I will briefly break a tradition. I am holding a sign I have up in my office, which says "Vote No to the Hanly Report". It is there as a reminder to me that 25 years ago, I marched through the streets of Nenagh holding that sign, to protest against the downgrading of my local hospital, the one in Ennis and St. John's Hospital. People can blame that report for me coming into Dáil Éireann. I jest, but it was an inspiration for me.

The mid-west - Limerick, Clare and north Tipperary - has been discriminated against when it comes to hospital services. The south east has a model 4 hospital and two model 3 hospitals. We have one model 4 hospital.

I speak about this from personal experience. On 22 October last year, I stood here giving live evidence of why elderly people are afraid to go into University Hospital Limerick, UHL. It was about my father. I had to convince him while I was here to get into an ambulance at his house. He said, "Alan, I will never come out" and he never did. He came home to die, despite receiving the best care. What is on my conscience is that he went in there afraid.

My mother is in Nenagh Hospital at the moment. She will not be put into UHL because, at this moment, I will not allow it. It has nothing to do with the workers or the management. It has to do with the circumstances. We have been discriminated against in the mid-west. I stand here with lived experiences. A few months ago, my wife got very sick. It was 4 a.m. I rang someone who works in the HSE to ask for advice. I was told to go to Portlaoise. I live about 25 minutes from UHL. I went to Portlaoise. That is what all of us in the mid-west are facing.

Now we have a HIQA report. It is beyond me why HIQA is even doing this report on hospital services. What needs to happen is as clear as the nose on my face. Deputy Sheehan and I, and all the other mid-west politicians, cannot be another generation that lets down our area. We need a new model 3 hospital with a full emergency theatre and intensive care unit in the mid-west. Full stop. If that means we will build a unit of 100 beds to deal with capacity at the moment and then wrap a hospital around it, that is what we need to do. I stand here today speaking from personal experience, but also as one of this generation of politicians. Will the Government and the Tánaiste personally, be the brave people to say they will deliver another model 3 hospital to stop the discrimination in our region?

I thank Deputy Kelly for highlighting this issue. I know he is using his personal experiences as an example but I want to extend my sympathy and that of everyone in the House for the bereavement his wife experienced recently and indeed the loss of his father. I also wish his mother our best.

The generation of politicians who went before us gave an example of how to botch health reconfiguration. I genuinely believe the people of the mid-west were badly served by a reconfiguration that tried to change services on the promise of a better tomorrow, but did not put the better tomorrow in first. It is an example or case study of how not to do healthcare reconfiguration. If we are honest, since then, successive Governments have been trying to play catch-up on a variety of issues in the mid-west, particularly and acutely on the issue of bed capacity, but also on the issue of how to properly utilise Nenagh and Ennis hospitals, which are excellent hospitals that are eager to do more and are now beginning to do more.

The Deputy has been a vocal advocate on this issue and will continue to be. I accept the collective challenge we face is to address this once and for all together. The Minister for Health takes this seriously. She will be in Limerick next week for the opening of a new 96-bed block at UHL. I acknowledge the roles the Deputy and others played in that. There are also plans to significantly increase capacity further in the hospital. We all welcome that, but what the Deputy is saying is that, in itself, is not enough. I accept that too.

The HIQA report was commissioned, regardless of the Deputy's view on it. The Government was briefed on it by the Minister on 30 September. It outlines three potential options for consideration. One is to continue to expand the capacity at UHL's Dooradoyle site. I think we should do that anyway, to be honest. It is not either-or. The second is to extend the UHL hospital campus to comprise the existing Dooradoyle site and another site. The third is to develop a model 3 hospital in the HSE Mid West. Alongside these options, HIQA presented an extensive number of additional considerations. In fairness to HIQA, it did not just lob out three options. It went through, in quite a bit of detail, the pros and cons of each of the options. There are extensive findings. Quite a lot of work was done behind each of the potential options and the Minister will now fully consider them and report back to the Government. However, I will share the Deputy's recommendation with the Minister. There is a lot of logic in it.

We need to drive on quickly with extra capacity. The 96 beds are great, but we need to drive on the next bit and the bit after that and so on and then we need to recognise that in itself will not be enough.

There is a compelling case in relation to the option identified in the report around a new level 3 hospital for the mid-west. That needs to be looked into. We all know that will not happen today or tomorrow so how do we make sure we put the capacity in in the meantime? I will ask the Minister to keep the Deputy and colleagues from the mid-west informed on this issue as she deliberates.

I appreciate the Tánaiste’s reply but we need more certainty. This has gone on way too long. His Government needs to make a decision now to have a model 3 hospital. The idea of sending everybody through the UHL emergency room is downright bananas. It is crazy. It is criminal. We need to upgrade the model 2 hospitals in Nenagh and Ennis, 100%. However, a decision has to be made on the principle that the mid-west would have one model 3 hospital. The mid-west has a growing population and a population that is larger than that in the south east which has two model three and one model four hospitals. I accept the Tánaiste has gone far but I urge him to confirm that he will do this because we need it. It may mean identifying a site, putting a 100-bed unit on it and wrapping a hospital around it, because I know that will take more years, or using Nenagh or Ennis. We will debate all that again. Will the Tánaiste confirm the principle that the mid-west will have a future, that there will be ambition for it and that we will be able to address these issues for the people and that in the future they will not be frightened of going into just one access point through UHL?

I thank the Deputy. I accept the Government needs to make a timely decision on this and I accept it is an issue that has gone on for many years. In fairness to the Minister for Health, she is proactively engaging on this issue. The point the Deputy makes about population is really key. He is correct that the population of the mid-west region is growing faster than the population of many other regions, including other regions that have a greater hospital capacity. That is absolutely factually correct.

When one looks at the three options, I do not really think there are three. There is to do one obvious thing, which is to expand capacity and then there is a choice between two others. That is how I read it.

Agreed.

All three.

We all agree with expanding capacity. Then there is the question of whether we further expand the UHL campus but also develop it on another site - that is what it says - or, for want of a less colloquial phrase, do we start from scratch and develop a new model 3 hospital? Both options recognise that there will have to be significant new healthcare capacity above and beyond the current Dooradoyle site. How quickly we can narrow down the pros and cons of each of them is very important.

The Minister will be in UHL with the HSE and local public representatives next week and she will have the opportunity to speak with the Deputy then. I take the point about the need to make a decision in principle as quickly as we possibly can.