Michael Harty (Clare, Independent)
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This is a very important question for the mid-west, particularly in the context of the controversies that are raging in so many areas of our health service. There is disquiet and frustration in the mid-west that the regional hospital, University Hospital Limerick, is first or second in the number of people waiting on trolleys for admission on a daily basis.

There are two proposals to address this. One is to build a permanent 96 bed unit at the regional hospital in Limerick. To my knowledge, that has not got to design stage. The other is an interim proposal to build a 60 bed modular unit at Limerick to try to deal with the trolly crisis that faces the hospital each day. On 5 November the Minister for Health announced in Limerick that funding had been committed for this urgent 60 bed modular block at University Hospital Limerick. The unit is expected to cost €19.5 million. There is every expectation in the mid-west, in Clare, Limerick and north Tipperary, that this would be completed by the end of this year.

University Hospital Limerick suffers extreme overcrowding. This is the result of reconfiguration almost ten years ago where beds were closed in Ennis and Nenagh but no replacement beds were provided in the regional hospital in Limerick. Since then the population of the area has expanded. The population is not only growing but also ageing and we know that it is older people who occupy beds for prolonged periods. We need this 96 bed unit to be provided on a permanent basis, but it is also necessary for the 60 bed modular unit to be provided as urgently as possible. The 60 bed modular unit is not a permanent solution but it is an important element in dealing with overcrowding.

Recently, doubt has been cast over whether the promised money will be produced and whether it will continue to be part of the capital plan. Recently the Minister of State, Deputy Pat Breen, expressed on local radio the hope that the money would be available but he could not confirm that it would be. This has caused great frustration in the mid-west. Two issues must be dealt with. When will the capital plan for 2019 be announced? Can the Minister of State confirm that it will contain the building of the 60 bed modular unit? What is the current status of the contract? When will tendering be made and when will contracts be signed? Construction is expected to take 300 days. If we are to have that by the end of 2019, construction must start immediately. When will the first patient be admitted to that block?

Then there is the issue of the 96 bed permanent unit. When will the funding be made available through the capital plan for that permanent 96 bed unit? How much will this cost? There is great controversy over how building projects such as this are tendered, procured, designed and built. Can the Minister of State confirm a costing has been placed on this 96 bed unit? What is the current situation in relation to design and planning and when does the Government expect the work to begin?

Finian McGrath (Dublin Bay North, Independent)
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I thank the Deputy for raising this important issue. I am very well aware of the situation in University Hospital Limerick and have direct experience from a family point of view.

I welcome the opportunity to update the House on the capital development projects at University Hospital Limerick, UHL. UHL is a model 4 Hospital and provides major surgery, cancer care treatment and emergency care in the region, as well as a range of other medical, diagnostic and therapy services. All critical care services are located here and it has one of the busiest emergency departments in Ireland with annual attendances of approximately 65,000 presentations and the only 24-7 emergency service in the University of Limerick Hospital Group. UHL is one of eight designated cancer centres.

A new emergency department opened at UHL in May 2017.

The new facility is triple the size of the old emergency department and immeasurably improves the experience of patients in terms of their comfort, privacy and dignity. The new emergency department is equipped with a CT scanner, which is considered international best practice.

As the Deputy will be aware, there are two distinct proposals for the development of ward accommodation at UHL. The HSE is working towards appointing a design team for the 96-bed acute ward block there. The timeframe for the completion of the project will be informed by the work of the project team, which will be undertaken in conjunction with UHL and the HSE. The required capital allocation for the project is being reviewed in preparing the 2019 capital plan.

The Minister for Health recognises that hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged over the winter months. Increasing capacity is therefore a priority for the Government. Over the past 12 months, an additional 240 beds have been opened, including 17 short-stay beds in UHL. The HSE's national service plan 2019 provides for a comprehensive capacity programme. This includes eight additional beds for UHL, five of which have already opened as part of the winter plan 2018-2019.

Last autumn, the Minister announced that a modular ward block would be built at UHL to provide interim accommodation. This 60-bed block will have three wards comprising 20 single-room occupancy with en suite facilities, two of which will be full isolation facilities and will provide care and treatment for patients from admission to discharge. The 60 single rooms will improve patient comfort, safety, privacy and dignity and assist with the management of infection control in the hospital. The additional 60 beds will also directly increase capacity, allowing patients access to an increased overall bedstock and improve patient flow across the hospital.

The Minister has set the construction of the UHL modular ward block as a priority. Following the publication of the national service plan for 2019, the HSE is currently finalising its capital plan or 2019 and funding will be provided to allow this important project to progress.

Michael Harty (Clare, Independent)
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When will the 60-bed modular unit be delivered? According to the Minister of State, capital funding will be made available. While we accept that, the capital plans for 2019 to 2021 are being reprofiled and we do not know whether that funding will be available. The 60-bed modular unit needs to be made available urgently. It cannot be put off until 2020 or 2021. I understand that it will be prioritised, but there are so many competing priorities in our health services that we are concerned this one will not be given sufficient priority to see it delivered in 2019, as promised by the Minister last November. We need clarity.

The mid-west has other urgent needs. For example, there was a proposal to build a 100-bed hospital to replace St. Joseph's Community Hospital's unit for elderly care on a greenfield site. What priority will that be given? It influences how people are discharged from our model 4 hospital in Limerick. That 100-bed unit was to be built and ready for occupation in 2021 as a priority, but we are now worried that it will be reprofiled off the priority list.

There is a plan to build two primary care centres in Ennis, which has never been lucky enough to get such a centre. When will they be delivered? There is also a proposal to move the outpatient department from Ennis general hospital to a new location. Will that be reprofiled and put on the long finger? The hospital is unfit for purpose. When will the upgrading of equipment and theatres in Ennis be delivered?

There are many more issues in the mid-west than just the 60-bed modular unit or the 96-bed permanent unit. When will they be prioritised and delivered?

Finian McGrath (Dublin Bay North, Independent)
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I take the Deputy's point. I have been told that this development will be a priority. UHL is an integral part of the University Limerick Hospitals group, providing health services and care to the people of Limerick and the mid-west. The hospital provides quality patient care delivered safely by skilled and valued staff through the best use of available resources. This has been achieved through the commitment, hard work and professionalism of all its staff.

The Deputy discussed a number of other issues, including St. Joseph's Community Hospital and sick patients. I will raise them with the Minister. This Government is committed to developing services and infrastructure at UHL. Funding will be provided in 2019 for these projects.