I welcome the acceptance by the Government of the Minister for Health's proposals relating to hospital facilities in the mid-west. These proposals were based on the HIQA report, which stressed patient safety. It said patient safety was central to its proposals, which means time is of the essence in implementing these proposals. We are all concerned about patients. I pay tribute to the staff, who have worked with great dedication and courtesy in UHL in what continue to be very difficult and sometimes intolerable conditions.

It is now proposed that a new building be erected in the vicinity of the Dooradoyle site. Has a site been identified and acquired for that building? When the Minister was asked about this yesterday, she said she could not talk about it due to commercial considerations. Surely there are no commercial considerations in asking whether the site has been acquired, when it will be acquired and whether we will be told when it has been acquired.

It is also proposed that a project management board be established to drive this project forward, which is essential. It has been some time since the HIQA report was issued. Has that management structure been put in place and if not, when will it be put in place?

In view of the urgency of the situation and the fact the safety of patients is central to these recommendations, will the Taoiseach give the House an assurance that sufficient capital will be provided to enable this project to go ahead within the required timescale in view of the fact that the ESRI has projected that over the next 15 years, a further 600 model 4 hospital-type beds will needed in this region? This is almost double the current capacity of University Hospital Limerick.

As the services are centrally located in Limerick, there is a huge problem with the ambulance service because a very far-outlying area surrounds Limerick, from the west end of Clare up to the very top of Tipperary, etc. As a result of that, we are exposed every day to lurid tales of people waiting five or six hours, or longer, for ambulances. These are people who urgently need to get to hospital. Is it proposed to revamp the ambulance service in conjunction with these new recommendations so that people will not be waiting in those circumstances for any longer?

I thank the Deputy for raising this issue. I know he has been a long-time advocate for health services in the Limerick region, in particular in light of the huge challenges that have faced acute services in the mid-west. I join him in paying tribute to all the staff working in our hospitals in the mid-west under difficult circumstances.

The Government's decision to support the Minister's memo that was brought to Government this week in respect of the HIQA report and HIQA review into urgent and emergency care capacity in the mid-west region, which the previous Government asked for, will need additional capital. Additional capital will be provided, in the first instance to progress option A. What is interesting is we know that the impacts can be quite dramatic when we get additional capacity. The average number of people waiting on trolleys at University Hospital Limerick has almost halved in the week since the new 96-bed block opened compared with the weeks prior. That 96-bed block that is now open has made a difference, so we want to do a second block at that scale. The sooner that can be done, the better. Enabling works are now under way for the second 96-bed block at UHL. Additional 16- and 66-bed blocks are also in planning for accelerated delivery at the hospital. That will increase capacity at UHL by a total of 306 beds since 2023.

On option B, the Minister has mandated the HSE to secure an available appropriate adjacent site. I do not have the information to hand as to whether it has that site at the moment, but it has the mandate to secure the site. The standard governance structure and the project board will have to be established, as required by the HSE, to explore additional opportunities to decant services away from the main Dooradoyle site. My understanding is the project board has not yet been established, but it will be imminently, once we get the other site. What is happening in other hospital locations is that decanting unnecessary services in an acute hospital environment - including patient records, or it could be outpatients - is working. I have seen it at the Rotunda and other hospitals, where it has had a really transformative impact and created huge space for the essence of what acute care should be all about.

To progress option C, the Minister and the Department will develop a strategic plan for the incremental reconfiguration of and investment in healthcare services in the mid-west region. I heard it said this morning, and I do not want to name people, that this is a very welcome development. I take the Deputy's point about timescale and capital. Subject to the revenues the economy is generating at the moment, we will have an expansive healthcare capital programme over the next number of years. I am confident we can accommodate substantive elements of this in the coming years.

Will the Taoiseach comment on the ambulance service in the area?

Two private hospitals were built in Limerick after the last 96-bed block was commissioned. They were built in two or two and a half years. It took six years, from start to finish, to build the 96-bed unit. It is projected it will take another six years to build the next one. The Minister, Deputy Chambers, has proposals to move on and expedite these large infrastructural projects. Does the Taoiseach envisage those will have an impact, such that that job will be done much more quickly and efficiently than has happened in the past? We wanted to know why two 96-bed units were not built together. We were told that would bring the budget to over €200 million, which would require going over a lot of other barriers and would delay the project. We are worried about that also and about how long this is all going to take.

On the ambulances, we want to continue to improve and revamp our ambulance service. It is a national service. It causes a lot of challenges for the public and people generally in trying to understand the methodology or framework governing it. We will continue to engage with the National Ambulance Service, particularly in respect of its manifestation and how it works in the Limerick region.

The issue of critical infrastructure and the initiatives of the Minister, Deputy Chambers, will impact on this because the esprit de corps now is not why something can happen but, rather, why it should happen. There have been planning challenges on that site and, probably, there will remain planning challenges in people having different perspectives on it. The Deputy referenced what would be known as the public spending code, and that is being amended. Of course, on another day, people will come to the House and say we spent too much on this or that. All of that means others want to develop the public spending code. There is always a balance here in getting projects through and getting them done, and turning up at the public accounts committee afterwards to explain the additional expenditure, but that is the world we are in.