Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank colleagues for their contributions. I have been trying to piece together responses to the various projects that have been raised. I acknowledge the Seanad's position on the naming of the children’s hospital. The advice I have is different. That is an ongoing consideration for Government.

On women’s health centres, the answer is "Yes", but not in the way laid out in the report. The report suggests that we put in those centres based on individual GP decisions to provide services, which is not how one would provide a national network. We are providing a national network and putting in place 21 see-and-treat gynaecology clinics.They are having a huge impact. We are now building some of them out into more holistic women's health centres. We are in the middle of putting an entirely new women's health infrastructure in place and we need to do it based on where patients are located rather than based on the decisions of individual GPs but GP services provided through those centres can certainly be looked at.

There were several contributions on Limerick. There is significant investment for Limerick in this plan. As colleagues will be aware, we have already started the first extra 96-bed block. A significant number of additional beds were provided during Covid as well. We now have agreement to proceed with the enabling works for the second 96-bed block. Between those two blocks and what was put in during Covid, we are getting close to an additional 300 beds. There is a suggestion that a number of these beds would be used as replacement beds but I want to minimise replacement beds. We are in the business of adding beds at the moment and in my view, too many of the extra beds we built were used for replacement beds. We are not there. We do not really have that luxury at the moment. We need extra beds to make sure patients get off the trolleys and the waiting lists get tackled. Obviously there are some cases where replacement beds are appropriate. Limerick got a lot of extra beds during Covid, and 96 more beds are being put in now. The enabling works for another 96-bed block have been agreed. There is a surgical hub going in, as well as an entire new suite of community-based services which did not exist two years ago. Limerick is also getting an extension to radiology and an additional MRI machine. There is a lot going on now. The request from the healthcare community to Government was for a massive investment in capacity and in staff. From memory, I think we have added about 1,000 staff in Limerick in recent years.

What we now need to see is a seven-days-a-week service. Improvements have been made in Limerick, but I am not satisfied that the hospital is where it needs to be yet. There is an ongoing process of engagement with the management, clinical workforce and the community workforce. The Government has more than stepped up in terms of the additional capacity required and it absolutely must be met with changes to working practices, seven-days-a-week services for patients and a zero-tolerance approach to patients on trolleys, as has been implemented in some other hospitals. It must be capacity plus reform. We can keep the situation with regard to St. John's under ongoing review. Croom Hospital has been doing incredible work in terms of the extra number of orthopaedic procedures that it has managed to do. We invested in a state-of-the-art facility in Croom to improve orthopaedic services there.

I am aware of the sexual health clinic in Soho to which Senator Warfield referred. There is a case to be made for 24-7 sexual health clinics in Ireland in the main urban areas for sexual health reasons, including for urinary tract infections, UTIs, and so on. If people are dealing with a UTI at 2 a.m. and need urgent action to prescription medicine, they cannot get it in many cases in Ireland at the moment. I am very much in favour of putting in hubs, particularly in urban areas, in order that we would have the kind of service provided in London to which Senator Warfield referenced.

We are investing strongly in Roscommon University Hospital. I was blown away by the dedication of and services being provided by our healthcare professionals in Roscommon. Obviously, we now have the hospice across the road as well. The hospital is very interested in expanding, using advanced nurse practitioners to provide same-day renal services, for example. I have been really impressed and am delighted to be able to continue to invest in and grow Roscommon hospital. For those who have very understandable concerns about Our Lady's Hospital Navan and who are wondering if it is going to be downgraded, the answer is that not only is it not going to be downgraded, we are investing in it. I would tell them to go and look at Roscommon University Hospital in that context. I am told the biggest problem in Roscommon now is that people cannot get parking because the hospital is so busy. There is a need to add more parking spaces. The hospital has been a great success and huge credit goes to the healthcare professionals there. They have done incredible work.

Do we need more rehabilitation beds, particularly in the West? The answer is "Yes". We have a significant deficit of rehabilitation beds and rehabilitation services in the country and are overly reliant on the National Rehabilitation Hospital in Dublin. There are more phases of development which we need to put in place. We had a bigger plan but it got scaled back. We need to get those extra beds open in Dublin but we absolutely need a better national provision of rehabilitation beds and services, including neurorehabilitation services which we are expanding at the moment.

On Galway, we had a really positive day there last Friday. I reiterate that while there has been some investment in beds, it has been small. Galway has not had many additional beds. There is a €60 million investment in radiation oncology, with four linear accelerators in an absolutely world-class facility. That is coming on line now for patients and it will make a big difference. What are we looking at for Galway and what is contained in this plan? In this plan there is a 76-bed block, new laboratory facilities which are essential, an eight storey emergency medicine, paediatric and maternity block, and a regional cancer centre. That is just in Galway University Hospital. In Merlin Park we will have a regional elective hospital and a surgical hub will be in place long before that. There is a new outpatient department going in, a new cystic fibrosis facility and more. There has never been an investment like this in healthcare in Galway. As Senators have said, we are going to progress each project as quickly as we can. We are not going to let any one project get held up because some other project might not be ready to go. We have four big projects for University Hospital Galway and while they will be done in sympathy with each other and cognisant of each other, we will move each of them on as quickly as we can. That is the way to do it.

I would say the same thing about Galway and reform. I had a very useful meeting with the hospital management after we announced the various capital plans. However, in Galway access to radiology and to MRI is typically scheduled from Monday to Friday between 9 a.m. and 6 p.m., with two nights where the service is provided a bit later than that. The operating theatres are generally closed on Saturdays and Sundays. We must move to a seven-days-a-week service. We must have scheduled operations in theatres on Saturdays and Sundays. We must have access to regular diagnostics and radiology on Saturdays and Sundays. The community teams, the health and social care professional teams, and the consultant teams must be working together to support the emergency department teams to free up the beds in the hospital, get people the scans they need and get them home, get them the treatment they need and get them into community care settings or get them home with a home care package. That is how we will free up beds and get patients off the trolleys in the emergency departments. What I saw while walking around the emergency department in Galway on Friday, which is typically one of the better days, was not acceptable. We had a temporary emergency department, with patients on both sides of a long corridor and the new surge beds were also full. It is not acceptable. In Galway and in Cork it is the same thing. This Government is investing in healthcare infrastructure at a level that has never before been seen, as it must because the system has not had the level of investment required. However, that investment must be matched with a fundamental modernisation of how patients are cared for in Cork, Galway, Limerick and right across the country. We know it works in some parts of the country and we must see that response in Galway and everywhere else.

In Cavan, memory tells me that there are two three-storey projects, one of which is more progressed than the other. One is now moving to tender while the other one is at the appraisal stage. We can always look at increasing the number of floors but all I would say as a cautionary tale is "Look at Galway". The Galway emergency department came up with the idea many years ago to just add a floor, then another floor, and then something else and it is only now making progress. Following my first trip to Galway I rang Mr. Paul Reid on my way back to Dublin and told him that we would prioritise the emergency, paediatric and maternity block and it is now happening. All I would say is "Just be careful". I understand the point but what can happen is that we can end up adding years on to a project. That said, if Senator Joe O'Reilly has a proposal, by all means let us take a look at it.