I thank the Deputy for her question. It is timely, as I will visit University Hospital Galway, UHG, on Thursday as it happens. The Deputy will be aware of proposals for further significant capital investment there. That includes additional bed capacity, a new emergency department, new paediatric and maternity facilities, a new helipad, replacement laboratories and a cancer centre at UHG. A surgical hub is under construction at Merlin Park and plans for the new elective hospital are progressing. Due to the scale and complexity of these projects, a programmatic approach is necessary to ensure the continued delivery of care on the congested hospital campus. We could not deliver it all at once on one site, so that master plan to move around is important. A UHG capital programme oversight board has developed an integrated, strategic master plan for UHG by way of a campus development control plan, DCP. That master-planning process, informed by population health needs and regional clinical demand will, as the Deputy will be aware, provide a clear plan for the sequencing and delivery of the new capacity and facilities. Both the DCP and the programme strategic assessment report are currently being finalised by the HSE. I understand that it is to be presented to the HSE board for approval at the end of this month. We expect that it will then be submitted to the Department next month for review in line with the infrastructure guidelines. The HSE has advised that initial enabling works to support this programme of works have begun as I imagine the Deputy will be aware.
Sentiment score: 0.14
Deputy-----
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I appreciate the Deputy's frustration. I appreciate that there needs to be a major plan. I also appreciate that this has to be done in a sequencing way so that the hospital can continue to function. The information I have for her is that it will be presented to the HSE board for approval at the end of this month. I cannot put it further than that. I am attending the hospital, as I attend many hospitals, not to take photographs but to visit and speak with management to understand better the hospitals and how they work, the local nuances that impact them and the fact that Galway has been in difficulties over the bank holiday weekends. I want to understand the scheduling and roster, quite apart from capacity issues, and what is happening with the rosters and with the public-only consultant contracts and whether there are local issues that explain the particular difficulties they have had over the weekends. I am not interested in photographs, but I have to do my work. It is not the first time I have heard it. I appreciate the Deputy's perspective on it, but I do plan to go anyway.
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Sure.
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I know.
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I appreciate that the Deputy has been raising this for many years. I appreciate the reasons for that, and I have huge respect for that. This is the approach that has been taken. From my perspective as Minister, I will be keen to see this move forward as quickly as possible with what sits within my control. I am concerned about the interaction with the infrastructure guidelines and the revision process that is ongoing with the Department of public expenditure and reform to make sure the delivery of these projects is done as quickly as possible. The question about whether, for example, we need four business cases or two businesses cases, as the Deputy said, when so much work has gone into it already to be further delayed by infrastructure guidelines such as they are would not be acceptable. That is a body of work I can take responsibility for by interacting with the Department of public expenditure and reform, and also the speed with which it moves with regard to my own Department. However, I do have very strong respect for the background work the Deputy has done and the way in which she has advocated for this month after month in this House when she has been a Member, and I understand the reasons for that. I look forward to going on Thursday to see for myself.
Sentiment score: 0.25
I thank the Deputy. The Government is committed to the ongoing development of Sligo and our other regional hospitals. As he said, I am aware that there were issues with water leaks at the hospital and that in particular on 18 April, the leak led to the temporary closure of the orthopaedic theatre for eight days to allow for cleaning and air sampling to be undertaken, and I am told that additional monitoring is ongoing. While the theatre was closed, as the Deputy will be aware, a number of orthopaedic surgeries were unfortunately postponed. The HSE is working to reschedule those surgeries for those patients as quickly as possible. As the Deputy will also be aware, two weeks ago I was there on site. I met with some of the surgeons. I heard directly from them on their perspective, not just on the theatre but as he said, on the surgical block and surgical issues more generally related to the north west. I thank them for their engagement. I was told at that point that there would be a meeting on 13 May, which is today, between surgeons, HSE estates and HSE management. I received an update this evening on that meeting. The purpose of that meeting was that the clinicians and HSE management would meet together to review the situation and plan the next steps and hopefully enable the full restoration of full orthopaedic surgeries, including elective surgeries. My information this evening from Mr. Tony Canavan is that, as I said on the day of the news report that I expected this to be fixed, HSE estates has outlined the immediate repairs to be done to the roof but more crucially, as the Deputy is more than aware, the plan to replace the roof entirely this year. It is my expectation that the roof will be repaired entirely this year, hopefully by somebody other than the people who did the initial leak repairs because they were clearly ineffective. That is my expectation of HSE estates. The surgeons will reflect on the situation and a follow-up meeting is planned with them next week, after which there will be a series of follow-up meetings to monitor progress throughout the year. I hope that will resolve the issues in respect of the roof. I will address the other issues in my next contribution.
