Martin Heydon (Kildare South, Fine Gael)
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I thank the Minister of State for taking what is a very important Topical Issue matter relating to the provision of health services in County Kildare and west Wicklow, as well as the infrastructure we have for those health services. As the Minister of State is aware, Naas General Hospital is an acute hospital with 243 beds, providing inpatient, general medical, surgical and acute psychiatric services, as well as a 24-hour emergency service to its immediate catchment population of Kildare and Wicklow. That is close to 250,000 people. Naas General Hospital works closely with Tallaght hospital and shares many consultant posts. Naas General Hospital is part of the Dublin Midlands Hospital Group, as the Minister of State knows, and Trinity College Dublin is the academic partner.

The hospital's current endoscopic unit is within one building that has been deemed not fit for purpose following a joint advisory group inspection in 2009. It comprises one endoscopy room in a prefabricated structure and the Minister, Deputy Harris, visited it last November and is very aware it is not fit for purpose. Endoscopy and day ward development for the Dublin Midlands Hospital Group is a key enabler for group-wide development and cross-site work, particularly with regard to Naas and Tallaght. Naas General Hospital received planning permission in January 2015 for the development of the new endoscopy and day ward unit, which would increase day ward capacity from 11 to 25 day beds. I will touch later on some of the demographics of County Kildare and west Wicklow, with their rising populations, and the staff and management in Naas are doing an amazing job despite increasing attendance at the hospital. For example, accident and emergency attendance has increased more than 4% and inpatient attendance has increased by more than 2%. There are capacity issues in Naas due to the increased volumes and staff are doing a remarkable job. Staff morale has been affected by the fact that a previous Government ten years ago promised this endoscopy unit. There was a belief it was coming but it never materialised.

As we head into review of the capital plan, this is a crucial development for health services in Kildare. There is a bigger benefit. The Minister, Deputy Harris, had meetings at the end of last year and in Leinster House this year with the consultants from the endoscopy unit in Naas and representatives of the hospital group. The strongest case did not come from Naas but from Dr. Susan O'Reilly, and those from St. James's and Tallaght hospitals, who will see a major benefit in Naas developing its endoscopy unit. There will be a benefit for Kildare residents who will not have to travel and there will also be a reduction in waiting lists, and St. James's Hospital has very significant urology waiting lists. The capacity element and these benefits mean there is a really strong business case for this to happen.

Enabling works for the project have been carried out already, which primarily consist of an upgrade to the hospital power supply system. They were undertaken between 2014 and 2016 at a cost of €1.5. The project is very much shovel-ready and unlike other projects in the hospital grouping, if we can secure State funding for it, we can go straight away. It has gone through all the approval processes with the Health Service Executive and design and planning stages are complete. It is ready to go. However, the capital cash flow required to fund the project is awaited and not yet allocated.

The cost of the proposed new build is €11 million spread over three years and, depending on start date and phasing options, the cost may be spread, with approximately €2 million in year one, €5 million in year two and €4 million in year three, so all the €11 million would not be needed up-front. As a key priority, the project would increase our ability and capacity manage our increasing elective workload across a range of services for Kildare and west Wicklow in the Dublin Midlands Hospital Group in specialist areas such as ear, nose and throat treatment; urology; neuroology and gastroenterology. Naas and Tallaght hospitals have recently appointed consultants in all these areas and these are excellent practitioners, working under difficult conditions. They deserve better and increased capacity so we can tackle waiting lists and ensure Kildare people do not have to travel for such services or wait any longer than they do.

Jim Daly (Cork South West, Fine Gael)
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I thank the Deputy for raising this important matter. It is timely as the Departments of Health and Public Expenditure and Reform are facing into the mid-term review of the capital spend. I appreciate it and it is helpful for the officials in my Department in trying to secure necessary funding for very important projects. The Deputy made the point very well about the importance not just of this project as a standalone issue but it serves a population of more than 220,000 people. It is networked with bigger hospitals in Dublin, with an overall benefit accruing to the hospitals with the supply of an important service. I welcome Deputy Heydon's focus on this project. It is vital that my Department gets this funding under the mid-term review to progress this worthy project.

I welcome the opportunity to update the House on this Naas General Hospital project. As the Deputy will be aware, my colleague, the Minister for Health, met the management of Naas hospital in April 2017 to discuss the plans for increased endoscopy and other health care services. The Dublin Midlands Hospital Group advised that this new development is a key strategic priority for the group. This development would help to clear the significant urgent scopes waiting list and Naas hospital would become a major ambulatory centre within the hospital group. This development would also enable significant strategic links to be developed between Naas, Tallaght and St. James's hospitals.

