Jan O'Sullivan (Limerick East, Labour)

I thank the Minister. She said in her own contribution that she has engaged with the Friends of St. Luke's and is waiting to hear from them. Maybe she can give us a clearer picture when she replies.

I have doubts and concerns because I am familiar with reconfiguration. It is happening in my own region. In spite of all the assurances given to us that there would be full resources available at the Mid-West Regional Hospital before services closed in Ennis and Nenagh, services have already closed in Ennis and Nenagh and further services will close in July but the critical care unit that was promised, the kind of resources needed by the accident and emergency department and the extra beds are not in Limerick yet. In fact, beds are being closed as they are being closed in other parts of the country. We were given all these undertakings that reconfiguration is good for everybody and that hospitals in the network could do more for patients. The hospitals in Ennis and Nenagh would get day beds and day wards and much more work would be carried out there, but that has not happened either. Therefore, I am extremely sceptical about promises in respect of the future use of health resources. It is an issue for other regions as well and people in those regions are beginning to experience what we have already experienced in the mid-west.

It is a huge issue in the north east and I am sure Deputy Ó Caoláin will address it when he contributes to the debate. We cannot trust the Government or the HSE to deliver what they undertake. That is the real problem, particularly so now because there is a shortage of resources. There are indiscriminate cuts across the board which do not take any account of their effects. The moratorium is crucifying many of the health services because key people are not being replaced.

Today, we heard that 60 beds are to be closed in the Mater Hospital. In Beaumont Hospital, 52 have already been closed with other bed closures throughout the country. More and more patients are not getting into hospitals because the beds are not there. People are clogged up in accident and emergency departments and on longer outpatient waiting lists. People in pain and distress are waiting to get access to the health services and that is a direct result of the closure of beds. The Minister cannot sit there and treat that as an abstract concept. These are real people with real suffering. I spoke with a man who recently sat on a hard chair for 15 hours in an accident and emergency department in Dublin with his sick wife. The real people of Ireland depend on the health service and most of them are public patients who do not have the opportunity to go into the more cushy surroundings of private hospitals. The Minister for Health and Children cannot stand over that and she needs to engage more in what is happening in the health services.

The Minister has promised legislation on the control of sunbeds and I understand they are to be banned for those under the age of 18 years. That legislation is urgently required because those who use sunbeds are usually young women who do not seem to have any understanding whatsoever of the fact that the rays in sunbeds are damaging. There is real danger that these young women will develop skin cancer as they get older and that is an urgent matter. I hope the Minister will respond to us on this.

With regard to other matters, if nobody is claiming the infectious diseases maintenance allowance then none of us has a problem with the fact that it will no longer exist. Will the Minister clarify the issue of the transfer of functions? Will the Minister update us on the plan to transfer some of the work of community welfare officers from the HSE to the Department of Social Protection? There is some concern among community welfare officers about what exactly is happening.

With regard to the measures on nursing homes in the Bill, I know they are minor amendments and I do not have any particular difficulty with them but other issues arise with regard to nursing home legislation, particularly the time that financial assessment takes. I believe there was a proviso in the Bill that it would be reviewed after a period of time. If the Minister is to review it, she should consult as widely as possible beforehand, including with the owners of nursing homes and with the workers in the HSE doing the assessments. There are difficulties with delays in people being discharged from hospitals because of the time it takes to do some of the financial assessments. While the Minister told me at one stage that it was alright to move people out even if the full assessment had not been carried out, I am told that no nursing home will take a person if it is not sure that person will qualify under the fair deal because nursing homes are afraid of losing money. As hospitals are trying to move out of acute beds people who are finished with their care, they cannot do so because the nursing homes will not take them. There are practical difficulties arising with the legislation and if there is a review the Minister needs to be aware of them.

I pay tribute to everyone involved in St. Luke's since 1954. I strongly reiterate the importance of retaining the premises for the use in health services and, more important, the ethos. It has been described as a haven in Rathgar and that is a very good description of what St. Luke's has meant to many families in Ireland over the years. We need to ensure that type of thinking remains in the care of cancer patients. Unfortunately, in the life of a busy general hospital or tertiary hospital it is difficult to maintain that so it is important that the units are appropriately designed, laid out and structured and that there are garden and outdoor areas and the sense of calm and peace that patients need. I do not know how that can be achieved but it is the strong view of people who have experienced what happens in St. Luke's that it should be retained for the families concerned.

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