Ceisteanna ar Sonraíodh Uain Dóibh - Priority Questions
115. Deputy David Cullinane asked the Minister for Health the steps she will take to avert industrial action among ambulance workers, the steps she is taking to meet the ambition of the ambulance service's strategic workforce plan and if she will make a statement on the matter. [28517/26]
View answerMy question concerns potential industrial action by ambulance paramedics, particularly pre-hospital care professionals, which would include emergency medical technicians, EMTs, paramedics and others. They voted overwhelmingly to take industrial action, as the Minister knows, on 12, 19 and 26 May. I imagine that the last thing paramedics and EMTs want is to be on strike. A number of votes were taken in recent times, including one last year, on the roles and responsibilities changes that paramedics voted against, so clearly there are issues. These are votes of no confidence in the system and no confidence in action that should be taken being taken, so what is next? What action will the Minister take to avert industrial action?
I do not think anybody wants to be involved in strikes of any kind. That is not how we do things, which is why we have the very comprehensive industrial relations architecture we have painstakingly built over some time. The HSE and my Department have engaged extensively, constructively and in good faith, as have the National Ambulance Service representatives, for more than two years to address the issues raised within the National Ambulance Service. That engagement has taken place through the State’s established industrial relations machinery, including the Workplace Relations Commission, WRC, and the Labour Court, and within the framework of the public service agreement.
A comprehensive and independently brokered set of proposals emerged from that process. These included significant pay improvements for staff, of between 3% and 14% on top of the 9.25% pay increases already provided for under the public service agreement. Crucially, those pay increases were linked to agreed reforms and I can go through some of the detail of those reforms, which would generate a more comprehensive ambulance response service for everybody and an easier working life. The HSE and my Department accepted the proposals and the subsequent Labour Court recommendation in full, and both SIPTU and Unite recommended them to their members at the time.
The difficulty now is that the unions are seeking to secure all the pay increases while there has been a reluctance to deliver the accompanying reforms. Those reforms are essential because they deliver real benefits for patients and service delivery, including faster response times, more ambulances available through modern crewing arrangements, greater flexibility across the service, stronger assurance of ongoing regulatory compliance and the ability to treat more patients safely in the most appropriate setting.
The problem is that the National Ambulance Service is massively understaffed. I put down a parliamentary question to which the Minister's office responded a number of weeks ago. In 2025, the HSE target was to have 4,162 whole-time-equivalent paramedics working in the National Ambulance Service. The number for this year is 2,657. By 2026, the target was to have 4,780. The number is estimated to be 2,920 by the end of the year. By 2028, it is meant to be over 6,000. At best, we are going to hit 3,500. We are somewhere between 2,000 and 2,500 paramedics short of what we need. That is leading to burnout and fatigue, which is why there has been vote after vote where paramedics, EMTs and others have said that they have had enough and cannot take any more. As far as I can see, they do not have confidence in the management of the National Ambulance Service because clearly if there are votes coming back all of the time where they are voting against recommendations and for industrial action, there is a problem. The problem is burnout and fatigue and can only be fixed by more capacity and better resources. I appeal to the Minister to do everything possible to support our paramedics and avert industrial action.
It is important to acknowledge that there has been 30% growth in the staff of the National Ambulance Service, which is a larger proportional increase than the health service received overall. We have invested an additional €75 million in the service since 2022 and staff members have increased by 761 since 2022. The total workforce is now 2,500.
Further investment planned for 2026 will deliver 21 extra crewed ambulances at peak demand. I understand that 134 of 168 posts have been recruited, so recruitment is progressing reasonably well so far this year.
My overriding priority, of course, like the Deputy's, is the safety of patients and the continuity of the emergency services. It is important to discuss the reforms that have been suggested and agreed in the industrial relations architecture, and I can do that. However, we cannot just increase capacity anywhere without introducing reform as well.
The paramedics that I have spoken to, and I have spoken to many, are all in favour of reform, but they also want to know that the Government has their backs and is putting in place the capacity. The Minister is right to say there has been an increase in the number of paramedics, but the objective was to double the number of paramedics over a five- to six-year period because that is what was estimated was needed. I gave the Minister the figure that, for 2026, the target is 4,780. The Department and the HSE are telling me that, at best, it will reach 2,920. We are going to be somewhere between 2,000 and 2,500 paramedics short.
