Paudie Coffey (Fine Gael)
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I welcome the Minister for State with responsibility for health promotion to the House, where I again raise important issues during a Commencement debate concerning the health service, not just in my county and city but nationally. In 2013, the previous Government, in an attempt to create efficiencies within acute hospital services, decided to reform the acute hospital network and reconfigure it into hospital groups. The South-South West hospital group in my area consists of University Hospital Waterford, which is my local hospital, as well as hospitals in Cork and Kerry. At that time, there was grave public concern that this reform would lead to the downgrading of the model 4 hospital at University Hospital Waterford, which has provided specialist services across a range of acute services for the region.

Certain assurances were given in writing by the former Minister for Health, the Secretary General of the Department of Health and senior management in the HSE that this would not lead to downgrading. However, I have concerns I wish to raise today. When these hospital groups were formed, hospital boards were to be appointed in tandem. Four years later, we still do not have sight of a hospital board being appointed for the South-South West hospital group. This is a cause of great concern to me because the hospital boards were meant to be appointed to bring oversight and accountability in terms of governance and efficiency of expenditure in respect of the HSE and various services.

This leads to my next point regarding the capital plan the HSE plans and adopts for health services around the country. Again, University Hospital Waterford is the example about which I can speak the most. I acknowledge the investment by the State in the new accident and emergency department, which was a major capital investment. I also acknowledge the news that the new palliative centre for the hospital will go out to tender and possibly building very shortly but I have to add that this is not before time. For many years, the south east has been the only region without that type of palliative care support. It would not have happened without fund raising by the hospice movement in Waterford and surrounding counties. The news that the five-storey block will be built is welcome.

Recent controversies around cardiac care continue. There are promises of a mobile catheterisation laboratory. However, I was horrified to read a plan that was recently disclosed to me. The plan was a report by a review team into University Hospital Waterford in December 2014. This report was carried out by the HSE to review the acute services as part of the reconfiguration plans. In this report, I was horrified to discover that the HSE has approved more than €5.4 million for a new mortuary for University Hospital Waterford at a time when all public representatives, all parties, consultants, the public and everybody in the region are crying out for an investment of €2.4 million for a second catheterisation laboratory for cardiac services in the region. I am dismayed and cannot believe that the HSE can invest €5.4 million into looking after the dead when it cannot invest €2.4 million to look after the living. I am horrified and wanted to bring it to the Minister of State's attention. I believe this is happening because we do not have the oversight, governance and accountability that was foreseen when these hospital groups were first established.Somebody needs to call the HSE to task. I have tried to do it but, unfortunately, to date I have failed. We need the political system to work and these bureaucrats need to be asked to explain why this investment is being put in the wrong place.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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I thank Senator Coffey for raising this issue.

Acute hospitals are organised into seven hospital groups, the formation of which is a key element in the reform of our health services. The establishment of acute hospitals into a small number of groups provides an optimal configuration for hospital services to deliver high-quality, safe patient care in a cost-effective manner. The establishment of hospital groups is a key enabler for the reorganisation of services across hospitals, with associated benefits in terms of providing care in the most appropriate setting and delivering a safe quality service.

Significant progress has been made in the implementation of the hospital group construct, with individual hospitals within the groups starting to work together to support each other, providing a stronger role for smaller hospitals in delivering less complex care and ensuring that patients who require true emergency or complex planned care are managed safely in larger hospitals. Chairpersons are in place for six of the hospital groups. Board members are currently in place for the University Limerick hospital group. In late 2016, the Department commenced advertising, through the Public Appointments Service, PAS, for candidates for appointment to the hospital group boards. This process began with campaigns in respect of the Saolta University Healthcare Group board and chair and the University Limerick hospital group board. Those campaigns have been completed. Arrangements to advance the South/South West hospital group and the other hospital group board vacancies, including phased timetable for PAS campaign, is under consideration, informed by the experience gained from the first two campaigns.

The projects under way at University Hospital Waterford are the new ward block and a decontamination facility to support the endoscopy department. Recently completed projects at University Hospital Waterford include: an upgrade of infrastructure, as approved in the hospital’s development control plan, including the development of utilities, power supply and roads to facilitate future development at the hospital; upgrade to the theatre air-handling units; refurbishment and upgrade of the acute mental health department; provision of a CT scanner in the emergency department; and a cystic fibrosis unit, with the provision of four isolation rooms, part-funded by the local cystic fibrosis group.

Future investment in hospitals must be considered in the context of the overall acute hospital sector infrastructure programme, the prioritised needs of the hospital groups and the overall capital envelope available to the health service. Nevertheless, the HSE will continue to apply the available funding for infrastructure development in the most effective way possible to meet current and future needs, having regard to the level of commitments and the costs of completion already in place. The Department of Health is working with the HSE and the Department of Public Expenditure and Reform to conduct a mid-term review of the capital programme. The Department is also conducting a bed capacity review. This will assess projected health care needs over the next decade and the associated infrastructural requirements to meet these needs.

The investment in the palliative care unit and other facilities which the Senator referred to are welcome. Unfortunately, I do not have any information on the report of the review team in 2014. I will contact the HSE on foot of the Senator raising the matter with me and come back to him with that information.

Paudie Coffey (Fine Gael)
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I thank the Minister of State for taking up my genuine concerns about capital plans adopted and pursued by the HSE. I acknowledge that the hospital groups were set up for the optimal configuration of acute hospital services in the interests of patient safety, as well as to achieve cost-effective patient safety. Unfortunately, until the boards are in place, we will not have the accountability and oversight over the HSE which is required.

I am horrified that in its review in 2014, the HSE could approve an investment of €5.4 million for a mortuary but that it does not have the vision or foresight to provide essential services. In the south-east region, we have patient apartheid whereby if one has a heart attack after hours in the evenings or at weekends, one does not have access to interventional cardiology. Somebody somewhere has his or her priorities wrong. My faith is still in the political system putting that right and that is why I raised the matter.I appreciate the fact that the Minister of State is not only taking it up on my behalf but also on behalf of people in Waterford and the wider south-east region. We must have oversight where it matters and bring these bureaucrats in the HSE to account. This Government is being blamed while the HSE is running amok investing in the wrong priorities.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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I will take on board the urgency of appointing the board, as the Senator has outlined. While I have been informed that it is under consideration, I totally understand the need for a timeline by which this matter will be concluded. That is what we really require, so I will certainly follow up on that for the Senator.