Ms Kate Killeen White:

On palliative care beds, I appreciate that those three palliative care beds were valued in the community. From an HSE perspective, we have to look at the building as a whole as opposed to segregating out certain beds. We have to look at the viability and the options associated with the building as a whole. As discussed and as outlined in the opening statement, works to make the existing St. Brigid’s site suitable for use in compliance with infection prevention and control and space guidance would be extensive. The opinion proffered to us from colleagues was that the upgrade of the existing building was simply not a viable option and we would be looking at significantly reduced bed bays. The works themselves and the building itself just did not gel and were not conducive to the works required. That is the reason we were also looking at an extension and I already outlined the reasons why one was not possible in the site.

On palliative care services, there is a spectrum of services provided for palliative care or those that require palliative care services, ranging from the supports in the home to level 2 beds to level 3 beds. I already outlined that a new 20-bed unit opened in Waterford in 2021, which is comprised of palliative beds. The new 50-bed unit in Clonmel in St. Anthony’s will also cater for the population of Carrick-on-Suir. I have heard the Deputy’s comments on the palliative care provision and I thank him for that. A spectrum of services are provided. The data are indicating that people are choosing to live out their end-of-life days at home and we facilitate that.

With regard to individualised arrangements for families, we appreciate that some families may not have access to transport and it might be a difficulty for those families to access services that are not in the immediate environs or immediate locality. At the time of this decision, we communicated that where that was presenting, we would work with individual families, like we do across the south east and across the country, to put in individualised or bespoke packages for those families. We would continue to do that and we do that across all of our services.

The primary care centre and the facilities there complemented the services that were provided in St. Brigid’s. It was not a case that it was one or the other. We simply found ourselves in a situation where the shortcomings, which had been identified in St. Brigid’s for many years prior to Covid, unfortunately, became very real during Covid, particularly from an infection prevention and control perspective. When we looked at the Covid step-down options available when we were planning for Covid, we were operating in a bit of a vacuum. We did not know what Covid was going to bring to this country and how it would impact and affect the provision of services. It was as time went on, as we progressed from one wave of Covid into another, learned more about Covid and learned more about how the infection travels and is spread that we realised that we could not admit people back into St. Brigid’s hospital given its environment. It would have been wrong to admit patients into St. Brigid’s when we were aware of the shortcomings in the premises.

I appreciate the Deputy’s comments and questions. I would like to reiterate that this was not an easy decision; it was not the easy way out. It was a very difficult decision because we are aware of how valued St. Brigid’s is in the community.