2026-02-17

I thank the Minister of State for taking this Topical Issue. It is ironic that he holds the role as Minister of State with responsibility for older people when my Topical Issue relates to people on the other end of the life cycle. There is a desperate need for critical care expansion at the Rotunda Hospital. All of us have childhood memories that will stay with us for life. Mine come from about 31 years ago. My two younger brothers, Alan and Paul, were born quite prematurely, each weighing about 1 lb or 1.5 lb, and spent months of their life in the critical care unit at the Rotunda Hospital. They grew up big and strong and they were looked after incredibly well. I have memories of the hospital and the critical care unit at that time as an older, antiquated building. In recent years, I have been going back to meet the masters of the hospital and management team as they started to develop their ideas around expansion, particularly in the last six or seven months when it became clear there were going to be objections to the expansion. What strikes me is that in my memory the hospital and critical care unit from 31 years ago looked almost exactly the same then as it appears today. While the machines have been modernised, as will happen with machines, the space in which critical care is afforded has not. Some 9,000 children are brought to life in the Rotunda Hospital every year. Not only does it care for the most vulnerable babies in this city, but babies in critical care from all over the country are sent to the Rotunda Hospital. The clinicians, midwives, master of the hospital and management teams are exceptional. They have a real sense of place and purpose. Every time I walk into that hospital, I am just blown away by the care they give. On Friday, like everyone across the Chamber - I am not the exception – I was furious that the desperately needed expansion at the Rotunda Hospital was declined by An Coimisiún Pleanála. I also heard Ministers, and the Taoiseach, convey their frustrations in that regard. It was declined after approval had been given by Dublin City Council and despite the fact that an coimisiún’s own inspectorate report stated that this progression is desperately needed. It was declined on the basis of architectural preservation, given that the Rotunda Hospital is in the centre of what is Georgian Dublin. The Rotunda Hospital was there first, however. It features in a 1795 picture just behind us on the wall of the Chamber where it is described as the lying-in hospital. I find it unfathomable that anyone could walk into the critical care unit of the Rotunda Hospital, understand the need and then turn around and object to its development into a modern hospital appropriate both to the needs of babies and women’s healthcare in this city. The State and Government have some responsibility in this regard. That needs to be accepted and rectified. In the end, the decision by An Coimisiún Pleanála states very clearly, despite the Minister, Jennifer Carroll MacNeill, claiming otherwise earlier, the reason this was turned down. It stated: Government Policy is to co-locate the Rotunda in the medium to longer term with Connolly Hospital in Blanchardstown, by which time the adverse impact caused by the development as proposed to the character and setting of Protected Structures and the Georgian Conservation Area, could not be undone. The only protected structures that should be prioritised are the babies in those incubators. The co-location plan with Connolly Hospital is never going to happen. There is already a co-location happening between the Rotunda Hospital and the Mater hospital. There are blue pathways that are needed. What are we doing to do? I am happy to work collaboratively in this regard, as is everyone in the Chamber. I understand the Minister of State will read a response. We will see what we can do from there.

I thank Deputy Gannon for the opportunity to address the need for a new critical care wing at the Rotunda Hospital. I am taking this matter on behalf of Minister for Health, Deputy Jennifer Carroll MacNeill. The Government is committed to driving improvements and continued investment in the Rotunda Hospital. Providing the highest possible standard of care at the Rotunda campus is a priority for the Minister for Health. This includes ongoing capital developments at the site to manage the current and future needs of women and babies. The Rotunda Hospital is one of the busiest maternity hospitals in Europe. More than 8,600 babies were delivered there in 2025, and more than 1,300 babies were cared for in the hospital’s neonatal intensive care unit, NICU. The Rotunda Hospital provides 25% of the neonatal care capacity in the State. This includes the most critically ill babies, many of whom must be transferred from other hospitals to receive the specialist care they need. The planned critical care wing at Parnell Square west is critical to provide essential upgrades to the existing Rotunda campus to meet high-priority clinical needs. The new wing would provide additional NICU capacity, single-room beds and a new theatre. This development would increase capacity at the hospital to provide safe and appropriate care for an increasing number of presentations, including the most critically ill babies. It would address the space shortages that restrict our capacity to deliver critical services to very sick babies and wrap-around supports to their mothers and fathers. In this context, the decision of An Coimisiún Pleanála to overturn the position of Dublin City Council and refuse planning permission for this urgent, critically needed expansion is deeply disappointing, particularly when we have had positive decisions accepting the public benefit of the development all the way through the process. Our priority now is to ensure the delivery of appropriate neonatal expansion at the Rotunda Hospital as quickly as possible. The Minister for Health, Deputy Carroll MacNeill, will meet with the master of the Rotunda, Professor Sean Daly, in the next two weeks once he has had an opportunity to consider all options available to him, as he is the applicant for planning. The Minister will also continue to work with the Minister for Public Expenditure, Infrastructure, Public Service Reform and Digitalisation, Deputy Chambers, to ensure that health infrastructure is fully recognised as critical infrastructure within the forthcoming reforms arising from the Accelerating Infrastructure - Report and Action Plan. We are committed to providing support for the hospital in meeting the current and future needs of women and babies at the current Rotunda site. The hospital budget has increased to €109 million in 2025. This is an increase of 47%, or €35 million, since 2020. The HSE purchased an additional building, Hampson House, to extend capacity, which officially opened in January 2025. Over 100,000 outpatient and ambulatory patients are expected to attend annually. A range of service improvements are also being driven by the hospital and through the national maternity strategy. The Minister for Health visited the Rotunda in June 2025 to launch a new neonatal intensive care unit, NICU, resource for parents, and again in January this year to welcome a new foetal surgery service. Following Government investment, the Rotunda has also been working closely with hospitals across Dublin to establish a new community post-natal hub service for women and infants following birth, which is being launched next week. We will continue to support the Rotunda with these initiatives as it strives to meet the needs of the women, infants and families it serves.

