Phil Hogan (Carlow-Kilkenny, Fine Gael)

I thank Senator Harte for raising this important issue. I apologise that the Minister of State with responsibility for care of the elderly, Deputy Kathleen Lynch, was unable to address the issue. It provides me with an opportunity on her behalf to update the House on the matter and to outline the background to the current situation and the action taken by the Health Service Executive.

The Senator will be aware that the moratorium on recruitment and compliance with national quality standards are impacting on the community hospital system in Donegal. These pressures are mirrored across the country and are well documented. I acknowledge that there is a considerable concern about the future of our community nursing units. There is no doubt that we are facing challenges in this sector owing to staffing and funding issues, and the age and structure of the existing units.

The HSE west service plan for 2012 proposes that a rationalisation of residential facilities be undertaken following extensive consultation with patients and relevant stakeholders regarding Lifford community hospital. Lifford community hospital is one of 11 community hospitals in County Donegal. It was established in 1799. Over the past 12 to 18 months the hospital has reduced its bed capacity from 40 beds to the current 20 beds. The HSE is now considering a proposal to discontinue the inpatient services at Lifford community hospital. This includes 11 long-stay residential beds, five respite-specific beds, one palliative-care bed and three assessment-rehabilitative beds.

The proposal envisages that the physiotherapy department, dental and chiropody clinics located at the hospital will continue to provide services to the local community. Access to the primary care services would remain unchanged. However, prior to any final decision being taken a three-month period of consultation by HSE management will begin on 1 March with all residents, their families and staff. This consultation period will focus on the provision of information on the proposed changes and the options that are available to the residents, and will allow time for them and their families to consider these. Any proposals for the continuation of services or provision of alternative services, whether from the local community or other interested parties will be actively considered as part of the consultation process.

The HIQA acknowledges that the facility's age, layout and structure pose challenges to the delivery of care. It further acknowledges that the reduction in numbers and the clear demarcation of respite and long-stay accommodation has assisted the hospital in meeting the regulations in terms of provision of service to long-stay residents. However, the HSE estimates the cost of future compliance with HIQA standards, SARI guidelines on infection and the national standards for safer better health care is approximately €1.5 million. The capital requirement to upgrade or extend the facility is one factor informing the decision to propose the closure of the facility in 2012. Other factors include the moratorium on recruitment and the cost of care per resident which is now not sustainable in comparison with other units and the private sector.

In addition, there is existing capacity within the local public and private residential facilitates to accommodate the 11 long-term residents in Lifford based on their preference. All developments have to be addressed in the light of the current economic and budgetary pressures and any decisions taken by the HSE must have regard to this and the current moratorium. I trust the House will agree that we need to ensure that the highest standard of care will continue to be provided to all residents in a safe and secure environment. Providing quality and safe care will always remain at the heart of any considerations.