Dáil debates

Wednesday, 30 January 2019

Saincheisteanna Tráthúla - Topical Issue Debate

Hospital Services

2:10 pm

Photo of Seán HaugheySeán Haughey (Dublin Bay North, Fianna Fail)
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The programme for Government contains a commitment to "commence the design of a new ED in Beaumont later this year with a view to funding for the construction being provided as part of the 2017 Capital Plan Review." It committed also that:

The new Government will immediately proceed to the design and planning stage for a dedicated Cystic Fibrosis Unit at Beaumont Hospital Dublin for inclusion in the 2017 Capital Plan review. The HSE Cystic Fibrosis Clinical Programme will make further recommendations in the next few months, following a survey of centres and will complete a CF model of care policy.

I am glad the Minister of State, Deputy Finian McGrath, is here because I know he is probably responsible for including that in the programme for Government and has a big interest in these issues.

Beaumont Hospital is one of the busiest in the country and it opened in 1987. It treats in excess of 45,000 patients a year and yet there has been no major investment over the last 30 years. It is operating at maximum capacity while wards are forced to close to facilitate essential temporary refurbishment. Staff are being forced to work under difficult and stressful conditions with limited space and resources to effectively treat patients. The facilities in the emergency department at Beaumont Hospital are in urgent need of investment and improvement. In short, it is not fit for purpose and the people in the area know that.

As it stands, it seems little progress has been made to meet the commitment outlined in the programme for Government to construct a new modern emergency department that is fit to deal with the needs of the large growing population of north Dublin and beyond. This area of north Dublin has a large elderly population and these are the people who primarily rely on the services provided in the emergency department. However, they are fearful to attend the department given the current pressure it is under. The need for a new emergency department in Beaumont Hospital is a major concern for north Dublin. It seems we are nowhere near turning the sod on this project, let alone opening its doors.

What concerns me are the cost overruns in the national children's hospital. The figure for that project is now €1.73 billion and in that regard, €100 million will be needed this year alone. The Taoiseach spoke in the Dáil recently of "re-profiling" projects. I have not heard that word before and it is a very creative word. The overrun of the national children's hospital must have implications for all the other capital projects in the pipeline. I heard the Minister of State on the news one evening saying the situation in Beaumont Hospital was a bottom line for him and in respect of his commitment to the Government generally.

On the cystic fibrosis unit, this is estimated to cost €11 million. I saw reports recently that a planning application is about to be submitted and I would welcome an update on that. The Minister of State will appreciate this is life and death matter. It is of very serious concern to cystic fibrosis patients. Cystic Fibrosis Ireland said that rooms currently used by people with cystic fibrosis were sometimes required by those waiting for a transplant or end-of-life care. These beds need to be provided at Beaumont Hospital and we need to push this project as it is a huge issue.

In terms of the progression of the CF unit capital project, I was informed by the Minister for Health in July of last year that it has been included in the national planning framework under Project Ireland 2040 as well as being recommended for inclusion in the capital plan by the HSE national capital steering committee.

We need these projects. I know the Minister of State is personally committed to them but he has to accept that there have been delays. I would welcome an update on these issues.

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent)
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I thank Deputy Haughey for raising this important issue and for giving me the opportunity to provide an update to the House on the provision of the new accident and emergency department and the new cystic fibrosis unit at Beaumont Hospital. I appreciate the fact he has raised this issue and is very supportive of it. I would agree with many of the comments he made.

As the Deputy is aware, the Programme for a Partnership Government contains commitments to the development of a new accident and emergency department and a new dedicated cystic fibrosis unit at Beaumont Hospital. I am the person, as the Deputy correctly identified, who included both of these projects in the programme for Government.

On the new emergency department, funding of €100,000 was allocated in 2018 to progress this project to design phase. Councillor Damien O'Farrell, one of my advisers, is driving these two projects with the Department and Government.

The HSE gave written approval for the funding which allowed Beaumont Hospital to go ahead with an EU procurement process for the selection and appointment of a design team for the project. The timeframe for the completion of the emergency department project will be informed by the work of the project team and this work will be undertaken in conjunction with the hospital and the HSE.

