2026-02-18

I recently asked the Minister for Health for an update on the development of the elective hospital at Merlin Park in Galway. Looking back at some documents I have, I note that the elective hospital was first proposed in 2018. It was also included as part of the national Sláintecare programme. It has been included in every HSE capital plan up to 2025. The description in each of those documents has been for an elective hospital. In 2026, when the HSE published its national service plan, I noticed that there had been a slight change of language. It was no longer described as an elective hospital but as an elective care centre. Following that, I put this question to the Minister which was referred on to local HSE officials as commonly occurs but the response I received is quite concerning. It stated: The HSE have identified the need to refine the scope and budget of the planned Elective Care Centres. [...] The result was a substantial reduction in the building area and in turn, overall cost. [The original building area in the scoping document had been for a building of between 60,000 sq. m and 80,000 sq. m] The design team are currently investigating the possibility of expanding or bolting-on the new facility to what will be an Operational Surgical hub. It is hard to consider that this is not a serious reduction in what had been planned as part of the elective hospital development in Galway. Furthermore, I am advised that the new facility, or care centre as it will now be called, will consist of two operating theatres, where the original plan had been, I think, for 11 operating theatres, five endoscopy procedure rooms, where I understand there had been eight procedure rooms in the initial resource requirements, and ten minor operation procedure rooms. In the elective hospital there were also plans for radiology and diagnostic modalities, outpatient rooms and pre-assessment rooms and there was a proposal for 200 beds - 75 inpatient and 125 day case beds. It comes as a deep disappointment to me, and I know it will to my constituents and indeed to the wider region, because part of this plan was to facilitate the decanting of the university hospital site in Galway, which is due for significant capital development and investment. I am concerned that not alone are we losing a facility where there was going to be 200 beds but this decision will not facilitate as easily the capital investment and expansion and development of University Hospital Galway, which is so badly needed. I hope I am misinterpreting the response but I am concerned that I am not. A decision of such significance should have been discussed and debated further and possibly information should have been provided before that. In terms of the elective hospitals, my understanding was that Galway was part of a package that included an elective hospital in Cork and Dublin. Where do they stand as well?

I hope I will be able to give the Deputy some clarity. I thank him for asking the question, which I am answering on behalf of the Minister for Health. I acknowledge the Deputy's dedication to the people of Galway and beyond on raising these important health issues. I can assure him that the Government is committed to increasing elective-only day case capacity through the elective ambulatory care programme. This is being delivered in two phases, a national network of surgical hubs in the first instance to meet medium-term demand and capacity and, in the longer term, a national network of elective treatment centres in Galway, Cork and Dublin. In relation to the surgical hubs, developments are well under way and a new hub is due to become operational at Merlin Park later this year, along with hubs in Cork, north Dublin, Limerick and Waterford. This will build on the success of the two hubs already opened, namely, the Reeves Day Surgery Centre in Tallaght and Mount Carmel surgical hub facility in south Dublin, which have reduced waiting times. The Galway hub will deliver thousands of procedures and treatments every year. As announced last July, surgical hubs are also in development for Sligo and Letterkenny to provide additional day theatre capacity in the west and north west. In relation to the elective treatment centres, also known as elective hospitals, we remain committed to developing these in Cork, Galway and Dublin. As the programme has developed and evolved, the HSE has determined the most appropriate design for the new facilities. The introduction of the surgical hubs was not originally envisaged when elective hospitals were first proposed. The significant additional capacity being provided by these hubs has been an important factor in determining the model for the centres going forward. I understand the HSE has been considering how best to deliver elective care at Merlin Park. As the Deputy is aware, the HSE is considering extending the surgical hub. I understand that the design team is working through this and further details will be available in due course. The HSE expects to be in a position to apply for planning permission in the middle of this year. The new elective treatment centre in Merlin Park will have six operating theatres - I think the Deputy referred to two - five endoscopy procedure rooms and ten minor operation procedure rooms. This is a significant addition of capacity and will make a real difference to patients. This is not a reduction in ambition. I want to be clear about that. As the Deputy knows, there are no beds at elective facilities and there is no intention to provide them. These are not for inpatient care. These are for people to get the procedure they want and to get them home to their own beds in a timely manner - in and out the same day. The intention is for the elective facilities to provide day case procedures and treatments, for example, those which do not require an overnight stay. Patients will arrive at and leave the facility on the same day. The development of the elective-only facilities I have outlined will also mean that capacity is freed up in existing hospitals for more complex or emergency acute cases. I understand where the Deputy might have had confusion in relation to how many theatres there are. When the surgical hub was proposed for Waterford, it was designed to have two. It has since been upgraded to four. It will be operational by the end of the year. There is a real push for these surgical hubs. Two of them are open in Dublin. They are being built around the country to take pressure off the acute hospitals. These will be staffed separately. Sometimes elective surgeries are cancelled. This will not be the case. I hope the Deputy can see that we are committed to improving elective care in Ireland. The plans we have in place are already making a real difference and helping to drive down waiting times. I look forward to the Deputy’s continued engagement on these issues.

The first thing I should have said is that I appreciate the Minister of State being here as a Minister of State in the Department of Health to take this question and provide an answer. However we present this, it is a significant change in what was to be the provision of a facility that had intended at its outset and up to 2025 to provide for 200 beds. I recognise fully the point she made that these are day procedures but I understand from the documentation that had been provided previously that there were to be 75 elective inpatient beds and 125 day case beds. That had been the position up to March 2025, when I had previously asked for an update. I was advised that the integrated design team was working at pace to progress the detailed design to inform planning submissions on a range of statutory and regulatory approvals to proceed to tender and construction. That was for the elective hospital. It had been perceived to be the development of a 200-bed facility. I understand some of those were only for day case beds. In terms of my reference to there being two theatres on top of the surgical hub, the information that I received from the HSE describes that the elective care centre will consist of two operating theatres plus four operating theatres in the surgical hub. We were always conscious and always felt that there were two developments here, namely, a surgical hub and an elective hospital. I want to reiterate that the development of the elective hospital was seen as something that could facilitate the increased development at the regional hospital site of the university hospital site. As far as I understood it, the plan had always been that elective non-emergency, non-acute outpatient facilities would all move to the Merlin Park site and that the university hospital site would be for acute, high-tech procedures, cancer care, maternity and accident and emergency. I am really concerned about that plan now. I am really concerned about the progression of that plan. We need clarity on that.

I thank the Deputy. In relation to the elective treatment centres, known as elective hospitals, the HSE and the Minister remain committed to developing these in Cork, Galway and Dublin. They will take longer to develop. In the short term, as the programme has developed and evolved, the HSE has determined the most appropriate design for the new facilities. The introduction of the surgical hubs was not originally envisaged when elective hospitals were first proposed. The significant additional capacity being provided by those hubs has been an important factor in determining the model for the centres going forward. I am not in a position to answer the Deputy's question. I have been in Merlin Park previously visiting mental health services but I cannot answer the Deputy's question in relation to where it will be located. I would be of the mind that if you are going to have an elective hospital with overnight beds, that colocation is important beside a model 4 hospital. Maybe that is the reason behind it but I am only thinking out loud. This is my sixth year in the Department of Health. I understand that decisions are made at times. A lot of people are on waiting lists for elective surgery. We have already delivered two new surgical hubs that are operational. A couple more will come on stream this year. I think what is being proposed for Galway is both. This states clearly that the Minister remains committed to developing the elective hospitals in Cork, Galway and Dublin but while we await those, the surgical hubs will be in place. That will take down a huge amount of capacity for his constituents who are waiting for treatment.