Marc MacSharry (Sligo-Leitrim, Fianna Fail) | Oireachtas source

I welcome the Minister of State, Deputy Byrne, and thank her for taking the time to hear about this matter. It relates to the Alzheimer's disease unit in Sligo, which covers the north-west region. The unit is based on the campus of St. John's Community Hospital there. It was opened as a dedicated unit some 20 years ago. The backdrop here is that the Mental Health Commission or HIQA did a report some time ago and found in the region of 13 non-compliances with regard to upgrades that might be required and so on. Since then, it seems that a HSE or Government decision was made to wind down and close this unit, thus leaving the entire north-west region without a suitable unit for respite or long-stay residents with Alzheimer's disease with a dedicated staff as this one was. There are now four of the 36 residents remaining. I got an email from the HSE last week stating that these people would be transitioned out and so on. In reality, what has happened up to Monday of this week is that families were effectively coerced and told to remove their loved ones, that it was a matter for them to deal with, that the unit was closing and that was the end of the story, which is totally unacceptable. The loved ones of some of these families have been living in this particular unit quite happily, including one for ten years and another for the 20 years it has existed.

I appreciate the need for and welcome inspections to ensure all our facilities are up to standard. However, it seems to increasingly be Government practice that when HIQA, the Mental Health Commission or another body does, for want of a better expression, the dirty work of finding flaws with a particular unit, instead of applying the necessary investment to get the unit up to standard and ensure the region still has that service available, it sets about closing the unit down. In effect, the Health Act 2004 is being used by the Government to subcontract the entire running of our health service and the €15 billion of taxpayers' money involved to the HSE. The HSE now seems to be hell-bent on subcontracting out the provision of those services and acting like a broker, pushing families into the private sector to get care. One could be forgiven for asking what we pay social insurance for. Where is that €15 billion going? If that is going to continue, then the HSE is clearly a very expensive broker for the procurement of private sector services. There was no consultation with the Alzheimer Society of Ireland or with the patients. As I said, up to Monday of this week, two of the four families who loved ones still live there were simply told to move on, that they had to take their loved one home, put the person somewhere else, and that the hospital had nowhere else to put them. It is not acceptable, in any event, that the north-west region will be left without a dedicated Alzheimer's unit. What is next? Will it be Dungloe Community Hospital near the Leas-Cheann Comhairle, Sheil Hospital, the Rock community nursing unit, St. John's Community Hospital itself or countless others throughout the north west?

People in the north west of the country, just like people in Dublin or in any other part of the country, are entitled to services and we are increasingly stripping them out and forcing people to deal with the private sector when there was a perfectly good functioning public service in operation. It may have needed some level of upgrade and continuing investment, as rightly highlighted by the Mental Health Commission, HIQA and other bodies, but that does not mean we should not apply those resources. We should not use it as an excuse to close services down. At some stage, we need to put the people, patients and families at the centre of our consideration of this process because, sadly, under the euphemism of "the best interest of the patient", the HSE is being budget-driven to close down and cut back services, and to push it back onto vulnerable families which have to dig deep for funds they do not have to procure these services in the private sector.

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