Éamon Ó Cuív challenges minister over slow health projects

Minister, the question is very, very simple. You have the money, the Government have the money and you have the money, but we are not getting delivery of big and small health projects as speedily as we would need them. We can go into this in more detail in the supplementary question. So my question is, what has been done to speed up procedures so that we can get necessary health facilities in place? Because the old barriers are gone, but as we eliminate old barriers, we always seem to arrive with a new one. Thanks very much for the Deputy and I fully agree with the premise of your question. I think before getting into what we're doing to speed it up, it is important to state that in spite of an extremely cumbersome process that leads us to being able to put new infrastructure in place, this Government has, over the past three years, expanded infrastructure, added beds, added critical care beds, added diagnostics, added primary care centres, at a level that hasn't been seen since the HSE was founded and likely long before the HSE was founded. So I just think we do need to give credit, dare I say, to the Government for allocating the money and to the Oireachtas, all of the Oireachtas, for supporting the allocation of that money and to the Department of the HSE and their partners because there has been a substantial increase in infrastructure. Nonetheless, it takes far too long to build things in this country and I'm very happy to be able to share, Deputy, that working with the Taoiseach, Minister McGrath, Minister Donoghue, who we have recently agreed some important changes. So the limit on the Public Spending Code, Public Spending Code being this extraordinarily detailed 17 step process. We have agreed that the limit of where that kicks in is moved from 100 million euro to 200 million euro. That means that most bed projects in the country will no longer have to go through the Public Spending Code. That's really going to speed things up. Secondly, in your own region and in the chair's region, there is a massive investment going into Galway, plan for Galway. We're looking at putting in the eight-storey ED women's health block. You'll be aware we're sanctioning a detailed design now for the cancer centre for the region. We're looking at putting in place the new labs. We're looking at putting in place the new elective hospital. And I'm working with government for these very large projects to reduce the number of steps required and the key number of steps required for a lot of these. The smaller projects have been brought down from five to three. And then we'll be looking at the bigger projects to see how they can be accelerated as well. I'm reasonably happy that the four big projects are going ahead. A specific question on that. The limit of 100 million is that per individual project? In other words, will the elective be taken as one project, the ED as another, and the cancer in the labs as another? Or is it an accumulative of 200 million between the four projects put together, even though they'll not be physically conjoined together? That's question number one. The second one is, there was one teacher who said, it's the little things that catch you. And we have that syndrome. So I can name out for you some health centres, an ambulance base, a CNU community and nursing home unit that just seem to be going on forever and not getting built. These are small projects. These should be done in a matter of two or three years. There's no big principle involved in them. We're promised them. They're needed. But they're not happening. And is there anything that can be done to speed up these small projects that are not held up by any government guidelines that just need to get done? Thanks, Deputy. In answer to your first question, each of those projects are a separate project in terms of 100 million versus 200 million. Now, it won't come as a surprise to any of us that several of those projects will be well in excess of the 200 million. But critically, even where they are, the public spending code to date has five separate approval stages. So I've had to bring memo after memo after memo back to government, for example, on the elective hospitals, much to the frustration of everyone in government. So critically, it's been agreed with Minister Donoghue and Minister McGrath that the five is brought down to three. And that is going to help with all of those projects. And then, Deputy, when it comes to the smaller projects, be that an ambulance base or a primary care centre, or indeed there's another project we didn't mention to go into Galway, which is just another beds block. They need another beds block as well. That might well fall under the 200 million. That might well be the kind of one where I'm looking to bring in if I can get agreement on the 1,500 rapid-build beds. Mr. Chairman Mark. Minister, just to give an example of what we face in practice on the ground. There was a health centre planned, the planning permission for Eishpoffin, back in the noughties. It never happened. Now, they're trying to move site, but it's going on forever. Over two years ago, you might remember the need for the ambulance base in Connemara. So we got the ambulance, we got the staff within six months. In fact, within four months. They were to convert an old health centre into an ambulance base. We seem to be running into all sorts of problems, even though it's within a 60K zone and within a village zoning. All sorts of problems with everything from parking space to planning and whatever. The community nursing home unit, you've heard the saga of Clifton Hospital, and your Minister of State there will be more than familiar with this. And St Anne's, we were promised, we were promised again and again, and the Cairlough, the Glasgow and Coeurlough knows all about this. We were promised a new community nursing home unit. And the reality is, it hasn't even gone to planning yet. So, these are the kind of, I could give you a list. And I know that Lasky-Anne Coeurlough is absolutely dying for me to go on, because she is as interested in this subject as I am. I won't delay her, but I would just say this. We need a rapid way of dealing with these problems, and it might also need issues such as planning, etc., to be fast-tracked, but there's an obvious need for health reasons. In terms of Galway and the smaller projects, can I say, I fully agree, it's Galway and it's right across the country. It just takes us too long. There's a few things need to happen. One is the capital allocation needs to be sufficient, and then secondly, there needs to be much more efficient processing of these. And I couldn't agree more, and we're working with the HSE, and I'm engaged directly with the chief exec on exactly that. Thank you.