In 2023, the Government cut the target response times for categories purple and red from 80% to 50% and from 75% to 45%, respectively, within the specified time period, but those targets are still not being met. The targets that were set are not being met in relation to response times, and the number of paramedics that we need is not being met. It is falling back on those paramedics who are in the system. They are clearly crying out to the Government, the Ministers and the HSE to say they are voting for strike action and voting no confidence in the management of the health service and the National Ambulance Service because they do not see the concrete actions that they need being taken.
I am very invested in resolving disputes, and that is why we put so much effort into the industrial relations architecture that we have. It is important to highlight some of the models of the proposed reforms under the agreement reached between union representatives and State representatives in those structures, for example, a modernised pay and allowance structure, which replaces a complex pay arrangement dating back to the late 1970s with a simpler, transparent structure aligned to wider HSE norms. It standardises overtime arrangements to HSE rates and incorporates rostered working requirements, including weekends and night working, to core pay structures. These are important reforms.
It is important that we discuss reform in the health service because while we can set a target of 4,000, if we are at 2,500, the Deputy and I both know that we have to deal with the practicality of today. There are 134 already in place out of the 180 posts that were funded towards the end of last year. We are desperately trying to recruit into all parts of the health service. However, it is not a realistic conversation for the Deputy and I to say that we are going to go from 2,500 to 4,000 within six months. We have to recruit where we can, and implement the reforms to make sure that everybody is working in different ways, including in a much more modernised structure. We cannot stand over one that comes from a pay structure from the 1970s.
116. Deputy Marie Sherlock asked the Minister for Health the specific actions she has taken to radically reduce the record high levels of delayed transfers of care out of acute hospital settings, as seen in March and April 2026; and if she will make a statement on the matter. [28377/26]
View answerI want to ask about delayed transfers of care. As the Minister knows, there is an enormous number across the acute hospitals at the moment. On 23 consecutive days between March and April-----
I am sorry. I have this question as "not submitted".
Is this question not related to delayed transfers of care?
It is Question No. 116.
I do not have a Priority Question from the Deputy. I will try to get an answer for her, but we have this question as "not submitted".
I believed I had resubmitted a Priority Question but, clearly, there was an issue with regard to it appearing on the Questions Paper.
To be clear, the question is on the Questions Paper.
I will do my best to answer.
On 23 consecutive days between March and April, the number of delayed transfers of care exceeded 500 across our acute hospitals, and again over the last six days. This has a major impact, not only on the people who are caught in hospitals who should no longer be there, but also on admissions. We saw that 129 people were waiting over 24 hours on Sunday night for admission to our emergency departments, 16 of them over the age of 75. It also has an impact on hospital activity, particularly with regard to the staggering reliance on surge capacity at the moment. What is being done with regard to step-down facilities across the health system at this point in time? There is a strong focus on the trolley numbers but, to my mind, insufficient focus on the step-down facilities.
My apologies for the mix-up, whatever the source. I will get the Deputy a full and more official answer. Nevertheless, I will speak from my own experience.
The focus on delayed transfers of care is an integral part of the focus on trolleys - the whole thing goes together. What we are really talking about is patient flow. Hospitals that experience ongoing delayed transfer of care, DTOC, problems include Letterkenny University Hospital, for example, where the number was in the 40s, but is now down in the 30s and moving towards 25. Directly across the road, there is a 100-bed community nursing unit that will open in 2026 and take some of the pressure off.
It is also about the management of this. For example, in Galway, we have gone through a deliberate reset. This speaks to the Deputy's example. The last week in Galway hospital was not good. It lost some of its private capacity for egress or transferring out of the hospital, and because that happened, the trolley numbers built up, and it has had seven very poor days. In the previous 25 days, it had only two red days, 22 green days and one amber day. In the 25 days before that, that was essentially inverted, and it was all red and maybe one green. Patient flow matters, and it matters all the time. It matters because of the impact on people in emergency departments, but it also matters to the hospital's ability to bring in inpatient day cases. As the Deputy highlighted, the use of surge means hospitals cannot do endoscopy investigations and so on. They cannot bring in non-time-critical electives. Of course, they bring in time-critical electives like cancer surgery, but not non-time-critical electives.
