Mary Harney (Dublin Mid West, Progressive Democrats)

The co-located facilities will have to provide 24-hour admission. That will be a new feature of private hospitals in Ireland. They will have to train doctors. Deputy Reilly said they will not train doctors, but they will have to do so. Their profits will have to be shared. If debt is being refinanced, public hospitals will have to benefit too. We will not have the situation that arose with a toll road recently, whereby a company got a contract that proved to be extremely lucrative 20 years later. Taxpayers will not be forced either to buy out such a contract or to assume the losses involved. That will not happen under these proposals.

I was interested to hear the maiden speech of Deputy Reilly, whom I congratulate on being elected. However, until recently, Deputy Reilly was a strong advocate of tax breaks for health provision.

Deputy Lucinda Creighton, whose election to the House I welcome, represents a constituency with a co-located facility, St. Vincent's Hospital. I am sure she is not suggesting that we should not have that hospital in her constituency. In respect of St. Luke's Hospital, all the expertise in Ireland and overseas indicates that stand-alone radiation is dangerous for patients and that one must, as Deputy Deirdre Clune said, integrate multidisciplinary care, with medical oncologists, surgical teams, pathologists, radiologists and radiation oncologists all working together in the interests of the patient. What is happening is that the radiation facility is being provided at St. James's Hospital. While the actual physical facility in terms of the hospital will remain there, it will probably do different things or may be for overnight patients. The treatment will be multidisciplinary and integrated because that is what patient safety requires.

That brings me to a point made by Deputy Seymour Crawford. My policy and that of the Government is to provide treatments for patients as close as possible to where they reside, provided it is safe to do so. In my view, patients in Ireland, like patients anywhere else, do not actually care how the facility is funded or who runs it. One need only talk to the many people who use the National Treatment Purchase Fund. What they care about is the quality of the treatment and the speed at which they can get it. That is what is important. Above all else, if somebody is sick or a member of his or her family is sick, he or she wants them to be able to access the best treatment as quickly as they can.

Deputy Brian Hayes asked me a number of questions. We will publish details in respect of each site. When that happens, the board of the HSE will meet on 5 July and I think at that point will select the preferred bidders on each site. Among the people who have come forward — the assumption here is that they are all people from outside the State — are the Bon Secours Group, which has a terrific record of health care in this country for many years; the Mater Hospital; and Mount Carmel. These are hospitals with a terrific track record so we should not assume that people in the independent sector in Ireland are not interested in getting involved in this as well because they are.

All the details in respect of each site, including the financing, will be a matter of public information. In respect of the costs, I heard a figure of approximately €700 million quoted here. The insurance foregone in respect of the six hospitals at the moment will be approximately €80 million. This is less than half the cost of running those beds. In respect of the site, no site has been given away. All of them will be leased at above the market value. There has been independent valuation. Many people and bodies have been involved in this, including the National Development Finance Agency, the Departments of Finance and Health and Children, the HSE, Farrell Grant Sparks, Prospectus and internal auditors. For each individual site, this project has gone through a procedure in terms of public procurement that we have not done in health care in Ireland before. All of the services being provided in this facility will be integrated with the hospital, which does not happen at the moment. Private hospitals emerge, are not integrated with the public system and do not necessarily complement the public system. This is different. What is being provided at each site is what each hospital wants. If patients do not have private health insurance, the hospital will be obliged to provide services procured by the HSE for these patients at discounted prices.

Lastly, in respect of the tax foregone, the maximum amount is approximately €455 million. The cost of providing these beds in the traditional way would be at least €1 billion. I think that is pretty good value for money.

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