Colm Burke (Fine Gael) | Oireachtas source

I thank the Minister for coming to the House to discuss the capital plan. It is important that we continue to develop and improve our healthcare facilities. One of my concerns relates to the negativity about our health service. I attended a health committee meeting this morning and the way some members of the committee were speaking, including Senator Swanick's colleague, one would swear that the 135,000 people currently working in the HSE are sitting twiddling their thumbs all day, with no healthcare being provided to anybody. I will outline the simple facts. Each week, 63,000 people go through outpatient departments, 16,000 go through day care procedures and 23,000 go through emergency departments. That is aside from the inpatient care that is being provided in all the hospitals across the country. It is a clear indication of the dedication and commitment of the 135,000 people who work in the HSE. The current negativity about healthcare is not helping them in the work they are trying to do. We must give far more acknowledgement to the work done by the doctors, nurses, support teams, carers, cleaners and porters because the vast majority of HSE workers go way beyond the call of duty in delivering healthcare in this country 24-7 throughout the year. It is important to acknowledge that. It is also important to acknowledge that life expectancy has improved by seven years compared to what it was in 1990. On average, people are now living seven years longer.

There are also challenges and we must confront them. With regard to the children's hospital, there is a cost overrun and that must be reined in to ensure that we are getting value for money, but one should look at the overall cost of this care facility. I did a comparison. It is worthwhile to tune into the SickKids Foundation in Canada and look at the building cost of the children's hospital there. The total project is costing $3.7 billion, which is approximately €2.6 billion. It is interesting to watch the costs for that rising. I am not saying we should allow costs to rise, but this is what one is dealing with in the building industry. In Canada, the average building cost is going up by 1% per month. It is worthwhile looking at that project to see what the people there are doing and the value for money they are getting.

The issue with our children's hospital is that we have talked about it for 25 years. The wrong site was picked for four years and there was massive delay. We are getting on with it and it is being built. It is important to build it for the children of this country, both this generation and the generations to come. It is also important to look at the cost of it and do a simple comparison, and I realise that Members might criticise me for using this comparison. Social welfare this year will cost us €21.2 billion. In real terms, the children's hospital is costing one month's social welfare. We are building this facility to serve the next 50 years. We should get on with the project, deliver it and ensure it is the best possible facility for the children of this country and for the difficulties families must face if they have a sick child. Every possible mechanism should be available for the proper treatment of those children.

With regard to the capital projects, I must refer to the elective hospital in Cork. I am a little concerned that many things are going on behind closed doors. We are not getting any information about what is happening or about consultation. I understand there has been very little consultation with the two local authorities. The Minister might clarify that. Cork County Council and Cork City Council should play an important role in that from the perspective of developing infrastructure and developing access to the facility, not only for those who will be using it but also for the people who will be working there. The population of Cork city and county has increased by 130,000 people in the last 30 years and it is continuing to increase. For example, there will be over 10,000 extra people working immediately alongside City Hall within the next three years. That is 10,000 people moving into new jobs. They are not moving out of existing premises as these are new jobs that will be created. There will be a huge and continuing increase in the population in Cork so there is a need for an elective hospital.Even if we decide the site in the morning it will still take two years to get planning and another three years to build it. We are now talking about five years down the road. This is why this project needs to be prioritised.

On fast-tracking and the use of our hospitals, one of the big issues is when, for example, a person has gone through a medical procedure and is detained in hospital for a period of ten days or two weeks while they really only need to be there for four days but there are no appropriate step-down facilities. Can a lot more be done in this regard? Step-down facilities can be built faster than anything else. Should we be looking at trying to develop or acquire step-down facilities so we can use our hospital facilities better? If somebody needs to go through surgery, there are a number of key components that need to be in place such as the consultant, the back operating team, the operating theatre and a bed. In some cases this needs to be an intensive care bed. If one of those components is missing, the procedure cannot go ahead.

I was in Cork University Hospital recently where a man had been in the Mercy Hospital for three weeks with a heart problem and needed surgery. The patient could not be transferred to CUH because it did not have a bed. When he did get to CUH, the man was another week in a bed there because they could not operate due to not having an intensive care bed available.

When one of those components is missing, they cannot do the surgery. This is one of the reasons we should look at developing further step-down facilities. They are faster to develop, the cost of running them is far less and we could get better value in the use of our hospital services, which is very important.

With regard to the primary care centre facilities, I understand there are 127 primary care centres in the State, 57 of which have been built over the past four to five years. Another 70 are in the planning and design stage or building stage. How many of these will actually be finalised and up and running over the next three years? This is not only about being built but also about making sure we have a sufficient number of staff to cover all of the additional facilities that will be brought in at the community level. I would like to see our target for those facilities over the next three years.

There is another issue with the employment of staff. I have raised this at the Oireachtas Joint Committee on Health and believe we need to get clarification on how we are putting in place more community healthcare. I have done the comparison with administration management. While that area needs to be developed and supported as well, it has seen an increase of 24% but public health nursing has seen an increase of only 3.7%. We need to have a clear plan regarding how we are going to roll out community healthcare. Sláintecare representatives were before the committee this morning. I am aware that they are working on this but I believe it needs to be outlined to us as Oireachtas Members. I am very concerned that so few public health nurses have been recruited in the past four to five years. If nurses are out in the community, they can deal with a lot of the problems rather than people having to go into hospital for care. We need to reduce the numbers of people who require hospital care when they can be dealt with in the community.

I put it to the Minister that we have a lot of work to do in healthcare. A lot of work is being done but it is also about making sure we can get value for money.

Will the Minister outline to us the computerisation of the whole healthcare centre system rather than using paper files? What progress will be made on that over the next three years? This is a huge cost saving and we need to put serious money into that area as well.