Tuesday, 3 February 2004
I thank the Minister for coming to the House at this late hour to respond to this matter. This is an important matter and it is very important to the people of Ballymun who are in the process of a major regeneration of their area. Ballymun is a significant town of approximately 15,000 people. As the Minister will be aware from the profile of the area, there is a very high social welfare dependency and a consequent very high health care dependency. There is only one health centre to cater for a town of 15,000 people which is unusual for most Irish towns of a similar size. That health centre was built many years ago at a time when the Ballymun estate was first developed. It is now completely inadequate and is a very dilapidated building in very poor condition. It is impossible for clients to attend in many cases and it is very off-putting. It is very difficult for the staff who work there. There is not enough room in the building for all the staff and this has been the case for the last few years. They are dotted around the northside in rented accommodation in Santry and Fairview. The situation is wholly unsatisfactory.
In light of the emphasis which the Minister is seeking to place on the important role of primary care, it is critical that should an area of high dependency like Ballymun, have good quality primary health care services available which are inviting and can accommodate the needs of the local area.
In 1998 the then Eastern Health Board identified Ballymun as an absolute priority area. The requirement to replace the existing health centre was identified and included in the Eastern Health Board's capital programme in 1998 and in every year since. A short while later Ballymun Regeneration Limited came up with a proposal to build a flagship centre on the main Ballymun Road. Anyone passing through the area will be familiar with that magnificent new building which has been completed since this time last year.
The agreement between the Northern Area Health Board and the ERHA which was entered into through the Minister's Department, was that the health board would take some 60% of that building in order to provide an adequately sized health centre for the whole town of Ballymun and to provide office accommodation for the area 7 headquarters of the health board. That agreement was entered into in 2000. Ballymun Regeneration Limited developed that proposal and brought it to fruition last year. The project was brought in on time and on budget.
There is great disappointment in Ballymun — on the part of the residents, the public representatives and the city council — at the fact that the health board and the Minister's Department have not delivered on their side of the bargain. That excellent and modern accommodation has been lying idle for the past 12 months. The rent has to be paid. It was built on a design, build and finance basis and rental purchase must be paid at approximately €3.5 million per year. The Minister is a year overdue with that payment.
Dublin City Council has been carrying that debt for the Minister since then and he will know that local authorities are not in a position to do that. As far as the council and I are concerned, the Minister's Department has welched on that agreement. The Minister was part of the deal and the cost of the project was always understood and there were no surprises for anybody. The project was completed on time but once it was completed, the Minister was not prepared to provide the money. He is not prepared to provide the money for the rental purchase but more critically, he has not been prepared to provide approximately €9 million which is required for fit out and furnishing of those premises.
The primary care health situation in Ballymun is at a critical stage. There are vacancies in many of the posts, particularly in the therapies such as public health nursing and social work. Very few children in Ballymun have developmental tests, for example.
I thank the Deputy for the opportunity to speak on this important matter.
The provision of health centres to meet the needs of local communities within its functional area is a matter for the relevant health board or the Eastern Regional Health Authority. In the case of Ballymun that responsibility rests with the Eastern Regional Health Authority and the Northern Area Health Board.
The authority has advised me that discussions involving the former Eastern Health Board and Dublin Corporation, regarding the provision of a new primary care centre with associated administration offices in Ballymun, date back to 1996. It was agreed by both these bodies that the health board should provide services from a central civic amenity building which was to be the centrepiece of the redevelopment of Ballymun town centre.
Ballymun Regeneration Limited, a wholly-owned subsidiary of Dublin City Council, established for the purpose of advancing the regeneration of the area in conjunction with the former Eastern Health Board, developed a brief for the civic centre which included provision for a primary care centre and the community care area 7 headquarters. I am further advised that following its establishment, the Northern Area Health Board, NAHB, continued to liaise with Ballymun Regeneration Limited on this project.
While the NAHB agreed in principle to become a major sub-tenant, it did so on the basis that it was made clear to Ballymun Regeneration Limited that its participation was subject to necessary approvals from the Eastern Regional Health Authority and the Department of Health and Children, and the making available of funds for the project.
The ERHA has confirmed that the construction stage of the development was completed in February 2003. The Northern Area Health Board's share of the floor space in the civic amenity building is approximately 60% of the total. The authority has further advised that the NAHB intends to acquire its share of the building on a lease-purchase basis over a 14-year period, at an annual cost of €4.02 million. The fit out of the NAHB's portion of the building, that is, building works, electrical, plumbing, painting and decoration, floor finishes, etc., has been estimated at €6.35 million and the provision of furniture and fittings has an additional estimated price tag of €2.8 million. It would take approximately eight months to complete the fit out.
The latest estimates provided by the ERHA would indicate a total funding requirement of in excess of €60 million for the provision of the facilities. The authority has advised that the proposed financing arrangement over the 14-year period will mean that the NAHB or its successors will own the relevant portion of the building after this period.
All health boards and agencies are required to follow the Department's guidance documentation for capital projects, together with national and EU capital procurement procedures. The availability of overall funding requirements is also a necessary prerequisite in informing decisions regarding proposals from health boards to proceed with capital developments. It is normal in the first instance for the health agency involved to submit to the Department project details for agreement such as assessment of need, option appraisal, design brief, cost estimates and cashflow projections.
The NAHB proceeded with this project with neither the involvement nor approval of the Department of Health and Children. The Department has requested information and requires clarifications from the ERHA and the NAHB on various aspects of this project, in particular those relating to the overall scope of the project, funding, procurement procedures and value for money. When this information is received the Department will complete its evaluation of the project in conjunction with the ERHA and area health board.