Some questions for Minister Butler
UHW
Endometriosis can affect women anywhere, as Ministers Mary Butler and Jennifer Carroll MacNeill, surely know. Last week, Minister MacNeill launched a new initiative to deal with that condition.
“Moderate cases will be treated in five regional specialist centres. Three centres are already established in the Rotunda Hospital, the Coombe Hospital, and University Hospital Limerick, with two more in development at University Hospital Galway and the National Maternity Hospital. Complex cases will be referred to two supra-regional centres in Tallaght University Hospital and Cork University Maternity Hospital.”
Would Minister Mary Butler care to tell the women of Waterford and the southeast why UHW, the regional Model 4 hospital, is excluded from having such services? Just like radiotherapy or interventional cardiology. What shameful excuse is offered this time for our non-inclusion? Sure women can go to Cork? Must we conclude that this condition does not impact this region? Is SF TD David Cullinane following this up? Must we march again for medical equality? Minister Butler must demand that UHW be included.
There is a vast difference between past delivery to UHW and what should be delivered to our regional Model 4 hospital to level up services with those available in other such facilities. The endometriosis exclusion follows a distinct pattern, despite UHW being one of the best performing Model 4 hospitals in the country. UHW staff numbers have increased over the past five years but it is still the lowest resourced of all Model 4 hospitals. The decision by UHW pathologists to end coroner-requested postmortems from January 2026 is more of the same.
UHW CEO Ben O’Sullivan says: “In a recent workforce planning exercise, the Department of Justice, in conjunction with the Faculty of Pathology, Royal College of Physicians of Ireland, indicated that the coroner’s postmortem workload in University Hospital Waterford requires four whole-time equivalent pathologists dedicated uniquely to this service. The hospital is currently significantly understaffed and HSE diagnostic workloads alone indicate a need for 18 full-time surgical pathologists.”
The pathology laboratory currently has six consultants, with recruitment ongoing for three additional posts. Recruitment is difficult because of the huge workload. We all remember the UHW mortuary debacle where four UHW pathologists were doing 600 post-mortems annually compared to 18 pathologists in CUH doing 800 per annum, so this is not a new situation. Meanwhile, the HSE is advertising for the positions of Directors of Nursing around the country, in Dublin, Cork, Limerick, Galway, Sligo and Kilkenny? The regional nursing school is in SETU Waterford and UHW has 1,150 nursing staff compared to 550 at St Luke’s General Hospital Kilkenny, but the Director of Nursing is based in Kilkenny? Is this how an efficient health service looks?
UHW capital investment is also questionable. A new surgical hub is under construction at Maypark Lane, but these were a separate government initiative from normal HSE investment. All Model 4 hospitals outside Dublin have one under construction. Investment to bring UHW capacity up to that of other Model 4 hospitals is barely being made. Sure, an ophthalmic theatre and second cath lab have been built and a long overdue extension of the main pathology laboratory is under way, but where is the heavy capital investment for the main hospital? Where are the extra bed block and the vertical or overhead Out Patients Department? Are these being delayed by the HSE Estate office in Kilkenny while projects in that town are pushed ahead? Something is not right and Minister Butler has to provide clarification.
Minister Butler has announced €1m for a Waterford Jig Saw initiative commencing in 2026, but this ranks as very small money indeed. A 50 bed UHW Adult Mental Health Unit is in the HSE Capital Plans since 2021 at the “appraisal “stage without moving. A children’s hub for St Otteran’s site in conjunction with the Touching Hearts charity is likewise listed since 2021. The HSE stated in February 2023 (PQ 3457/23) that a design team for this was appointed, that a planning application would be made in Q3 2023, that construction could commence in Q3 of 2024, with an 18-month timeline to completion. None of this has happened. Why not? Can you provide an update?
In February 2022 a meeting of Oireachtas members at UHW was told by management that the vertical OPD was being priced with an onsite contractor for construction under a Covid derogation (no planning required). This did not happen. Instead UHW got two modular prefabs and a tent outside the Emergency Department. UHW management indicated that the vertical OPD was the most vital development project for the hospital. Full planning permission was obtained in May 2022, but has not yet gone to tender. It is still listed as at “appraisal” three and a half years later in the HSE 2025 Capital Plan. That Plan also contains proposals for enabling works for an essential multi-storey car park at UHW and other developments, but I wouldn’t hold my breath.
When Taoiseach Micheál Martin made you government chief whip instead of Minister for Children (as was totally expected), you said that your pivotal position would have influence across all Departments. Did you put party loyalty above all else? Maybe real productive stuff is going on in the background, but without planning or tenders, nothing can proceed. It may also be the case that departmental officials are not playing straight, or HSE officials are pushing their agenda ahead of yours. Such things happen.
Last week the government e-tender website listed 10 separate tenders on one day, for various developmental enabling works at UH Galway. Can you remember the last time a tender for UHW works appeared? While some progress is undoubtedly being slowly made, real urgency is not in evidence with the physical development of UHW, the lowest resourced Model 4 hospital in the country. Perhaps, to allay worries, your officials would provide a detailed inventory of where UHW and Waterford projects are at present? An international business downturn or hiccup in Ireland’s public finances could derail a lot of things. A change of Taoiseach or of government could see you without influence. Waterford shouldn’t be the one left with all its proposed healthcare projects marooned at the ”appraisal“ stage.