With regard to the cystic fibrosis unit, the project will be underpinned by the model of care for people with cystic fibrosis in Ireland which has been developed by the national clinical programme for cystic fibrosis. This will set out standards and requirements for the physical and human resources to be provided for treatment of cystic fibrosis patients from a national perspective. This model of care has been written and is undergoing the final stages of approval. The model of care states that adult cystic fibrosis units must have dedicated single inpatient isolation rooms with en suite facilities. The number of rooms will depend on the number of patients and there should be five inpatient rooms for every 50 adults with cystic fibrosis attending a unit.

Beaumont Hospital submitted a planning application to Dublin City Council on 6 December 2018 for the development of the new cystic fibrosis unit. As I speak, the planning application is up on the wall at the entrance to Beaumont Hospital. The hospital has informed the Department that "the programme of works, if commenced and delivered aggressively and without foreseeable delay, is estimated at 24 months subject to planning permission".

The national development plan, NDP, provides €10.9 billion for health capital developments across the country, including national programmes and individual projects across acute, primary and social care. Health capital projects and programmes currently under way will continue.

Following the publication of the its national service plan for 2019, the HSE is currently developing its capital plan for 2019. The HSE capital plan will determine the projects that can progress in 2019, having regard to the available capital funding, the number of large national capital projects currently under way and the relevant priority of each project. I reassure the Deputy that, despite the debate on the overruns for the children's hospital, about which we are all very upset, these two projects at the emergency department and the cystic fibrosis unit will not be affected, and I have received that commitment from the Government. The requirements of the new cystic fibrosis unit and the emergency department at Beaumont Hospital and other health capital projects, currently at various stages of development, are being considered as part of the capital plan process. When the HSE has finalised its capital plan for 2019, it will be submitted to the Minister for Health for consideration.

I agree with the Deputy that the bottom line is that the emergency department project needs to be done. The people of the area and throughout Dublin Bay North need a new emergency department and we also need the new unit for children and families affected by cystic fibrosis. The planning permission for the unit is up on the wall and we need to drive it on. I will continue to ensure we drive it on within government.

2:20 pm

Photo of Seán HaugheySeán Haughey (Dublin Bay North, Fianna Fail)
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I do not doubt the Minister of State's commitment to these projects but, as I said, the timescale has slipped and there are delays. Beaumont Hospital was opened in 1987 and there has been no major capital investment since then. The services provided there always seem to be on a knife-edge, and while they are first-class services, it needs major capital investment, in particular in the emergency department. People report sitting on plastic chairs for hours at a time and not being admitted, and so forth. The physical infrastructure of the building needs to be modernised, changed and reconstructed.

I accept that procedures have to be followed and that there has to be a stage 1, 2 and 3. I recall being in the Department of Education and Skills and dealing with a school building project that seemed to go through endless stages before a sod was turned or a building opened, and it would seem this is the case with regard to these HSE projects. While the procedures have to be followed, I hope the procedures and stages are not just put in place to delay because the money is not available.

I welcome the Minister of State's commitment and statement that despite the overrun in the cost of the children's hospital, which will now cost €1.73 billion, these two projects will not be reprofiled, deferred or delayed. That is a very important commitment.

In regard to the cystic fibrosis unit, we are coming up to purple rose day, which is organised by Cystic Fibrosis Ireland, yet it is reported that patients and sufferers of cystic fibrosis and their families are deeply upset that this project is not up and running. As the Minister of State said, these projects need to be drive on and brought to fruition.

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent)
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I again thank the Deputy for raising the issue. The Government and I are particularly committed to supporting hospitals to develop their services. Of course, I take the point regarding the need to support Beaumont Hospital. With regard to capital investment there, in 2016 we had the opening of the new, world-class kidney unit at a cost of €6.5 million. The wards and rooms in it are fantastic and I commend the staff and the team directly involved in that. Nonetheless, we need more.

Under the NDP, capital funding for the health service will be 165% higher for the next ten years than it was for the past ten years, which will make up for all the bad years. There has been a sea change in commitment to capital investment in the health services, with €10.9 billion available over the next ten years. The development of the new emergency department and the dedicated cystic fibrosis unit at Beaumont Hospital is progressing. We agree the hospital has the reputation for high quality and safe care of patients. The development will support the delivery of key services to all the patients in the hospital. When we talk about big plans such as the NDP, people are right to question them, but the bottom line is the emergency department and the cystic fibrosis unit at Beaumont Hospital have been included in the plan. It is my job as Minister of State, particularly as the local Minister of State, to drive these projects on and I will absolutely do that. As I said, the planning permission for the cystic fibrosis unit is up on the wall but we need to drive these projects on.