Billy Kelleher (Cork North Central, Fianna Fail)
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I thank the Ceann Comhairle for the opportunity to raise this issue as a Topical Issue matter. It was brought to my attention by Councillor Paul McAuliffe, who represents the Finglas-Ballymun ward in north Dublin, that an X-ray machine purchased for some €500,000 in 2006 as part of the fit-out of the health centre at the Ballymun civic offices has never been used. I had to read the entire Health Service Executive report on the matter before I could be convinced he was correct in his information. A spokesperson for the HSE, indicating that it was not financially viable to use the expensive scanner at present, further stated:

Following wide consultation with relevant clinicians regarding the X-ray machine, which was installed in the Ballymun health centre as part of the initial fit-out, it has been decided that in the current economic climate and with reduced resources, it would not be prudent to invest further in the X-ray facility... This decision was taken following consideration of the highly responsive X-ray service currently available, the fact that plain X-ray is only occasionally used in routine GP investigations and due to the potential waste involved in investing in a service that would result in the under utilisation of staff and the equipment.

The spokesperson went on to indicate that alternative venues had been explored but the costs associated with relocating the X-ray machine were, in the current climate, prohibitive.

There must be a further evaluation of the HSE's position in regard to the relocation of the machine. Surely this costly equipment could be put to good use elsewhere if it is not needed in the Ballymun area because of the X-ray services that are already available there. Has an evaluation been done of the depreciation to which the machine has been subjected and do we know how much it is now worth? Has the HSE undertaken an extensive review of potential alternative locations or considered the possibility of selling the machine? The Minister of State, Deputy Róisín Shortall, can rightly say this situation did not arise on her watch, but it is now her responsibility to find a solution to what is an appalling waste of public money. Councillor McAuliffe has written to the Chairman of the Committee of Public Accounts seeking an investigation of the matter. In these straitened times, it is simply unacceptable that a machine worth up to €500,000 has been lying idle for six years. It is not good enough merely to have a statement from the HSE that the situation has been evaluated and it would be too expensive to relocate the equipment. The machine could be used elsewhere, or sold. What is certain, however, is that it should not be left to lie idle and depreciate in value in the years ahead.

Róisín Shortall (Dublin North West, Labour)
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I welcome the opportunity to respond to the Deputy on an issue with which I am very familiar. The Health Service Executive established the Ballymun primary health care facility at the civic offices in April 2006. It is fine facility offering a wide range of services including an X-ray suite. The latter was fully commissioned in 2008 but, as I understand it, it was not possible to staff it due to the moratorium on recruitment.

The fact that this facility was lying idle was brought to my attention last year, whereupon I visited the site and raised the matter with the HSE on several occasions. As a result of those inquiries, the HSE established an assessment team in 2011 comprising the area manager for north Dublin city and the national clinical leads for primary care and emergency medicine to explore evidence-based options for the use of the X-ray machine that was installed as part of the centre fit-out. Following wide consultation with relevant clinicians, it was decided that in the current economic climate and in view of reduced resources, it would not be prudent to invest further in the X-ray facility. As the Deputy observed, this decision was taken following consideration of the highly responsive X-ray service currently available, the fact that plain X-ray is only occasionally used in routine GP investigations and taking account of the potential waste involved in investing in a service that would result in the under utilisation of staff and equipment.

The assessment team found that the existing X-ray services for north Dublin are very good and that there is no waiting time for trauma cases or chest X-ray referrals. The service at the Mater hospital was found to operate very successfully as a walk-in facility and GP satisfaction with the service is very high. The availability of the community rapid access clinic at Smithfield has, the team concluded, provided another option for GPs. It was further observed that Beaumont Hospital operates a similar service with equally high levels of local GP satisfaction. While it was decided to explore the option of relocating the X-ray machine, the costs associated with moving and installing it in the current climate were found to be prohibitive. The HSE will consider other options regarding the future of the machine, but no consideration has been given as of yet to selling it.

I am loath to lose an important item of medical equipment from the primary care service or the public health system generally and I am keen to ensure it is brought into use as soon as possible. Therefore, I have asked the special delivery unit to ascertain whether it could be used as part of the unit's work in taking pressure off local hospitals. I await a response in this regard.

Billy Kelleher (Cork North Central, Fianna Fail)
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I thank the Minister of State for her comprehensive reply. There is a positive in this in the acknowledgement that there are reasonable X-ray facilities available between the Mater hospital, the rapid access clinic at Smithfield and Beaumont Hospital. I am not asking the Minister of State to give firm commitments today but she might consider whether this expensive equipment could be incorporated into the roll-out of primary care centres. In an area where there is a deficiency of X-ray facilities to GPs, the machine could, perhaps by way of a lease arrangement, be pressed into service. It might even be given as a gift from the State to the State as part of its regional primary care programme. Every option must be considered to ensure this machine is plugged in and used for the benefit of the citizens who do not have access to X-ray services on a walk-in basis. The last thing we need is for this issue to be brought before the Committee of Public Accounts and tied up for ages in discussions about what went wrong while the machine remains idle in Ballymun.

Róisín Shortall (Dublin North West, Labour)
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It is a shame that the necessary resources for staffing were not provided when the facility was established in 2006. It is yet another example of poor planning within the health service, where capital and revenue are often not co-ordinated. It is important to point out that there is changed thinking in regard to diagnostics. There are concerns, for example, about having an X-ray machine in a primary care facility on the basis that it is unlikely there would be sufficient critical mass to justify the provision of attendant staff. The thinking now tends to be that where one has X-ray facilities, it is important also to have the follow-on services on the same site.

I take the Deputy's point, however, and agree that the current situation is far from ideal. I would very much like to see the machine brought into use, but I understand the cost of moving it would be substantial, being in the region of €85,000. We are considering all possibilities with a view to seeing if it can be used. It is a shame to see facilities like this lying idle. I thank the Deputy once again for raising the matter.