Jackie Cahill (Tipperary, Fianna Fail) | Oireachtas source

I welcome the HSE staff and thank them for coming in. I do not think we agree with what they are saying but we will be courteous at any rate.

I refer to narrow corridors, flood plains and fire safety. Was an estimate provided for refurbishment of the building? Ms Killeen White mentioned St. Anthony’s unit in her opening statement. The last correspondence I got from the Minister of State, Deputy Butler, said there was only plans to put in one palliative care bed into St. Anthony's. Hopefully we will get that rectified and there will be more but St. Anthony's is not going to solve the issues in Clonmel not to mind taking on Carrick-on-Suir as well. There are three palliative care beds in the plan I have in front of me and they would be the envy of any hospital. There is a lounge off each bedroom and a sun room off the third. They have exactly what any family unfortunate enough to have someone who requires palliative hospital care would want in order to have adequate space so the family can stay there in - luxury is the wrong word - some kind of comfort. That is what we are looking for in St. Anthony's and we have a serious uphill battle trying to get it. In this case, we have them in Carrick-on-Suir and now we are doing away with them.

St. Theresa’s hospital in Clogheen and the unit in Cluain Arann were mentioned both by the witnesses and by the Cathaoirleach as possibilities for residents of Carrick-on-Suir. There are an awful lot of people in Carrick-on-Suir without their own transport. The distance from Clogheen and Cluain Arann to Carrick-on-Suir would make that completely impractical. As to the talk about Covid-19, St. Brigid's was adequate to be a step-down facility if we had a very bad Covid-19 epidemic but unfortunately in the middle of the pandemic and under the darkness of this time, the decision was made to close it. I just cannot understand. It was going to be okay as a step-down facility for Covid-19 but in the middle of the pandemic, St. Brigid's is closed.

There are so many things here that do not sit well with me. A huge amount of money has been spent on the primary care centre. We have the children's hospital here in St. James's. At the time I was only at my first parliamentary party meeting and we were in opposition. I could not see the logic of trying to build the children's hospital where they were trying to build it. I am not saying I am a construction expert or anything but it was in a confined space. It is getting near completion and has cost a huge amount of money.

Here in Carrick-on-Suir was a building and definitely the ground floor was exactly what we wanted. There was no one saying that we expected to keep the respite beds upstairs and the same number of people in respite. Anyone you talk to in Carrick-on-Suir would have accepted a lessor number of beds and improvements to the infrastructure that was there. We had a building there with two five-bed wards and twin bed wards. Surely with a proper design an adequate respite facility could have been put in there.

I would accept we would have had to lose beds out of it. If they had their three palliative care beds and a number of respite beds with the proper infrastructure, the people of Carrick-on-Suir would be very happy. I do not think any attempt was made, on economic terms even, to put an argument in place about achieving the beds for Carrick-on-Suir. We all argue about the scarcity of beds in the HSE and the crisis the whole health service is in. Here we had low-hanging fruit that could provide a certain number of beds and we have just decided to take the easy option and close it. It is just not good enough. As I said, it galls me to look at the floor map here with the three hospice rooms and ideal facilities off them which we are just going to let go.

The upstairs would obviously have required significant investment and refurbishment but when the primary care centre was being built, were there discussions or do we have minutes of any discussions about what impact it was going to have on St. Brigid's? St. Brigid's was there at this stage and was providing a vital service for Carrick-on-Suir and its environs; Waterford and south Kilkenny included. Was there discussion at that stage? If not, why not?

St. Brigid's was the facility that was there and it needed to be established if this facility was going to impact on it. Now the HSE is telling us, because the primary care centre has gone up 1 m in height, it is impacting the possibility of renovating St. Brigid's. Surely that discussion should have taken place before the construction of the primary care centre. The reality is that we are here now. We have a primary care centre which has a very impressive list of staff providing community care but every community unfortunately wants palliative care beds. We have three excellent beds in St. Brigid's. We have people ringing us in our constituency offices every day who want a respite bed when a person is coming out of hospital and they need another week or two weeks before being able to come home and be looked after at home. We accept there is a focus on home care but ironically, the more people in home care, the more demand there will be for respite because the people who are providing that home care will want a rest at certain times whether it is going on a weekend away, a week's holiday or whatever. The two go together.

Ms Killeen White has said in her statement that the HSE is focused on home care. We will all hopefully be able to be looked after at home in our old age but the people doing that will want a break at certain stages. To leave an area of this size without palliative care and respite beds limits that.

St. Anthony’s was referred to. I had to smile because I have had serious correspondence over St. Anthony's going back over the past 18 months to try to get proper palliative care into St. Anthony’s. I can produce the letter for Ms Killeen White. The last letter stated there would be one palliative care bed in it. I do not think that will be the case when we have that finished, but that was the last official letter I got. Definitely, a town the size of Clonmel would want a multiple of that.

We are completely unhappy with the way this decision was arrived at and the research that was done into it. Did the HSE put together an estimate of what a refurbishment of St. Brigid’s would have cost to keep the three palliative care beds downstairs and whatever a healthcare expert would say was the optimal level for the wards upstairs? Whatever that came out at, with proper shower facilities etc., the people of Carrick-on-Suir would have embraced that with open arms. Everyone accepts the building needed refurbishment and improvement. There is no argument there. To just close the gate and leave an area without its palliative care and respite is not acceptable.

I would like to know what the costs were and what the cost of the refurbishment would have been. When we opt to build new facilities, the costs go into the millions. It does not rest with me to walk away from a building we have. Councillor Bourke, who is here in the Gallery, and I got assurance on St. Brigid’s. While I do not want to harrow old ground, the people of the area do not accept this was the best option for them. To say to them that they can go to Clogheen or Tipperary town or we will have St. Anthony’s up the road for them is just not acceptable. The people of south Kilkenny, Waterford and Carrick-on-Suir want respite and palliative care there. We will not rest until we get that.