Much of the €100 million needed to reconfigure hospital services in Dublin and the midlands if Portlaoise is downgraded would be 'catch up' spending to cope with current demands.
The lead author of the plan to regrade the Midland Regional Hospital Portlaoise as a Category 2 hospital also says the money need to spend on several of these capital projects has yet to be approved by the Department of Health.
Under the Dublin Midland Hospital Group plan at least €100 million. The Coombe maternity hospital in Dublin requires €20 million just to make its operating theatres safe. The cost of completely relocating the Coombe to St James is not outlined. Laois women will travel to Dublin to have babies under the plan
Tallaght is earmarked for a €15 million investment while at least €40 million has to be spent on Tullamore hospital. Both hospitals will pick up the slack for emergencies diverted from Portlaoise under downgrade. Dr O'Reilly said Tallaght is 'in dire' need of more hospital beds.
Portlaoise is due to get a €20 million investment. Naas would get nearly €2 million.
In an extensive interview with the Leinster Express, Dr Susan O'Reilly, DMHG CEO, stood over the credibility on the cost of implementing the plan and the time frame involved.
The plan put together by Dr O’Reilly and others puts a four year time frame on downgrade as part of reconfiguration of hospital services in Dublin, Kildare, Offaly and Laois.
Dr O’Reilly says the projects earmarked for investment are already a priority. The Leinster Express put it to Dr O’Reilly that the public do not believe the time frame and ability to get the money is credible.
“I can appreciate why they would have that concern. I really appreciate and understand that. Let me be clear. The €100 million capital is already funding we have officially prioritised,” she said.
She said approval is awaiting the outcome of the capital review by the Government and any assignment of capital.
“That €100 million was not contingent on any reconfiguration of Portlaoise. It is contingent on the fact that we need capacity across the entire group. It is catch up money for critical care, beds and some elective.
“There is another component which is the Tullamore hospital extension. It needs to be done anyway but it would be a bigger extension to develop some addition Emergency Department and inpatient bed capacity,” she says.
She accepted that the ability to implement the plan is out of the DMHG’s control but said it is a priority at high levels.
“It was significantly influenced and prioritised in the HSE and the Department of Health. I do feel that I have some clout here in terms of getting capital but there are no guarantees,” she said.
Dr O’Reilly insists that no unsafe risks will be taken.
“We within the group know from our discussions with the HSE that this is a four year implementation plan and we are committed to not closing any services in a way that is going to create more risk," she said.
The Coombe Hospital in Dublin is managing the Portlaoise hospital maternity unit. Dr O'Reilly acknowledged that the current Coombe theatres have been regarded as 'not fit for purpose' by the health watchdog HIQA.
Dr O'Reilly was confident, however, that the Coombe hospital’s upgrade will happen ‘soon’ but said this was also dependent on ‘capital assignment to be decided by the Department of Health’. She said the Minister for Health Simon Harris has to get ‘capital approval for all of this’ from the Cabinet.
The Coombe is also due to be completely relocated.
“The Coombe moving to the St James’ Hospital site with the National Children’s Hospital will happen but it could take up to 10 years. Any refurbishment of theatres and beds in the Coombe won’t go to waste because if the Coombe moves they will be used for elective surgeries of other sorts,” she said.
The Leinster Express asked Dr O’Reilly if she believes there is capacity in Dublin at present in the Coombe in Tallaght hospitals to take anything more from Portlaoise or anywhere else.
“There will be as long as we get the resources. Don’t forget paediatric beds are moving from Tallaght in 2020. That will free up some space for more beds not enough. We have another capital plan in evolution right now for another building for an additional building for Tallaght. They are in dire need for beds.
“We are coming out of a financial crisis and years of decisions, particularly to reduce (hospital) beds,” she said.
Dr O'Reilly has earmarked €20 million investment for Portlaoise so that it can provide new services. She believes it will be a busier hospital. However, she said in the initial stages the hospital would have to rely on the existing three theatres for elective non-complex surgery.
Dr O'Reilly said she 'hopes' that resources will flow, in particular capital spending to expand capacity.
The decision on what to do with the hospital rests with the Minister for Health Simon Harris and the rest of the Government.