That is why the focus on urgent and emergency care, UEC, is important. It is a complete piece. There is no point in focusing on UEC without making sure they have a full awareness of what is available in the nursing homes. University Hospital Waterford does that particularly well. It has visibility in its patient control room of all of the passages out of the hospital. There are others that could do it dramatically better, such as Letterkenny University Hospital, and many of those have a DTOC problem, except for St. James's Hospital, which is a weird one that I will come back to.
The Minister referred to beds and management. When I talk to a number of the hospitals that are experiencing some of the worst problems with transferring those patients, there is a huge absence of neurorehabilitation beds and dementia-specific beds. In particular, we know that in Cherry Orchard, two wards have been closed for almost the past two years, supposedly for fire remediation works. The Killarney Community Nursing Unit was ready a year and a half ago, but has yet to be opened. We know that at South Infirmary, there are beds closed that should be open. We know that at a facility that is due to open in Blarney, as I understand it, the governance is due to lie with the Mercy Hospital, which has no neuro responsibilities because they are with Cork University Hospital.
The question concerns the decision-making and the management. It makes no sense to me that the sole responsibility for this lies with the hospital itself. What is the community element? In particular, what is the IHA doing to try to address these issues?
The Deputy is 100% right. It does not necessarily lie with the hospital management. For example, in Cork, with the IHA managers, there is no governance element to this. They are not CUH beds or Mercy Hospital beds, and nobody had better tell me that they think they are. They are beds for the south west, and they have to be managed from a single centre, which happens to be in CUH at the moment, but we will see about that. They have to have visibility over what is the situation in Blarney, Bantry, Mallow, South Infirmary and other places. It is their whole responsibility to be able to move people through.
As for the hospital managers' responsibility, I do not want to hear from consultants who say they cannot move X patient because they need to be in CUH instead of the very good care in Mallow. There needs to be an understanding that every hospital sits within a region, and patient flow works in that way. That is the only way this can possibly work. I am glad to hear the Deputy highlight that because it is the sort of reinforcement I need, particularly in the south west, to make sure that the patient flow experience is fully understood and that every bed is opened.
As regards the Killarney unit, I am told that will be in the next couple of weeks. There was a HIQA registration problem and there is engagement with the union but, frankly, it is not good enough that those beds and other beds have not been opened. Mallow's 24 beds were supposed to be opened in quarter 1. It will now be very shortly but it should have been done.
When I look at the Minister's letter of determination to the HSE this year, or arising from the budget, I see the big emphasis on home care support and very little emphasis on the construction of new step-down beds. We know that the vast majority of those being constructed at the moment are replacement beds. I think there are many reasons there is a need for step-down beds. I know my colleague, Deputy Conor Sheehan, had figures with regard to those who were exiting into homelessness.
One other issue I want to introduce to the conversation regards under-65s with dementia and other acquired brain injuries in hospitals who have nowhere to go. When I asked the Minister's Department last week about care of the under-65s in nursing homes, I was told that this was not the responsibility of the Department of Health. If it is not the responsibility of the Department of Health - of course, the Minister sets the funding for the HSE - then whose is it? I do not accept that it is fully the responsibility of the Minister for disability because she does not control the HSE budget but we need to be very clear to those families out there who want an alternative to nursing homes for their children under the age of 65 who are adults.
I understand. For example, I visited a facility very like that. Please forgive me; I do not have the name in front of me but it is in the north of Dublin, an acquired brain injury-----
An Saol.
That is exactly it. Forgive me. It is looking to build the facility adjacent to the primary care centre.
It is residential there.
Exactly. What we can do is work with an approved housing body, AHB, to build that residential. The HSE is for delivery of healthcare and we try to make it work as well as we can but here are the things we are not: we are not a transport company and we do not build homes. What we can do is partner with AHBs to make sure we are developing long-term residential that is adjacent and appropriate for needs of that kind.
On that site in particular, what we are looking at is what capacity we can have for people who need to come to that facility and that form of residential. We are trying to work with the sites we have adjacent to a primary care centre. I used that example because I happened to be there so recently.
The Deputy is right about acquired brain injury and dementia but the HSE has to focus on healthcare and partner with bodies like approved housing bodies that are experts in building housing.
There is HSE money going to nursing homes. They are residential facilities.
I would rather it did not.
