Seanad debates

Wednesday, 28 February 2024

Nithe i dtosach suíonna - Commencement Matters

Hospital Facilities

10:30 am

Photo of Seán KyneSeán Kyne (Fine Gael)
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I welcome the Minister of State, but I join Senator Horkan in expressing disappointment that neither the Minister nor one of the Ministers of State at the Department of Health are here to take these matters. The Minister of State, Deputy Heydon, is on duty in both Houses. Unfortunately, it seems to be the new trend that Ministers come in to speak on behalf of all Departments on a certain day.

Bernard Gloster, the CEO of the HSE, is on record as saying that Galway is far behind the capital curve in comparison with other places. In Galway and the wider region need a new emergency department, improved paediatric and maternity services, new laboratories -- the existing laboratories are more than 50 years old - a cancer care centre and additional beds. I know there are also plans for a surgical hub at Merlin Park University Hospital. Last October, I raised the HSE's capital investment plans with Bernard Gloster at a meeting of the Joint Committee on Health. This was following the opening of the radiation and oncology centre at University Hospital Galway. The people of Galway are frustrated. As Mr. Gloster said on the day, nobody should try to persuade the people of Galway from their frustration because it is justified. He stated:

There is a group of internal and external experts in a project group, supporting the CEO of Saolta and me nationally, to bring together all the previous work that was done into one tight, comprehensive plan with a list of priorities ... Government will be in a position to be fully confident in investing in the scale of that plan.

He also stated that he would "expect to see a definitive, total project site plan in no more than three months." I told him I would hold him to that. That was more than three months ago. Has progress been made? Is a definitive date likely to be set with regard to the plans for University Hospital Galway?

When I was out and about at the weekend, I met a lady who was evidently unwell but who was in relative good humour in spite of that. She told me she is undergoing cancer treatment. I expressed my sympathy and wished her well in her course of treatment. She then went on to say that she had spent seven days on a trolley in Galway. Another individual who was present stated that they spent nine days on a trolley. The lady to whom I refer was not giving out, but, to be honest, she would have every right to do so. She had every right to eat me if she wanted. She did not. She thanked me for other things, but that was her journey as someone undergoing cancer treatment.

Cancer patients still have to go through emergency departments. There is no separation in Galway, hence the need for the comprehensive plans. We need additional beds, the cancer centre, a new emergency department and paediatric and maternity services. Bernard Gloster is on record as saying too much time has been lost on debates back and forth between Merlin Park and University Hospital Galway and on options and appraisals. That was the greatest waste of money and, more importantly, time. There was a debate about a new €4 billion hospital to be built at Merlin Park. That was never feasible. All this has done for Galway is caused delays. It has caused delays and frustration in respect of the delivery of projects we all know we need. It is back and forth. What are we going to do? Will we build it in one place or the other? Ultimately, we are building very little. We have the state-of-the-art radiation and oncology building that was opened last November. We have the 75-bed ward from a number of years ago that some people also opposed. We have a massive need for capital investment in Galway. In that context, I want to see the plans progressing.

Photo of Martin HeydonMartin Heydon (Kildare South, Fine Gael)
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I thank Senator Kyne for raising this important issue. It is important to put the first-hand story of his constituent's experience on the record of House. What he outlined is not good enough. I am giving this response on behalf of the Minister for Health, who, unfortunately, cannot be here.

The Minister and his officials have visited the University Hospital Galway campus on a number of occasions over the past year. The Minister recognises the need for additional capital investment in the facilities at University Hospital Galway and wants to reassure Senator Kyne and others that there is a clear pathway forward to achieve this. There are a number of significant capital investment projects proposed for the campus, which include an emergency department, a women and children’s block, a regional cancer centre and replacement laboratories. These proposals are of significant scale. An integrated approach is required to ensure that any works do not adversely impact the ongoing delivery of healthcare on the congested campus. To progress this as effectively and as efficiently as possible, the Department of Health agreed to the establishment of the University Hospital Galway programme oversight board. The oversight board is chaired by the CEO of the Saolta Hospital Group.Its initial focus is on the development of an integrated strategic master plan for UHG to support the phased delivery of capital investment there. To support the oversight board, a dedicated programme manager has been sanctioned by the HSE's CEO. This role is currently being advertised and the closing date for interested parties is next week. The work of the oversight board will leverage the work carried out to date on the three separate significant proposals for the campus.

