Keith Swanick (Fianna Fail) | Oireachtas source

I welcome the Minister and thank him for his recent visit to Mayo. There was a fantastic day last Friday in Castlebar with the opening of the Mayo-Roscommon hospice. It is truly a fantastic facility, full of hope, and somebody described it as a sacred place. It is a facility where the size of a bank balance makes no difference and the facility is there for people in the counties of Mayo, Roscommon and Galway. I also welcome the Minister's announcement last week regarding the funding of the facility for 2020.

Fianna Fáil welcomes the proposed developments in the HSE capital plan and hopes it can be delivered on time and on budget. However, the children's hospital debacle and delays in nursing home upgrades demonstrate that the Government's record of timely delivery on key projects is simply not good enough. There are many genuinely important projects listed in the plan that are welcome and which will improve public health care services. However, it is impossible to know why these projects have been selected over others. There is no analysis of the value of the various projects, how investment is being allocated or supply and demand of healthcare services.

The plan includes using public money to build private facilities at the new maternity and children's hospital. This directly contradicts the way the Government voted in the Dáil and its public utterances on the matter. The Government has stated that this is the first phase of a ten-year capital investment programme. Over the next three years, there is a commitment to 250 projects across the country, including 480 new beds, 30 new primary care centres, 58 community nursing units and significant investment in mental health and disability projects in the community. The capital plan provides for the spending of just over €2 billion on health capital projects from 2019 to 2021, with €335 million pledged for a wide range of capital projects at individual hospitals and community facilities to provide modern health accommodation and equipment to improve service provision.

We all welcome the new children's hospital but the issues surrounding its cost overrun are not going away. The State's chief procurement officers, who failed to flag the spiralling costs of the hospital with the Government, has resigned from the hospital development board. The resignation of Mr. Paul Quinn, who led the procurement reform programme, is one of a spate of high-profile resignations from the board this year in the wake of cost escalation. In a recent letter, the Taoiseach confirmed to Deputy Micheál Martin that BAM Ireland, the construction company involved, is seeking additional money for work not included in the original scope of work. The Taoiseach has refused to indicate how much this would cost the State, claiming that the "individual details of these claims are commercially sensitive". Fianna Fáil has called on the Government to come clean about new potential overruns given the burden it imposes on the taxpayer. We need full transparency around the potential cost overruns because they need to be budgeted for. It is taxpayers' money that could be put to so much good use in the healthcare system. The PricewaterhouseCoopers, PwC, report on the construction of the new children's hospital was a shocking indictment of a badly managed project, one of the most expensive undertaken by the State. Nevertheless, there has been no accountability. Red flags were missed and the public spending code was not adhered to. The project has been poorly co-ordinated and controlled, with fragmentation, poor communication and poor flow of information. It is a far cry from April 2016, when the Taoiseach, who was then Minister for Health, announced that the project would, taking account of contingencies and inflation, cost approximately €650 million.

New information supplied to my colleague, Deputy Mary Butler, has revealed that almost a third of nursing home upgrades announced in 2016 have missed their completion date. Once again we can see that the Government is big on promises but maybe behind the curve in the context of delivery. These upgraded, refurbished and new facilities are urgently needed so we can comply with HIQA standards around the country. I was personally disappointed that more investment was not attributed to the district hospital networks but I acknowledge the recent visit by a Minister of State, Deputy Jim Daly, to Belmullet hospital in County Mayo. I am a medical officer at the hospital. I have spoken about this matter many times in the Seanad. The district hospital networks play a vital role in the delivery of a modern healthcare service. They should not be seen as a relic of a bygone era. A failure to invest in the services provided at district and community hospital level is counterintuitive and counterproductive.

These hospitals play an important role in step-down facilities, preventing admissions to acute hospitals and facilitating discharges from the acute hospital sector. With appropriate investment in the community hospital network, we can facilitate respite care and GPs and public health nurses can admit patients to these facilities in order to prevent patients from having to go to acute hospital sectors. Many of these hospitals have palliative care beds. There are two at the hospital in Belmullet. These hospitals are a vital cog in a modern healthcare system.

I welcome the developments in the mental health facility at Portrane. I worked as a senior house officer at Portrane when specialising in psychiatry. It is a fantastic facility, as it was back then, despite much of the negative connotations in the media coverage relating to the institution.I had a very fruitful six months there and met some great people. The new infrastructure in Portrane is welcome. I look forward to visiting it. I have visited the children's hospital. I was given a tour by BAM Ireland a few weeks ago. If the Government is interested in controlling costs, there must be a ground up policy. We must tackle the meltdown in our healthcare system. We must get a handle on spending and cost control to prevent the yearly ritual of announcing Supplementary Estimates.