Pat Buckley (Cork East, Sinn Fein) | Oireachtas source

It makes for difficult listening. I was honoured enough to sit on the committee that produced the Sláintecare report. I could use choice words here but I will not. I am looking at a HIQA inspection from 2018. The report on St. Brigid's Hospital, Portlaoise, from 2021 is practically identical until it comes to the premises. Inside the premises, the staff and everything else are working perfectly. Some of the speakers said it. Sláintecare involves community-led and community-integrated services. What does the HSE do? It sends them from Tipperary to Waterford or put them down in Clonmel, which is bonkers. That is not going to wear with the public.

As the HSE is the proprietor of this building, it is in charge of its maintenance. In every HIQA report, I suspect that even prior to 2018, the HSE was told about windowsills, the toilet not being right or the handrail being loose. It is down to here. How many centimetres? The number is 76 cm - take one bed out.

I think the people who put public money into St. Brigid's would accept losing a bed to keep the services in the community. It is a human rights issue because the HSE is not providing what it says under HSE policy is the best possible healthcare, which is care within the community. It is taking it all out of it. The inspections go back to 2018. Were there any more before that which made similar recommendations? The majority of things in the report are compliant or get excellent marks. That will tell you how well it is run until it comes to the one thing, namely, the premises. The building is originally from 1817 and we are up to 2023 so we are talking about 206 years and nobody decided to put a paintbrush to a wall. It just drives me bonkers.

I cannot believe the comments as regards opinions. I am not talking down to the witnesses but this seems to be systemic. There was mention of a HIQA report in the last two years. I am in CHO 4, which is Cork and Kerry. We have a fully integrated mental health respite centre in the town of Midleton in County Cork and because of a HIQA report and a Mental Health Commission report, the HSE has come back and said it is not compliant. It was not compliant in 2016, 2017, 2018, 2019 or 2020. There were two reports in 2022 and yet the HSE did not spend a brown penny to even fix a fire alarm or change the hinges on a door. It left it, to the detriment of the people who actually use the service and we are facing a loss of 22 beds there and all the additional services.

The witnesses say they are repurposing the building but I would say to people not to believe that because we are losing faith. We should have one of the best health services in the world. We have the best people on the ground working there. It seems all these local community buildings are going to be closed because of the failings of the HSE as an entity. As the proprietor of all these buildings, it has failed in its duty of care to maintain the buildings. Who suffers because of that? It is all the patients it is supposed to be supplying the service for.

I suspect St. Brigid's in Portlaoise is the next hospital we will be discussing here because it is not compliant or fit for purpose because the building has not been maintained. I do not know how many floors are going to be built on the children's hospital. Surely you can go up if you cannot go out. We have been talking about that in planning for years. I do not know how the people of Tipperary feel but I can tell you this: somebody has to talk. This is not a personal attack. If this non-compliance of buildings is happening in my area of CHO 4 and is happening again in Tipperary, Portlaoise and another county I cannot even remember now, why is the HSE not being held responsible?

The general public and the people who need those services are the ones who are suffering here and it is because of the incompetence of management. Again, this is not a personal attack on the witnesses because this is happening all over the country. Why is nobody being held to account? What is going to happen next week when inspectors go into another hospital and there is another HIQA report that says the staff and medicine are brilliant? Someone mentioned infectious disease. HIQA will produce reports that everything is perfect and the only thing the non-compliance will come down to again is the actual structure of the building. That is the entity the HSE is responsible for, on top of other services, but it has been totally ignored. It has been ignored in a number of centres

Regarding Covid, we did not have Covid in 2018 when this report was published. Why were none of these recommendations taken on board? It is like a car. If someone goes to get the NCT and the car fails they will get a snag list saying to fix the steering rack or put in a ball joint and then when they go back the car passes the test. It is then fit for purpose.

The witnesses are using the excuse that it is HIQA's fault that this place is not fit for purpose when the HSE let it go. I just cannot understand it. These are excuses to move away. Ms Killeen White mentioned 13 private nursing homes and 147 public beds across four units. It seems to be a case of trying to get rid of this. The HSE wants to push it into the private sector so it will not have to worry about it anymore and so it will not get a beating for not looking after the buildings over the years. It is hoping it will all go away.

We should not even be in here talking about this. I am not even from Tipperary but if my parents or somebody in my family had the option of staying there in St. Brigid's I would want them to because I see the amazing level of care and skill. This has to be down to the failings of the HSE as an entity that has ignored report after report. I do not know if there were reports prior to 2018 on this but I suspect there are and I will go looking for them. I imagine the majority of things would have come out as compliant, above average and a good standard, or a gold standard in some of cases, and yet the building will be what let it down.

I do not think anybody in here is able to give me an actual reason this is happening countrywide. Each CHO area is coming in and making excuse after excuse when the excuses do not boil up here. I genuinely think it is a human rights issue. The HSE is supposed to be the public health service in this country and taxpayers' money - it is not Government funding but taxpayers' money - is going into this the public should at least be entitled to their opinion. All this seems to be based on opinion and that it should be a two-way system.

I asked before if CHO areas talk to each other about this and say they are having a problem with X, Y and Z. If it is the same type of problem, it must be the same situation and it is the same situation because report after report has been ignored. I would revisit this. The HSE needs to go to the Minister or the Department and say there is a problem here. A figure of €5 million was mentioned. That is pennies in the overall budget. Somebody has to grow a pair of balls here and say what the cost is. This is the financial cost but we also have to ask what the cost is to the community and what does it cost to get all this community-led and community integrated. Public money is going into the place, never mind the additional money because the people in the area believed in it. I have read statements from people who used the service and the HSE is going to take the whole lot away because it failed to do what it was told to do. It is as simple as that.

I do not want a reply because I do not think I am going to get a response. I just want the witnesses to take it on board. It is not a personal attack. There are amazing people within the HSE but senior management need to be called out here. We have ageing buildings and we need to be addressing that, not shutting them down and using excuses. We are decimating communities when all our new health policies, whether on the future of mental health care or Sláintecare, call for community-led fully integrated local care. Yet we are actually doing the opposite because there was a failing within the management of the HSE. In 2023, it is just not good enough. I am sorry for going on. I am conscious there are people here from Tipperary who want to get in. I just had to say my piece because it is happening all over the country and we are going to be in here again in another couple of months dealing with another hospital.