Maria Byrne (Fine Gael)
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I welcome the Minister of State to the House to discuss the 120 replacement beds that are needed at St. John's Hospital, Limerick. In 2017 the Minister, Deputy Harris, visited St. John's and acknowledged that he could see the need for the 120 beds to be replaced. My question is whether St. John's Hospital will be included in the capital plan. University Hospital Limerick is in the news all the time in respect of its beds and its bed capacity. While 60 modular beds have been started, it will be a while before they will be opened. We need to start planning for the future. Attendance numbers are up at both University Hospital Limerick and St. John's Hospital. St. John's Hospital is a minor injuries clinic but it does some day procedures and if it received 120 replacement beds on a permanent basis, it would be able to carry out more procedures and deal with more minor injuries. This would alleviate the pressure on University Hospital Limerick. The beds need to go ahead at the same time as in University Hospital Limerick because we need to alleviate the pressure. People come from all over the mid-west and Nenagh Hospital is now carrying out cataract operations but we need St. John's Hospital and University Hospital Limerick to deliver at full capacity to meet the needs of the mid-west.

Finian McGrath (Dublin Bay North, Independent)
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I thank Senator Byrne for raising this issue and I commend her on her work to drive the project at St. John's Hospital. I know she has a particular interest in it and that she is very committed to the people of Limerick. It also gives me the opportunity to outline to the House the position on the proposed capital development of a 120-bed ward to replace the existing ward accommodation at St. John's Hospital, Limerick.

St. John's is a model 2S voluntary hospital within the University of Limerick hospitals group covering Limerick, Clare and north Tipperary. The hospital currently has 88 inpatient medical beds and ten beds for day surgery. It also provides a medical assessment unit, a minor injuries unit and five-day surgery to the people of the region. I understand the current proposal is for a 120-bed replacement ward block, consisting of four units of 30 single rooms for inpatient ward accommodation. Progress in respect of these and all other capital projects are subject to the availability of capital funding. All healthcare infrastructure developments, including this development, must comply with the Department of Public Expenditure and Reform guidelines and EU directives and will require a lead-in time to complete the various stages of public capital projects. These stages include appraisal, project brief, design feasibility, detailed design, some of which may overlap, the review of costing estimates and the finalisation of financing.

The national development plan, NDP, announced last year as part of the Project Ireland 2040 policy initiative, provides €10.9 billion for health capital developments across the country, including both national programmes and individual projects, across acute, primary and social care. The delivery of NDP projects and programmes, including developments in Limerick, will result in healthcare facilities that allow for implementation of new models of care and for delivery of services in high-quality modern facilities. The revised health capital allocation in 2019 is €642 million for the construction and equipping of health facilities. The Department and the Health Service Executive are currently engaged in a process to finalise the HSE capital plan for 2019. In developing its capital plan for 2019 and future years, the HSE must consider a range of issues, including the expenditure that is contractually committed, the HSE's annual requirement in relation to meeting risks associated with clinical equipment, ambulances and healthcare infrastructure.The HSE capital plan will propose the projects that can be progressed in 2019 and beyond, having regard to the available capital funding, the number of large national projects under way, the cashflow requirements attaching to each project and the relevant priority. Projects that are currently under construction and contractually committed to will not be affected. Once the HSE finalises the capital plan for 2019, it will be submitted to the Minister for consideration.

I will convey the Senator's considerations and concerns to the Minister.

Maria Byrne (Fine Gael)
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I understand the Minister of State's point that everything must meet the requirements under procurement. My understanding is that St. John's Hospital is at an advanced stage and everything that needs to be submitted has been submitted. It has submitted all the required documents that have been requested to date.

University Hospital Limerick is constantly in the news. We need the two hospitals to be developed together because it is the only way forward. It is not just about serving the people of Limerick but also the people of the mid-west generally. There is a great deal of capacity. I read a tweet about figures by a senior member of staff at the hospital. It referred to some of the other, larger hospitals which have fewer members of staff and so on, but the number of people who present at University Hospital Limerick is 21% higher than the number who present at some of the larger hospitals in Dublin and the surrounding area. It is a high number. If we can get the small injuries clinic up and running properly, there can be more day procedures and it will take the pressure off University Hospital Limerick.

Finian McGrath (Dublin Bay North, Independent)
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While St. John's Hospital is at an advanced stage, I fully accept the Senator's point because I know Limerick well. I have spent much time there and my sister lives there. I am aware, therefore, that Limerick needs two hospitals, which would take the pressure off. I also agree that it is important to bear in mind that the hospital serves the general mid-west, while the fact that 21% more people attend University Hospital Limerick than other hospitals must also be considered. The Government is committed to delivering acute hospital services and infrastructure. St. John's Hospital is an integral part of the University Limerick hospital group, providing hospital services and care for the population of counties Limerick and Clare and north County Tipperary. The hospital provides high-quality patient care. As I outlined, proposals for the new 120-bed ward, to replace the existing board accommodation at St. John's Hospital, are at an early stage of planning and appraisal. All capital developments depend on the resources.

I will convey to the Minister the relevant points raised by the Senator. The HSE capital plan will determine the projects that can be progressed in 2019 and beyond, having regard to funding.