Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 10: To ask the Minister for Health if he will set out in detail the basis for his contention that Health Service Executive care homes for older persons with less than 50 beds are unsustainable; and if he will make a statement on the matter. [1317/12]

Kathleen Lynch (Cork North Central, Labour)
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The Health Service Executive is facing challenges in respect of all services in 2012. In the case of Community Nursing Units for Older People these include challenges regarding staffing, funding, and environmental factors around the age and structure of the units. In addition further losses of staff are anticipated between now and the end of February 2012.

It is clear that on a business as usual basis, the HSE would have to close further beds across a range of public community nursing units in 2012. In the absence of reform, this would increase the cost of caring for older persons within the public system, undermine the viability of public community nursing units and reduce the overall number of older persons that can be supported within the budget available for Fair Deal. This is not a sustainable way forward and would not meet the needs of older persons, local communities, the taxpayer or those working in the public service.

Instead, we need a more pro-active approach to the provision of community nursing home units which seeks to protect the viability of as many units as possible within the funding and staffing resources available, including smaller units where challenges of scale may require more innovative approaches to service delivery. This is likely to require a combination of actions such as consolidation of services; changes in staffing, skill mix and work practices; the different types of services required – such as long-stay and transitional – and the respective strengths of public and private community nursing units in that regard; the public and private capacity available within an area; the age and structure of public units; the wider needs of the local community and alternative options for providing a viable community nursing service including a possible role for local communities or other voluntary providers. The HSE is already examining issues in this regard and will be working closely with the Department to develop an overall set of proposals for the Minister.