Frank McDonald, writing in The Irish Times, recently outlined the continuing dominance of spending and resource concentration in Dublin and its surrounds, to the detriment of the other regions. The article states: "We are sleepwalking our way towards a deeply dysfunctional, inequitable and unbalanced Ireland." The allocation of capital resources to Waterford is a clear reflection of that image. The endemic failure to resource Waterford as the regional driver for the south east is all too easily illustrated. For example, despite the hype relating to the university, no new visible investment in teaching buildings in Waterford has taken place in the past 20 years. The vaunted purchase of the Waterford Crystal site and the promised engineering building remain purely aspirational. The primary routes from Waterford to Cork and Limerick have remained devoid of upgrade for more than two decades. In the period 2019 to 2021, IDA Ireland site visits for the entire country totalled 558. Waterford was the subject of just 6% of those visits. In fact, just 30% of the visits were directed to Cork, Limerick and Galway. In two years, GDP in the south east has fallen by 20% while the economic juggernaut that is Dublin rolls on.

Surpassing this, it is in acute healthcare that discrimination in capital resourcing is most evident and egregious, as is the political gaslighting that comes with it. Replies to recent parliamentary questions I tabled outline that from 2013 to today, capital allocations to University Hospital Waterford, UHW, were just 45% of the budgets given to its peer regional hospitals in Limerick, Cork and Galway. That figure includes the Dunmore wing, the palliative ward and the new cath lab so often referenced by the Government in the House. Despite the continuous underfunding and having the lowest employee headcount of its peers, UHW still outperforms all others, even with the surge of patients from Wexford redirected there. Officially, its emergency department has been the busiest in the State since March and it continues to be an exemplar in emergency care key performance indicators.

Knowing this, why did the Government see fit to award between €54 million and €94 million each to the other eight model 4 regional hospitals in the HSE's 2023 capital development plan while completely excluding UHW from accessing one red cent of funding from the national acute spending programme? Could it be because Waterford lacks the Cabinet seat required to drive investment along the VIP lane reserved for Minsters' pet projects? If that is not the case, understanding that there have been ten years of discriminatory spending injustice, as I have laid out and as evidenced by replies to parliamentary questions and the research of Frank McDonald and many economists, can the Taoiseach outline why the Government's spending decisions for Waterford are always wrong while those for him and his Cabinet colleagues are always right?

If the Deputy looks back over the past ten or 20 years, there has been very considerable public and Government investment in the south east. There is the motorway to Waterford, the New Ross road, the Enniscorthy bypass, the Viking Triangle and the Waterford greenway, also known as the Déise greenway. The long-promised South East Technological University is now a reality. There have been major port investments in Belview and a major one about to happen in Rosslare. Money was offered to the airport in Waterford for its further expansion. The north quays project is a huge investment to transform Waterford city and allow it to grow in a compact and sustainable manner. There is also the Abbey quarter in Kilkenny, and major IDA Ireland investments in Wexford, Waterford and Kilkenny. There has been a great deal of Government investment in the region.

As regards the hospital specifically, under this Government in the past three years, the budget for UHW has increased by 30%, staffing levels by 23% and there has been more than €90 million in capital investment. There is more to come. The Minister for Health, Deputy Donnelly, met with the leadership team from the hospital last Friday to discuss future investment. Already, as the Deputy mentioned, with the Dunmore wing, there are an additional 60 beds, the second cath lab is due to open in September and there is the palliative care centre. Very much on the agenda now is the new surgical hub. Waiting lists are already falling in Waterford. We think they will fall faster once the surgical hub is up and running. As the Deputy rightly pointed out, notwithstanding the enormous additional pressure because of Wexford hospital being closed temporarily, the emergency department in Waterford is still performing relatively well. There is a lot more investment in the pipeline and I am determined to do anything I can to help push that through.

That will include the laboratory extension, a new outpatient department vertical extension, additional day ward beds at the second cardiac centre laboratory and a new additional mental health unit. In the medium term, there is also a proposed new ward block containing 160 beds.

The figures relating to the underfunding of the region are stark. On the hospital, I remind the Taoiseach that despite the increases in revenue to the operating budget that he outlined and the capital grants, it is still the least resourced of all the nine model 4 hospitals in the country. Yet, its emergency department has been the busiest in the country since March. If the Taoiseach looks at the investment that has been given in the 2023 capital development plan, the allocation to Waterford represents less than one third of the moneys given to University Hospital Galway, Cork University Hospital, and University Hospital Limerick in an 11-year period. That is the stark reality no matter how it is dressed up. I accept the Taoiseach's bona fides in that he is keen to move things along. However, we have a dysfunctional procurement system in terms of trying to deliver these projects. In that context, there is no allocation in the capital plan for UHW in the context of design and build specifications to UHW in the capital plan. People from RTÉ are in the Oireachtas at the moment talking about dysfunction, shining a light and achieving new levels of governance. I honestly believe that we need to start looking at the Department of Health and the HSE in terms of the inequitable allocation of resources to Waterford and the south east.

I thank the Deputy for his question. What I meant to say earlier is that, as Taoiseach and as a former Minister for Health, I have had the benefit of visiting hospitals regularly. It is something I make a point of doing. I visited Castlebar recently and Waterford not too long ago. I have been to Limerick many times. Almost every hospital or region makes the case that they are the most underfunded. They cannot all be right.

From the replies to my parliamentary questions, we are right.

It is often about the way it is calculated. People will calculate things in a different and particular way. As I said earlier, under this Government €91 million has been invested in the hospital so far. That includes the construction of the new outpatient department, OPD, with 16 consulting rooms, four virtual consulting rooms and two minor procedure rooms. That was completed in quarter 1 of this year and it has been opened. In the pipeline is the lab extension, the OPD extension and the additional day beds for the cath lab, which are crucially important as the Deputy will agree. Beyond that are the new adult mental health unit and the new ward block. I am determined to get those projects moving. I have sought from the Department of Health a list of projects that are shovel-ready, in respect of which there is planning permission and that could go to tender. I do not have that yet. As soon as I get it, I will engage with Minister for Health and the Minister for Public Expenditure, National Development Plan Delivery and Reform, Deputy Donohoe, in order to see if there are projects in respect of which planning permission has been obtained but that have stalled for some reason. We will get them moving.

I thank the Taoiseach. That concludes Leader's Questions. Before we move to the Order of Business, the Taoiseach has a brief comment he wishes to make.