While originally a new emergency department was proposed for Galway due to service-led demands it now incorporates new maternity and pediatric departments. An interim ED was developed and opened in October 2022, as Senator Kyne will be aware. It includes additional resuscitation spaces, support accommodation and improved infection prevention and control measures. This work will also serve as enabling works for the larger new ED, women and children's departments proposals. The project team and oversight board have been tasked with enhancing the strategic assessment report-preliminary business case, SAR-PBC - there are an awful lot of acronyms in my response - for the ED and women and children's block to ensure it meets the standards required for the external reviews required under the infrastructural guidelines which have replaced the public spending code. It will also ensure it appropriately captures the important work of the oversight board to ensure the successful delivery of the new investment at the UHG campus.

With regard to the proposals for the replacement laboratories and the regional cancer centre, the Department of Health has provided comprehensive feedback on what the project team and oversight board need to do to advance these proposals. Incorporation of this feedback will ensure that robust business cases are developed to support the important capital investment in the Galway campus. Much investment is needed in the facilities of University Hospital Galway to support the staff there to continue to deliver the high standard of care patients and their families expect and deserve. A clear process is under way to deliver that much-needed investment in Galway. Again, I thank Senator Kyne for raising these important points today.

Photo of Seán KyneSeán Kyne (Fine Gael)
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I thank the Minister of State for the response from the Department of Health. He is right that there are a lot of acronyms in his response but there are not any timelines - any dates for delivery, for when planning permission might be lodged, for when the design might be complete or for when the oversight board might report. There is not any date for meaningful progress that could help constituents in the medium term, because there is no short term here. As I said on numerous occasions, when the former Minister, Deputy Harris, was in Galway in September 2018 he was told by Saolta that the planning permission for a new ED would lodged before Christmas. That was 2018 and here we are in spring 2024. The project specification has changed somewhat but we are still waiting.

Yes, we have the temporary ED and we have planning permission to demolish the old ED. That is slight progress but we still do not have a firm date for when a planning application for emergency, paediatrics and maternity will be provided or indeed for the new laboratories and cancer care centre. There is a lot of work needed in Galway and all we have is talk and plans. We need delivery.

Photo of Martin HeydonMartin Heydon (Kildare South, Fine Gael)
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I again thank the Senator for raising this. The response I was given by the Minister for Health, Deputy Stephen Donnelly, does not have clear timelines in it. It does have a process. In fairness, it can be hard to predict specific timelines in each stage of the process. That has potential for delays. I will outline further in the supplementary reply I have that the proposals are significant in scale and complexity for a busy and congested hospital. When complete they will provide state-of-the-art facilities at Galway University Hospital. The approach of the capital programme oversight board will ensure the much-needed capital investment in Galway will be based on current and future population demand and reflect integrated service capacity needs. It will also ensure the practical delivery of investment in Galway is achievable, affordable and represents value for money. There are important principles for the delivery of the capital infrastructure funded under the national development plan. The proposals for the ED, women and children's block and the cancer centre are in excess of €200 million and must meet the requirements of new infrastructural guidelines put in place under the public spending code in December 2023.

The work that is under way by the project team oversight board will ensure that robust business cases are developed to support proposals and enable the project to progress to the next stages of the development process. It must be subject to independent external review and validation before Government consent can be sought to proceed to developing the final business case and advancing the design and statutory planning process for the proposals involved. Again, I thank Senator Kyne for raising this and I will bring back the points he raised specifically to the Minister, Deputy Stephen Donnelly.