Catherine Byrne (Dublin South Central, Fine Gael) | Oireachtas source

The new body will have to have an arrangement with multiple universities, academic institutions and research entities due to its national remit in the education of healthcare professionals in paediatrics and engagement in paediatric research. The formal arrangements between the universities and the new body will require some corporate identity to be decided. While this is not yet clear, it was considered prudent to allow the new body to become a member of a company, subject to the consent of the Minister. The provision also keeps options open for the type of structure that may be required for a body to carry out philanthropy for children’s health Ireland.

The provision allowing the new body to borrow for current as well as capital purposes is considered useful, but as you can see from the Bill, strictly controlled. The ability of service providers to respond to strategic investment opportunities in the public interest, within legal control limits, must be seen to be a progressive step in managing hospital facilities into the future.

The primary driver for a service provider to borrow is to drive better value in services provided to patients in a cost-effective and timely manner. Borrowing for current purposes could be considered in scenarios where the hospital cannot generate sufficient internal funding resources in the short term to develop a service but is able to demonstrate longer-term viability and an ability to repay. The ability to borrow within controls creates this opportunity.

Circumstances in which the new children’s hospital would make a case to borrow money or engage in activities that have an element of borrowing may arise in regard to leasing or licensing of commercial areas, or leasing of equipment. This could also encompass pump-priming investment in a strategic service initiative or expanding capacity that has potential to generate income for a hospital, such as attracting international patients to avail of cutting-edge, high-technology services or the specialist paediatric expertise and experience that will be available in the new hospital.

There is also the need to consider possible scenarios whereby the new body could require the potential to borrow to invest in extending existing services to generate hospital income by providing cross-jurisdictional services, for example, for Northern Ireland. As part of an accountability framework, such scenarios would be subject to approval of a business case demonstrating a return on investment with the potential to repay borrowings and generate hospital income.

The Bill allows for proper and fully accountable governance and management within the framework of national policy. It is acknowledged that, since the new body will be largely funded by the State, its borrowings will form part of the overall public debt of the State, as assessed by the EU and other bodies, and the State must exercise control before such liabilities are undertaken. The Bill, therefore, includes a provision for borrowing, subject to the approval of the HSE, the Minister, the Minister for Public Expenditure and Reform and the Minister for Finance. It is, therefore, considered appropriate to provide for the potential to borrow in the Bill. Accordingly, I do not intend to accept amendments Nos. 5 and 6.