Kathleen Lynch (Cork North Central, Labour)

I thank the Deputy. From my additional notes I see the estimated population of people aged over 65 years in his county is 12,636. There is a myth abroad which tells us that now we are living longer we will need additional nursing home beds. The percentage of those of us who will need nursing home beds in the future will remain the same. We are living longer and are healthier but this does not mean we will all end up in nursing home beds - nor will all the 90 year olds Deputy Kirk meets. The percentage who do is 4.5% and I believe we should be able to deal with that.

I have known the Deputy for some considerable time and it is not usually his form to make claims such as that people will have their nursing homes closed down. That is scaring very vulnerable people. As I know from my in-laws, people listen to and watch the proceedings in this House during the day. It is unfair to frighten them. I know the Deputy a long time but that is not his form.

St. Joseph's nursing home, Ardee, is a listed Georgian building that is over 150 years old. It provides accommodation on two floors for 23 people. There are currently 19 long-term residents and four respite beds at the home. I am sure the Deputy knows this better than I do. The Cottage Hospital, Drogheda, was founded in 1908 and was taken over as a nursing centre by the HSE in 1988. It provides 14 long-term care beds and 15 respite beds. St. Oliver's Hospital is situated in the grounds of the Louth County Hospital. It is a single-storey building that opened in 1987. Accommodation is available for 92 residents in four separate units. Two beds have been temporarily closed to conform to fire regulations. The remaining 90 beds comprise 87 long-term care beds, 16 of which are specifically for people with dementia. In addition, three beds provide a respite service to clients in the community.

The Health Service Executive is currently examining the future use and development of public nursing homes in County Louth, taking into account the potential of these units to comply with HIQA standards. In this regard a project group held its first meeting on Tuesday, 24 January. The group is starting work on an optimal appraisal for the most appropriate service delivery model for elderly residential care in County Louth. It has agreed a framework, with mid-March as the expected time for completion. During the process, the project team will be in regular communication with all stakeholders - patients, families, staff and the wider community.

The moratorium on recruitment and compliance with national quality standards are both impacting on the public nursing homes in Louth. These pressures are mirrored across the country and are well documented. I acknowledge there is a great deal of concern about the future of our community nursing units. There is no doubt we are facing challenges in this sector due to staffing, funding and the age and structure of the existing units. However, I can confirm that no decision will be made to close a public nursing home without a full consultation having taken place with all stakeholders.

It is clear that, on a business-as-usual basis, the HSE would have to close further beds across a range of public community nursing units in 2012. In the absence of reform, this would increase the cost of caring for older persons within the public system. Consequently, this would undermine the viability of public community nursing units and reduce the overall number of older persons who can be supported within the budget available for the fair deal scheme. This is not a sustainable way forward and would not meet the needs of older persons, local communities, the taxpayer or those working in the public service. Instead we need a more proactive approach to the provision of community nursing home units which seeks to protect the viability of as many units as possible within the funding and staffing resources available. That includes smaller units where challenges of scale may require more innovative approaches to service delivery. This is likely to require a combination of actions such as consolidation of services and changes in staffing, skill mix and work practices.

All developments have to be addressed in the light of the current economic and budgetary pressures and any decisions taken by the HSE must have regard to this and to the current moratorium. I trust the Deputy and those listening will agree that we need to ensure the highest standard of care will continue to be provided to all residents in a safe and secure environment. Providing quality and safe care will always remain at the heart of any considerations.

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