Seán Kyne (Fine Gael)
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I welcome the Minister of State, Deputy Feighan. I am delighted to see somebody from the west here as this topic relates to hospital services in the west, in particular the Galway region. The Minister of State will be aware that Galway University Hospitals comprises University Hospital Galway, UHG, and Merlin Park Hospital, which provide a range of emergency elective services for the people of Galway and the western region. UHG is a model 4 hospital.

I am sure the Minister of State was invited to participate in the presentations from the Saolta University Health Care Group regarding ambitious plans for the future of healthcare in Galway and the west. The group commissioned an options appraisal, published in 2019, which gave a range of indicative costs for a new hospital in Merlin Park, the refurbishment of University Hospital Galway, the creation of acute services in Merlin Park and elective services in UGH or vice versa. These costs ranged from €2.9 billion and €3.4 billion, which the Minister of State will agree is a considerable amount of money.

Saolta is right to have a vision for the future of healthcare. I acknowledge and commend the group in that regard. The options appraisal acknowledged that an emergency department should be built on the existing site at UGH and that consideration would be given to a range of services and the possibility of an elective hospital in the Merlin Park unit. We were awaiting plans. There were frustrating delays with regard to planning applications for an emergency department and a lot of talk and discussion about what would or would not be included as part of the facilities in Merlin Park. Lo and behold, the Department of Health, through the Sláintecare team, made a presentation to the South/South West Hospital Group that referred to the plans for Galway, Cork and Dublin, and there was a lot of similarity and information that was relevant to all three sites. This presentation showed that the facilities will provide high value, low complexity procedures on a day and outpatient basis, together with a range of ambulatory diagnostic services. The chosen model for the Merlin Park facility, according to the presentation by the Sláintecare team, was for selective day surgery plus a minor see and treat service, which was one place above a minor procedures unit and three places below a full elective hospital. There was no mention of any inpatient beds and, in fact, there was no mention of anything except day facilities, six days a week, 50 weeks of the year.

There is absolute confusion in Galway at the moment in terms of what Saolta, the Department of Health, the Sláintecare team and, dare I say, the Government have in mind in regard to the competing demands of Merlin Park and UHG. The planning application for an emergency department has still not been lodged despite the then Minister, Deputy Harris, being told in 2018 that it would be lodged before Christmas of that year. We have talk but no concrete plans in respect of Merlin Park. We are at sixes and sevens and are falling between two stools. We have a grand vision and we have immediate needs in regard to an emergency department and extra elective beds. Thank God we delivered a 75-bed unit in new, modern facilities in UHG, which the then Taoiseach, Deputy Varadkar, opened. Thank God we got that delivery at UHG. Perhaps the Minister of State will be able to shed some light on what the Department of Health has in mind for healthcare in Galway.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank Senator Kyne for raising this important issue. I attended those presentations of the Saolta Group, which were quite interesting. As the Senator is aware, the national development plan states:

New dedicated ambulatory elective only hospital facilities will be introduced in Dublin Galway and Cork. These facilities will provide high volume, low complexity procedures on a day and outpatient basis, together with a range of ambulatory diagnostic services. The high volume of demand for such services in these major urban centres is sufficient to justify the construction of dedicated ambulatory centres.

I note that the introduction of these dedicated elective sites is also in line with the recommendations of the 2018 health service capacity review. These high-volume, low-complexity facilities will play a crucial role in developing the elective hospital capacity with a ten-year horizon of need, looking to current and future population demographics, which facilitates the separation of scheduled and unscheduled care and provides quicker, higher quality, safer care for selected elective patients. The new elective hospitals will also create capacity for acute hospital sites and reduce or eliminate outlier boarding - effectively trolleys - assist in reducing cancellations and acute hospital footfall, and drive down waiting lists, both outpatient and inpatient or day case.

An elective hospitals oversight group, chaired by Professor Frank Keane, is following the process outlined in the public spending code in bringing forward this project for the Government's consideration. As required under the code, a strategic assessment report has been completed. This sets out the rationale for investment, the alignment of the programme with strategic requirements of Government, some initial options and potential costs and the governance of the programme. Work is ongoing on a draft preliminary business case, which will recommend a single site option in each of Galway, Cork and Dublin. A site identification exercise to identify possible suitable sites in the three locations will begin in the near future. In accordance with the public spending code, sites short-listed following this exercise will be appraised on a qualitative and quantitative basis, with a view to recommending a single preferred option in each location. Once completed, the draft preliminary business case will go to Government for consideration and decision.Department of Health officials have engaged in consultations with the management of the hospital groups around the country, including, in recent days, the Saolta University Health Care Group. The Minister is conscious that the elective hospitals programme is only part of the solution for deficiencies in existing healthcare facilities highlighted by Covid-19, including issues such as privacy, single bedrooms, space, light, air ventilation and ICUs. The review of the national development plan under way may provide an opportunity to address some of these infrastructural and other issues. In the meantime, the Minister has committed to exploring synergies between the electives programmes and plans for the development of other services drawn up by the hospital groups in Galway and elsewhere. Under the current site identification exercise, for example, it is a requirement that sites must be sufficiently large so as to be capable of expansion and have the potential, in a later phase, to accommodate possible other services on-site.

The Minister looks forward to continued discussions with the Senator and keeping the Seanad informed of developments on the programme.

Seán Kyne (Fine Gael)
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That would be a first if we were kept informed as we are not being kept informed. In fact, the information that we got came through a colleague in Cork. There seems to be some surprise that I was given access to this information and that I am now raising these concerns, which I have raised locally as well.

The Minister of State referred to a draft preliminary business case, site specificity and choosing the site. That is going backwards because it seemed to have been acknowledged that the site would be at Merlin Park if there were to be an elective hospital built or perhaps we are talking about the Galway Airport site but who knows. We seem to be going backwards if that is the case.

We need to keep the pressure on. Galway University Hospitals are for the west. They cover Sligo, Leitrim and Donegal as well. The west and Galway deserve the best and as good as anywhere else in the country. I ask the Minister of State to keep the pressure on in his Department to provide some certainty on healthcare plans for Galway. We have heard rumours and speculation; we need certainty about the Department of Health's future healthcare plans.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Senator for his contribution. He must keep the pressure on and we hope that the Seanad will be kept informed. This issue is not part of my area in the Department but I am keen to ensure that we are kept informed.

As I noted in my opening statement, the newly elective-ambulatory facilities in Galway, Cork and Dublin are expressly designed to deal with the high volume and low complexity procedures on the basis of day patients and outpatients. The site identification, validation and selection process that will begin in the near future will be detailed and thorough, as will the appraisal of the sites identified under the process.

When the key criteria for capacity, expansion and development for additional facilities, and I take on board what the Senator said about various sites, and once a preferred option in each location has been identified, the draft preliminary business case can be concluded. I hope that it can be submitted to the Government before the summer. In this regard, the Sláintecare Programme Implementation Office will continue to engage with the local hospital groups.