy. TUH is a model 4 voluntary hospital, serving a population of greater than 800,000 people across Dublin and the wider region. We provide a broad range of services - national and regional - including specialist, surgical, medical, diagnostic and emergency services and are the second largest site providing dialysis services nationally.

The hospital accommodation includes 476 inpatient beds, 125 day case beds, 65 treatment spaces within the emergency department and access to over 200 step-down beds off-site. Regarding activity, 63,000 patients attended our emergency department in 2025, which was an increase of 8% on the previous year and an increase of 11% in the number of patients who presented who are over the age of 75 within that timeframe. This trend continued into quarter 1 2026 with a 12% increase in attendances and a 6% increase in admissions compared to the previous year. Despite improvements in patient flow, the hospital runs at an occupancy rate of 110% to 115%, resulting in delayed admissions through the emergency department and growing waiting lists for scheduled care. There were almost 205,000 outpatient attendances in 2025. That is an increase of 5.5% on the previous year. In tandem, almost 83,000 patients were admitted for elective inpatient or day case procedures within that timeframe.

As a voluntary hospital, TUH is mainly funded by the HSE through the annual service level agreement. The cost of running the hospital in 2025 was €438 million. The projected out-turn for 2026 is €471 million. The hospital carries a historical deficit of €25 million. Other funding sources include HSE capital funding, the NTPF and HSE access to care funding. Additional revenue sources include income from private health insurance, the hospital car park, retail outlets and the private clinic. Funding received from our three foundations support the implementation of the hospital strategy in relation to patient care, research and innovation, the arts and education.

TUH operates within a governance and accountability framework providing assurances in relation to our statutory, regulatory and professional obligations. This is implemented through national and local policies. A set of internal and external controls are in place that demonstrate financial probity and operational effectiveness, with appropriate risk management procedures in place to deliver safe, effective patient care.

A number of challenges are outlined in our submitted briefing document inclusive of the HSE annual budgeting process, reliance on short-term funding sources, such as the NTPF, a reoccurring funding requirement to support ongoing IT and capital infrastructure developments and the availability of inpatient bed capacity.

I assure the committee that the board and the executive team are deeply committed to ensuring the hospital is managed responsibly and transparently. We recognise the trust placed in us to use funds wisely and that responsibility guides every decision we make. My colleagues and I are here to provide clarity, contribute proactively to the committee's deliberations and to ensure that the public can have confidence in the service we deliver. I thank members for listening and we look forward to addressing any questions they may have.