Bertie Ahern (Dublin Central, Fianna Fail)

We all know that the provision of step-down services for patients ready to be discharged from hospital is a key element of ensuring that health services are matched exactly to patient needs. It is a priority to increase the availability of community nursing and other units which would meet the needs of people who need care and would not be adequately provided for at home. As the Deputy stated, the Minister made the announcement in question two years ago. Work on the proposal for a public private partnership investment for 850 beds in community nursing units in two locations has continued in the Departments of Health and Children and Finance where discussions on how best to obtain the beds, whether through a PPP scheme with a developer or by some other means, continue.

As the schemes are complex, it is important to have a clear view of the benefit which would accrue given the complexity of the PPP structure. Instead of constructing the units, the previous Minister and the Tánaiste and Minister for Health and Children have continued, in 2003 and 2004, to use a better, more direct approach of providing money to the health boards and, in the most pressing area, the Eastern Regional Health Authority to facilitate the discharge of some 280 patients, mainly elderly people, into private nursing homes and other more appropriate settings. An additional €5 million was provided in recent months to facilitate the transfer of a further 200 patients, including some chronically disabled patients. In August this year the Department provided a further €3 million to the ERHA to transfer a further 120 patients.

I understand the Tánaiste stated in a recent parliamentary question that she was examining whether the work being done on the PPP is the best approach to this issue or whether it would be much quicker and better to continue to try to use the facilities already available, as has been the case for two years, and transfer patients directly. The Department of Health and Children takes the view that having some stand alone community nursing units outside the private area is a better approach. This is the issue the Tánaiste and Minister for Health and Children is examining and on which she will report back.

None of the 850 community nursing home beds has emerged using the public private partnership approach. We have taken a different approach by sourcing and using the facilities in the private sector.

See this speech in context