The Phoenix opinion column has been running in the Waterford News & Star for more than 30 years
THE HSE’s Capital Plan for 2022 was published recently with the usual pomp and ceremony and just as usual we scan it for evidence of investment in our local health and medical facilities. Local TD and health minister Mary Butler informs us that the “wheels have been set in motion for the development of a 50 bed acute psychiatry building on a site adjacent to UHW. The next stage will be to complete design and go to tender.” The princely sum of €100,000 is allocated this year.
This is the exact same amount spent on the project in 2021. Everybody welcomes progress on the provision of this much needed facility (said to be at “appraisal stage”) but one is tempted to ask if Ms Butler is a prisoner of civil servants in the HSE and Dept. of Health, who have convinced her that these tiny sums really represent departmental commitment. An allocation of €1 million would have driven the design planning and tender process much more quickly.
‘The Capital Plan contains zero evidence of what hospital manager Grace Rothwell told local Oireachtas members were urgent last February’
Maybe our political reps are happy with the crumbs that fall from the Cork table? While prefabs (now eulogised as “modular units”) are lifted from trucks and erected at UHW, our oncology unit is to be facilitated in a converted store (city planning says: Change of use of existing store and office building to medical use as Oncology Unit with the construction of new two storey Plant Rooms (97m2)) on campus. Meanwhile, the plan happily shows us glitzy pictures of the limestone and fancy architecture that surrounds a spanking new oncology unit in CUH.
It’s like the National Children’s Hospital. No one can explain how this is going to cost over €2 billion, or how the proposed new National Maternity Hospital will cost near €1 billion or how these vast sums can be committed to Dublin while we scramble for pennies. People in Cork argue about whether a new 400/600-bed elective hospital should be on the north or south side of that city. €100,000 in health care project terms is loose change. Is Ms Butler being codded?
We all know the endlessly glacial steps in HSE capital projects. Darren Skelton once listed them in this paper as nine or 10 in all. Each of these can be endlessly extended or delayed at the whim of civil servants and politicians. It would be no harm to remind Ms Butler that UHW’s new mortuary had planning in 2015 but wasn’t built until 2021. And it took a political debacle by the Tánaiste and bodily fluids on the floor to get it done. The second cath lab was agreed in September 2018 and, Covid notwithstanding, it’s still not complete.
A new psychiatric unit is long overdue, but the Capital Plan contains zero evidence of what hospital manager Grace Rothwell told local Oireachtas members were urgent last February: an in-patient block and doctors’ on call residence. Ms Rothwell also indicated that a review by Archus consultants had been carried out over previous months. In March of this year CEO of SSWHG group Gerry O’Dwyer informed local Oireachtas members that the report would be available within weeks. The Taoiseach told Matt Shanahan in the Dáil recently that the report would be “available within weeks”. Has the report been rolled into a larger report on needs of SSWHG group across Waterford, Cork, South Tipp and Kerry? The corollary is that local needs will be dismissed as simply intra-group deficits to be remedied by additional services in Cork. CUH (20 pathologists did 800 post mortems) is already overstaffed in some areas if the post mortem numbers there compared to UHW (four pathologists did 600 post mortems in 2018) are anything to go by. Meanwhile, has the UHW Archus report been buried?
Last year, all the government politicians in this area raved about the €14 million in capital investment in UHW, a second cath lab, a new ophthalmology unit, completion of the mortuary building and a new MRI and CAT scan machine, plus a couple of hundred grand to “progress” the new psychiatric unit and a redesign of buildings at St Otteran’s to facilitate the relocation of community audiology, orthodontic and ophthalmology from UHW.
The latter would facilitate some redesign of internal spaces at UHW. The Plan states this work is at “detailed design” stage! I can find no indication of when work might start, even though it went to tender months ago. It is very unlikely that any of the government Oireachtas members will issue press releases this year about the money being spent on local projects for the simple reason that there are no major local projects in the plan!
The local planning application system does show two developments being applied for: a two-storey extension to the Laboratory Department to include office, analytical workstations and ancillary staff facilities, and a new extension at the Outpatient Department consisting of a two storey extension over the existing OPD building with a new circulation core to serve all the levels of the building. The accommodation would include consulting rooms and associated support rooms. Should these proceed in a timely manner they would create some of the extra space UHW needs. However, UHW clearly needs €150 million projects rather than the tiny capital developments and penny prefabs that we see. Read the Capital Plan to see the proposals for Dublin, Cork, Limerick and Galway!
The HSE manpower figures for April 2022 allow some necessary comparisons to be made. UHW, a Model 4 cancer and PPCI centre at the end of April, had a staff headcount of 2,490 and 137 consultants. The Model 3 hospitals in Drogheda had 103 consultants and a staff headcount of 2,716. Sligo Hospital had 2,217 staff and 80 consultants. Letterkenny had 2,252 headcount and 61 consultants. I don’t begrudge them their staffing and include them for comparison purposes only but it is obvious that UHW consultants are not well supported. We need to see equity. The system fooled John Halligan with reviews and reports. It is to be hoped that Ms Butler has enough peoples around her to stop her falling for the same dose of Cork-led and Dublin-administered endless process and non-delivery.