117. Deputy David Cullinane asked the Minister for Health the model that the Sláintecare programme board will operate on following the appointment of a new HSE CEO and a new Secretary General at her Department; the reason her Sláintecare implementation plan for 2025-plus does not have year-to-year measurable actions for 2026 onwards; and if she will make a statement on the matter. [28518/26]
View answerI am seeking an update, if I can, on the Sláintecare programme board and how that will operate, given that we have a new CEO of the HSE and, indeed, a new Secretary General in the Minister's Department. I wish to take the opportunity to thank Mr. Bernard Gloster and Mr. Robert Watt for their many years of service, two people I have worked closely with and have a very high regard for. I also want to wish Ms Anne O'Connor and Mr. Derek Tierney the very best as well. We obviously want them to succeed. They are two highly professional people who I have a lot of faith in and I know they will do lots of good things.
During the previous Dáil, the leaders of the Sláintecare programme board were the heads of the Department and the HSE. Will that continue? I also refer to the implementation plan, which I think ended in 2025. We need an updated implementation plan with clear timeframes and targets so that the new CEO and the Department head actually have a plan to work to.
I thank the Deputy, and I join him in thanking the Secretary General, Mr. Robert Watt, and the previous CEO of the HSE, Mr. Bernard Gloster, who both did outstanding work in the Department of Health and the HSE in different ways. They have really stabilised and improved the service more broadly since 2022 in particular and I thank them for that. I also wish both the new Secretary General, Mr. Derek Tierney, and the new CEO, Ms Anne O'Connor, well in their new roles, which are very significant roles for everybody.
Notwithstanding those changes in personnel, there is no change to the programme of work. That needs to continue. We remain fully committed to the Sláintecare vision. The next meeting of the Sláintecare programme board will take place on 28 April. At that meeting, progress across all of the Sláintecare projects will be reviewed in respect of the action plan for 2026, the second of three action plans under Path to Universal Healthcare: Sláintecare & Programme for Government 2025+. The Deputy knows what they are. For quarter 1 alone, this includes 90 actions across 12 Sláintecare projects. In total, the programme board oversees 23 projects with approximately 400 actions. What does that mean? It relates to reforms being driven through, for example, with the enhanced community care programme, the public-only consultant contract, POCC, and, crucially, the implementation of the POCC, the digital health transformation and women's health. It is envisaged that the same structure will be co-chaired by the new Secretary General and the HSE chair, so there will not be a change there, which I think is very welcome. That is really the answer to the Deputy's question.
I welcome some of what the Minister said but the problem is there are not clear deliverables and timeframes in the current Sláintecare action plan. That is something that has to change. I want to see, for example, changes to the medical card and GP card thresholds. There have not really been any substantial changes to medical card eligibility in a long time. The big reform that the health service needs, from an acute hospital perspective, is delivering the elective hospitals. If you really want to deal with waiting lists, then build the four elective hospitals as quickly as possible. I guarantee that that will give us capacity to deal with lots of the planned procedures that need to be done, separating scheduled from unscheduled care.
I am big believer in a seven-day-week health service.
I know.
I know the Minister is. When she is pushing forward those reforms, I will be supporting them, as I did with the public-only consultant contract because we needed it. We have to get bang for our buck. I agree that we need reforms and efficiencies but we also need capacity. If we do not have the diagnostic capacity, the bed capacity and the staff in our hospitals, then it is more difficult to reach our targets and actually get the reforms. It is a combination of all of that, and all of that is obviously part of Sláintecare.
I agree and I thank the Deputy for his support on these reform programmes. He is right about the elective hospitals but before then, we have the opportunity with the surgical hubs, which will be delivered in 2026. The delivery of the surgical hubs is going to create all sorts of different waves. We are looking at what procedures need to go there immediately and what that will free up in the hospitals where they would otherwise have been done. How is that going to be staffed and when? I am looking at the National Treatment Purchase Fund, NTPF, buying capacity in our own hospitals but I am also looking at underutilised capacity in our own hospitals, like the endoscopy suite in Bantry. There are two of them. One of them is used a half a day per week. We have appointed additional people specifically to Bantry but how can that be, and why are we buying any endoscopy action in that area? Why is there endoscopy happening in Roscommon when there is a very good suite there that does not operate after a certain part of the day? How are we using our own resources and how are we going to collectively, as the political leadership in health here, make sure that we are using the assets we have as we build? The elective hospitals are entirely necessary but we have capacity that is not being used. There is room after room in different hospitals and we are not using them.
