James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 248: To ask the Minister for Health and Children the position regarding the co-location plan; and if she will make a statement on the matter. [26766/08]

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 249: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to ensure that clear benefits to the public are identified and achieved in the hospitals co-location policy; and if she will make a statement on the matter. [26767/08]

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 250: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to carry out an independent review of the co-location policy; her views on whether it would have been better practice in public sector policy to conduct the independent review prior to pursuing the policy; and if she will make a statement on the matter. [26768/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

I propose to take Questions Nos. 248 to 250, inclusive, together.

Under the Programme for Government, the Government is committed to providing an additional 1,500 public acute hospital beds. The co-location initiative aims to deliver approximately 1,000 of these beds for public patients through the development of private hospitals on public sites.

The essential idea underlying the co-location initiative is to free up capacity for public patients and deliver new public acute beds in the quickest and most efficient manner. The initiative was founded on the principle that all patients ordinarily resident in the State should have access to public hospitals based on medical need; the possession of private health insurance should not influence timeliness of access or treatment. A diversity of providers of hospital care is commonplace in many countries and is entirely appropriate.

The scheme of capital allowances for the construction or refurbishment of buildings used as private hospitals was introduced in the Finance Act 2001 and came into effect in May 2002. Provided that capital expenditure on the proposed co-located private hospitals conforms with the existing legislation governing that scheme, normal tax relief will apply. Under the terms of the Finance Act 2001, the co-located hospital must ensure that at least 20% of its bed capacity be made available to the HSE for the treatment of individuals awaiting in-patient or outpatient hospital services as public patients. The fees charged must be not be more than 90% of the fees that would be charged for equivalent treatment provided to a patient with private medical insurance.

The new privately-managed facilities will be available for public patients and will supplement rather than supplant public service provision. In principle, all such hospital capacity that meets standards and offers value for money should be capable of being used for all patients.

The Government endorsed the co-location initiative in July 2005. The policy direction I subsequently issued to the HSE required the Executive to undertake a rigorous value for money assessment of co-location proposals which would take account of the value of the public site and the cost of the tax forgone. The HSE had to satisfy itself that proposals represented better value for money than building, commissioning and operating beds in the traditional manner. Projects in order to proceed must meet a rigorous value for money test which accords with a Public Sector Benchmark applied by the HSE in the first instance, which is verified by the National Development Finance Agency (NDFA) which acts as advisor to the Department of Health and Children. The HSE and NDFA calculations went through all aspects of each project in great detail, including such matters as site value, capital allowances cost, value of released beds and loss of private income to public hospitals. The HSE and NDFA have confirmed that the tenders received for the six most advanced projects provide value for money and the projects must continue to demonstrate value for money as they proceed.

Detailed and innovative features will promote the public interest. Each site will have one accident and emergency department. The private hospitals will facilitate medical training and research and development; accept direct admissions to medical and surgical admission units from primary care centres and general practitioners on a 24-hour basis; comply with physical design requirements to fit with the public hospital; have joint clinical governance, shared information and records management, performance management and documented service level agreements, where these are undertaken; and participate in the public HIPE and casemix information systems.

The Board of the Health Service Executive (HSE) has approved preferred bidders for six co-located hospital sites: Beaumont Hospital, Cork University Hospital, Limerick Regional Hospital, St. James's Hospital, Waterford Regional Hospital, Sligo General Hospital.

The Project Agreements for Limerick Regional Hospital, Beaumont Hospital and Cork University Hospital have been signed. Planning permission has been granted by the local authorities concerned for the co-located hospitals at Beaumont and at Cork University Hospital Planning permission for the Beaumont and Cork projects has been appealed to an Bord Pleanála. The HSE has advised my Department that a decision to grant planning permission for the Limerick Regional Hospital project was given in mid June and that this decision is scheduled to be made final later this month subject to no planning appeal being lodged.

The HSE advises that the Project Agreements for St. James's Hospital and Waterford Regional Hospital are expected to be signed shortly. The HSE expects the Sligo Project Agreement to be concluded by the autumn.

Connolly Hospital and Tallaght Hospital, which are also participating in the co-location initiative, are at an earlier stage of the procurement process. Connolly Hospital is at preferred bidder stage and it is expected that the invitation to tender (ITT) for Tallaght Hospital will issue in the near future.

The Programme for Government contains a commitment to carry out an independent review of the co location initiative following completion of the current programme. In accordance with this commitment, my Department will make the necessary arrangements to commission such a review in due course.