Barry Andrews (Dún Laoghaire, Fianna Fail)

I thank Deputy Upton for raising this issue. I am taking this matter on behalf of the Minister for Health and Children and it provides me with an opportunity to reaffirm the Government's commitment to services for older people.

Government policy with regard to older people is to support people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care where this is appropriate and we continue to develop and improve health services in all regions of the country and to ensure quality and patient safety.

The Health Service Executive has operational responsibility for the delivery of health and social services, including those at facilities such as Cherry Orchard Hospital. The Deputy will appreciate that all developments have to be addressed in the light of the current economic situation. The executive has been asked to make a rigorous examination of how existing funding might be used to ensure that the maximum number of people benefit from the best service possible. This requires on-going review.

Cherry Orchard Hospital provides services for older people, younger people with chronic illness or disability, and for people suffering with of AIDS-HIV infection, as well as Drug Detox beds, broken down as follows: long stay care of the elderly (170 beds); respite care of the elderly (22 beds); young chronic sick long stay (29 beds); young chronic sick respite (6 beds); AIDS/HIV Unit (17 beds) and; acute drug detox unit (17 Beds).

The hospital therefore currently has 261 beds, and capacity for day care for eight elderly people. In order to manage the hospital more efficiently within existing resources and to ensure that the same number of patients have access to the service they need in Cherry Orchard it was decided to consolidate one long stay unit on the campus. Residents in the 23 bedded Laurel unit are being moved on a phased basis, to other vacancies within Cherry Orchard.

The HSE has assured the Department of Health and Children that this will have no effect on existing respite and other services, which will remain unchanged. It will allow the hospital to continue to provide its usual high standard of quality care to residents, and the process will be closely overseen by nurse management to ensure the minimum discomfort to residents.

The HSE has advised that where patients are required to move within the campus the families concerned can be met on an individual basis by local management and nursing management. Advocates for the patient/family can with the appropriate permission also attend these meetings. The meetings with each family concerned allows for a patient focused approach to this situation and will be handled in a manner sensitive to the needs of the patient and their families. In addition the confidentiality and dignity of the residents can be maintained at all times. Patients and their families will be given time to consider the options available to them.

The HSE also held a meeting to which all local public representatives were invited on 29 June 2010. At the meeting local councillors outlined the concerns expressed by families of residents who had approached them. This included staffing issues at the hospital.

Employment control frameworks have been used for a number of years in the health sector to give effect to Government policies on the number employed in the health sector. The 2009 framework gave effect to the Government decision on the moratorium on recruitment, promotion, or payment of an allowance for the performance of duties at a higher grade. The Health Sector Employment Control Framework 2010-2012 has been agreed between the Departments of Health and Children and Finance and has issued to the HSE. The framework provides for a target reduction in health numbers of 1,520 wholetime equivalents.

Once this target is being met, the HSE is able to recruit staff in grades that are exempted from the moratorium. This includes certain frontline grades to address needs in the community, including areas such as care of the elderly, mental health, people with disabilities and child protection. In addition to these exempted grades, the 2010 framework allows the HSE, subject to meeting the target reduction of 1,520, to fill critical posts by way of exceptions to the moratorium. Such exceptions may be made where the HSE has satisfied itself that there are compelling reasons for doing so in order to maintain essential frontline services. This arrangement supersedes the requirement to obtain the approval of the Departments of Health and Children and of Finance for the filling of any vacancy arising in a post in a non-exempted grade. It is, therefore, a matter for the HSE to determine the relative priority to be accorded to the filling of such vacancies without reference to either Department, provided it delivers the required overall reduction in numbers and the associated payroll savings, and meets the policy requirements in regard to service development posts and exempted grades outlined above.

It is the view of the Department of Health and Children that exceptions should be kept to the absolute minimum in order to achieve the target growth in exempted grades and support the transformation agenda. It is a matter for the HSE to deliver services, both nationally and locally, within its budget and overall health policy priorities. Understandably, the executive regrets any inconvenience or concern caused to patients and their families in this particular instance, and will obviously try to minimise this as far as possible.

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