I could not agree more. I have been saying this for a long time. I am a big supporter of the surgical hubs. There is one coming in my own constituency adjacent to University Hospital Waterford, so I know the difference that will make. I fully agree that we have to look at how to take pressure away from our acute and major hospitals, for example, more off-site rooms for outpatient activity where we can free up clinical space. I am in favour of all of that. I am fully on board with a seven-day-week health service. I want all of that to happen, but for the efficiencies to happen, there also have to be the resources.
While the surgical hubs will be a game-changer, I can tell the Minister for a fact that the elective hospitals will be an even bigger game-changer. I am saying that to her because there will be push-back from consultants. I have got it in relation to the elective hospitals. They want the low-lying fruit still in public hospitals. It is why insourcing was so profitable and something they were trying to protect. We have to protect public patients, get value for money and efficiencies but also reduce waiting times. I guarantee that if the elective hospitals are built, the Minister will see some of those wait times in orthopaedics and other areas come down rapidly. It will be the biggest reform that could be made in the health service.
I totally agree with the Deputy and I think we will get there with Galway and Cork much more quickly. I would like to discuss with all Deputies options around Dublin because clearly we have the option in relation to Connolly hospital. The Deputy may have noticed that we put in some high-dependency unit, HDU, beds in advance because that is really going to be an important enabler. We did that in the past number of weeks. We put the staff in to have significantly expanded HDU capacity in Connolly hospital with a view to where that goes for the elective.
It is well worth us considering constructively the best other use of brownfield space that is available within other Dublin hospitals, how we might consider that as alternative elective capacity and what we do with Crumlin. It is a useful open conversation that we should have. More than anything else, I need Deputies' help with the implementation of the public-only consultant contract and five over seven.
I cannot have the NTPF buying activity in hospitals from 5 p.m. to 8 p.m. and not have consultants rostered at those times. That intersection is going to be really important between surgical hubs, the NTPF and the actual rostering. I am going to need Deputies' help.
118. Deputy Pádraig Rice asked the Minister for Health the timeline for the full commencement of the Health (Assisted Human Reproduction) Act 2024; to provide an update on the drafting of supplementary assisted human reproduction legislation; and if she will make a statement on the matter. [28695/26]
View answerI begin by welcoming the commencement of section 232 of the assisted human reproduction Act which took place yesterday, and the changes to the Children and Family Relationships Act that resulted. This provides a pathway to parentage for some donor-conceived children. I know there were celebrations in many households across the country who benefit from those changes, which are welcome. When does the Minister intend to commence the rest of the Act and what is the update on the supplementary legislation that is required?
I thank the Deputy for his ongoing engagement on this. As he knows as well as I do, this makes a huge difference to families around the country. Much progress has been made now. The Health (Assisted Human Reproduction) Act 2024 was signed into law by the President in July 2024. I have a difficulty with a definitive timeline as to the complete commencement of the AHR legislation as there are a number of interdependencies and considerations involved, not least the timing that I do not control over a Supreme Court case. On the full commencement of that and the full application of the legislation, there is an interdependency there that is outside of my hands. The others include the second Bill, the AHR amendment Bill being enacted, and the regulatory authority being fully operational. I can give the Deputy an update on what is happening with that, but there is also an important relevant Supreme Court judgment pending. I understand the case is due for mention on Monday, 27 April but it will be very difficult for us to get to Committee Stage without that having been resolved. That is really important.
As the Deputy is aware, our formal drafting of the AHR Bill is at an advanced stage. It is very substantive. It is on the priority list for publication. Department officials in my Department are scheduled to meet with the Office of the Parliamentary Counsel tomorrow to discuss what is expected to be one of the final drafts and I expect to be in a position to introduce it to the Dáil this term.
Some administrative sections of the 2024 Act have been commenced, specifically to establish the Assisted Human Reproduction Regulatory Authority, as the Deputy knows. The Deputy mentioned that three subsections of section 232 of the 2024 Act have been commenced. It is complex and there are very many slightly competing and multifaceted perspectives to be considered. We are going to have to think about the sequencing of some of it but I hope to advance it as quickly as I can.
I thank the Minister. I welcome the commitment to advance it because the pace of change has been far too slow. It is now 26 years since the commission on AHR, four years since the Oireachtas Committee on International Surrogacy, and seven months since the health committee published our report providing pre-legislative scrutiny of the legislation. There is real frustration about the delays here. We need to see urgent progress.
