Gary Gannon (Dublin Central, Social Democrats)
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I thank the Minister of State for taking this issue tonight.

A couple of week ago, I visited the neonatal unit of the Rotunda Hospital, which is just off Parnell Street in my own constituency of Dublin 1. While there, I met the clinicians there who are being asked to work in conditions that are incredibly unsuited to the importance of the work and to the vulnerability of the babies who they care for while there. The impression you could not help but leave with is that although there are amazing clinicians in the Rotunda, who offer the very best of care where possible, the systems, the building and the rooms they are asked to work in and perform their duties, are simply not suitable for purpose in a modern republic in 2025. Indeed, it was not suitable when my own younger brothers were in that neonatal unit in 1994. The Rotunda has put forward a proposal that is not about luxury or even about expansion for its own sake but is about basic standards of care. The plan it put forward includes 19 new post-natal beds, a state-of-the-art new neonatal intensive care unit with 46 separate spaces for babies, a new labour ward with appropriate numbers of bathrooms and a midwifery-led unit on the ground floor. That stands in stark contrast with the current facilities I witnessed where 37 babies, some who were critically ill, were sharing one small space. Clinicians were stretched to the limits and infection control standards simply do not match the level of care the babies, their families and the clinicians who work there deserve. The Rotunda is the busiest maternity hospital in northern Europe. Thousands of babies from the most vulnerable populations are born there each year and 40% of all the babies in Dublin are born in the Rotunda Hospital, yet the infrastructure is dangerously outdated. There already have been multiple infection outbreaks in the unit in recent months directly linked to overcrowding and inadequate space.

I am aware there are objections raised in the planning process to the expansion. However, I want to say with all urgency that I see no building in this city as more important that the little protected structures that I witnessed in those incubators that day, as well as their survival and dignity. It is the most critical infrastructure. I understand that, strictly speaking, this matter lies with the planning system. I am not immune to that fact or reality. However, we stand here in the national Parliament where there is a picture of the Rotunda Hospital on the wall behind me. If this Parliament cannot take a stand and make not only requests but demands and an urgency known to those who stand in the way of such critical infrastructure, we certainly have to find a way. I am sure the Minister of State will agree that what the expansion of the hospital needs cannot be achieved through a delayed, dragged out, planning process that may take a decade. It requires urgency and may require intervention. I am somebody who believes in the architectural heritage of this city. I am somebody who loves the fact that walking through Dublin you can feel its history. I live just around the corner from the Rotunda Hospital, off Mountjoy Street, so I understand the importance of the history of the area. However, there is no history more important than the future of the babies who I witnessed in those incubators. I appreciate the Minister of State may be tied in her response but I also appreciate that working collectively together, we may find a way.

Emer Higgins (Dublin Mid West, Fine Gael)
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I thank Deputy Gannon for his Topical Issue on this subject. I was born in the Rotunda Hospital and my mother used to work there, so I appreciate the opportunity to address the concerns relating to the expansion of neonatal facilities at the Rotunda Hospital. I do so on behalf of the Minister for Health, Deputy Jennifer Carroll MacNeill.

As the Deputy said, the Rotunda is one of the busiest maternity hospitals in the whole of Europe. More than 8,600 babies were delivered there in 2024 and more than 1,300 babies were cared for in the hospital’s neonatal intensive care unit, the NICU. This NICU is one of four tertiary NICUs in Ireland, providing essential support for some of the sickest infants and their families. The Deputy will be aware that the critical care wing is a planned development on the existing Rotunda Hospital campus to address high-priority clinical areas. The new wing will provide additional NICU capacity, more single rooms, more delivery suite capacity, and a new theatre. This development will increase capacity at the hospital and ensure that the hospital can provide for the increasing number of presentations. The HSE has advised that this project is currently at stage 2B of design, and is looking to progress procurement of enabling works. In August of this year, the Master of the Rotunda, Professor Sean Daly, wrote to both the Taoiseach and the Minister, Deputy Carroll MacNeill, among others, concerning the development of the critical care wing. Professor Daly noted concerns raised from An Taisce and the Dublin Civic Trust regarding this development despite engaging with them at a local level. He advised that the Dublin Civic Trust has indicated its intention to appeal the planning decision. It is important to note that neither the Minister nor the Department of Health, as the Deputy noted, have any remit over planning regulations. Planning regulations lie within the remit of the Department of housing, which has responsibility for the implementation of the planning Act 2024, including the design and implementation of planning regulations under the Act. Neither the Department of Health nor the HSE can comment on the review of planning regulations currently under way. However, while the planning process for the critical care wing progresses, the Government is investing to ensure the Rotunda continues to deliver the highest standards of quality care, including for neonates.

