Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Senator Maria Byrne for raising this important issue and for her continued advocacy for health services in the Limerick area. The cross-party Sláintecare report in 2017 articulated a new vision for healthcare in Ireland, including the provision of elective-only hospitals to provide protected capacity for elective care. This policy has also been informed by a number of subsequent policy documents and Government decisions including the 2017 Sláintecare report, the Sláintecare implementation strategy of 2018, the 2018 National Development Plan, the programme for Government in 2020, the Sláintecare implementation strategy and action plan up to 2023, as well as the new national elective ambulatory care strategy agreed by the Government in December 2021.This new strategy aims to change the way in which day-case scheduled procedures, surgeries, scans and outpatient services can be better arranged to ensure greater capacity in the future and help to address waiting lists at a national level.

The development of additional capacity will be provided through dedicated, stand-alone elective hospitals in Cork, Galway and Dublin. The elective care scope of service will be provided in two phases commencing with day cases, diagnostics and outpatients, and then by inpatient treatment. On this basis, the elective care centres, ECCs, will be designed to provide sufficient capacity to facilitate future phases, including some elective inpatient capacity, thereby providing a sustainable and strategic response to cater for the highly dynamic landscape of healthcare policy and practice.

It is important to note that the locations chosen will allow for new facilities of a size and scale to implement a national elective care programme that will tackle waiting lists on a national basis. This means the new facilities will be designed to maximise their capacity and, in doing so, will operate to meet the demands of as wide a catchment area as possible, extending beyond existing and future health areas, including Limerick and the mid-west.

The locations were chosen in line with good practice, which suggests that in order to maximise economies of scale, dedicated, stand-alone elective centres should be as big as is reasonably possible to meet identified demand while providing appropriate population coverage. Locating the new facilities in Cork, Dublin and Galway will enable the provision of a national service that aims to maximise the coverage of the ECCs as far as is reasonably possible. A central point of introducing these new facilities is not that they will only benefit the subset of the population that sits within their direct catchment, but, rather, that the introduction of this new delivery capability into the public healthcare system will benefit the whole population, including those who do not fall within the immediate geographical catchment. An additional elective facility in Limerick would have a minimal impact on population coverage relative to the significant increased investment to build and operate.

Nonetheless, I am conscious of the desires expressed by the Senator and I take on board her point that there are 80 people on trolleys today in Limerick. The Minister for Health, Deputy Stephen Donnelly, was in Limerick the week before last and discussed this matter with local representatives and the senior management team at St. John's Hospital. As the Senator will know, we are fully committed to the continued improvement of the elective care system in Ireland and have been impressed to see innovative care solutions developed locally, such as the Reeves day surgery unit at Tallaght University Hospital, which has succeeded in significantly reducing day surgery waiting times for patients.

As well as the strategic intervention under the national programme for elective care, the Minister will consider any similar proposal by University Limerick Hospitals Group to deliver elective day care in the shorter term.