In relation to the case, and I mentioned this to the Minister of State, Deputy Butler, when we debated this in December, the State's failure to legislate has resulted in these cases. In the absence of legislation, people had no option but to go to the court to try to vindicate their rights. This will continue. We will have more people going to the courts trying to vindicate their rights in the absence of legislation. We need to pass the Bill. I have no doubt that, in some cases, there are people threatening the Minister with legal action who would withdraw that, but it is the absence of legislation. We have created this mess by delaying the legislation and by not progressing it in the 26 years since the commission published its report.
The Deputy is a practical person, as am I. If a court case is before the Supreme Court, then there is a court case before the Supreme Court and there is nothing I can do about that. I would be in breach of my own responsibility not to cross over in the separation of powers were I to do anything other that wait for the outcome of that. I do not have any discretion in relation to that. As for people threatening to take legal cases, people are entirely entitled to take legal cases if they wish to do so. That is the essence of being an Irish citizen. There is no quid pro quo in relation to it. I am dealing with what I am trying to get resolved now. The reality is that we are advancing the legislation. We will not be able to take it to Committee Stage until the Supreme Court case is determined. It is not that I wish to be in that situation; I do not wish to be. That is simply the factual reality of that situation. There is nothing I can do about that but I will do everything that I can control as quickly as possible.
I do think it is a situation of the Government's making. People absolutely have the right to take cases but people do not want to go before the courts. These families do not want to have the legal costs and the stress imposed on them by going before the courts. I think the Minister would agree with me that we need to expand personal freedoms generally in this republic. We need to vindicate the right to procreation, the right to private and family life and reproductive freedoms. There is much work left to be done, in particular the rights of the child, the rights of their parents and greater equality more broadly. This is a key part of that. I really hope that we get this legislation enacted and commenced, and that we are not waiting and waiting because we have waited long enough.
I agree with the Deputy. Indeed, this is something I have been involved with in different ways since working in the Department of children and since advancing the Children and Family Relationships Act, as I did when I worked in the Department of justice in 2013. I have been working on this for a really long time and I share the Deputy's frustration. I want to see people having access to families where they can.
We need to speak about rights in totality, however. Yes, there is a right to family, a right to procreate and all of those different things. There is also a right, and we have an obligation as an outward-looking country, to make sure we are doing everything we can to protect everyone else. I am not saying this specifically to this but I do remember questions, when I started working here and we were dealing with, for example, adoption, the Hague Convention and the restrictions that were put in place because some of our actions at that stage were, frankly, exploitative or potentially exploitative. That was pulled back and for good reason. It changed the adoption rules for the future and they were very significant changes that were made. There were people who felt that they had a right in a particular way, but those rights always have to be balanced and because we are an outward-looking, humanitarian society, we have to take the rights of everybody into account. I know the Deputy will be at the front of that, having advanced looking at things through a human rights lens. There is more than one human involved in these and we have to be careful and balanced. I am not trying to limit anybody but I just have to say it as well.
119. Deputy David Cullinane asked the Minister for Health to provide an update on the delivery of new outpatient mental health capacity and mental health beds, as previously announced in the HSE capital plan for Waterford and the south east; and if she will make a statement on the matter. [28519/26]
View answerI am looking for an update on the replacement of the existing adult mental health 44-bed unit at University Hospital Waterford with a 50-bed single bed unit. I acknowledge the work of the Minister of State, Deputy Butler, in making sure this was on the current capital plan recently. I was criticised in one local newspaper for doing so.
I heard that, too.
I think the criticism was because there was frustration that developments can be glacial and it takes a long time for these projects to get over the line. There are other projects I want to talk about, which I will later. On this particular project, it is important to have timeframes as to how quickly we can expect this development might be delivered, which I think we all accept would be massive and a game-changer for mental health services in Waterford.
I thank the Deputy. The frustration that many people feel I have felt as well for quite a while. When it was announced initially in 2020 or 2021, we were in the middle of Covid. It was then held up for three years by the clinicians. At the time, I was very frustrated with them but I agree with them now. They did not want the new approved centre, the new department of psychiatry in UHW, to be, as was proposed, on the site adjacent but not connected to it. It is now going to be connected.
