Seán Kyne (Fine Gael)
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I thank the Cathaoirleach's office for choosing this Commencement matter for debate. I welcome the Minister of State, Deputy Butler, to the Chamber.

I have raised this topic on a number of occasions with the Minister of State’s colleagues, the Minister of State, Deputy Feighan, who has been in the House a number of times, and the Minister of State, Deputy Niall Collins. Unfortunately, the senior Minister has not been to the Chamber as I would like to raise directly with him the ongoing and long-running saga of the new emergency department for University Hospital Galway, UHG. We been talking for a long number of years about the need for a new emergency department. When the Taoiseach, the Minister of State’s party leader, appeared before us before Christmas, I reminded him that he raised this matter with the former Taoiseach, Enda Kenny, in 2015. The then Taoiseach responded at the time that the emergency department in Galway was not fit for purpose. It had not been fit for purpose for a long time before or since and it is not fit for purpose now.

There are plans for a new emergency department, including a paediatrics and maternity ward beside the existing emergency department. Works are ongoing on a new temporary emergency department to allow for decanting and the construction of a new emergency department. I have said in respect of many construction projects that nothing can be built without planning permission. We have not even reached the stage in Galway where a planning application has been lodged for a new emergency department.

When the former Minister for Health, Deputy Harris, visited Galway in September 2018 he was told by the Saolta University Health Care Group that a planning application would be lodged before Christmas 2018. The project specification has changed somewhat since then, which I appreciate. However, considering that the project was so advanced at that stage, with so much work having been done on finalising the design, I still cannot get my head around the fact that all of these years later, and accepting Covid-19 and all that goes with it, we have not yet got to the stage where we can give a concrete date for lodging the planning application. That is without mentioning all the other phases - I hope of course that planning permission will be granted - of detailed design, tender documents, contractors and construction.

There is a long way to go in this process and I understand from engagement with the Saolta group that this project still has to go to the HSE board, the Department of Health, the Department of Public Expenditure and Reform and Cabinet for signing off before a planning application can be lodged. If she has been provided with the information, I ask the Minister of State to set out some timelines for those stages, the current position in relation to them, whether they can be completed in a short period and whether it is just a case of rubber-stamping them.

The Minister of State will appreciate the frustration in Galway, particularly among hospital staff and those who have received excellent care in the hospital but have endured conditions that are less than ideal and which, in the words of Enda Kenny, are not fit for purpose. She will understand the frustration among staff, management and members of the public in Galway. As I said, people have received excellent healthcare but the facilities are not what they should be for a centre of excellence in a regional capital of the west covering an area that extends from Donegal to Galway. I hope the Minister of State will provide some better news than I have received heretofore. There needs to be some concrete dates on the delivery of this project, the lodging of the planning application and the various stages to allow it to proceed to construction.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator for raising this matter. As he said, he has raised it several times before, which I acknowledge. I welcome the opportunity to provide an update on the status of the new emergency department at University Hospital Galway. I also take this opportunity to acknowledge the very difficult and unacceptable conditions for patients, families and healthcare staff working in University Hospital Galway.

I am pleased to say that a €13 million capital investment was approved for an interim emergency department, including additional resuscitation spaces, support accommodation and improved infection prevention and control measures. This facility is under construction using a rapid-build solution.These critical services are expected to be completed by the end of June 2022, about eight weeks away. Further reconfiguration works to the existing emergency department will also be completed as part of the project. I expect that these new facilities will be available for patients and staff during August. While improving service delivery capability, the interim emergency department and associated works will also serve as enabling works for the larger project the Senator spoke about, freeing up the site required for a proposed new block.

I am aware that this project has been discussed for the past ten years and I share the frustration of the team in Galway and the patients there. One of the reasons the project is still in the development phase is that there has been a significant increase in the scale and ambition for the solution on the Galway site. Originally the proposal was for a new multistorey emergency department block, but now the proposals, driven by local requirements and the need to better utilise a constricted site, mean the Department of Health will shortly receive proposals costed in the hundreds of millions. The estimated cost is likely to be in the region of €275 million to €300 million, significantly higher than the €65 million to €120 million cost for the original proposal.

As the Senator will be aware, all projects proposed in excess of €100 million must be subject to the full scrutiny of the public spending code process. The public spending code is designed to ensure that investment decisions are underpinned by a clear policy rationale and costs are well understood. This ensures that maximum value for money for the taxpayer, through disciplined project evaluation, preparation and implementation, can be achieved. The HSE is drafting a strategic assessment report to ensure full compliance with public spending code requirements. I expect this to be submitted to the Department later this month. If granted approval in principle, the preliminary business case, which is at an advanced stage of drafting, will be subject to the external assurance process prior to the submission of the final business case to Government for decision.

I am pleased to say that following the €13 million capital investment, the interim emergency department, which will provide critical services, is expected to be completed by end of June 2022. This will increase service delivery capability.

Seán Kyne (Fine Gael)
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I thank the Minister of State for the response. The only concrete date there is for the opening of the interim emergency department at the end of June 2022. Other than that, there are a lot of words I have heard before. Some are new, such as the phrases "strategic assessment report" and "external assurance process". They do not fill me with hope about the delivery of the project. I am afraid, as I said last time, that the project is going backwards.

The costs were originally less because the project was on a smaller scale. I welcome the admission of the Department in relation to the HSE to ramp it up to include maternity services and paediatrics. Before this, it was a shell and core project. A detailed design of the project was then carried out which pushed the figure into the €275 million to €300 million category. I appreciate there are processes but this does not fill me with hope about when we will get a solution, when a planning application will be lodged and when the process can go towards the long, complicated process of tender documents, contractors being appointed and construction. It is still years away. I wish I could say, as we start the month of May, that a planning application will be lodged before the end of the summer or in the autumn, but I am not getting that from the Minister of State's response.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator and will convey his concerns to the Minister, the Department and the HSE. The proposed new emergency department and the women and children's project is a large and complex project and is in the early stages of design progression. The original proposal was for a new multistorey emergency department block. However, as a result of service-led demands, there has been a significant increase in scale and ambition for the constricted Galway site and the proposal is now for much more than an emergency department.

The strategic assessment report is being drafted by the HSE to ensure full compliance with the public spending code. I hope we will get project board approval and submission as quickly as possible. If granted approval in principle, the preliminary business case, which is at an advanced stage of development, can be updated by the HSE and brought forward for review to progress proposals.This project is part of a larger development that incorporates maternity and paediatric services. It is a complex project that is in the early stages of design progression. In advance of the more permanent arrangements, the interim extension to the emergency department is expected to be completed by the end of June. While there is no date yet for the planning application for the main building, and I know this is the core of what the Senator is saying, the HSE is actively engaging with the local authority as the project proceeds through the initial stages of the public spending code. The Senator has spoken here many times to push this project. I hope progress can be made as quickly as possible if the strategic assessment report stacks up and I have no doubt it will.