Róisín Shortall (Dublin North West, Labour)

I thank the Deputy for raising this matter.

Intrinsic to the Government policy of keeping older people at home and in their communities is that we enable them to access quality short-term care. This option also alleviates pressure on acute hospitals by providing an alternative to admissions or lengthy stays. It makes sense from the patient's point of view and from an economic point of view. The programme for Government includes specific provision under capital developments in health for step-down facilities. Our intention is that people are cared for in the most appropriate and cost effective setting, including short-term care.

The HSE has sole operational responsibility for the delivery of health and social services, including those at facilities such as St. Joseph's District Hospital, Ballina. The Department is reviewing the provision of public residential care in light of the need to meet national standards and regulations, local demographic pressures and public and private provision. The review will serve as a platform for discussion and will inform the development of an overall strategy on how the HSE should continue to provide this service in future in view of current budgetary and other pressures. The review must also be seen in the light of the wider health reform programme to which the Government is committed, and the position of social care services in a future health service.

St. Joseph's District Hospital currently has 62 beds, of which 25 are designated for female patients and 37 for male patients. The facility mainly provides semi-acute step-down care and also accepts admissions directly from general practitioners in its catchment area. During 2010, there were 741 admissions, of which 500 were transfers from Mayo General Hospital and other acute hospitals. The stay at the hospital is 24 days. The total staff complement is 60 whole-time equivalents, of which 30 are nurses and 22 are support staff. Between January 2011 and February 2012, it is expected that eight vacancies will arise due to retirement.

Detailed discussions have taken place between management and the director of nursing to determine the number of patients that can be safely cared for with reduced staffing levels on the roster. It is anticipated that, in the circumstances, the HSE proposes at this stage to reduce the number of beds at the hospital by 12, from 62 to 50. I understand that staff have been informed of this proposal and that further meetings between management and staff representatives will be arranged, as necessary. The expected position regarding bed provision will apply from a current date, yet to be decided, to the end of January 2012, at which time the matter will be reviewed, as appropriate.

The main objective of the HSE is to maintain the maximum number of beds in line with staff resources available. The Deputy will appreciate that all developments have to be addressed in the light of current economic and budgetary pressures overall. Decisions taken by the executive must have regard to this, including the current moratorium on the recruitment of nursing and non-nursing staff. The executive has been asked, in this context, to make a rigorous examination of how existing funding might be reallocated to ensure maximum service provision. In particular, we need to ensure the highest standard of care will continue to be provided to all patients in a safe and secure environment, including to those at St. Joseph's.

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