Kevin Humphreys (Dublin South East, Labour)
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It is a matter of urgency that the National Maternity Hospital on Holles Street, Dublin, is moved to Elm Park, Dublin 4, so that it is co-located with St. Vincent's University Hospital. The National Maternity Hospital has been located on Holles Street since 1894 and has provided 118 years of service. However, the site is unsuitable for future expansion and there have been a series of recommendations for it, the latest being the 2008 KPMG independent review of maternity and services in the greater Dublin area. It recommended the hospital should be co-located alongside adult acute services at St. Vincent’s. Holles Street is Ireland's busiest maternity hospital with nearly 10,000 babies born there in 2010. The baby boom is stretching the fabric of its outdated building to the limit.

As a former member of the board, I am aware there were concrete plans to relocate to Elm Park. Unfortunately, this was not carried out by previous Administrations when funds were available. The National Asset Management Agency, NAMA, has informed me two buildings are available in the Elm Park development with 19,230 sq. m. of gross internal floor area and another with 10,869 sq. m. The building could be retrofitted to accommodate a maternity hospital which would provide the modern facilities and co-location all experts agree is required. I understand discussions took place between the Minister for Health and NAMA which have now concluded. When will the Minister seek sanction for a move from the Department of Public Expenditure and Reform for this move?

Maternity services in Dublin are at breaking point. With the recent announcement of the location of the national children's hospital, it is important we recognise the new-born and mothers are provided with a building fit for purpose and are co-located with adult services. The HSE has spent over €16 million on capital investment at Holles Street in the past ten years, over €2 million alone in 2011, to adapt a building over a century old. Tacking on space is not an answer. The announcement of the site for the national children’s hospital was very much welcomed. For well over two decades, it has been identified that the current site of the National Maternity Hospital is not fit for purpose. The building is shoehorned into a very tight space. The space and facilities for a new hospital site are just down the road beside an acute hospital, St. Vincent’s. Now is the time to make the commitment and start planning to make this move. The National Maternity Hospital services not just the greater Dublin area but the eastern region. It is important to make those decisions now to ensure the delivery of maternity services the country deserves.

Paul Kehoe (Wexford, Fine Gael)
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In 2008, KPMG reviewed maternity and gynaecology services in the greater Dublin area and recommended that Dublin maternity hospitals should be located alongside adult acute services. This is the optimal solution for hospital-based maternity services, as it gives access to the full range of medical and surgical specialties and clinical support services, in sufficient volume and complexity. This is particularly important for high-risk mothers and babies. In this context, it is proposed the National Maternity Hospital be relocated to St. Vincent's hospital.

There is a real opportunity for the maternity service providers to formalise their relationship with their partner adult hospital at the earliest opportunity to realise clinical and financial benefits as well as efficiencies well in advance of physical co-location. The National Maternity Hospital has been working with St. Vincent's University Hospital to progress this from a service perspective and working with the HSE in the development of the business case for relocation.

Management and delivery of health infrastructure programmes, including financing, is the responsibility of the HSE. However, as this project cannot be dealt with in isolation, it must be considered in the context of the HSE multi-annual capital programme. In prioritising capital projects within its overall capital allocation, the HSE must take into account existing capital commitment and costs to completion over the period.

Work on the draft capital plan for the next multi-annual period 2013-17 will begin shortly and will be submitted to the Department of Health in due course. The Department will then review the proposals and follow up with the HSE where further details may be required. The draft capital plan will require the Minister’s approval with the consent of the Minister for Public Expenditure and Reform.

In the interim, specific improvements can and have been made in defined areas in the existing hospital such as the recent provision of a new operating theatre and a hospital rewiring project. I accept these remedial works will only address the immediate problems of the infrastructure. The proposed relocation of the hospital to the St. Vincent's University Hospital site is still being given high priority. The Minister's concern with this issue, as with all health issues, is with patient benefit and patient outcomes. We must use within the acute system our extremely limited health resources for the maximum possible benefit and to deliver safe, modern services. Any decision on the future delivery of maternity services in Dublin, including the location of those services, will be made in this context.

Kevin Humphreys (Dublin South East, Labour)
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I thank the Minister of State for the response. As he outlined, a new operating theatre was added to the hospital while a new two-storey educational and medical centre is planned for the site. It would be more cost effective to redevelop the Elm Park site for the new National Maternity Hospital, however.

I remarked earlier that there are more than 19,000 sq. m. in one block alone in Elm Park. To me it would appear to be cost effective at this stage to put in the preparation and to include this plan in the capital programme of the HSE for 2011 to 2013. We should put this in motion in order that we could move the hospital as soon as possible. If we use the current buildings we could turn the site into a modern functioning national maternity hospital by 2016 for as little as €100 million.

I realise the Minister of State may not have the answer in the House now but if the Minister of Health was here he might have been able to answer it directly. An article was published in the Irish Examinerin July indicating that a memorandum was to be brought to Cabinet seeking approval for the transfer. If the volume of work reported in the Irish Examineris correct it would suggest the work is well down the path but we need to bring it to a speedy conclusion. We should include it in the capital programme for 2013 to 2017 and it would represent a job of which we could all be proud during the term of this Government.

The maternity hospitals are in crisis. The original building was excellent. It served the city well and it is in the heart of my community. Seldom does one hear a Deputy suggest that a hospital should be removed from his constituency but we must consider the projected increase in the rate of childbirth in the city and the greater area. I call on the Minister of State to go back to the Minister for Health, Deputy Reilly, and outline the points made.

The financial package stands up by itself. This is a once-off opportunity because the vacant buildings are in the right place. This could be delivered speedily and in a cost-effective way. We could end up with a national maternity hospital co-located with a major hospital as recommended in the 2008 independent report. If we did this in the coming six months there could be a national maternity hospital in Elm Park by 2016. I urge the Minister of State to discuss this with the Minister, Deputy Reilly, in order that he could come back with some of the answers to the questions I have put today. It boils down to the fact that this is the most cost-effective solution to provide a national maternity hospital for this city and country.

Paul Kehoe (Wexford, Fine Gael)
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I assure Deputy Humphreys that I will take back his concerns to the Minister, Deputy Reilly. I realise he is aware of the geography of Dublin and given his experience of living here he understands what is best for the city. I will take back his ideas to the Minister, Deputy Reilly, and have him communicate with Deputy Humphreys.

Deputy Humphreys will understand that the Government has announced the location of the national children's hospital.

Kevin Humphreys (Dublin South East, Labour)
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It was very welcome.

Paul Kehoe (Wexford, Fine Gael)
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It was very welcome. The Government now has time to reflect on the best way forward for the location of maternity services in Dublin. Deputy Humphreys is correct to note that we have a once-off opportunity now to ensure that we get the maternity services right and that once the Minister and the Government make the decision, it will in place for many years to service many families in the greater Dublin area. The Deputy can rest assured that the Government will make the decision in the most cost-effective way possible. I realise Deputy Humphreys has several ideas, including those he has outlined today. He can rest assured that I will take these back to the Minister and that the Minister will communicate directly with him.