Martin Daly urges delivery of Roscommon hospital rehab unit

Minister, today I want to highlight the urgent need for the long-promised rehabilitation unit at Roscommon University Hospital. In 2015, a commitment was made for a £7.8 million investment to provide 20 dedicated rehabilitation beds. Yet despite entering detailed design phase in 2021, appointing a design team in 2022, and further design assessments in 2023, in 2024, the rehab unit was abruptly admitted from the HSC Capital Plan without explanation. We face a 58% shortfall in neuro-rehabilitation beds nationwide, with huge geographical disparities in bed availability, ranging from 6.4 per 100,000 people to 45 beds per 100,000, which I assume is in the Dublin area. Patients in the West of Ireland are left with limited or delayed access to specialist rehabilitation at a centre remote to them in Dublin, which is resulting in unsuitable care settings and long-term dependency, both clinically inappropriate and economically unsustainable. The evidence is clear. Specialised rehabilitation is the most cost-effective intervention. Data from intervention trials for sudden-onset neurological conditions, progressive or intermittent neurological conditions, or limb absence, result in significant reduction in dependency and ongoing care costs. The greatest savings are in the high dependency group, and the cost of intervention is recouped after only 16 months. This is in stark contrast to late intervention in non-specialised environments, which lead to significantly higher costs for the State. This is not simply a health care issue, it is an economic issue. Investing in a dedicated rehabilitation unit in Roscommon University Hospital would be a proven evidence-based solution that will improve accessibility, patient outcomes, reduce long-term health care dependency, and ultimately save the State millions in avoidable disability and ongoing care costs. In spite of the deep disappointment at the reconfiguration in 2011, Roscommon University Hospital has reimagined itself as a very successful Model 2 hospital. It has a successful medical assessment unit, which is a unit of choice for older people in the area, a successful regional gastrointestinal endoscopy unit, and a minor injuries unit that serves not just Roscommon, but East Galway, Mayo, Longford, and West Smead. The people of Roscommon were promised a Model 2 hospital that would be developed to its maximum potential. However, currently the outpatient department built in 1947, astonishingly lacks a disabled toilet and adequate wheelchair access. Given the current emphasis on disability in the programme for government, one would expect all outpatient departments would be disability proofed infrastructure. Minister, I urge you to expedite this long overdue project, and ensure that this regional rehabilitation infrastructure is delivered as planned, as was planned in Roscommon University Hospital. The reasons for choosing Roscommon University Hospital in 2015 could not have changed substantially in the intervening years. The people of Roscommon Galway deserve a transparent explanation as to why this piece of critical infrastructure appears to have been mothballed. I would like to thank Deputy Daly for giving me the opportunity to update the House on behalf of the Minister for Health and the development of Roscommon University Hospital. To ensure delivery of the right care in the right place at the right time, there are robust systems procedures to appraise, manage and deliver infrastructure projects required for regional health services. Projects are appraised by the National Capacity and Property Steering Committee of the HSE. This is to ensure compliance with service priorities and policies and feasibility of delivery. It also ensures alignment with the National Service Plan and Capital Plan. The National Capital and Property Steering Committee then recommend projects for inclusion in the capital investment programme. A prioritisation process is conducted to inform the annual capital plan. A review of the Spaceship Plan at Roscommon University Hospital was re-initiated in 2024, following the completion of the hospice build of the hospital site and the need to update site ward expansion, replacement of existing facilities with modern compliant accommodation and a possible site for replacement acute adult mental health unit was considered. The Minister for Health has been informed by the HSE that the physical review of space has substantially been completed based on brief confirmed by the hospital service. In recent weeks, HSE Capital and Estates and Integrated Health Area Management have requested that clinical planning consultants are engaged to verify service brief requirements, including the updated version of the Spaceship Plan 2024-2025 and also in alignment with other hospitals in the catchment and national programme. The Rehabilitation Unit at Roscommon University Hospital is a project currently included in the updated exercise of the Spaceship Plan 2024-2025. The development of new or refurbished healthcare facilities anywhere in the country cannot be seen in isolation or separate from the delivery of related health services. Projects are approved by health services before being submitted by the HSE Centre of Steering Committee for approval and progressing through the capital process. Once approved by the HSE Centre of Steering Committee, the project is resolved for prioritisation and inclusion in the capital plan, subject to the level of funding. In addition to the above process, in order to enhance capital investment, the Department of Health has developed and published a Strategic Health Investment Framework to ensure the investments are evident-based, equitable and ensure slant-to-care reforms are achieved, with the overall objective having better health outcomes for the population of Ireland. The Strategic Health Investment Framework is a high-level framework that sets out the investment criteria and an intervention hierarchy based on the principle of continuation of care, by which all capital investments in the public health sector are to be assessed. The Capital Plan is an annual lock that sets out the planned health infrastructure investment within a given year. Capital investment plays a critical role in enabling and enhancing health service provision. The Capital Plan 2025 will outline the planning investment in health infrastructure throughout the country. I expect the Capital Plan to be published in the coming weeks in line with established procedures. I can take it then Minister, you are confirming that the rehabilitation unit in Roscommon University Hospital is still planned for that area and is undergoing review in the spatial assessment that you described there. I think the people in Roscommon have reason to be suspicious. They feel that a Roscommon hospital after reconfiguration in which they developed a whole host of new services, everything from a very successful medical assessment unit to an injuries unit to an endoscopy unit, that things are left in abeyance. As I've already pointed out, the outpatients department is not fit for purpose. It was built in 1947. The endoscopy unit can't expand to ENT and urological endoscopy because we're want of a decontamination unit. The injuries unit can't expand its service because of a shortage of advanced nurse practitioners. In addition to that, we have a situation where elderly frail people are going to memory clinics and to frailty clinics, but they can't park on the grounds of Roscommon Hospital and have to walk from the local GAA grounds, which is about 500 metres away, in spite of adequate space around Roscommon University Hospital. So, I think the people of Roscommon need to be reassured that in the deal that was proposed to them after the reconfiguration of the hospital, which deeply disappointed people in that area, that the state is not going to forget the investment in what is a critical piece of infrastructure in the delivery of healthcare in the west of Ireland. I am happy that you have confirmed that this rehabilitation unit has not been removed from the planning of health services in Roscommon. As I already stated, a review of the space will create for our start, and the Department of Public As I have already stated, a review of the Spaceship Plan at Roscommon Hospital has been concluded and the clinical planning consultants are being engaged to verify service brief requirements including in the updated version of the Spaceship Plan as well as in alignment with other hospitals in the catchment and national programmes. As I have already stated, the Rehabilitation Unit at Roscommon University Hospital is a project currently included in the updated exit of Spaceship Plan in 2024-2025. The development of new or refurbished health care facilities anywhere in the country cannot be seen in isolation or separate delivery of related health care services. Capital Plan is an annual document that sets out a planned health infrastructure investment within a given year. Capital investment plays a critical role in enabling enhancing health service provision. Capital Plan 2025 will outline the planned investment in health infrastructure around the country and as I have already stated, the Capital Plan will be published in the coming weeks in line with established procedures. Thank you. Thank you. Thank you.