Fourteen new Primary Care Centres are to be built across Ireland, including ones in Dungarvan (left), Waterford City and Carrick-on-Suir, following agreement of a new €70 million 25-year loan from the European Investment Bank.
Backing for the care centres comes from the new European Fund for Strategic Investments (EFSI), the heart of the Juncker Investment Plan.
EFSI supports lending to crucial infrastructure projects by the European Investment Bank in strategic sectors (such as renewable energy, digital infrastructure, social infrastructure, transport and R&D) as well as financing for SMEs by giving a Commission-backed guarantee on the loans to investors, which increases the amount they are willing to lend.
Financing from the European Investment Bank represents 49.5% of the total investment cost of the new care centres. The project will be co-funded by commercial lenders Talanx Asset Management and Bank of Tokyo-Mitsubishi.
The new PPP-based scheme will support the shift from hospital based healthcare to community-based care closer to patients.
They will provide basic health services including GP surgeries, occupational therapy, social work and dietary advice. In some locations additional services will also be provided, including mental health, dentistry and addiction services and a local ambulance base. A total of 150 primary care centres are already operational, underway or in varying stages of development across the country.
The EIB loan to build 14 new primary care centres across Ireland was made possible by support from the Investment Plan for Europe. This new, large-scale investment project will improve patient care and create jobs across the country.
This is the second healthcare project to be backed by the new European Fund for Strategic Investments (EFSI), the heart of the Investment Plan. EFSI was established a year ago by the European Investment Bank and the European Commission to enable increased lending crucial projects by the EIB in strategic sectors such as renewable energy, digital infrastructure, social infrastructure, transport and R&D; as well as financing for SMEs.
Over the last 5 years the European Investment Bank has provided more than €3.3 billion for investment in schools, university campuses, upgraded energy links, renewable energy projects and transport infrastructure across Ireland.
A large backlog of mostly elderly patients awaiting cataract surgery at Waterford Regional Hospital has been significantly reduced by outsourcing operations to private healthcare providers.
Last year the Dáil Public Accounts Committee was asked to look at how certain public hospital waiting lists were being tackled and whether value for money was being achieved.
In response to a January 2014 parliamentary question submitted by Waterford TD John Deasy the HSE outlined the steps it was taking to reduce the cataract surgery list.
The HSE subsequently confirmed there had been 1,135 patients on the WRH Ophthalmology Scheduled Care register as of July 31, 2013. Of these, 382 had breached the Department of Health 12-month waiting list target.
PAC member Deputy Deasy says: “An analysis of the hospital’s capacity to manage the accumulation of cases identified that only 320 would be treated by the end of 2013.
“The inability to deal internally with the backlog was attributed to three vacant permanent posts at Ardkeen — the hospital having been down to one full-time ophthalmic surgeon and two part-time consultants.”
The Hospital’s general manager sought and received approval from the HSE to outsource procedures to five hospitals to complete the volume of surgeries by the end of 2013.
Of the 815 patients offered a service in private hospitals, 666 accepted. Some patients wished to remain on the WRH waiting list and others had already received treatment elsewhere.
A breakdown shows the operations were carried out in Whitfield Clinic, Waterford (171), Auteven Kilkenny (196), Eye and Ear Hospital Dublin (122), and two Cork hospitals, The Bon Secours (101) and Mater Private (76).
Initial discussions with the private providers indicated a cost of around €2,300 per cataract procedure. Agreement was reached on a price of €1,900, paid to the hospitals, which the HSE regarded as “reasonable”.
In a follow-up report to the PAC last week, the head of the HSE’s South/South West Hospital Group said that since December University Hospital Waterford has had a full complement of four consultant ophthalmologists. There's also a plan in place to cater for patients in-house, “ensuring reduced waiting times”.
John Deasy added: “While the numbers who have received procedures are significant, I’m aware of others who couldn’t wait and went abroad to get treatment.
