Upgrades to ministers' local hospitals accelerated
Hospital upgrades in the constituencies of two Cabinet colleagues were accelerated in the HSE Capital Plan at the behest of the Minister for Health, RTÉ's This Week programme has learned under documents released under the Freedom of Information Act.
The documents also show that the improvements to the emergency departments in Wexford General Hospital and St Luke's Hospital Kilkenny were announced by ministers Brendan Howlin and Phil Hogan before the HSE Board were aware of the proposed changes.
The improvements involved changes to the HSE Capital Plan.
Mr Howlin and Mr Hogan announced the commencement of work on their local hospitals in early June 2011, a number of days before a HSE board meeting on 9 June.
Board minutes show the ministerial announcements about the hospitals were queried.
They also show that a written confirmation of the changes to timelines in the capital plan was sought by HSE Director of Estates Brian Gilroy, who was unaware of the new timelines for the proposed hospital upgrades.
Following the board meeting, Mr Gilroy wrote to the Department of Health.
This Week has seen the letter, which informs Principal Officer Jim Breslin of the need for extra money if the upgrades to the emergency departments in the two hospitals are to be completed on the timelines announced by ministers Howlin and Hogan.
In the case of Wexford General Hospital, the HSE informed the Dept of Health that an extra €20m would be needed for the building works, while just over €14m would be needed for Kilkenny.
Approval of this funding had to be sanctioned by the Department of Public Expenditure and Reform.
An exchange of emails between the HSE Director of Estates and the Department of Health reveals an additional €12m was ultimately approved for Wexford General Hospital by Mr Howlin's department, while improvements in Kilkenny were to be financed by "efficiencies" in other hospital equipment budgets.
At a subsequent board meeting on 14 July 2011, HSE Chief Executive Cathal Magee received a letter from the Department of Health's then secretary general Michael Scanlan confirming that the Minister for Health requested that these two projects be "accelerated in the HSE's capital programme".
Howlin's department sanctioned expenditure
The letter also noted that Mr Howlin's department had sanctioned this expenditure.
This Week asked the Department of Health why the Kilkenny and Wexford Hospitals were chosen for acceleration in the HSE Capital Plan.
A spokesman for Minister for Health James Reilly said: "The Emergency Department in Wexford Hospital was of very poor condition and it was considered appropriate to expedite its replacement.
"Among the problems in Kilkenny, the Medical Assessment Unit has been housed in a Portakabin, and again it was considered appropriate to ensure completion of the project there.
"The decision was made in July of 2011 and was made at the board meeting of the HSE. The minutes of the board meeting showed this decision clearly at the time."
When questioned as to why announcements were made by Mr Hogan and Mr Howlin about the projects in early June before capital sanction was acquired, the Minister for Health's spokesperson directed such queries to the relevant ministers' offices.
This Week contacted the Department of Public Expenditure and Reform to enquire what contacts had taken place between Mr Howlin and Mr Reilly about Wexford General Hospital.
The programme also enquired why Wexford General Hospital received an extra €12m in capital allocations.
Mr Howlin's department sent the following statement: "The proposed extension to Wexford General Hospital features in the HSE Regional Service Plan for 2011 and preceding years.
"Planning permission for the project was lodged by the HSE in 2010 and granted by Wexford Borough Council in 2011. Design and planning work commenced as far back as 2009."
In separate letter from HSE South Director of Operations Pat Healy to Mr Hogan concerning St Luke's in Kilkenny, which has been seen by This Week, Mr Healy wrote: "As you will be aware, while the project has been included in the overall capital plan for the HSE for some time, we had only been able to bring the project to design stage and had not secured sufficient funding to enable the project to be approved to commence to full development.
"With your own support and that of the Minister for Health, the project was fully approved for development in the HSE Capital Plan 2011-2015 and authorised to the CEO of the HSE on July 14, 2011 by the Secretary General of the Department of Health."
In his letter, Mr Healy gives a completion date of late 2013 for the St Luke's upgrade.
In a statement, the Minister for Health's spokesperson also said: "Wexford and Kilkenny were on the Capital Plan in advance of the July 2011 decision. Significant work had already been carried out in terms of planning design etc."
However, email correspondence between the HSE's Director of Estates and an official in the capital section of the Department of Health shows that design work in Kilkenny was not complete and that some of the money approved to accelerate the project was for the completion of this design work.
While the Wexford and Kilkenny hospitals were included in the HSE Capital Plan for 2010-2015, both projects were at design stage, with no completion dates assigned to them.
Completion dates for both projects do not appear until the amended HSE Capital Plan 2011-2015, which was approved at the 14 July HSE Board Meeting.
Roscommon TD Denis Naughten, whose local hospital's emergency department was downgraded in June 2011, said: "At the time when we had a Government that was ignoring clear commitments given by the Taoiseach, the Tánaiste, the Minister for Health to retain services at Roscommon County Hospital, they were downgrading the hospital at the same time as clearly ensuring that investment was going into Wexford and Kilkenny hospitals, which had not been on the previous priority list."
Mr Naughten also expressed surprise at Mr Hogan and Mr Howlin announcing the hospital projects prior to being approved by the HSE Board.
He said: "Yes, I am surprised in relation to it and that approval had not been given prior to it, because the minister [for health] was saying to me about Roscommon that the decision was outside his control, that the HSE and HIQA had made the decisions.
"Clearly in relation to other A&E's the ministers could go and make the announcements and get the approval afterwards."
Fianna Fáil health spokesperson Billy Kelleher has accused the Minister for Health and other ministers of seeing the HSE capital budget as a slush fund for electoral gain.
Speaking to This Week, Mr Kelleher said that one would be left with a clear conclusion that there was political interference in deciding and prioritising hospitals.
He said health services should be prioritised based on need.
Mr Kelleher said the issue should be investigated further and that Fianna Fáil would be raising the matter.