Dáil debates

Wednesday, 21 June 2017

Other Questions

National Maternity Hospital

5:40 pm

Photo of Mick BarryMick Barry (Cork North Central, Solidarity)
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52. To ask the Minister for Health his views on whether the allocation of space for private practice in the plans for the new national maternity hospital is compatible with the elimination of private care from public hospitals; and if he will make a statement on the matter. [27861/17]

Photo of Mick BarryMick Barry (Cork North Central, Solidarity)
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128. To ask the Minister for Health his views on the fact the State will pay for the construction of the new national maternity hospital yet it will be owned by a private entity; his Department's general policy in this area; and if he will make a statement on the matter. [27860/17]

Photo of Mick BarryMick Barry (Cork North Central, Solidarity)
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The Committee on the Future of Healthcare has proposed the phasing out of private practice from public hospitals yet it is clear the plans for the national maternity hospital make provision for a significant amount of private practice within it. I do not know how that can be squared but I look forward to hearing the Minister's comments on the matter.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 52 and 128 together.

Deputy Barry must remember that when reforming a health service, one has to continue to run it on a day-to-day basis while those reforms are under way.

Discussions are ongoing with the St. Vincent's Healthcare Group on the terms of the State's investment in the new hospital and, in particular, arrangements for the protection of this investment - I had a question on this earlier from Deputy Shortall. There are long-standing arrangements in place between the State and the 17 voluntary hospitals to allow for public investment in the development of health care facilities and for these facilities to be protected for publicly funded health care. The Mulvey agreement envisaged that further consideration was required in regard to the precise legal mechanisms necessary to protect the State's considerable investment in the development of this much-needed national maternity hospital. My Department is actively engaged in discussing suitable arrangements to ensure the facilities are legally secured on an ongoing basis for the delivery of publicly funded maternity, gynaecology and neonatal services. I hope to update the Government and the Oireachtas on this progress very shortly.

On the issue of the allocation of private space in the new hospital, I would like to clarify that there is no differentiation between public and private inpatient rooms in the hospital designs. All inpatient rooms are of a similar, high quality design given we want to build a state-of-the-art new hospital. In terms of outpatient consulting space, some limited private space will be provided, based upon existing policy and subject to any policy development, in so far as this is necessary to support the commitment in the current consultant contract. As the Deputy knows, the current consultant contract does envisage that consultants can carry out a degree of private work. If that changes in line with the Sláintecare report or any consultant contract discussions, which I think is the Deputy's question, that will be reflected in the changes to policy development.

In regard to the more general issue of private care in public hospitals, I look forward to the Dáil debate on the Sláintecare report tomorrow and I will give full consideration to the report's recommendations when I have had the opportunity to hear views from across the Dáil. Following the debate, it is my intention to bring detailed analysis and proposals to Government. I have no doubt the report will be an essential document for this and future Governments and all parties in the fundamental reform of our health services over the next decade. While I know the Deputy was not in a position to sign off on the report, I acknowledge he worked very hard with many colleagues on it.

Photo of Mick BarryMick Barry (Cork North Central, Solidarity)
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The architect's plans for the national maternity hospital, if anyone puts them up on the wall and has a look at them, show a corridor marked "private clinics". There are five rooms on the plans marked "private consult". We have a two-tier health service and it is two-tier in maternity services as well. I reject the Minister's point that there is equality. If anyone goes private, there is continuity of care. If they go public, that is very unlikely. A private patient who arrives for prenatal appointments does not have to wait whereas a public patient has to wait. It is two-tier. I am asking the Minister to comment and to state whether he agrees there is a two-tier care system within the health service or within maternity services in the context of planning for the future and the development of the national maternity hospital.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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We all want to arrive at a single-tier health service, and if we were already there we would not all be working so hard to arrive at that point. That is the purpose of the Sláintecare report, which has received broad political consensus. I do not know if the Deputy has walked the corridors of Holles Street hospital lately but I have been there many times. The point I am making, which the Deputy seems to reject, is that at the moment public patients are receiving excellent care from staff in deplorable conditions. Every patient, whether public or private, in this new state-of-the-art national maternity hospital will have the same high quality inpatient room. That is very important and is a significant development.

Yes, there will be rooms for consultants to see outpatients; in fact, there will be 32 consult examination rooms in total. Under the current consultant contract, roughly proportionately, some five of them would be used for private clinics. The point I am making in direct answer to the Deputy's question, which is how it is compatible with the Sláintecare report, is that if policy changes in this area, so too will the allocation of those rooms. I have to comply with the law today in terms of contracts but we are going to deliver the same rooms to the exact same specification as outpatient consult examination rooms and to the exact same specification as inpatient rooms as well. That is very significant progress for women in this country in terms of their own treatment.

Photo of Mick BarryMick Barry (Cork North Central, Solidarity)
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It is nothing to boast about that both public and private patients will have their own rooms. This is something that has existed for a long time in the National Health Service in the UK.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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Not here though.

Photo of Mick BarryMick Barry (Cork North Central, Solidarity)
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It is a real sign of the backwardness of the health service in this country that we have not had this up to now. It is not something to be boasting about.

Ireland is one of the few countries in Europe that does not have universal foetal anomaly screening and many pregnant women were not able to avail of that last year. If a woman has concerns about genetic defects, she has to pay for the tests. The nuchal translucency scan costs €250 while non-invasive prenatal testing costs €450. This is really backward.

I too look forward to the Sláintecare debate tomorrow. The sooner we get this for-profit, two-tier operation out of our health service and maternity services, the better.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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My party has signed up to the implementation of the Sláintecare report whereas I do not believe the Deputy has. I look forward to that debate as well. It is not a matter of boasting; it is a matter of actually acknowledging when we make progress. I am determined and proud that this Government will deliver a state-of-the-art world class national maternity hospital for women and infants in this country, something that has not been done and was not done even in the boom years.

Photo of Mick BarryMick Barry (Cork North Central, Solidarity)
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Single-tier.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I want to have a universal single-tier system. I ask Deputy to take up my invitation to go across to the National Maternity Hospital, Holles Street, and ask to meet with the master of the hospital, walk the facility and see the conditions in which women have to give birth in this country. It is not acceptable.

Photo of Mick BarryMick Barry (Cork North Central, Solidarity)
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It is outrageous.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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It was forgotten about, even in times of economic boom. We are going to do it and we are going to get it right. We have seen developments in regard to this project, with the Sisters of Charity withdrawing in recent weeks. I have made it clear that my Department, the Chief State Solicitor's office and St. Vincent's Healthcare Group are now in discussions in regard to the ownership model. We will get this right and we will build this. I share the Deputy's view that we are coming from behind when compared to where many other countries are in terms of capital infrastructure and single inpatient rooms. However, this is an example of good practice, which means we are going to deliver a high quality inpatient room to every woman, regardless of whether she is a public or private patient.