Pearse Doherty (Donegal, Sinn Fein)
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This is not the first time I have raised this issue on the floor of the Dáil. The Leas-Cheann Comhairle and I have continually raised it with the Minister of State for a number of years. Táim buíoch go bhfuil an cheist seo roghnaithe inniu le plé a dhéanamh ar Ospidéal Íosaf Srath an Urláir agus ar Ospidéal Pobal Ráth Mealtain mar tá an cheist seo fíorthábhachtach do dhaoine i nDún na nGall.

The communities in Ramelton and in the Finn Valley remain in limbo about the long-term future of residential care in their much-loved community hospitals, Ramelton and St. Joseph's. Despite repeated assurances from the Government, including from the Minister of State, Deputy Jim Daly, that the projects would be financed, but that has not happened. We even had an announcement by the Minister for Education and Skills, Deputy McHugh, that the funding was allocated. Oireachtas Members have been told that everything will be fine, that detailed design will take place in late 2019 and that planning will occur in early 2020. Despite the assurances given to Members who wish to save those vital services, however, we know that not a red cent has been allocated to date.

Just last week, senior officials from the HSE confirmed to us at that forum that they have not received formal approval for either project yet despite their repeated requests. That leaves them in a position whereby, if nothing happens to these hospitals by 2021, HIQA will close the beds down. That is basically it because there will be non-compliance. Given the current position on the commitments made heretofore, to the effect that significant works would be carried out at the hospitals to the value of over €300 million, the HSE now has to consider plan B. Plan B is to carry out minor works by 2021 to make sure the hospitals are in compliance with HIQA standards. This is to prevent HIQA from coming in to close the facilities down. That means some en suitefacilities will have to be added to rooms and that the dignity of patients will need to be preserved, but it is another example of the HSE squandering money and waste within the public service. It is another example of everything that is wrong with this Government and with planning. What should happen is that the project should be given the green light this year, as committed to. It makes no sense to carry out minor works on the hospitals only to have to carry them out again when doing the major works. The Government will probably tell us again it is committed to this work.

I will focus on the Minister of State, Deputy Daly, personally. He sat with me, the Leas-Cheann Comhairle, Deputy Pringle, the current Minister for Education and Skills, Deputy McHugh, and the committee members who travelled a long distance from Donegal to come to the Oireachtas on 7 November 2018. The Minister of State told us, along with senior officials from the HSE and the Department of Health that the project was going ahead. He told us there would be a detailed design in 2019. He told us there would be an allocation. He told us planning would proceed in early 2020 and that there would have to be sequencing in terms of patient transfers between Ramelton and Letterkenny while the works were ongoing. That is now not happening. The Minister of State's promise has been broken. There have been deep suspicions among members of the community and the activists about what the Government has been telling them because they have heard all this again. Last week, a statement was made to us categorically, in black and white. It is nothing but another set of broken promises because the Government has not given the go-ahead for the project to commence.

Jim Daly (Cork South West, Fine Gael)
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I thank the Deputy for raising this issue and giving me the opportunity to provide an update to the House on the development of community nursing units at St. Joseph's Community Hospital, Stranorlar, and Ramelton Community Hospital, County Donegal.

The overarching policy of the Government is to support older people to live in dignity and independence in their own homes and communities for as long as possible. The standard of care delivered to residents in public units is generally very high but we recognise that many of our community hospitals are housed in buildings that are less than ideal in the modern context. Without them, though, many older people would not have access to the care that they need. It is important, therefore, that we upgrade our public bed stock, and this is the aim of the capital investment programme for community nursing units that was announced in 2016. This provides the framework to allow for an enhanced programme to replace, upgrade and refurbish these care facilities, as appropriate.

The HSE is responsible for the delivery of health and personal social services, including the facilities at St. Joseph's Community Hospital, Stranorlar, and Ramelton Community Hospital, County Donegal. The HSE has advised that the capital programme provides for the retention of services at St. Joseph's Community Hospital, Stranorlar, and Ramelton Community Hospital, with a requirement for refurbishment of both centres.

Significant work was undertaken to determine the most optimum scheduling of projects within the phased provision of funding to achieve compliance and registration with HIQA. In the short term, the HSE will invest minor capital in both units in 2019 and 2020 in order to deal with HIQA compliance issues, and an agreed schedule of works is being finalised with HIQA.

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. This includes, where possible, future-proofing to ensure capital developments meet current standards and that provision is made for additional capacity and improved equipping, or both, and that these are addressed appropriately.

My Department has been working with the HSE and Department of Public Expenditure and Reform to develop a multi-annual capital plan for the health services. The health capital allocation in 2019 is now €642 million for the construction and equipping of health facilities. This represents an increase of €224 million on last year's capital provision. My Department and the HSE are currently working to finalise a multi-annual capital plan, which will determine the projects that will progress in 2019 and beyond, having regard to the available capital funding, the number of large national capital projects currently under way, the cash flow requirements attaching to each project and the relevant priority.

