Catherine Murphy (Kildare North, Independent) | Oireachtas source

I welcome the opportunity to make a contribution to this debate and I believe a wider debate is needed. In an example that graphically displays the issue, a couple of weeks ago I was contacted by a constituent about his father who has been a patient in Naas General Hospital since last July. All Members will appreciate that it is a very emotional matter to come to the conclusion that a parent, who may not wish to enter a nursing home, must do so. This is a major hurdle many families are obliged to go through. The man in question was approved for supplementary funding and the family found a private nursing home bed, which was held for him. Within days of this supplementary funding being approved, the family was advised that no funding was available for the nursing home bed. The nursing home costs approximately €1,000 per week, while the nightly cost of a bed in Naas General Hospital is somewhere between €850 and €1,000. Therefore, one would accommodate seven people in nursing homes for the cost of accommodation one person in an acute hospital bed.

While I understand this scheme has been capped, people can understand when there is no money. However, what really offends them is when money is spent in the wrong ways. It makes no sense for this hospital, which really is under pressure. Last week, 17 people who were there had been fair deal scheme-approved, whereas this week the number was 12, because there had been a protest and there was some movement as a consequence. However, in the context of Naas General Hospital, 17 patients is like having 50 patients in Tallaght hospital and is a very large number. Moreover, there are quite a lot of nursing homes in County Kildare that are receiving patients from a catchment outside the county, quite a number of whom are from the Dublin area. Consequently, one gets a more dependent group of people who then ultimately end up in Naas General Hospital. This is putting a kind of dual pressure on that hospital and the protest yesterday was about demonstrating that the hospital has become unsafe because of the overcrowding. This should be taken on board in its own right.

There is a lot more that is wrong with the system, some of which the Minister of State herself has outlined with regard to trying to keep people at home for longer or sometimes having respite or partial arrangements. Such a suite of measures is needed but people must see them functioning. In addition, I wonder whether the design of the HSE in hiring companies, which then take care of the responsibility, is about outsourcing the responsibility or not having the layer of management that would take care of it. This is a missing piece in all this and between the amount paid to the individual who provides the care and the amount the care-providing company actually gets, this is costing quite a lot of money.

There are some really good examples of best practice and in my own constituency, the Nás na Ríogh Housing Association is an absolutely superb example of people moving from their home into a sheltered environment, and more of that must be seen. There is a lot of living to be done by people who are older but who are not ready to go into a nursing home. However, they may be happy to go into a sheltered arrangement in which there are support services. Members must think in this way, in which a range of different things are available. As for the fair deal scheme at present, the obligation on people who have been approved to spend such long periods waiting to go into nursing homes - when no other approach is open - is putting financial strain on the hospitals. Moreover, it is putting a severe numerical strain on them as well with regard to catering for people who require elective surgery. However, it is also levying a terrible emotional toll on the families who were obliged to make that decision. Often, such families were obliged to have a major family gathering and to go through all of that. Members must accept this is a serious problem. This is not saving money but when one considers the cost of having somebody in an acute hospital bed as opposed to a nursing home, it is costing a lot of money, which simply does not make sense.

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