I thank the Minister of State for his response. I listened carefully to it and read the words. I heard the Taoiseach today and listened to the Minister for Health on the radio this morning. Everybody shares the frustration. I understand the Minister is going to meet the master of the Rotunda, Professor Sean Daly, in two weeks. I met him yesterday. It is vital that when the Minister for Health goes to meet the master of the Rotunda, she brings options to the table. What we need here is not just collective lamentation about how frustrated we are and how wrong this decision is. We need to know how we can now speed up the process. The Taoiseach today talked about emergency critical infrastructure legislation. That is brilliant; it is fantastic. He asked for support from around the House. The Government will have full support if we can have some innovations in legislation to provide for critical healthcare capacity and move this along fast. I do not doubt for a second that the human care being provided in the Rotunda Hospital is second to none. What is lacking is infrastructural assets. What we need now is a collective agreement that if emergency legislation is needed, we will do it fast. We are talking about one of the busiest maternity hospitals in Europe. We are talking about a maternity hospital that provides care to an incredibly vulnerable cohort in its immediate vicinity and a vulnerable cohort nationwide of babies who require critical care. If the Minister of State were to take a message back to the Minister from me, I would ask her to act with urgency, to be innovative in her approach and, when she meets with the master of the Rotunda in two weeks' time, to bring options to the table because the staff, clinicians and midwives in the Rotunda Hospital have done everything to this point. The preservation of architecture is never more important than the preservation of life.

Once again, I thank the Deputy for raising this important matter. As I said, I am taking this matter on behalf of the Minister for Health, Deputy Carroll MacNeill. The Government is clear that we need increased capacity at the Rotunda to ensure it can meet the needs of women, infants and families in the short term. My priority, and that of the Minister, Deputy Carroll MacNeill, is to work with the master, Professor Sean Daly, in making sure we take the correct steps to deliver appropriate neonatal care for the Rotunda as quickly as possible. The Minister has spoken of her disappointment at the decision by An Coimisiún Pleanála, which references the longer term plans to relocate the hospital. To be frank, the time needed to co-locate the Rotunda with another acute adult hospital would by far exceed the delivery time of this new critical care unit, which is needed now. The successful relocation of the Rotunda will require a strategic reassessment of prevailing conditions and factors that impact the project at the time of the planned relocation. This would also need to be viewed in the wider context of all hospitals in the region, including Connolly Hospital. The Rotunda is currently working closing with the Mater hospital, a model 4 hospital that the Deputy referenced. It has a protected blue light corridor to provide adult acute services when needed. The priority now is to support the Rotunda to continue to provide essential maternity and neonatal services. Given the importance of infrastructure to Ireland's social and economic success, under an ambitious plan under the revised national development plan, all stakeholders need to engage willingly in open dialogue around planning concerns. The health needs of women and infants presenting to our service are increasingly complex and the National Maternity Strategy 2016-2026 is in its final year. It has been driving national reforms across our services to better meet these needs. We have committed in the programme for Government to developing a successor to the national maternity strategy. It will consider a broad evidence base and will involve policy considerations that may have evolved since the first strategy was initiated ten years ago. I will bring back the specific points raised by the Deputy to the Minister.