David Cullinane (Waterford, Sinn Fein)
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78. To ask the Minister for Health if she is confident that sufficient capital funding has been provided for in the national development plan to deliver elective centres, 3,000 additional acute inpatient beds, digital transformation, and the entirety of health infrastructure commitments made by the Government; and if she will make a statement on the matter. [52529/25]

David Cullinane (Waterford, Sinn Fein)
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Capital funding in health is really important. This capital allocation is one of the most important because it is linked to many of the big projects that are about reform of the health service. It is about more hospital beds and the 3,000 beds that were promised by the Minister's predecessor before the local elections last year. Elective hospitals have to be built, which is really important in following on from those surgical hubs and separating scheduled from unscheduled care.

We have the new National Maternity Hospital. We need to develop Galway. I know there are plans for other acute hospitals in my own constituency in Waterford. I will get to those projects as well. I do not believe the capital funding is there to deliver on all of those projects so the question is: which projects are not going to be delivered because of the capital funding that is allocated up to 2030?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank the Deputy. As he is aware, the programme for Government will set out a review of the national development plan as a key priority. Through the NDP review, we are prioritising critical economic growth but also the health infrastructure we need to have, which the Deputy has articulated.

The substantially enhanced NDP provision for the health sector of €9.25 billion will support the delivery of equitable, accessible and high-quality healthcare across Ireland. We have seen a number of examples of that happening so far but there is quite a lot of work to do, such as the new surgical hub at Mount Carmel, the HSE health app and the 96-bed ward block in UHL. That is what has happened so far. As the Deputy and I both know, we have to drive further ahead.

The NDP settlement recognises that there are certain key programme for Government priorities in health that will progress to statutory approval towards the latter part of the current NDP. In relation to shovel-ready projects, I have assurance from the Minister for Public Expenditure, Infrastructure, Public Service Reform and Digitalisation and his Department that they will be priorities for funding in the post-2030 NDP. The basic point is that if we get something to shovel-ready, we will be making the case to central Government for the funding to be enabled for that.

The Minister for public expenditure and reform has also confirmed that should there be underspends evident in the overall NDP allocation, the first allocation for that will go to the Department of Health. We have a programme of funding for the next five years. We have a challenge to meet that and get those to construction phase. Where we get something else to shovel-ready, I will be going to the Minister for public expenditure and reform looking for unspent allocation in other NDP programmes, the first call on that and indeed the first round of funding. My challenge is, frankly, getting things to shovel-ready stage. I am confident of the funding for electronic health and for the infrastructure projects we have. Our bigger difficulty is getting them to shovel-ready.

David Cullinane (Waterford, Sinn Fein)
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I do not believe that is the biggest challenge at all. It is a challenge, of course, to get projects ready and obviously they have to go through planning processes and there are other processes as well. I met with senior officials in the Department before the last general election. What they set out to us was an ask of about €13.5 billion up to 2030. What was achieved was €9.5 billion. Even looking at some of the costs, we know there is at least €1 billion, at a minimum, needed for digital transformation. We have to finish out the children's hospital which, it is estimated, will require about €300 million in addition to the current €9.5 billion allocated. The surgical hubs have to be paid for. Primary and community care facilities were estimated to be €270 million. On the 3,000 hospital beds, they average out at about €1 million each. That is €3 billion alone for those beds. Half of those beds, in my mind, will not be delivered and we will see who is right and who is wrong as all of this plays out. The new National Maternity Hospital is at a minimum of €900 million, at best, and then we are into the elective hospitals. We know from the preliminary business cases they are about €1 billion at a minimum for those four. When you add all of that up, it is well over €13 billion. It does not add up. Then the question is: what projects are not going to be delivered?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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The question is around what is capable of being delivered to absolute completion within the next five years and how we balance and manage that. I do not think it is question of right or wrong. Both the Deputy and I want to see the infrastructure delivered immediately if possible but we both live in the real world where we have to go through planning and procurement processes. There is a slowness in doing that, unfortunately - in the Government and the public sector doing that - which does not challenge the private sector in the same way. It is very frustrating but we both want to see the projects delivered.

I now have a capital envelope the size of which we have not had in health. There was an underspend on capital investment for a very long time in health, with significant additional funding on the current side. That was fine and necessary but there has been an underspend. I have secured a large capital portion of the NDP and the additional programme that is there. I have the assurance that where I get something to shovel-ready, I will get the funding for that and I would welcome the Deputy's support when I get to that point.

David Cullinane (Waterford, Sinn Fein)
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Despite all of the best efforts of people who will work in this space, even if they get them to shovel-ready, I have already outlined and done the maths. I have met with the Department. I know the money simply is not there to do all of these projects. It is a case of who is right or who is wrong when it comes to the funding. I would accept that the Minister wants as much as possible to be done, as I do, but it does come down to money. It is a case of "show me the money". If the money is there, we can do these projects. If the money is not there, whether they are shovel-ready or not, they simply will not proceed. We have seen health projects stalled.

We can all give examples in our own constituencies. I have dealt with the bigger State-wide projects. In my own constituency of Waterford, we need to deliver 24-7 cardiology care, which the Minister committed to. We need to invest in the adult mental health unit. There is a need for PET scanner. There are loads of projects right across each individual hospital that will also have to be funded. They have to be taken into account when you look at all the bigger projects as well. I believe - and it is my analysis based on the discussions I have had with the Department and the HSE - that there is a funding shortfall in regard to capital. I fear that some of those big reforms, especially the elective hospitals, simply will not happen as quickly as they should because the money will not be there.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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There is no barrier to them in the context of the funding side of it. The bigger issue is the planning side but we will work through it together.

I had the good fortune to be in Waterford, a really excellently run hospital. I was in the CAT labs and got to see the different theatre configuration, which, of course, has been delivered. It is the case that the cardiologists have been recruited and that was confirmed to me by the hospital management and the IHA management so we will see that commitment delivered. The current funding was put beside it.

David Cullinane (Waterford, Sinn Fein)
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That is for 8 a.m. to 8 p.m., not 24-7.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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There was a recruitment process, and there you go. I stood, as I am sure the Deputy has done, and his party colleagues were there with me, outside the pretty magnificent surgical hub that is being completed there. We would very much like to see that. If anybody is going to run that well, I am confident that Waterford will do it. Those projects are being delivered and I look forward to seeing the physical transformation of that hospital as much as every other hospital with the ongoing capital investment that has happened and continues to happen, and the major projects, such as the one in the Deputy's own constituency, which is being delivered in front of his constituents' eyes.