Charlie O'Connor (Dublin South West, Fianna Fail)
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I thank the Ceann Comhairle for being kind enough to allow me raise this item. I acknowledge the presence of Deputy Brendan Smith, Minister of State at the Department of Health and Children. I hope the Minister of State will carefully note the concerns I will express.

Very often, I raise issues on the Adjournment and through other business which is Tallaght-based. The service I will discuss tonight is Tallaght-based but I stress to the Minister of State that this is not just a Tallaght issue but one which concerns Dublin as a whole. It involves most Dublin constituencies and I know other colleagues are as concerned as I am. I particularly acknowledge the support I have received on this issue from Deputy Darragh O'Brien, our colleague in Dublin North.

The Acting Chairman knows that not a week goes by when we do not raise issues relating to hospital services. I have always been very supportive of my local hospital in Tallaght, which I have been involved with since its planning stages and through its opening. I was a member of the board when it opened in June ten years ago.

All of us know the hospital in Tallaght, as well as St. James's, Beaumont and all the other hospitals in Dublin, are regularly under pressure. Not a week goes by when the Mater Hospital is not highlighted for its particular challenges. There is no question there is a need to find a way to deal with the crisis in accident and emergency departments and the input of patients.

Some months ago, a number of my constituents in Tallaght brought to my attention the fact that they had availed of what they described as a dynamic new HSE initiative which provided a hospital in the home service. One individual recounted being plucked from a trolley in the accident and emergency department and transferred to this programme. I took the time not only to visit Tara Healthcare at the South City Business Centre in Killinarden. As a result of the co-operation of those who work there, I was able to visit patients in my constituency who were availing, in a positive way, of this service. They told me great stories about being kept off trolleys in hospitals and out of accident and emergency departments and being provided with a service by highly professional people. Not only were the latter providing such a service, they cared about the patients' plight. I was deeply impressed by the service on offer and I thought that, for once, the HSE had come across a tremendous initiative that is well worth funding.

To my distress and that of many others — as already stated, the effects of what is happening will be felt across Dublin — Tara Healthcare was informed last week that the HSE intends to suspend the service for the summer months. The management at Tara Healthcare informs me that this will effectively mean an end to the service. At a time when we are seeking innovative ways to preserve a good health service and cater for the needs of patients in a caring and effective way, I do not understand how the HSE can say to the 2,000 patients treated by Tara Healthcare and the 70 nursing staff, six doctors and ten administration staff who work there that the service will not be continued.

I obtained access to the HSE's evaluation of the service and it makes for amazing and positive reading because it points out that the service has provided a valuable alternative to hospital care for almost 2,000 patients since its introduction in March 2007. The evaluation proceeds to state that referrals to the service have increased steadily over time and that the service has been working to capacity over the winter months. It further states that the service provided by Tara Healthcare has evolved over time to cater for patients with a number of different diagnoses. It also highlights the success of the service.

I visited Tallaght hospital in recent days and the acting chief executive stressed that the service provided by Tara Healthcare has been a great boon to the hospital. Having checked with colleagues, I am aware that it has also been of tremendous value to other hospitals. The HSE has been the subject of many bad news stories in recent times. This is a good news story. The HSE stated in its evaluation that this service is effective and first class. However, it is now stating that it will no longer fund it through the summer months. Effectively, this means that the service will no longer be provided for those who benefit from it and who it keeps off trolleys and out of hospital accident and emergency departments.

I am informed that Beaumont is the largest catchment area for this programme at present and, therefore, this matter relates not only to Tallaght. I want to fight on behalf of people throughout the Dublin region who will be deprived of a first-class service. I ask the Minister of State to reply to the matter I have raised and to make it clear to the Minister, Deputy Harney, that the service must be retained.

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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I thank Deputy O'Connor for raising this important issue, to which I will reply on behalf of the Minister for Health and Children, Deputy Harney.

One of the key challenges facing the Health Service Executive is the need to ensure that services are planned and provided in line with the clinical need of patients. A number of experimental initiatives were put in place by the HSE with a view to providing, where appropriate, care in community-based settings instead of hospital settings. The hospital in the home service, with the introduction of primary care teams, community intervention teams, a rapid access service for the elderly and the GP out of hours service, is one of these initiatives.

The hospital in the home service was delivered by the service provider in question on the basis of a service level agreement with the Health Service Executive and for a period of one year. This agreement came to an end on 16 March. However, it was subsequently extended to 18 April.There are approximately 400,000 presentations to accident and emergency departments in Dublin annually. Some 100,000 of those who present are admitted. During the period of the agreement, the hospital in the home service treated in the region of 2,000 patients at an annual cost of €6.83 million. The hospitals benefiting from the service are Beaumont, Connolly, the Mater, St. James's, St. Vincent's and Tallaght hospitals.

A review of the service was carried out between January and March of this year under an independent chairman. The review made a number of recommendations. The main recommendation in the report, which has been adopted by the HSE, is that the concept of hospital in the home be retained and that it should be repatriated within existing HSE post-acute care and community services. The HSE is considering the manner in which it can best mainstream the service, previously offered by the service provider, into the executive. There is capacity within the community intervention teams in the greater Dublin area to absorb this service. Accordingly, the HSE is not in a position at this time to commit to a further 12-month contract. However, it is considering a number of points put to it by the service provider. The HSE has emphasised that no patient will be disadvantaged by this decision.

I assure Deputy O'Connor that the points he raised will be brought to the attention of senior management in the HSE tomorrow.