Midlands misses out €1.6 billion plan for new hospitals and surgical hubs

Hospitals in Portlaoise, Tullamore, Mullingar have not been selected as locations for new surgical hubs  which will cost up to €100 million nor is the Midlands deemed in need of a new hospital for elective procedures as up to €1.5 billion is being spent on two hospitals in the south and west of Ireland.

However, the Minister for Health Stephen Donnelly says the new national Elective Hospitals which will be located in Cork, Galway and Dublin, will provide services for the whole population, extending well beyond their traditional ‘catchment’ area.

The indicative range for the capital budget for the build, technology and programme team for Cork is estimated to be between €614m - €828m.

The indicative range for the capital budget for the build, technology and programme team for Galway is estimated to be between €516m - €695m.

Laois and other parts of the Midlands will likely be served by a third Dublin hospital but a site has yet to be selected. The Department of Health says an announcement on the Dublin project will follow once its associated Business Case has been approved by Government.

He also says the HSE plans to work with Hospital Groups to progress proposals for a shorter-term measure by developing ‘surgical hubs’ in Cork, Galway, Limerick, Waterford and Dublin.

The HSE will work with hospitals/hospital groups to develop these units on site or close to existing Model 4/3 hospitals. The Minister's Department says they will be modelled on the successful Reeves Centre at Tallaght University Hospital which is a sister hospital of hospitals in Laois and Offaly in the Dublin Midland hospital Group.

A statement says the Tallaght model took 12-17 months to open on a phased basis and we can use the learnings from the Tallaght model and develop these quickly.

The Department says the cost for five surgical hubs is expected to be €90-100 million.  It says this shorter-term intervention will also support efforts to consider the necessary reforms and enablers needed to separate unscheduled and scheduled care pathways that will be required by the longer-term provision of the Elective Care programme

The announcements are part of next stage of the so-called Enhanced Provision of Elective Care Programme

Apart from the hubs, the Minister Donnelly received Government approval of the and progression of the development of new Elective Hospitals in Cork and Galway. The preferred sites, recommended to be brought forward into the planning phase, are at St Stephen's Hospital, Sarsfield Court in Cork, and Merlin Park in Galway.

Minister Donnelly TD, said he was delighted that Government has approved the plans.

"The development of these facilities represents a major change in how we’ll deliver quality care based on future demand. By separating elective (scheduled) from emergency (unscheduled) care, we will be able to deliver better care and outcomes for all patients.

"These new Elective Hospitals will have a real impact on people up and down the country and I am keen that they are up and running as soon as possible. For this reason, I will work with colleagues across Government to consider options to expedite their delivery wherever possible. 

 "Additionally, the HSE will progress proposals for ‘surgical hubs’ which can quickly deliver elective care complementary to the electives programme,” he said.

The Department says it is too early to give precise project costs  on the new elective hospitals as they have yet to go through the planning and procurement stages. However, the preliminary business cases did set out indicative estimates:

• The indicative range for the capital budget for the build, technology and programme team for Cork is estimated to be between €614m - €828m.
• The indicative range for the capital budget for the build, technology and programme team for Galway is estimated to be between €516m - €695m.

The Department says the surgical hub initiatives are estimated at a cost of €90 - 100 million between capital and revenue, which will be funded from within existing resources. Any further additional investment will be subject to the estimates process in the usual way.

The Department says that in December 2021, the Government approved the National Elective Ambulatory Strategy to implement a national strategy of elective ambulatory care and to progress capital investment proposals for the establishment and operation of dedicated elective hospitals in Cork, Galway, and Dublin. It was agreed that the elective care scope of service be developed in two phases commencing with day cases, diagnostics, and outpatients and then by in-patient treatment.  

The strategy is informed by a number of policy documents and Government Decisions, including the 2017 Sláintecare Report, the Health Service Capacity Review 2018, the Sláintecare Implementation Strategy (2018), the National Development Plan (2018), the Programme for Government (2020), the Sláintecare Implementation Strategy & Action Plan 2021-2023, and the Ireland 2040 National Planning Framework.

The Department says the Strategy for Elective Ambulatory Care represents a step-change in the ability of the national public hospital network to deliver high-quality and timely elective care services that will provide resources to address the known demographic changes to 2035 (up to a 40% increase in day-case surgeries) and significant additional service delivery capacity.

It adds that the development of the elective hospitals, in Cork, Galway, and Dublin, will provide coverage to more than 80% of the overall population (travel distance within 120km, or approximately 90 mins).

The Department says some patients currently travel longer distances for some elective care procedures.

It adds that the proposed service model for elective services would be, initially, high volume, low complexity procedures, and a range of related diagnostic services.