“I also know there are people who don’t fall into these categories so I’ll be asking the HSE what the current waiting list is like and how quickly it will be dealt with.
“There has been progress but there are still people waiting too long. Elderly people shouldn't have to endure diminished sight and blindness considering how treatable the condition is in most circumstances,” Deasy said.
“Ideally all these operations should be taking place in University Hospital Waterford but the priority has to be to ensure people get the treatment they need. And if that means outsourcing procedures to private providers then that’s fine.”
::: As published on May 22
Fine Gael TD John Deasy says senior consultants at Ardkeen have questions to answer as to why, having spearheaded a public campaign for the retention of the South East Hospital Group, they dramatically changed tack mid-campaign and entered into negotiations that ultimately led to Waterford being linked to Cork University Hospital.
Last November, a week before they met with organisers of what became the ‘Save Waterford’ campaign, Waterford Today published a front-page story in which Deputy Deasy warned it was “time people began questioning the individuals who are responsible for representing WRH.”
He did so having arranged meetings between specialists at Ardkeen, senior HSE officials, and government TDs from the region – only to find “the performance of these senior consultants was underwhelming to say the least.
“They are the ones who needed to make the argument based on medical best practice and they failed miserably. In my opinion others from the regional hospital need to step in immediately to rescue this situation before it’s too late,” he said at the time.
Now, with the Higgins Report’s recommendations for six new groupings adopted by Government, he wants to know what prompted the consultants to do a u-turn.
“For six months the emphasis was on keeping the South East Hospital Group together, with the priorities being patient safety and the future of Waterford Regional Hospital. We had reached agreement politically for that to happen. But for some reason the consultants in Ardkeen decided after six months of campaigning that it wasn’t the best option.
“They need to explain why not, particularly given that the agreement reached to keep the South East Hospital Group together incorporated almost every element of the deal finally reached with regard to Cork,” Mr Deasy said.
The senior consultants at WRH involved in the negotiations with the region's other hospitals are scapegoating politicians for their lack of success in critical negotiations concerning the status of the Regional Hospital.
As the most vocal public supporter of maintaining the regional hospital's status, I believe people who work at the regional hospital need to understand the background to the current situation and begin legitimately questioning the individuals who are responsible for representing WRH.
I have arranged meetings in the past with these senior consultants from Waterford along with the CEO and senior officials from the HSE and government TDs from the region. The performance of these senior consultants was under whelming to say the least. They are the ones who needed to make the argument based on medical best practice and they did not perform. In my opinion others from the regional hospital need to step in immediately to rescue this situation before its too late.
I would contend that the general issue of Waterford Regional Hospital and the South East hospital grouping is not as simple as it might seem. Some of the other consultants and hospitals within the South East Hospital group are leaning towards leaving the existing structure and creating partnerships with hospitals in Dublin where university hospital facilities are available.
That is their choice if the Hospital Trust structure goes ahead. The senior consultants at WRH have lost the debate with Kilkenny and may be losing the debate with Wexford.
I and the other Waterford TDs were heavily criticised for not attending a meeting last week about the future of Waterford Regional Hospital. I've never actually experienced anything like it in my political career. I had texted, emailed and spoken to some of the senior consultants in question and informed them that I wasn't available to attend the meeting. They accepted my apologies but for some reason that information was not passed on to the meeting or on local radio the following day.
In my opinion, politicians are being scapegoated due to the lack of success in these negotiations. I think Waterford has been outmanoeuvred in discussions and the blame for that has been shifted in our direction.
I have a record of the emails and texts communications I had with senior consultants at Waterford Regional Hospital where I indicated formally the reason for my non-attendance at the hospital meeting last week and the efforts I was making with Government Officials.
I will continue to do my job and I will continue to do what I can to maintain the status of Waterford Regional Hospital as the regional base, but I won’t be scapegoated because the talks being carried on with other hospitals around the South East aren't going very well.