Phoenix: What do they want?

Minister for Health Jennifer Carroll MacNeill was in town last week to review developments. She seems independent-minded and determined, having already announced that the cabinet has given the go ahead for 24/7 cardiology at UHW. 

She expects it to happen by year's end subject to recruitment, saying: “I have written to the HSE to begin developing an implementation plan by the end of June 2025.” 

There is much anxiety that the service is not in place and the €600k funding provided seems a little low given a consultant’s salary is c. €300k? The minister says UHW has 4.5 whole-time cardiologists but needs seven or eight. 

In fairness, two cardiologist posts for UHW have already been sanctioned by the Consultants Applications Advisory Committee.

The minister mentioned €116 million spent by HSE on local capital developments, €17 million on completed community facilities at St Otteran’s and €89 million allocated for the new modular build surgical hub in Maypark Lane. 

That project is instructive for those Waterford politicians who believed that modular OPD and Emergency Department extensions at UHW in 2022 are the same as modular projects built in The Mater, St Luke’s Kilkenny, Limerick UH and elsewhere. They are not. 

UHW got modular prefabs, they got proper modular concrete buildings like our new surgical hub. We were fobbed off with seconds. 

Meanwhile, with the unfinished National Children’s hospital costing north of €2.5 billion and preliminary tenders for Dublin’s new National Maternity Hospital coming in at €1.5 billion, plus extra contingency sums of €500 million, our small demands are like penny toffees in a corner shop. 

Surgical hubs are being built in Dublin, Cork, Limerick, Galway and Waterford. Their financing is separate from the usual acute hospital funding stream. The investment, while enormously positive for Waterford, does not close the acute hospital capital funding disparity between UHW and other Model 4 hospitals by one cent.

Minister MacNeill is new at the job and cannot be blamed for past failings. She came here to praise the success that staff and management have made of UHW’s acute health services and rightly wants to celebrate excellence. 

It’s the unfair departmental or HSE conflation between money already spent and money to be spent at UHW that really irks. 

Every cent spent here is welcome and there has been a welcome and obvious uptick in UHW budget and staffing and a broad national acceptance of its vital tertiary regional role, but it is a matter of public record over the past 10 years that UHW has had the lowest capital spending of Ireland’s Model 4 hospitals. 

The figures were produced dozens of times by Deputy Matt Shanahan. 

In fact, it appears that more (c. €50 million) was spent on St Luke’s Model 3 hospital in Kilkenny in the past five years than on UHW. 

All health investment is welcome, but a fair share would be nice for UHW, which is the most important hospital in the South East. 

Minister MacNeill’s personal secretary told SEPAG’s Hilary O’Neill in a letter on 16th May 2025: “Since 2020, capital projects with a total project cost of €64 million have completed construction at UHW.” 

Unfortunately, I understand that this includes the €17 million spent on St Otteran’s community projects on the basis that the money helped decant community services from UHW. 

It also includes some costs for the Dunmore Wing, built in 2018. 

The net figure for the past five years is nearer €30 million at best. 

If Minister Butler provides us with a detailed breakdown of the actual monies spent to clarify the situation, we will happily publish it.

Was it Taoiseach Varadkar who said he would not announce anything in Waterford because people here would not believe him anyway? 

When you have been led up the garden path very often, cynicism becomes engrained. Whatever, there are thieves who steal your possessions, there are thieves who steal your wallet and there are thieves who steal your future. Universities are the key to future employment, yet WIT was crucified by the “system” for daring to aspire to what our peer cities have and for 20 years Waterford’s future has been degraded. 

What does the government want or expect of Waterford as a regional city? 

The National Development Plan literature is clear on our role, yet the failure to co-fund our small airport is counterintuitive. €18 billion is spent by government every year on capital projects, yet nothing has been built in Waterford SETU for 20 years. 

Every other third-level college in the country, without exception, has had two, three or more new buildings. 

Carlow has had five and opened a new corporate services building last week. 

Yet the carapace of departmental incompetence and/or deliberate mischief, which surrounds the development of SETU Waterford, goes on. Does anything ruin potential, staff morale and confidence more than poisonous delay? 

The cabinet signed off on the SETU engineering building on December 11, 2024, with construction to start in quarter 1 of 2025. Now as we hurtle towards quarter 3, there is still no sign.

An article last week on property investment in Galway said that eight out of 10 top medical devices manufacturers in the world have plants in that city. It is recognised as a hub for that business. The sector was developed there after the large Digital plant closed. 

After the 2008 financial crash when the Troika had control of the national finances, it was widely rumoured, although never explicitly announced, that they had suggested that Ireland needed only three cities in Dublin, Cork and Galway. 

The notional exclusion of Limerick ended with the tsunami of investment during Michael Noonan’s tenure as Minister for Finance. 

Despite a massive rebound in Ireland’s fiscal position and strong population growth, the three- pole idea has stuck in some departmental sections in education, transport and FDI, and to a lesser extent in health. 

Quite obviously there is no apolitical delivery of capital projects in Ireland. Our North Quays investment is an outlier in the sense that its development is mirrored in many even smaller places like Wexford’s Trinity Wharf and Kilkenny’s Abbey Quarter. 

The conundrum over government capital funding prompts the question as to just exactly what does government expect or want from Waterford. Where do we fit in?