I have allocated over €40 million for capital projects this year, including for the next stages for the acute mental health unit at Waterford. The project will move to design feasibility this quarter when a design team will be appointed for the new unit. Most importantly, because of delays, we are now moving from a 50-bed unit to a 60-bed unit. There is going to be an extra ten beds for psychiatry of later life. We have an ageing population and it is really important for people who have enduring mental health conditions, as they age, that they would also be able to get those supports if needed.
It will be built immediately behind the Dunmore Wing, which the Deputy knows very well. He visited it with me previously. It will come out immediately behind the Dunmore Wing as part of the department of psychiatry that is there at the moment. The current car park will be lost but I spoke to the general manager of the hospital about that and he said it was a small price to pay for this new development. We expect it is going to cost in the region of at least €50 million. I met with HSE estates recently in St. Otteran's campus. I was visiting psychiatry of later life there and we went through it. We can discuss the other pieces shortly. The good news is that the design team will be appointed very shortly, I am hoping in the next few weeks, and we will finally make the progress. The funding has been provided.
I very much hope that the new adult mental health unit will progress as quickly as possible. I agree with the location and I want to see it developed as fast as it can be. There was also a promise for a 96-bed ward block over five storeys at University Hospital Waterford, and a multi-storey car park. The Minister of State issued a press statement a number of years ago where she said there was a proposal for a two-floor vertical extension over the existing outpatients department, to provide an additional 36 consulting rooms, four treatment rooms, four measurement rooms and two virtual consultation rooms.
I do not know the status of that plan at the moment. I have been tabling parliamentary questions seeking updates on all of these projects. We need the additional 96 beds, we need the underground car park and we need the two-storey extension to the lab, but we also need the vertical two-storey extension that the Minister of State talked about and all that additional space. The frustration is that these projects are listed in the capital plan, or maybe some of them are not now listed. People do not know if we are going to get them, if they are funded or how quickly they will be delivered. We all want the best for our regional and local hospitals. I raise these projects because they are really important in the context of University Hospital Waterford.
The question the Deputy asked was about the HSE capital plan for Waterford and the south east in relation to mental health and mental health beds. I can speak to that. In relation to the other issues the Deputy mentioned, I do not have the relevant information but I discussed it when I had the meeting with HSE estates. On the two-storey vertical extension, the vertical overhang as it is called, my understanding is that the management at the hospital has made a different decision in relation to that and thinks that it should be a stand-alone building on the hospital grounds. I understand the new consultant-only contract is the reason for that.
I was delighted to secure funding for a ten-bed unit in the Wexford area. As the Deputy knows, since St. Loman's closed in 2010 or 2011, we have been getting patients from the Wexford area, which was a long journey for them. We are also looking at putting in a new ten- or 12-bed unit in Wexford.
I raise these issues to illustrate the point that when announcements are made, people expect things to be delivered and then ask how quickly they will get them. If there is an announcement regarding additional health capacity, that is really good news. It is exciting, and people want it. When people hear about the announcement of an additional 60-bed ward block over five storeys at University Hospital Waterford but then do not see it and when I am putting in parliamentary questions and cannot get answers on the timeframe for it to happen, that causes frustration. There was a clear announcement of a proposal for a two-floor vertical extension with all of those consultation and treatment rooms to come with it. We are now being told there is a change to that. We still do not know what that means and when the facility will be built, which also leads to frustration.
It is the same with the multi-storey car park. In fact, it is the same with the mental health unit as well. I do not doubt that the Minister of State is pushing these issues; I accept that 100%. All I am saying is that there is frustration that when announcements are made by local Ministers or senior Ministers, they then seem to either fall off a cliff or take far too long to go anywhere. That causes frustration, particularly when we cannot get answers to parliamentary questions when we table them.
It is important acknowledge the surgical hub. Earlier, the Deputy said he is a fan of surgical hubs. Some €90 million in capital investment is being spent on the surgical hub. I was delighted to be there last year, along with the Minister, to turn the sod on it, even though it was well under way at the time and will be open before Christmas, which is really important. Another piece of good news is that a site has been identified in Waterford city for a new ambulance base, which is also really important. I do not have any detail on the 96-bed unit the Deputy mentioned. I guarantee that I have also raised everything he has raised here. It is really important that we see progress.
I want to put this on the record of the Dáil. Improving capital infrastructure for mental health services a key priority for me. I was delighted to work with the Minister recently to secure an unprecedented €470 million in capital investment for mental health over the next five years under the National Development Plan 2026-2030. That has never happened before, and I think everybody will welcome it.
