Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I welcome our esteemed guests from Mayo too. They are all very welcome. It is better than being in school, doing schoolwork and homework, is it not? It is way better.

I thank the Acting Chairperson and Senators for the opportunity to discuss with the Seanad today the very substantial capital investment in our health and social care services. This Government is absolutely committed to transforming how we deliver care to patients in our country. Our aim is universal healthcare so that everyone can access affordable, high-quality care when he or she needs it. I am delighted to confirm that the capital plan has been published. The plan makes funding of €1.027 billion available for this year for the construction and equipping of healthcare facilities. That is an increase of 11% on core 2022 funding. Funding of €140 million is also available for investment in our health ICT infrastructure.The scope of the capital plan is broad, and balanced across the sector and the country. I could happily spend hours detailing the hundreds of projects that are being progressed. However, I only have enough time to address some of the projects and programmes, including the new children's hospital, hospital projects, including extra capacity, critical care and maternity services, and investment in designated cancer centres. In the community the projects include the primary care centres, the HIQA programme for community nursing units, and the enhanced community care programme. Also included are mental health facilities, investment in trauma and rehabilitation projects, investment in ambulances, ambulance bases, equipment replacement and infrastructural risk projects, and climate action and sustainability projects.

In the area of hospital beds, over the past three years there have been more hospital beds delivered than at any other time since the foundation of the HSE. We have now delivered just short of 1,000 extra hospital beds since 2020. This year, we plan to construct an additional 261 hospital beds, 96 beds in the Mater hospital, which we opened in April, 12 beds in Naas, on which construction is complete and equipping is now under way, and 48 beds in Mallow, which are expected to complete construction this month. Similarly, we have expanded the number of critical care beds, with adult critical care capacity now at 323 beds. The capital plan for 2023 includes construction completion and commissioning of an additional 16 critical care beds in the Mater hospital.

I am in discussion with Government colleagues to expedite the rapid construction and delivery of 1,500 additional hospital beds across the country. Details of the proposal will be confirmed as discussions progress. In essence, this proposal is about driving time and cost efficiencies using standardised repeatable design solutions, with standard schedules of construction and accommodation, and using modern off-site manufacturing approaches.

A central objective of the programme for Government is to deliver increased levels of integrated care with service delivery orientated towards primary care, community-based care and home care. Projects being progressed this year include the construction and completion of nine primary care centres across the country: six under the operational lease model and three via the own-build model.

The capital plan also provides for the progress of the capital programme for older persons residential centres developed in response to the introduction of HIQA’s national residential care standards for older people. Construction is expected to complete at 11 centres around the country. I am delighted to say the 11 centres equate to 500 replacement community beds, which makes an enormous difference for all of the residents in these new facilities.

Progressing the new children’s hospital remains a core tenet of our capital plan for this year. It is the most significant investment in health infrastructure ever in the State. The hospital will play a vital role in strategic reform for children's services. The project is over 85% complete. The focus this year continues to be on the internal fit-out and commissioning, particularly around mechanical and electrical services.

I confirm that, this year, funding for the national children's hospital is specifically profiled. That means there will be no negative impact on other projects identified in the capital plan. The plan will continue to support the delivery of other Government priority projects, including the new national maternity hospital. I expect a recommendation to commence the tender for the main works can be brought to Government in the coming months, which will be a really important milestone. Following Government approval, we are also progressing the new elective hospitals in Cork, Dublin and Galway.

In the shorter term and to address waiting lists, surgical hubs are being developed in Cork, Galway, Limerick, Dublin and Waterford. Locations for four of the six hubs were announced last Friday. The first of the new hubs will be operational before the end of this year, with more following next year.

Looking at how we deliver capital projects, the approach to date has simply been far too slow. The approach has too many stages and projects have been susceptible to veto and delay. As such, I have had considerable and very constructive engagement with Government colleagues, my Department, with the Department of Public Expenditure, National Development Plan Delivery and Reform and the Minister, Deputy Donohoe, critically, and with the HSE to explore all opportunities to speed up the delivery of capital projects. I am very happy to confirm that important progress has been made. In March, changes to the public spending code aimed at enhancing delivery were introduced that streamline the appraisal and approval of projects. This means we have a faster project with fewer steps. I have also met with the HSE to ensure the internal processes of the HSE and the Department are streamlined to get infrastructural projects completed to deploy them for better patient care. I have been encouraged by the response by the HSE to this challenge.

I am working with my Department and the HSE to ensure policies and procedures to plan and deliver capital projects are improved. This includes the development by my Department of a strategic healthcare investment framework, implementation of HSE's capital and estates strategy, and updating the HSE's capital projects manual.

There is a strong track record of delivery of infrastructure in the health sector. Every allocated euro in the current national development plan provision is invested to ensure we deliver on our core goal of universal healthcare. This is underpinned by a strong pipeline of capital projects being progressed, including several new hospitals, significant new facilities for existing hospitals and our essential community-based services.