Catherine Connolly (Galway West, Independent)
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5. To ask the Minister for Health further to Parliamentary Question No. 136 of 21 June 2017, the progress that has been made on the relevant plan and the options appraisal in view of his approval, in May 2017, for the Saolta health group to develop a plan for the future of its hospitals and necessary service expansion and for the conduct of an options appraisal for the future acute hospital needs in Galway; if the process has begun; the completion date; the person or body carrying it out; the cost of same; and if he will make a statement on the matter. [41007/17]

Catherine Connolly (Galway West, Independent)
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This is a specific question and I would appreciate if the Minister answered it, rather than discussing the accident and emergency unit or other planned developments at University Hospital Galway. I am seeking specific information. In December 2016, the Saolta University Healthcare Group wrote to the Minister seeking approval to carry out an options appraisal in respect of a new hospital. The Minister waited five months before, thankfully, giving it permission to do so. It is almost October 2017 and I ask specifically whether the options appraisal has commenced. If so, when did it start, when is the completion date and who is carrying it out?

Simon Harris (Wicklow, Fine Gael)
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I will endeavour to answer Deputy Connolly's question specifically. She is correct that in May I gave my approval to the Saolta University Healthcare Group to conduct an options appraisal in respect of the future acute hospital needs in Galway. The structure of the hospital groups is such that my approval is not required for such an analysis to be carried out. It is the responsibility of the hospital groups to carry out analyses of their needs. The whole idea of establishing these groups was to avoid having everything being done centrally and to have the Saolta group and all other hospital groups examine their needs. Nonetheless, I assured the Saolta group that any funding costs it incurred would be met and that continues to be the position.

As part of the appraisal, the Saolta group is undertaking a medium-term planning project to assess the population health needs for University Hospital Galway's catchment to inform existing and future service needs. I am informed by the group that this process will be completed by mid-2018. I would welcome its completion as soon as possible, as would Deputy Connolly, because any further investment in Saolta hospitals will have to be considered by the Health Service Executive based on the strategic priorities put forward by the Saolta University Healthcare Group. For this reason, we need to hear from the group what are its priority projects for further investment.

In the interim, I have requested the Saolta group to provide a short-term plan for the University Hospital Galway and Merlin Park sites to maximise the effective use of both hospital sites to meet the demand for care. The Deputy indicated to me previously that more could be done, even on a short-term basis, on the Merlin Park site.

The Deputy clearly does not want me to speak about a number of other investments made in the Galway area. However, a new 75-bed ward block was recently completed at University Hospital Galway and a new acute mental health department is expected to be operational by the end of 2017. Planning is also under way for a new emergency department at University Hospital Galway. I instinctively share the Deputy's view that the Saolta group needs to revert with its appraisal of its future options. We have given it approval to complete this task and its work is under way. I am informed the work will be completed by the middle of 2018. The appraisal will inform us of what further investments we can and must make in Galway.

Catherine Connolly (Galway West, Independent)
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I thank the Minister for providing a completion date of mid-2018 for the appraisal. I also appreciate that he did not sidetrack from my question. I asked him not to do so because of the urgency involved. The Minister's party colleague in the Galway West constituency clarified through a question to the Minister that the hospital finds itself in the wrong position and unable to cope.

Today, I attended a meeting of the Committee of Public Accounts attended by representatives of the Health Information and Quality Authority, HIQA. I read some of the authority's reports on University Hospital Galway, one of which states, "The infrastructure and the design of the Paediatric Ward was outdated and as such had the potential to impact on effective infection control." The accident and emergency department has reached crisis point, while two theatres have been closed at Merlin Park Hospital as a result of a leak in a roof, an issue I will raise later in the Topical Issues debate. I could go on. The Government clearly has a role in this matter given the substantial capital outlay involved in building a new hospital. There are 150 acres available on the Merlin Park site. Higgledy-piggledy development is no longer acceptable because it was this approach that caused the crisis in University Hospital Galway. We want proper planning in Merlin Park rather than piecemeal development.

Simon Harris (Wicklow, Fine Gael)
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I do not disagree with anything the Deputy said. When people want responsibility to be devolved to the regions rather than exercised centrally, they must seize this responsibility. I have given the Saolta hospital group approval for the appraisal, if it ever needed it, and an assurance that the Department will meet the funding costs required to carry out a proper detailed appraisal. It will not only consider what projects need to be done immediately - some must be done and others have already been done - but will make a proper assessment of the planning and development of health services in Galway, which is a vibrant city and large county.

I acknowledge some of the progress that has been made by front-line staff and management in University Hospital Galway in recent times. The hospital is a pilot site for the national patient flow improvement programme and patient experience times have improved. For example, compliance with patient experience times for all patients of less than 24 hours in the emergency department increased from 93% to 98%. For those patients aged 75 years or older, compliance increased from 75% to 85% within the same period. That is not something to write home or get excited about but it shows that targeted investment in pilot projects is leading to improvements.

The new 75-bed ward block has been opened and 30 additional beds opened in early 2016 as part of the winter beds initiative. A new clinical research facility has been delivered, the maternity unit has been upgraded and a cystic fibrosis outpatient department was completed in 2014. I agree that a master plan is required and look forward to receiving it.

Catherine Connolly (Galway West, Independent)
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If the Minister continued to outline what he regards as improvements, I could not argue with him but all these improvements have added to the problems at the site. While a 75-bed unit was provided, the closure of two wards meant the hospital did not receive a single extra bed. The new mental health facility has been delayed and will not open until the end of the year. It also has implications for car parking at the site. There are 40 patients on trolleys in University Hospital Galway, where the number of beds has been reduced from 812 in January 2006 to 655 at present. We have a major crisis.

The Minister referred to good planning. There has never been good planning regarding the regional hospital in Galway. It has been forced ó ghéarchéim go géarchéim - from crisis to crisis - and has never had the luxury of long-term planning, nor the support of any Government. With the exception of today, every time I have asked a question since my election almost two years ago, I have been given a list of positive developments that will make a congested site more congested. Am I to understand from the Minister's reply that by mid-2018 we will have some answer with regard to planning for a new hospital on the 150 acres available at the Merlin Park site?

Simon Harris (Wicklow, Fine Gael)
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What I am telling the Deputy is that I expect an options appraisal paper by mid-2018, if not earlier. I would welcome the paper as soon as the Saolta group has completed it. The paper will indicate to the Government, Oireachtas and HSE how the group would like to develop its services. It is not for me to tell it how it should develop its services. What is the point in having a group and people in positions to manage the service if I try to micro-manage services? I have given the group the go-ahead in terms of funding to produce an options appraisal. If that plan is delivered to me, I assure the Deputy that the Government and I, as Minister, will support proper planned development of health services in Galway.

As the Deputy will be aware, the original emergency department at University Hospital Galway was constructed in the 1950s and upgraded in the late 1990s. The department accommodates more than 62,000 attendances per annum and sees 130 patients on a weekend and approximately 270 patients every day during the working week. We need proper planning in this area. The position in Galway is a microcosm of the broader challenges we face in terms of proper, long-term planning. I look forward to receiving the options appraisal from the Saolta group, acting upon it and liaising with Oireachtas Members from Galway.