Mary Upton (Dublin South Central, Labour)
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I thank the office of the Ceann Comhairle for the opportunity to speak on this issue, which is affecting a large number of people — many of them in my constituency — who are dependent on the availability of respite care in the excellent facility in Harold's Cross. I should point out it is not the palliative care unit that is affected, but the community respite unit.

The service provided is vital to the health and well-being of a large number of people, especially those in need of intensive physiotherapy. The closure of the 45 beds will have a severe impact on the people who were dependent on the service being available to them later this year. The service is to be closed for eight to ten weeks. Not only the people in the front line, the patients, but also the families will be affected by the closure. What the closure means is that the respite care that would normally have been available to patients will not be available for those eight weeks. As a result the families will have to provide constant care for their family member.

Unfortunately, once again it is the most vulnerable who will suffer on account of the loss of this service over the next eight weeks. Overall, up to 56 patients or 45 beds will be affected. Many of these patients are in constant pain as the unit affected deals particularly with patients with rheumatoid arthritis. These are the people who will be affected by the closure. I have had a number of phone calls since the closure was announced, from individuals affected or their families.

These people have pointed out that the amount of money that is to be saved on account of the closure is less than €1 million. This is a paltry saving in the eyes of those people who will lose out due to the closure. I understand the saving relates in particular to the cost of drugs and that the hospice can no longer provide these. It is also the case that this community unit must devote much of its time to fund raising. Despite its best efforts, there is a limit to the amount it can raise voluntarily. Therefore, it is dependent on HSE funding.

The service provided by the hospice is specific and extraordinarily effective for its patients. The outcome of the closure is that these patients will be left in limbo for the next eight weeks, while the hospice is endeavouring to ensure that the patients are provided with alternative placements. Unfortunately, this does not look optimistic. If it is the case that the patients could be accommodated in some other location, what is the point of moving them and closing this facility, since it would appear the shortfall has arisen because of the cost of drugs, not the bed spaces?

One lady to whom I spoke today told me how she depends on this service to give her some relief from her constant pain. Only last week her condition was exacerbated by a bad fall, making it now very difficult for her to get around. She had been looking forward to her two weeks respite care here, where she would be given excellent attention. All those to whom I have spoken have been highly complimentary of the service and the staff in the unit. The lady in question was shocked by the news that the service would not be available to her, particularly since she has had a fall that has made her condition even worse. It is unlikely she will get an alternative place before Christmas.

I urge the Minister to ensure that the money needed to keep this service open is found within the budget of the HSE. If necessary, the solution should be found through cuts in some area of the HSE service that does not affect frontline services.

Mary Wallace (Meath East, Fianna Fail)
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I thank the Deputy for raising this issue as it provides us with an opportunity to reaffirm the Government's commitment to services for older people generally and, in particular, to the important area of the management of existing services and associated funding. I should advise the Deputy that the Health Service Executive has informed me that it is unaware of any proposal to close 60 respite beds at Harold's Cross. It is understood that the current issue concerns, primarily, the rheumatology service.

While robust financial management systems are an essential feature of any health service, they are not an end in themselves. Our primary focus has to be on patients. Each hospital, each local health office, managers, clinicians and others working in the health services have a responsibility to ensure that they strive to provide the best possible service to patients and other clients of our health services, but within agreed budgets.

The HSE has committed, through the national service plan 2008, to delivering services within its Vote as provided by the Oireachtas. Significant ongoing resources are provided by the HSE for the delivery of services by a range of statutory and voluntary care providers across the country on an annual basis. This investment in services allows for the provision of a wide range of supports for palliative care patients, including specialist inpatient beds, home care teams, palliative supports in acute hospitals and day care services.

Earlier this year, the executive allocated an overall budget of €33 million to Our Lady's Hospice. The hospice was advised by the HSE that there would be no additional funding provided beyond the allocation. At a meeting in April, the hospice was further advised of the requirement to deliver services within available funding and to submit a plan to this effect. This was submitted in May. The hospice continued to be advised by the executive over the following months of the need to achieve a break-even position. This is no different from any other agency funded through the HSE.

At a recent meeting the executive requested that the hospice submit a revised break-even plan as it was not achieving its targets. Our Lady's Hospice confirmed that there were a number of options to be considered by its board of management at a meeting last Wednesday in this context. The HSE understood that when a decision was made by the board of management with regard to the break-even plan, it would be communicated to the executive for consideration. The hospice announced on Friday, 31 October 2008 its intention to close 34 rheumatology rehabilitation beds and 11 community rehabilitation beds for a temporary period, with effect from mid-November, with a view to meeting budget overrun.

Our Lady's Hospice provides specialist care for people with a range of needs, from rehabilitation to end-of-life care. Facilities and services include an extended care unit, a palliative care unit, a community re-ablement unit and rheumatology rehabilitation. The rheumatology rehabilitation centre is a multi-disciplinary unit for the assessment and management of rheumatic diseases. It is the only facility of its kind in Ireland and is linked to the rheumatology department at St. Vincent's University Hospital, Elm Park. The unit provides care and treatment for people of all ages with arthritis and other bone and muscle diseases. Over 800 patients are admitted annually. It provides medical, nursing, physiotherapy, occupational therapy and radiology services.

It should be noted that the decision to issue a press statement, or the content matter of that statement, was not agreed with the HSE in advance. The executive is working closely with the hospice to ensure that the infusion treatment currently being provided for rheumatology patients at Harold's Cross will continue to be provided. The HSE is continuing to work with the hospice in order to achieve a break-even position at year end. A further meeting between the executive and the hospice has been arranged for tomorrow, Thursday, 6 November 2008.