Stephen Donnelly (Wicklow, Fianna Fail)
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The Cross Party Sláintecare Report in 2017 articulated a new vision for healthcare in Ireland, including the provision of elective only hospitals, providing protected capacity for elective care. The “Elective Hospitals Oversight Group”, under the joint governance of the Health Service Executive, Department of Health and Sláintecare, has been guiding the development of the elective hospital proposals, following the process outlined in the updated Public Spending Code, setting out the value for money requirements for the evaluation, planning, and management of large public investment projects.

In December 2021 the Government agreed, subject to the necessary approvals and requirements under the Public Spending Code being met, a new National Elective Ambulatory Care Strategy. This new strategy aims to change the way in which day case, scheduled procedures, surgeries, scans and outpatient services can be better arranged to ensure greater capacity in the future and help to address waiting lists. The development of additional capacity will be provided through dedicated, standalone Elective Hospitals in Cork, Galway and Dublin. No other locations are under active consideration. It is important to note that the locations chosen will allow for new facilities of a size and scale to implement an elective care programme that will tackle waiting lists on a national basis. This means that the new facilities will be designed to maximise their capacity and in doing so will operate to cover as a wide catchment area as possible, extending beyond existing and future health areas including Limerick and neighbouring mid-west counties.

The elective care scope of service will be developed in two phases commencing with day cases, diagnostics, and outpatients and then by in-patient treatment. On this basis, the Elective Care Centres (ECCs) will be designed to provide sufficient capacity to facilitate future phases, including some elective in patient capacity, thereby providing a sustainable and strategic response to cater for the highly dynamic landscape of healthcare policy and practice.

Individual Preliminary Business Cases for each location are at an advanced stage of development. and will be subject to technical review by the Department of Health and the Department of Public Expenditure and Reform. Pending favourable review(s) under the Public Spending Code, that further memoranda for Government would then be brought forward to progress this proposal for Cork, Galway and Dublin.

Catherine Connolly (Galway West, Independent)
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609. To ask the Minister for Health his plans to publish the Safety Net 4 agreement; and if he will make a statement on the matter. [5852/22]

Catherine Connolly (Galway West, Independent)
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610. To ask the Minister for Health his plans to publish the Safety Net 2 agreement; the total cost to date of the Safety Net 2 agreement; and if he will make a statement on the matter. [5853/22]

Catherine Connolly (Galway West, Independent)
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611. To ask the Minister for Health his plans to publish the Safety Net 3 agreement; the cost to date of the Safety Net 3 agreement; and if he will make a statement on the matter. [5854/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 609, 610 and 611 together.

In January 2021 all 18 private hospitals signed a Safety Net 2 agreement to provide additional hospital capacity to the HSE to deal with the surge in Covid-19. The agreement is a standard agreement, signed individually between the HSE and the relevant private hospital/private hospital group. Details of the agreements cannot be released as they are commercial sensitive.

Under the agreement the HSE can obtain up to 15% or 30% of the private hospitals’ capacity, depending on certain metrics regarding the level of community transmission of the disease, or numbers hospitalised or in ICUs occurring. The agreement remained in place until between the middle or end of January 2022, depending on the hospital concerned. The arrangement provides that where the HSE invokes the agreement but does not use the full capacity sought it makes a payment for the unused capacity.

The HSE also made use of private hospital capacity, through a Safety Net 3 arrangement it made with the private hospitals, to help it deal with the cyber-attack which occurred in May 2021.

The HSE has further advised that the cyber attack in May 2020 made it impossible to assign unique identifiers which would allow it to track the SN 2 and 3 patients. The latest figures received from the HSE show total payments under SN2 and 3 of €116.57m.

The HSE and the private hospitals have agreed an amended and extended Safety Net agreement, Safety Net 4, building on the lessons learnt from the operation of Safety Net agreements 2 and 3. The agreement will be submitted to Government shortly for its approval and if Government agrees to it, the details will be made available then.