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The HSE's capital plan for 2025 details the planned infrastructure investments for Sligo University Hospital. We have discussed the roof but there are also plans for a multi-service block development that will encompass a wide range of services, including a theatre department. Plans for that multi-service block are currently at detailed design stage. There has been significant investment in Sligo in recent years, including in the new 26-bed block. As I saw the day I was there, a 42-bed block is due to begin construction this summer. There is also a new CT scanner. I compliment the staff of Sligo University Hospital, who have been much more effective in the past number of months in the management of their rosters, with the exception of one blip last weekend in regard to infection. They really have made a significant difference since February through their rosters and practices, thereby bringing trolley numbers down very considerably, including by more than 70% on bank holiday weekends. That is a function of their additional time investment and focus on the issues. I acknowledge that and thank them for their work.
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I agree with the Deputy. It is my intention to do that, along with expanding surgical capacity more broadly in the north west, which we will speak about further. I agree about the need for an innovative approach. Already, some measures have been put in place in that regard. I want to see the immediate issues resolved very quickly in order that the surgeons are not dealing with them going into the autumn this year. There should be no excuse in that regard. I agree with the Deputy about what needs to happen over the medium and longer term. I go back to the question we are all going to face regarding the infrastructure guidelines, how we deliver major capital projects, the length of time they take and the number of stages involved. It is a question of coming to the best way of proceeding whereby we get multiple bidders for these major infrastructure projects and have a competitive process that will deliver the right outcomes. In my time in the north west ten days to two weeks ago, across Leitrim, Sligo and Donegal, while I saw significant capacity and additional beds through community nursing homes, chronic disease management centres, community virtual wards and so on, there is a substantial body of work to do.
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The Government approved the preliminary business cases for Cork and Galway, and the preferred sites for the two Dublin facilities. Following a public tender competition, the HSE appointed a design team and project controls team at the end of 2024. The design team is progressing design and engagement to inform statutory planning submissions and the regulatory approvals required. I go back again to my infrastructure point. Surveys and site investigations have been conducted, which are informing the design and planning applications for enabling works that are expected to be submitted shortly. The design team is also progressing detailed design and tender documents to commence procurement for the main works. The granting of full planning permission for the Cork and Galway main works, expected to be submitted next year, will determine when construction works can commence. The Dublin plans will also be progressed, using the principle of design once, build four times to optimise efficiencies, delivery timelines and value for money. Delivering these new facilities will require significant investment. I am engaging with my colleague, the Minister for Public Expenditure, National Development Plan Delivery and Reform, to secure the necessary funding through the NDP review. In the interim, new surgical hubs have been developed, with south Dublin already operational and those in north Dublin, Waterford, Galway, Cork and Limerick now under construction and expected to open for patients during the course of this year and next.
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I completely agree. It is important to note that engagement with planning authorities is under way on agreement in regard to the principle of design once, build four times. I really cannot overstate that there is no room for local variation or perspectives. This is about doing something in the most efficient way and also having the ability to move between the different elective hospitals without any difficulty whatsoever. These elective hospitals will alleviate pressure on major hospitals. Precisely as the Deputy said, we should not have elective capacity within an acute hospital, which should be for the treatment of significant illness and trauma. The disruption that can happen for various reasons in acute hospitals delays planned surgeries and takes up capacity that should be there for urgent and emergency care within the acute system. My priority will be to secure the funding to advance these projects and also, working with the House, to revise the infrastructure guidelines to get to a way where we can build more effectively and efficiently, which is what we need for these projects in particular.
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While I agree with the Deputy, local issues that come up, including site selection and other questions like that, all delay the delivery of the different hospitals. We simply need to move forward with all of them in the most efficient way. In Cork, the HSE is progressing that enabling package in advance of the main construction, including pitch and putt relocation, site clearance and demolition work, site access, roadworks and the planning applications to be submitted on a phased basis from September 2025 while work in Galway includes demolition and site clearance, with the planning application to be submitted in September 2025. That engagement with planning authorities is under way.
Sentiment score: 0.33
The Government is committed to the implementation of the national cancer strategy and to improving the services patients receive. Infrastructural developments are a key enabler of timely cancer detection and treatment. Since the launch of the strategy in 2017, more than €140 million has been invested in capital infrastructure. This funding has improved cancer facilities throughout the country. It has delivered the new national cervical screening laboratory hospital and two new radiation oncology facilities in Cork and Galway. This year, the HSE’s capital plan includes a further €20 million for diagnostic facilities. This will improve access to imaging, endoscopy and laboratories. The plan also includes €12 million for radiation oncology projects. These investments will continue to modernise our cancer care and diagnostic infrastructure. Access to radiology and diagnostics has been recognised as an issue and I thank the Deputy for highlighting it. The productivity and savings task force published an action plan for 2025 to address this. This commits to greater evening and weekend availability of diagnostic equipment. I have spoken to the CEO of the HSE, Bernard Gloster. On foot of that conversation, he is conducting a review of diagnostic equipment utilisation. The findings will be presented to me along with the waiting list task force in June. This is very important to understand the local nuances of how diagnostic equipment is or is not being used and when it is or is not being used. The Deputy can be sure I have a very direct interest in that. The Government continues to build on our investment and strategic approach to cancer control. Since 2017, funding of €105 million has been invested in the national cancer strategy. This has enabled the extension of population cancer screening, increased access to therapies and services and improved quality of life for people with cancer but, of course, we need to continue that work.
