I ask the Minister to outline the level of additional core expenditure for new developments, excluding funding for carryover and otherwise maintaining existing levels of service, which has been allocated to the RCSI Hospital Group for 2024.

The RCSI Hospital Group contains model 2, model 3 and model 4 hospitals with one specialist hospital, the Rotunda Maternity Hospital. The hospitals in the main serve populations in five counties – Dublin, Meath, Louth, Cavan and Monaghan. The budget for the hospitals in the group increased by 11% between 2019 and last year. There has also been very significant capital support.

At Beaumont, the €6 million breast care centre opened in last year, and this will benefit approximately 10,000 women every year. Phase 2 of the Beaumont outpatient department was completed in May 2022, at a cost of €1.5 million, benefiting approximately 140,000 patients annually. The minor injury unit at Monaghan hospital is now funded to open seven days a week, allowing more patients to be seen at weekends. Next year a new surgical hub is planned to open in Swords, under the governance of Beaumont Hospital. This is based on the Reeves centre in Tallaght University Hospital and will specifically focus on increasing the speed at which people in these counties can get access to day case procedures for which to date some people have had to wait an unacceptable time.

Every year at this time of year, we go through the process of deciding exactly what funding and additional funding will be allocated to each hospital. I issue a letter of determination to the HSE. That will issue very shortly. The HSE then comes back with a proposed national service plan. Through that national service plan, we can all look at exactly the level of investment and expected activity at a hospital-by-hospital level.

On the national service plan, I will break this down to two particular questions. One of them will relate to one of the issues the Minister dealt with on the radio earlier. I am talking about people, particularly families, who are under severe pressure. If Our Lady of Lourdes Hospital wants to discharge somebody, sometimes the staff are put under severe pressure to discharge into a nursing home. Because of the size of area covered by CHO8, a family from the Cooley Peninsula or Omeath could be under pressure to have their loved one placed somewhere in the midlands. There could be a solution for this. We have a very good discharge step-down unit in Louth County Hospital in Dundalk. It is a matter of whether we can put more resources into that because that is one of the biggest issues we have at the minute. Families are under pressure and a huge level of distress. It gives people time to organise home-care packages and we know the issues that exist there.

I agree that in recent years the hospital in Dundalk has done well in dealing with discharged patients. The hospital team outlined to me that, exactly as the Deputy said, it has good relations and good connections in place. It is a clinically appropriate setting for patients to be discharged to.

Broadly, we know we need to increase community beds. The Minister of State, Deputy Butler, has taken the lead on a massive increase in the number of home care packages and home care hours, with well in excess of 3.6 million hours since 2019. What Deputy Ó Murchú has identified can be looked at within the broader question of a substantial increase in the number of community beds more generally.

I might come back to him on the policy of discharge in my final response.

I welcome that. We need to make sure that people in distress are relieved and that a system that works is created. However, we will have to address the underlying issue, particularly in north County Louth, that there just are not enough people working as home carers at the minute and people cannot get the hours they need to keep their loved ones in home settings. This would provide some level of reprieve, however.

I brought up another issue. We all welcome the likes of Louth County Hospital. There will be a lot less pressure on our accident and emergency department system if we can have more community beds, more community services and more day services. I am talking about the diabetes clinics and so on and making sure they are resourced. There is, however, an issue with orthodontic care. I think we have in Louth County Hospital, in Dundalk, only one orthodontic consultant, and while people, including kids, who are in, I think, category 4, are being seen, the more serious category 5a cases are not being dealt with at the moment. We have a huge waiting list. It will need to be looked at. There is an issue even with computers and laptops that have been lying in Dublin for that particular setting. We need to make sure that is dealt with. Staff are still using older Windows 7 systems in Louth County Hospital. We know the problems we have had with IT and the HSE in recent times, so that is a matter we need to address. First and foremost, however, is the difficulty of kids with severe problems not being able to get the orthodontic care they need. The fact is that can lead to huge surgical interventions being needed later in life.

If the Deputy wants to send me a note on that, I will get back to him with detailed points on it. We are very much aware of the long waiting lists for orthodontics. It is one of the areas that is funded in the waiting list action plan. Good progress has been made, as he said, for the children most in need of the most urgent care. I would like to see the waiting list action plan expanded next year. Waiting list initiatives have funding next year of in excess of €400 million. If the Deputy wants to send me a note specific to his local area, I will make sure the HSE gets back to him.