Dáil debates

Tuesday, 11 June 2019

Saincheisteanna Tráthúla - Topical Issue Debate

Hospitals Funding

6:35 pm

Photo of Micheál MartinMicheál Martin (Leader of the Opposition; Cork South Central, Fianna Fail)
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I again raise the issue of the plans to extend and build a new children's unit in Cork University Hospital, CUH. The Minister of State will be familiar with this but I must articulate my extreme concern at the lack of transparency and honesty in answering clearly whether there is a specific budget for this project and a meaningful timeline for its planning and extension. The Minister of State will be aware that the development of regional units is an essential part of the national paediatric model. Substantial funding has been allocated for the national children's hospital. It will probably cost up to €2 billion, and that involves the completion of Blanchardstown and Tallaght hospitals.

The national model of care for paediatrics involves regional units, Cork being the largest of those and Galway and Limerick the others. The funding envelope for the Cork project was estimated to be between €34 million and €38 million. It was approved for preliminary planning in 2015. There are issues not only in respect of the building, but in the availability of surgical and anaesthetic care. It is available at the moment but the facility has to be built, otherwise the capacity of Cork to attract and retain sufficient paediatric anaesthetic and surgical cover will erode. That will have serious implications for the national children's hospital, and, particluraly, for children in the Munster region in particular, because the Cork paediatric facility is essentially a Munster facility. It performs 5,000 operations at the moment. The national children's hospital would not be able to take that volume of surgical demand on board. In addition, the paediatric centre in Cork deals with paediatric neurology, respiratory, cystic fibrosis, endocrinology, diabetes, allergy, and cardiology cases. It is delivering specialist care as close to home as possible, in line with the national model, in all of those specific areas and it does approximately 5,000 operations per annum. Crumlin does approximately 22,000 at the moment.

We have received different answers to various questions we have put on this.For example, last March, it was stated that funding had been provided for the detailed planning, and that it was funded up to 2019 for detailed planning and design. That reply was signed by Jim Curran, the head of estates in the HSE. Furthermore, on 3 May, I received another reply which stated:

The preliminary scheme design has been completed of the proposed extension to the Cork University Hospital paediatric unit and reviewed by the CUH project team. Progression to the next stage of developed design and submission of a planning application is subject to the availability of capital funding. The HSE capital plan for 2019 is currently being finalised and will be submitted to the Minister for consideration.

That differs from the reply that was given to my colleague in March, which suggested that all the funding was provided for the detailed planning and design and that it was fully funded. I have the letter from 12 March, signed by Jim Curran, which stated that CUH was at stage 1 and was funded up to stage 2b, which is detailed design and planning. That seems to suggest it was covered for detailed design and planning. It also stated that a capital submission to the national capital and property steering group was being prepared. This was back in March. People who are on the ground working in the hospital are fed up of all the verbosity and meaningless language around this. They want to know whether this is provided for in the capital plan for 2019, 2020, and 2021, because we know that the memorandum from the Department of Public Expenditure and Reform to the Government on broadband mentions the need for €343 million for the national children's hospital. We need straight answers because otherwise, it seems to me that the regions, and the Cork facility in particular, are being neglected. I want a straight answer.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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I welcome the opportunity to update the House on the paediatric development at CUH. A national model of care for paediatric healthcare services in Ireland has been developed by the HSE and sets out a vision for high quality, integrated, accessible healthcare services for children from birth to adulthood with an emphasis on early detection and prompt treatment.

The model will ensure that all children access high quality services in an appropriate location and within an appropriate timeframe. The model of care explicitly supports the development of the new children's hospital and an integrated national network of paediatric units. This will strengthen the connections and roles for local and regional paediatric units, including the regional unit in Cork University Hospital, CUH.

As the Deputy is aware, there are a number of distinct phases within the proposed paediatric developments at CUH. The HSE has advised the Department that phase 1 of the development has recently been completed and entails an outpatient facility and day-care, including a separate outpatient clinic facility for children in CUH, plus day-care for surgery and facilities for children living with diabetes and cystic fibrosis and their medical and nursing teams. There is also an attached facility for paediatric medical education.

Phase 2 of the paediatric development includes 74 inpatient paediatric beds and enhanced facilities for children who have to spend some time at the hospital. It is currently at the design stage. Capital funding for phase 2 is provided up to the detailed design and planning stage in 2019. I understand from the HSE that a capital submission for phase 3 of the development is being prepared to enable the "shelled" construction of this phase during the construction of phase 2. This submission will be considered by the HSE's capital steering committee.

