Garret Ahearn (Fine Gael)
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I thank the Cathaoirleach for accepting this matter, which relates to an issue that is very important to us in Tipperary. It is particularly important to Councillor Declan Burgess, who has been working with the HSE for a number of years to try to push this project along in his home town of Cashel. It is infuriating because the process is stuck at a particular stage. St. Patrick's Hospital in Cashel in County Tipperary provides residential rehabilitation and respite care to older adults in the south Tipperary area. It provides a top-class service and is considered a very strong example of how to do community healthcare right. The national capital plan includes the new build for St. Patrick's Hospital in Cashel. It will be a 60-bed unit that will replace the current St. Anne's, St. Bernadette's and St. Benedict's wards. It has survived the review of the capital plan on numerous occasions and remains committed to by the HSE.

Councillor Burgess has been advised on numerous occasions that a design team has been appointed, and that a pre-planning meeting was conducted with Tipperary County Council. Members of the HSE design team have visited several sites as part of the process of agreeing the overall layout and design of the premises. It was planned to submit for planning permission by August 2019, and then subsequently in early 2020. We are very concerned that the delay in submission for planning permission is not a good indicator to the future development of this project. Time and again the HSE has said to us that they are at stage 2, which is the detailed design and planning application. It is imperative that planning permission would be submitted as soon as possible. There were significant delays due to Covid 19 and the complicated site investigations that have to be carried out in respect of historical locations. Despite several motions and questions tabled by him at the HSE health forum, Councillor Burgess is none the wiser as to the reasoning behind the delay in submitting the application to the planning section of Tipperary County Council. They were ready for submitting in August 2019 and early 2020 but it just never materialised.

We want to get to the bottom of the situation here. We made a commitment to develop this 60-bed unit. We have announced to the people in Cashel. The people in south Tipperary want this project delivered. It is very frustrating when, as a local councillor in your home town, you see people every day who know that the Government you represent announced a project in respect of which nothing has happened and which is stuck in the planning process. That is just not acceptable. Our representatives on the ground need answers when something like this happens. I really hope that the Minister of State will be able to provide some extra information for me and for Councillor Burgess.

Thomas Byrne (Meath East, Fianna Fail)
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I am taking this matter on behalf of the Minister for Health, Deputy Donnelly, who is in the Dáil taking parliamentary questions on health. The Minister thanks the Senator for raising this issue and providing the opportunity to update the House on the position relating to St. Patrick’s Hospital in Cashel.

In early 2016, a capital programme for older persons residential centres was developed in response to the introduction of HIQA’s national residential care standards for older people and the requirement that all facilities providing long-stay beds be registered by HIQA. This is a programme to replace, upgrade and refurbish care facilities, as appropriate, at 90 locations. The vast majority of projects are replacement capacity. The emergence of the Covid 19 pandemic in March 2020 interrupted work on St. Patrick's Hospital. As a response to Covid-19 risks, upgrade works were carried out to make facilities located on the campus of the nearby Our Lady’s Hospital, Cashel - now called the Cashel Residential Older Persons Services - suitable for long-stay residential use. Residents from St. Patrick’s Hospital were moved to this facility, which was registered under HIQA for three years from June 2020. The three-year registration is due for renewal and the HSE is engaged with HIQA regarding registration.

The Minister, the Minister of State, Deputy Butler, the Department and the HSE are committed to the development of a new community nursing unit for older persons for Cashel. The HSE advises that the existing site is not suitable for the new 60-bed community nursing unit, CNU. The HSE also advises that the site is very limited in size. Challenges regarding the amount of parking space and access to the building have been identified. A site in Cashel town is currently being reviewed by HSE for suitability for a new CNU. In line with project guidelines and best practice, an options appraisal will be completed to review all options for delivering the required CNU accommodation. This review is expected to be completed in quarter 2 of 2023. An assessment and rehabilitation unit, and a day hospital for older persons services, continue to operate at St. Patrick’s Hospital.

Specialist renovation works have been carried out on some of the vacated space at St. Patrick’s Hospital for the development of new facilities for the children’s disability network team for Cashel, Tipperary and surrounding areas. This will also accommodate children’s disability services originally based at Our Lady’s Hospital. Other available space at St. Patrick’s Hospital is being considered for the development of facilities for the HSE’s roll out of the enhanced community care programme. In addition, the public private partnership build in Clonmel, with a completion date of quarter 4 of 2024, has started. This will provide a 50-bed CNU.

All capital development proposals must progress through a number of approval stages, in line with the public spending code, including detailed appraisal, planning, design and procurement before funding for each stage can be confirmed. The successful completion of the various approval stages will determine the timeline for delivery of this project. It is not possible to provide a timeline for construction or operation of the facility at this point.

Garret Ahearn (Fine Gael)
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I thank the Minister of State for his response. In fairness, I understand that the Minister for Health and the Minister of State, Deputy Butler, are in the Dáil taking questions. I welcome the fact that they are committed to the development of a new CNU for older persons in Cashel. That is the most important thing. It is important that there is a commitment in this regard. Investment has been made in Tipperary in other areas and there is future investment planned also. The Minister of State, Deputy Byrne, will understand that from local perspective it is incredibly frustrating when projects are being delayed and when we as public representatives cannot get the answers on when the projects will move forward.

I welcome that there will be a bit of movement in quarter 2 of 2023. I ask that there be as much communication as possible with councillors, particularly as this matter relates to their home town where a big development is going to happen. They are the ones who will be asked the questions about why the project has been delayed and when it will be completed. Will the Minister of State, Deputy Byrne, contact the Minister of State, Deputy Butler, to ask if she would meet with me and Councillor Burgess to discuss the project? It is a really positive story that will be a huge benefit for the area. We just need to make sure that it keeps moving along and progressing, in a timely and speedy manner.

Thomas Byrne (Meath East, Fianna Fail)
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I will certainly communicate that to the Minister of State, Deputy Butler. I reiterate that the Department of Health, the HSE, the Minister for Health and the Minister of State, Deputy Butler, are all committed to the development of a new CNU for Cashel. Provision has been made in this year's capital programme to progress a 60-bed CNU for Cashel. A site in Cashel town is currently being reviewed by the HSE for suitability for the new CNU.

Services are still be provided at St. Patrick's Hospital in Cashel. An assessment and rehabilitation unit and a day hospital for older persons services continue to operate, and will continue. I will bring the concerns raised by Senator Ahearn to the Minister and the Minister of State, Deputy Butler. There is a commitment there and there is funding in the HSE capital plan. Work is under way to review a particular site and let us hope that this is successful.