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The Deputy raised a number of issues, which I will try to take in turn. On medicines, approval for reimbursement by the HSE was given for 74 cancer drugs between 2021 and 2024. The total spend on cancer drugs in that period exceeded €645 million. We have launched an application tracker and have recruited an additional 34 staff, which is a 100% increase. I expect to see that move more quickly. It is also important that applications are made in a timely way. It is a two-stage process, as the Deputy will understand. We hope the uptake of HPV will increase across all ages. It is, of course, important to note it is a good thing that the numbers of diagnoses are increasing. It is a bad thing if the numbers are not increasing, considering our expanding population. We are living longer and detecting more cancers. We are treating more cancers successfully. We are identifying and diagnosing more cancers, particularly as we age. We must understand the implications of that marker. It is not necessarily a bad thing. It is about how we treat it. I will come in again.
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I agree with the Deputy. The point about diagnostics is important. It is one of the reasons it is important for me to visit different hospitals and understand the efficiency of their work. Sligo hospital, for example, has two CT machines beside each other, which allows staff to move back and forth between them and thereby increase the number of scans being conducted. Some hospitals use their CT machines between 8 a.m. and 5 p.m. Others use them between 8 a.m. and 8 p.m. This inconsistency can have an impact on diagnostics. I highlight the increase in the number of radiographers registered with CORU. There was a 10% increase between the end of 2023 and the end of 2024. Numbers are increasing in 2025. It is important that the registration of radiographers who have the capacity to work in Ireland is progressed by CORU efficiently. I would say the same for any other healthcare professionals who want to work in Ireland. If they are entitled to, they should be able to do so quickly. That might be an interesting programme of work for the health committee. On rapid access clinics, I will be able to give the Deputy more detailed information but I am over time.
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I thank the Deputy. In 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 with HIQA. This is a programme to replace, upgrade and refurbish community nursing units as appropriate at 89 locations. The new 50-bed community nursing unit in Midleton is part of the programme. At the end of 2024, 51 community nursing units were completed. Seventeen are currently under construction; seven of those, including the unit at Midleton, are being delivered through public-private partnership, PPP. The remaining 21 are at various stages of appraisal, review, design or tender. The community nursing unit in Midleton is anticipated to complete construction in quarter 3 of 2025. The HSE advised the Deputy in reply to a parliamentary question in February 2025 that it was anticipated that Midleton would be completed by quarter 2 of this year; however, there are a number of outstanding items that need to be addressed prior to completion. It is important to note that these items are essential for HIQA registration. All parties are actively engaging to address the outstanding items and ensure we achieve construction completion for each of the seven PPP sites, including Midleton. Following construction completion and commissioning, the new building must be registered with HIQA as per the Health Act 2007, as amended. Once the community nursing unit is registered, the HSE can admit residents. Workforce planning is progressing across all staff disciplines to ensure the required complement and skill mix of staff is in place to facilitate the operational schedule. It is estimated that, pending successful registration and recruitment, the new community nursing unit will be fully resourced and operational during quarter 4 of 2025.
Sentiment score: 0.25
I will address the delay, such as it is. We want to anticipate the workforce planning is there to ensure it is operational. The delay is one that is essential for HIQA. On the Deputy's question about the plan, when a HSE-owned property has been vacated by a health service, we have to determine whether it is surplus to health requirements in the area. That involves HSE engagement with other HSE services to establish whether they have a need for the property. I would be very interested in the Deputy's perspective, representing the area as he does. There is a programme of sale of buildings by HSE estates, which I have been partially updated on. There is also a programme to offer them to the Land Development Agency for housing, if that is suitable, or to other State entities. I would be interested in the Deputy's perspective on the best use of the facility. It is important to hear from public representatives as well as every other stakeholder.
Sentiment score: 0.19
A scoping exercise with regard to the existing Midleton Community Hospital site is under way to identity possible future uses which align with existing service needs. My view is that we need healthcare capacity and we need to think about that in every way. There are multiple stakeholders. The Deputy's voice and view will be important in relation to that. With a rising population, we are trying to increase capacity in suitable ways. Not every site is suitable. Some are better sold or just moved forward. The HSE is not a property developer as such. We have a pressing housing need as well. Acknowledging all of that, a scoping exercise is under way with regard to the existing hospital. As soon as I have any information on that, I will update the Deputy.
Sentiment score: 0.11