The hospital's budget has increased to €109 million this year. This is an increase of 47% or €35 million since 2020. The HSE has purchased an additional building, Hampson House, to extend capacity. Hampson House was officially opened in January this year. Over 100,000 outpatient and ambulatory patients are expected to attend there annually. Several service improvements are also being driven by the hospital and through the national maternity strategy. The Minister for Health visited the Rotunda in June to launch a new NICU resource for parents. This welcome pack has been designed for parents of babies transferred to the Rotunda NICU, and particularly those who have been unexpectedly transferred from maternity units around Ireland. It includes a variety of immediate practical support and guidance, including leaflets, toiletries and gift vouchers for accommodation and groceries. This is just one example of how the Government will continue to support the Rotunda Hospital to meet the needs of the women, infants and the families it serves.

Gary Gannon (Dublin Central, Social Democrats)
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Yes, that is completely as I expected. I understand and accept completely that as legislators, we do not, nor should we, have a role over planning but we do have leadership roles. We do have voice. We are elected to represent the people of our constituencies and to have a say about what is common sense, what is basic humanity and what is just nonsensical. I found it unfathomable when I walked into that room and saw the clinicians and the babies in the incubators. I did not get a chance to meet their parents that day but I can only imagine when they walk into that room and see the little cots that are separated less than a metre from each other, which is absolutely no way in accordance with medical best practice. I cannot understand how any body designed to protect our heritage, which it does a good job at, could not simply look and see how that pales into irrelevance when it comes to the future, which is actually the children in these incubators. I do not want anybody to interfere with a planning process. That is not what we are after here. However, we do want to find a way. Maybe that is through legislating for critical infrastructure, which the Rotunda expansion absolutely is. That could be done fast.

The Government will get support across the Chamber as it applies or speaks with the authority of the offices of the Minister for housing, the Minister for Health or the Cabinet. I imagine they will have the full support of the rest of us across the Opposition. Let us call this what it is: a nonsense objection to critical infrastructure that genuinely risks costing lives. We cannot separate ourselves from that as leaders in our communities, as a Cabinet and as people who have been asked to act on behalf of the people of Ireland.

Emer Higgins (Dublin Mid West, Fine Gael)
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It is my understanding that at this point no objection has been lodged. I hope the Deputy's passionate plea tonight has an influence on whether it will be lodged.

I thank the Deputy for raising this important issue. Increasing capacity at the Rotunda Hospital to ensure it can meet the needs of women, infants and families is a priority for the Government. The health needs of women and infants presenting to our services are becoming more complex. The National Maternity Strategy – Creating a Better Future Together 2016-2026 is in its final year and it has been driving national reforms across our services to better meet those needs. Of the €28 million new development funding, over €100 million in capital funding has supported that strategy since its development and significant investment has been directed into the Rotunda Hospital. Three additional consultants, a registrar, 13.5 full-time equivalent midwives and nurses and ten health and social care professionals have been funded at the hospital through that strategy. Significant capital funding has supported refurbishment, the purchase of training, equipment for emergencies, birthing aids, monitoring equipment and research projects.

In addition post-natal hubs are currently in development in Dublin. They will be run jointly by the Rotunda Hospital, the National Maternity Hospital and the Coombe hospital. This is supported by funding of €400,000 from the women's health task force. These hubs will provide a range of services and supports for women, infants and families in the weeks immediately following birth. The staff in the Rotunda neonatal intensive care unit, NICU, care for some of our most vulnerable patients. The NICU welcome pack is a small example of the kind and supportive way in which they carry out their important work so well. The Government will continue to invest in the Rotunda Hospital's infrastructure and services. The primary motivation for investment and development of the Rotunda is to continue to provide the highest standard of care now and in the future for women and babies.