I am happy to confirm that the paediatric development at CUH has been included in the Project Ireland 2040 policy initiative announced last year. This provides €10.9 billion for health capital developments across the country, including national programmes and individual acute, primary and social care projects. The delivery of these projects and programmes, including developments in Cork, will result in healthcare facilities that allow for implementation of new models of care and the delivery of services in high quality modern facilities.

My Department is continuing to work with the Department of Public Expenditure and Reform and the HSE in a process to finalise as soon as possible a multi-annual capital plan for the HSE, which will include capital projects to be funded in 2019 and beyond, having regard to the available capital funding and the number of large national capital projects currently under way. The availability of funding determines the timeframe for the delivery of capital projects such as the proposed paediatric development at CUH. It is important to recognise that all capital development proposals must progress through detailed appraisal, planning, design and tender stages before a firm timeline or funding requirement can be established.

6:45 pm

Photo of Micheál MartinMicheál Martin (Leader of the Opposition; Cork South Central, Fianna Fail)
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It is time for honest and straight answers. This is a variation of the same reply that has been given for the past six months, maybe even the past 12 months. It is incredible that the capital plan for 2019 has not yet been finalised and published even though we are in June. Is the Government taking people for a joke? This is crazy stuff. The Government is still considering the capital plan. I have told the House what Mr. Jim Curran, the HSE's head of estates, wrote to me, namely, that progression to the next stage of development, design and submission of a planning application was subject to the availability of capital funding. Is that capital funding available for the detailed planning and design stage? Is funding available for the hospital's construction?

In terms of paediatric care, this represents a shocking discrimination against the regions. Three facilities in Dublin are covered - that is fine and I wish them the best of luck and I have no issue there except with the inability to control costs - yet there seems to be nothing for the rest. I would ask the Minister of State to contradict me. Is it the case that funding has not been provided for this project over the next three years? Is it the case that no capital money has been provided for this children's facility in 2019, 2020, 2021 and 2022? Can the Minister of State contradict me? I would be happy if he could, but it is time to be honest with the people on the ground who are providing this service. They cannot find answers.

Do not cite Project Ireland 2040. It is a wonderful piece of fiction and made it into the geography exam in this year's leaving certificate. The terminology involved in that surprised me a little by the way, but the question of who is setting exams these days and the politics of that is another day's work. Project Ireland 2040 is a piece of fiction, though. People want to know what the budget for 2020 to 2023, inclusive, will be. I read the memo from the Secretary General of the Department of Public Expenditure and Reform regarding the broadband plan. He is saying that the Government's national development plan, NDP, figures do not align with the reality of available funding. It is time to come clean and tell the people of Cork whether money will be available in the next two or three years. Please, do not mention Project Ireland 2040.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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I promise not to mention it so as to avoid the risk of annoying the Deputy opposite, but I will not announce the details of the capital spending plan now. They must be submitted by the HSE and finalised.

Photo of Micheál MartinMicheál Martin (Leader of the Opposition; Cork South Central, Fianna Fail)
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But this is June.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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A submission has been made to the HSE to include phase 3 in its capital plan, but it is yet to be finalised by the HSE's steering committee on capital projects and submitted to the Minister. As such, I cannot preordain what the plan will contain or announce it selectively in the Chamber on a case-by-case basis. We must wait to get the plan from the HSE. When it comes to the Department, the Minister, Deputy Harris, will be in a position to confirm funding, but I cannot do so ahead of then.

I do not see anything dishonest in my reply. I have given the House the facts as they are.

Photo of Micheál MartinMicheál Martin (Leader of the Opposition; Cork South Central, Fianna Fail)
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The Minister of State has been given a reply that he has read out.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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I refute the Deputy's allegation that there is a dishonest element to the reply. I cannot preordain what will happen with the capital plan. When the Department receives it from the HSE, the Minister will publish it for everyone's information.

Photo of Micheál MartinMicheál Martin (Leader of the Opposition; Cork South Central, Fianna Fail)
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Is there funding to take this project to the planning stage?

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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It is funded up to the detailed design and planning stage. The Deputy understands the phases of development from when he worked in what is now the Department of Health.

Photo of Micheál MartinMicheál Martin (Leader of the Opposition; Cork South Central, Fianna Fail)
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I understand the language the Minister of State has read out. It tells me that nothing is happening.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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A submission in respect of phase 3 is being made under the capital plan, but I cannot confirm-----

Photo of Micheál MartinMicheál Martin (Leader of the Opposition; Cork South Central, Fianna Fail)
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This has been going on since 2015.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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That is a matter for the Deputy to-----

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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I thank the Members, but we must move on.