Pearse Doherty (Donegal, Sinn Fein)
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That just confirms exactly what we have been told by the HSE, that the commitment given by the Minister of State has been ignored. I ask him about this on behalf of the committee members who made the long journey to meet them in his ministerial office. He told them face to face that there would be a detailed design in 2019, planning in early 2020 and a phased transition based on the movement of patients as works progressed. Now, as just confirmed in the Minister of State's response, this is not happening. A sum of €2.75 million was the allocation for St. Joseph's, and there was €1.5 million for Ramelton. The HSE and Government have refused to give the go-ahead. Instead, as the Minister of State said, minor capital works are to take place in 2019 and 2020.

Can the Minister of State acknowledge - I will be careful with my language here - that, at the least, he misled the community activists and has broken his promise to them and the members of the community who turned out both on the streets and at public meetings? We have addressed and been with hundreds of people who are angry at the fact that the Government is drip-feeding them misinformation. Does the Minister of State accept that he told them what I said? The reality is that the people in Donegal will say the Minister of State told them bare-faced lies. That is what they will say because the Minister of State told them the works would be in the capital plan and proceed to detailed design this year to allow for planning next year. Now that decision has been reversed and all the fear in the community still exists. What changed since 7 November last year, when we all sat around the table and believed there was a genuine plan, light at the end of the tunnel and a timeframe in which to do all the work?

As the HSE has told us, unless the works are part of the capital plan they cannot proceed. There is an aspiration but unless money is allocated for the projects, involving detailed design as the first step, they cannot proceed. That is why plan B is being considered. It is to ensure HIQA does not close down the facilities in 2021. It is a waste of money. Why would the HSE be spending over €0.5 million on this type of work when most of it will be obsolete and it will have to do it all over again in a couple of years? It is a clear example of waste. Worse, it is a clear example of the Government demonstrating bad faith to the community that values these projects and hospitals so much.

Jim Daly (Cork South West, Fine Gael)
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I am 15 years a politician and this is the first time I have ever been called a liar or accused of lying. Well done to the Deputy on crossing that threshold. Let me be very clear to him because I am not sure what part of this he does not understand. I appreciate he is a politician and it is his job to stoke up fear among the elderly, create hype among the communities and tell them the hospitals will be closing. He said that in his speech. I do not subscribe to that type of politics. It is beneath the Deputy to be frightening the life out of people in the areas concerned.

Pearse Doherty (Donegal, Sinn Fein)
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I did not.

Jim Daly (Cork South West, Fine Gael)
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The reality is that a decision was taken by my predecessor, former Minister of State Kathleen Lynch, to build a new unit in Letterkenny and not to proceed in respect of Ramelton or St. Joseph's. The current Minister for Education and Skills, Deputy McHugh, put a lot of pressure on me, my Department and the HSE to have the decision reversed. We acquiesced and the HSE and Department have agreed to retain the two units but to continue to build the new unit in Letterkenny. When former Minister of State Kathleen Lynch announced the capital programme for Donegal in 2016, the county was allocated €51 million for new projects. That was an enormous contribution on the part of the Government to the older people in Donegal. We have now increased that allocation by a further €6 million to ensure we can retain St. Joseph's and Ramelton community hospitals. We have given that commitment. It was made by the HSE and the Department of Health.

I cannot give the Deputy the capital plan piece by piece across the floor here. The Minister, Deputy Simon Harris, is to publish it. The Deputy will have to wait to see it. I have given the Deputy a commitment that the works in question will be in the capital plan. When it is published, the Deputy will see the commitment delivered on. He can continue to call me a liar, do all he likes, stoke up fear and engage in whatever form of politics he wants but I am not interested and I am getting a bit bored by it. His games and my having to answer the same question time and again are making me a little bored. I suggest, with respect, that the Deputy wait for the capital plan for his local community nursing units, just as every other Member has to do.

Declan Breathnach (Louth, Fianna Fail)
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The Deputy's time is up.

Pearse Doherty (Donegal, Sinn Fein)
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The Minister of State is accusing me of lying and that is a serious accusation.

Declan Breathnach (Louth, Fianna Fail)
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The Deputy's time is up, can he resume his seat, please? We are moving on and the Deputy is out of order. The Deputy's time is up.

Pearse Doherty (Donegal, Sinn Fein)
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The Minister of State has not refuted the point that he told them that the unit was going to be in design stage. What I said was that what the people in Donegal will say is that he told them barefaced lies. Will he refute the point that he sat across the table and said the unit was going to detailed design in 2019, instead of throwing accusations at me? Will he refute that point?

Declan Breathnach (Louth, Fianna Fail)
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Will the Deputy stop and respect the rules of the House, please?