Seán Crowe (Dublin South West, Sinn Fein)
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The good news can wait.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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We are nearly ready.

Seán Crowe (Dublin South West, Sinn Fein)
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This Topical Issue matter relates to the dialysis unit in Tallaght Hospital. The HSE and the Dublin Midlands Hospital Group agreed in 2017 that the building of a new unit would proceed, but inexplicably in January this year that proposal was cancelled. The existing unit is operating above capacity and cannot cope with the numbers attending. Clearly, there are problems in the delivery of the service.

Finian McGrath (Dublin Bay North, Independent)
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I thank the Deputy for raising this very important issue and giving me the opportunity to address the House on behalf of the Minister for Health.

The Minister wishes to acknowledge the distress overcrowding in the dialysis unit at Tallaght Hospital may cause to patients, their families and the front-line staff working in very challenging conditions. Improvements in healthcare delivery have resulted in the improved survival of all patients, particularly those with diabetes and suffering from hypertension. This, coupled with the increased prevalence of both diseases, have led to a progressive rise in the numbers of patients presenting with end-stage kidney disease who require dialysis. The Minister accepts that the haemodialysis service in the dialysis unit at Tallaght Hospital is under increasing pressure to meet the new level of demand and ensure the provision of timely, safe and effective care for patients.

The dialysis unit at Tallaght Hospital was designed in 1985 and the Minister is aware that there are challenges in complying with current clinical guidelines and concerns about infection control. The dialysis unit is operating at full capacity and there is no scope to increase capacity because of infrastructural issues. In the short term, to address the requirement for additional haemodialysis service capacity, consideration is being given to providing additional funding to enable the hospital to outsource additional haemodialysis sessions to satellite dialysis units. The Deputy will be aware that in the longer term the development of a new facility to replace the existing dialysis unit is planned. The importance of the project is acknowledged as it reflects a long-standing need to upgrade dialysis facilities. Detailed designs have been completed and planning permission has been obtained for the project. The Minister understands that in December 2017 the hospital invited contractors to tender for the works and that the tenders have been evaluated. He further understands from the HSE that its directorate recently approved the award of the contract for the project and that this will be formally communicated to the hospital in the near future. The hospital will continue to work with the HSE to complete the project.

Seán Crowe (Dublin South West, Sinn Fein)
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While I welcome the good news that the project will go ahead, I have a difficulty because similar news was relayed previously to the hospital authorities and the patients who use the facility. In that context, I am seeking an assurance from the Minister of State that the project will definitely go ahead. The dialysis unit at Tallaght Hospital is clearly not fit for purpose, given the number of patients being treated and the pressures on staff. There is also a danger of cross-infection because the beds are so close to each other. The HSE is spending over €4 million on private dialysis services and a further €1.2 million on patient transport services. What is happening does not make sense on either health or financial grounds. Clearly, if a commitment is given to go ahead with the project, it must be honoured. As I said, it was agreed to in 2017, but inexplicably the proposal was pulled in January this year. There is no problem with planning permission and the building of the new unit would not have a negative impact on the hospital or patients. It can be built quite readily and is badly needed to increase capacity. The Dublin Midlands Hospital Group is supportive of the project which forms part of the Government's national service plan. While I welcome the announcement made by the Minister of State that the project is to go ahead, my worry and that of everyone associated with the dialysis unit at Tallaght Hospital is that the development might be cancelled again. I have raised the matter on numerous occasions by way of a Topical Issues debate and parliamentary questions to the Minister. I have also written to the HSE about the matter. It is welcome that things have moved on, but the next step is critical.

Finian McGrath (Dublin Bay North, Independent)
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I totally accept the points made by the Deputy, particularly about the €4 million being spent on private dialysis services and the €1.2 million being spent on patient transport services. The number of dialysis treatments at Tallaght Hospital has increased to more than 30,000 per year. The dialysis unit had been designed to provide 9,000 treatments per year but had to provide 13,000 per year. The remainder were provided in the aforementioned satellite dialysis units. This level of activity is more than double the national average. However, the Minister accepts that satellite dialysis units cannot manage complex medical disease cases. He is fully aware of the overcrowding in the dialysis unit at Tallaght Hospital and monitoring the position closely. The Department of Health, the HSE and the hospital are working to address the capacity issues in both the short and medium term and taking measures to improve the position. The award of contract has been approved. I will push the issue very strongly and assure the Deputy that work will continue and that developments will be closely monitored.