The project to be delivered at Naas General Hospital is more extensive than the endoscopy services department and associated works. It also includes accommodation and ancillary services to support the new physical medicine, physical therapy, oncology services and day procedures departments; a duplex - rather than simplex - reverse osmosis filtration system; and two lifts. All stages of capital projects, including the design and tendering processes, are subject to review to ensure the projects deliver value for money. This includes, where possible, future proofing to ensure capital developments meet not just current standards but that provision is made for additional capacity and improved equipping, and that these are addressed appropriately. This has resulted in a significant increase in the scope of the project and as a consequence its estimated cost.

I can confirm the Department has forwarded its submission under the mid-term review of the capital programme to the Department of Public Expenditure and Reform. The submission is based on the projected funding requirement arising from existing commitments, strategies, demand-led service needs and commitments contained in the programme for partnership Government. At this stage in the process it is not proposed to specify the individual project details contained in the Department's submission. However, as with all health care projects, including this project, further investment in hospitals must be considered within the overall acute hospital sector infrastructure programme, the prioritised needs of the hospital groups and within the overall capital envelope available to the health service. I will be happy to keep the Deputy updated on this important project.

Martin Heydon (Kildare South, Fine Gael)
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I thank the Minister of State for his response and it is good to know this has been an important part of the Department of Health's application to the Department of Public Expenditure and Reform for its consideration as part of the critical capital plan. For me, that is about all the different parts of infrastructure in this country that we will develop for the betterment of citizens. There are many cases where it makes economic sense to spend money on infrastructure that will lead to savings and this is a perfect case in point. It is about developing and expending the endoscopy unit at Naas General Hospital and the hospital grouping of which Naas is a part. The group has identified efficiencies and Tallaght hospital is currently renting rooms at the Beacon Hospital for endoscopic services. If this unit at Naas was completed, the group could use it instead and generate savings for the group as a whole. St. James's Hospital would also use Naas for urology services. The completion of this new unit and extension would secure the future of Naas hospital as a key strategic part of the group. It is very important to the people of Kildare and west Wicklow but it is important we solidify its base within the group as a whole for the future.

I wish the Minister of State well in his new role with responsibility for mental health and older people. I look forward to him visiting Naas and Kildare, where there is a large population of older people because of the large number of nursing homes in our county. That is because of our close proximity to Dublin. Similarly, we have one of the youngest populations in the country and our mental health services are not fit for purpose. The former Minister of State with responsibility for mental health, Deputy McEntee, visited us recently and we have received an allocation for the expansion of the Lakeview unit at Naas hospital.

There is potential for further expansion. I know the Minister of State if aware, as we discussed it previously and will explore it further, of the need to ensure that Lakeview mental health services are fit for purpose for the next generation because they do not have the capacity currently to meet the significant demand in Kildare. That, along with the endoscopy unit, is a vital investment we need to see in our health services in Kildare. I look forward to working with the Minister of State and the Minister for Public Expenditure and Reform on it into the future.

Jim Daly (Cork South West, Fine Gael)
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I thank Deputy Heydon. I assure him of the Government's commitment to the future of this hospital and to seeing it progress, and not just as a stand alone project. This year, €58 million has been committed to Naas General Hospital, which is a very significant part of the health budget and is well deserved. I pay tribute to and acknowledge the commitment and dedication of the staff in the hospital but also the management team, the hospital network and group that are looking ahead. They will have their ducks in a row to ensure that Naas General Hospital can avail of the funding that will become available in any capital development plan. I commend them for future proofing those projects and for their forward thinking in that regard. The integral role Naas General Hospital plays is recognised, not just in terms of the immediate catchment area of almost 1.25 million people but in terms of the entire hospital network, including St. James's and Tallaght hospitals. The number of people it serves is a crucial cog in that wheel. That is well recognised by the Department and the Health Service Executive and will ensure that these projects are progressed in a timely and progressive manner. I thank the Deputy for his interest in the project and ensuring that it receives ongoing attention at a political level and proceeds to completion. We all want to see those stages.

On the Deputy's closing comments about mental health services, I would be delighted to take him up on his invitation to visit the area to see what is not working and, more importantly, what is not working with a view to seeing how we can, with his help and that of the other Members in the Kildare, address the shortcomings in the services. I look forward to that.