Tuesday, 5 December 2006
Care of the Elderly.
Question 49: To ask the Minister for Health and Children her views on the lack of provision made for specialist medicine for older people in the buildings of three major Dublin hospitals; her further views on claims that departments of geriatric medicine are being marginalised and that, according to the Kennedy report, from the 1980s older people should hold a central place in general hospitals, which is not the case today; and if she will make a statement on the matter. [41733/06]
The Government's commitment to the development of a comprehensive range of services for older people has been demonstrated by the significantly increased resources made available in recent years.
The Mater hospital has 39 beds in a geriatric acute facility and four day beds specifically for older persons. The hospital has three geriatricians and appropriate staff support, including physiotherapists and occupational therapists. The geriatricians have links to St. Mary's Hospital, Phoenix Park, which provides continuity of care for older patients before and after acute care. The Mater is also participating in the proposed complex discharge for older persons project, the objective of which is to provide full medical, nursing, rehabilitation, allied health and social care services to patients over 65 years who have completed their acute medical episode of care.
The HSE has contracted the Charter Medical Group to provide a rapid access clinic to significantly improve access to services for older people. This new service at Smithfield will treat more than 2,000 Dublin patients annually.
St. James's has developed a proposal to build a centre of excellence for successful aging at the hospital. The HSE is examining the scope for including this project in its capital programme. St. James's is also participating in the proposed complex discharge for older persons project. In addition, St. James's Hospital opened a new falls unit for older patients in December 2005, which has treated 1,200 people this year.
The current phase of development at St. Vincent's Hospital provided for a new emergency department and ambulatory care such as outpatients and diagnostic facilities. All other redevelopment at the hospital, including inpatient care and a day hospital for medicine for the elderly, is planned for the next phase of the capital project. In the current phase of the building project recently opened, older people benefit from significantly enhanced facilities when attending for a broad range of conditions. Furthermore, in recent years there has been significant investment in medicine of the elderly for St. Vincent's patients. This includes the development of Leopardstown hospital and the Royal Hospital, Donnybrook. Consultants from St. Vincent's provide the specialist services for these two facilities.
Does the Minister of State agree that Professor Des O'Neill has done a considerable service in his report on Leas Cross nursing home? It was a thoughtful and hard-hitting report. Has the Government accepted its recommendations? Does the Minister of State agree with Professor O'Neill's criticisms of the over-reliance on the private nursing home solution in care for the elderly? How will the recommendations on inpatient facilities be met?
The report clearly states that inpatient facilities both in medical and psycho-geriatric care are deficient and the issue has to be addressed. The Minister of State indicated there were some proposals floating around from the three major Dublin hospitals. Is he aware that the capital programme was underspent last year? What capital provision will be made in 2007 to meet recommendation No. 10 on inpatient facilities for the elderly in the report on the Leas Cross nursing home? The Kennedy report recommended that elderly people be central to the acute hospital service, but the only way they are central is when they are lying on trolleys in corridors and cared for in a most inappropriate way. What is the programme, timeframe and financial commitment to ensure inpatient facilities are in place to meet medical and pyscho-geriatric needs of the elderly?
Since 1997 the Government has shown a great commitment to improving services for older people. Last year's budget saw additional significant investment in the services. There are 39 beds in the geriatric acute facility and four day beds, specifically for older people. The hospital has three geriatricians, 47 physiotherapists, 12 occupational therapists and 19 social workers. These geriatricians have links and work with St. Mary's Hospital, Phoenix Park, which provides for continuity of care for older people before and after the provision of acute care. I mentioned the Mater Misercordiae and St. James's Hospitals, both of which participate in the complex discharge of older persons project which runs in line with the investment in home care packages we made in last year's budget when we increased the number from 1,100 in 2005 to 3,000 this year. That investment has worked well and it will be continued.
I agree with what the Deputy said about Professor O'Neill who did the State some service with his report. We are happy to work with its recommendations. I indicated a number of improvements that have been made and proposals under consideration in the HSE. These will be of significant benefit in the treatment of older people.