Hildegarde Naughton (Galway West, Fine Gael)
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I thank the Ceann Comhairle's office for affording me the opportunity to raise this issue which is of the utmost importance to the people of Galway and the broader western region. At University Hospital Galway we are blessed with a team of world-class doctors and health care professionals, but they are struggling beneath the weight of inadequate resources and unmanageable demand. As the Minister of State will be abundantly aware, the hospital is beset with the country's longest waiting list, has the most cancelled procedures and frequently has the most patients on trolleys. In the Minister's defence and that of his predecessors, it is not the case that no money has been made available for capital spending on the hospital in recent years, but in times of scarcity it is equally important to consider how money is spent, as well as how much.

The central government funding invested in capital projects at University Hospital Galway in recent years represented a wasted opportunity. The hospital campus has dated facilities and its capacity to cater for the needs of a growing and ageing population cannot be expanded owing to restrictions on its current site. I will cite two of the most recent capital projects to illustrate this point.

This year will see the opening of a new 75-bed ward block. For some time, this prospect gave people in the hospital's catchment area hope that it would go some way towards alleviating the seemingly perpetual overcrowding crisis. However, it emerged in recent months that there were three wards being closed to make way for the new €18 million block and that there would be no net increase in bed capacity once the block's doors opened. This was confirmed in letters from the chief operations officer to the planning authority, in a letter to me from the hospital's general manager and in briefings by senior management of the group's patient council. A key reason for this is that the additional beds cannot be provided under the terms of the city development plan without creating an equal number of car parking spaces, for which there is no room on the campus.

That brings me to the second capital project. The hospital undertook to build a new two-storey parking facility on the site of an existing car park a few years ago. Remarkably, the project's net impact following completion was that there were 80 fewer spaces. We are building car parks that do not result in the creation of extra parking spaces and ward blocks that do not result in the provision of extra beds.

5 o’clock

We need to stop this, take stock of why this is happening and decide what should happen next.

Given the gravity and scale of the overcrowding crisis at University Hospital Galway, I consider it a shame that scarce resources were poorly utilised on capital projects that would offer no respite from the crisis. It is one thing in the midst of an economic crisis to say there is no money but it is quite another to have the money and waste it in a way that would do anything other than confer the maximum possible benefit on the maximum number of people. That, I fear, is what has come to pass in the two instances I have outlined today.

The present set of circumstances is not tenable. Put simply, the region’s population is going to grow but the hospital’s capacity is going to remain the same. The sooner we realise that a longer-term vision is required in the form of a new facility on the grounds of Merlin Park University Hospital, which is on State-owned land, the sooner we can restore confidence in the fact that the current and future health care needs of the people of the west will be catered for.

Endemic short-termism appears to have overtaken most of the planning on the existing University Hospital Galway site. Bearing in mind the Minister’s vision and the setting up of the all-party Oireachtas committee, of which I am a member, to consider a ten-year plan for the health service, does the Minister of State agree that since University Hospital Galway is the major acute hospital for the west, we now need to grasp the nettle and look at the bigger picture?

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Naughton for raising this issue and I welcome this opportunity to outline the up-to-date position on recent health infrastructure developments at University Hospital Galway. These developments recognise that demand for health care is rising, with our elderly population increasing at nearly double the European average. Other factors, such as the rise in obesity, chronic disease and advances in health care technology, are also increasing demand for health services. In this regard, A Programme for a Partnership Government sets out a clear vision for health services that is community based and responsive and accessible to patients. The development of primary care is central to this, by shifting the balance of care from a hospital-centric system to one located in the community, enabling users to access a broad spectrum of care services easily through their local primary care team. The development of a new hospital anywhere in the county must be seen in the context of the delivery of related health care services in the locality and region.

With regard to University Hospital Galway, the State has invested in the healthcare infrastructure at the hospital site and continues to do so. Given the ongoing investment that has been made at the site, it would not represent value for money to walk away from this significant investment. A number of significant projects have been completed at University Hospital Galway in recent years. These include the clinical research facility, the upgrade to the maternity unit and the cystic fibrosis outpatient department, which was completed in 2014 and is now operational.

There are also two major developments currently under way in Galway. Construction work is ongoing on the new 75-bed ward block, which will provide single-room inpatient accommodation. Work on a new acute mental health department is under way and is expected to be completed early in 2017. Following the transfer of mental health services to the new acute department, work will begin on the construction of the project under the national plan for the radiation oncology, for which project the HSE has already obtained planning permission.

A Programme for a Partnership Government commits to progressing a new emergency department facility for Galway University Hospital. The HSE Capital Plan 2011-2016 includes funding for a full option appraisal and cost-benefit analysis to inform planning and funding requirements for a new emergency department at University Hospital Galway. The cost-benefit analysis is in its final stages and it is anticipated that this will be completed shortly. If favourable, this will proceed to the design phase in 2016. The building of this urgently needed emergency department remains a capital priority for the Saolta University Health Care Group. Pending the development of a new emergency department, in order to alleviate pressures and to ensure that patient experience in the existing emergency department is improved, 30 additional beds opened at the hospital in early 2016.

There are no plans for a new hospital to be built in County Galway. Moreover, University Hospitals Galway comprises both University Hospital Galway itself and Merlin Park University Hospital, which is not far away. The rationale behind the establishment of the hospital groups is to facilitate collaboration between hospitals serving a particular patient population and to maximise the utility of existing resources. The Saolta University Hospital Group will continue to enable cross-development of both University Hospital Galway and Merlin Park to accommodate the best use and expansion of the services provided.

Further investment in individual hospitals must be considered within the overall acute hospital infrastructure programme and as part of the establishment of hospital groups. Development control plans have been completed on all major hospital campuses, including University Hospital Galway. These provide a blueprint for future development and rationalise construction and capital expenditure. This exercise focuses on what constitutes good practice, planning and addressing service needs, and all current and future development of health care infrastructure will be based on this considered approach.

Hildegarde Naughton (Galway West, Fine Gael)
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I thank the Minister of State for his response. I acknowledge that the new 75-bed ward block will offer patients more modern single-room accommodation, but the simple fact is that it will not offer one single extra bed. My point today is on value for money. The Minister of State implied walking away from the University Hospital Galway site would not represent value for money. If he investigates the amount of funding invested in the two projects I have outlined today, he will note it is an example of how we are not looking at the bigger picture or adopting a longer-term vision for Galway and the western region.

Questions need to be asked on whether these projects should have been allowed to proceed when it was apparent that they would not bring any appreciable relief in the current crisis in University Hospital Galway. Prior to my election to this House, I stated the University Hospital Galway campus was at saturation point and was unfit to provide for the present and future health care needs of people along the western seaboard. I examined the Merlin Park site, which is State-owned. We have Merlin Park hospital, as the Minister of State said. Since the time in question, the assessment has gained the support not only of my political colleagues but also that of the clinicians and hospital management. In the interest of the future health care of our citizens in the west, we need to be considering a plan and phasing out from University Hospital Galway. I appreciate the investment in that site but we need to be considering a larger one. The current one is in the city centre. It is hemmed in and, because of parking restrictions associated with the Galway city development plan, we cannot have an extra bed without an extra car-parking space. That is simply the case and we need to be considering the use of the State-owned land at Merlin Park. We also need to consider the ten-year plan and include a provision whereby University Hospital Galway would move to Merlin Park as part of that plan.

Finian McGrath (Dublin Bay North, Independent)
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I accept some of the comments made by Deputy Hildegarde Naughton on these issues and that there are questions to be answered. I welcome the fact that the Deputy welcomed the 75-bed single-room unit. Of course, we must examine how we spend capital funding.

The Deputy made a very positive point on the problems with the city development plan and the car-parking issue. I am listening to the points she has raised. She is saying the clinicians on the ground support her position on this matter. We have a duty to listen to the people who run the services and the service providers. I will raise the Deputy's concerns with the Minister, Deputy Simon Harris.

I know University Hospital Galway very well because I spend a lot of time there visiting relations and extended family members. I know of the problems with patients on trolleys and the other issues. Our job is to try to come up with sensible proposals. However, part of our job, which the Deputy rightly highlights, is to determine how we spend the money to provide services on the ground.

We must recognise that chronic disease management is a major driver of health care costs. It accounts for 80% of health expenditure.

The number of people affected by chronic conditions is increasing by approximately 5% annually. We must address this issue.

I will convey to the Minister the issues and concerns raised by the Deputy and we will ascertain whether anything can be done about them. As I stated, we all have a duty to listen to citizens, local representatives and the professionals on the front line.