Brian O'Shea (Waterford, Labour)
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Both Waterford city and County Waterford require substantially more public continuing care beds for elderly patients. The decision to close St. Bridget's ward at St. Patrick's Hospital, Waterford with the loss of 19 beds beggars belief and is nothing short of a money saving exercise, justified on highly questionable health and safety grounds. There is an extensive waiting list for St. Patrick's Hospital. There are patients in short-term contract beds in private nursing homes or in the community who encounter major or insurmountable financial difficulties in terms of taking up or staying in long-term beds in private nursing homes while awaiting a public bed. This situation is worsened in the absence of the long awaited appropriate new funding mechanism.

There is a crisis situation in the community and yet the HSE has decided to eliminate 19 public beds from St. Patrick's Hospital. Patients in the hospital are to be transferred to other wards and the hospital is to cease taking admissions. The HSE says the closure is necessary for health and safety reasons but the rest of the hospital will remain open.

The HSE has also stated that there is no question of St. Patrick's Hospital being shut down entirely. The Minister for Health and Children, Deputy Mary Harney, is on record as stating that if the HSE does not close St. Bridget's ward, then the Health Information and Quality Authority, HIQA, will do so. The Minister, Deputy Harney, is further quoted as stating that the new standards for the care of the elderly come into effect this summer and will be implemented by the HIQA. These assertions need to be fully substantiated. They are questioned by the excellent and dedicated staff of St. Patrick's Hospital. The HSE states that the provision of a new 50 bed unit is a priority. The Minister of State, Deputy McGuinness, should note that some 30% of the beds at St. Patrick's Hospital are occupied by patients from south Kilkenny. Opposition to the closure of St. Bridget's ward is widespread, not only in Waterford but among the broad community of south Kilkenny.

The Friends of St. Patrick's organisation has contributed substantially to the hospital for many years and will continue to do so. It is eminently reasonable to request if, as stated by Mr. Pat Healy, assistant national director of primary and continuing care, the new 50 bed unit for Waterford is the priority project with the HSE, why the project is not being fast-tracked and why the beds in St. Bridget's ward do not remain in use until such time as the new unit is up and running.

Officials of the HSE have stated that a total of 30 beds are to be acquired in the private sector in the Waterford community care area that will have the same clinical back-up as the patients in St. Patrick's. That is difficult to believe. There needs to be much more clarification on the health and safety issue and the HIQA standards which are being used as an excuse for closing down the more expensive St. Patrick's Hospital long-stay beds with their hospital support to be replaced by cheaper beds in the private sector. This is an exercise in privatising the health service.

It is totally unacceptable that the elderly patients of Waterford and South Kilkenny and their relatives are caused to suffer in this way and I am calling on the Minister to make sure that St. Brigid's ward remains open until such time as the alternative public long stay beds are available in the new 50 bed unit.

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

I thank Deputy O'Shea for raising this issue. It provides me with an opportunity to update the House on this matter and to outline the background to the situation and the action taken by the Health Service Executive, HSE. I also want to reassure the older people concerned, and their families, about the future.

Government policy on older people is to support people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care where this is appropriate and we continue to develop and improve health services in all regions of the country and to ensure quality and patient safety.

The HSE has operational responsibility for the delivery of health and social services, including those at facilities such as St Patrick's Hospital, Waterford. The executive is working on an action plan to prioritise a phased programme of refurbishment and replacement of existing public nursing homes, where necessary, to meet the proposed new national standards for residential care facilities for older people. Ongoing reviews are essential to ensuring that resources are properly channelled, and that the changing needs of older people are suitably addressed.

St. Brigid's ward is the last remaining ward on an upper floor of St. Patrick's Hospital. Concerns have been expressed about the ward in terms of health and safety and fire issues. The fire safety officer has highlighted the difficulty of evacuating high dependency patients from St. Brigid's ward in the event of an emergency. With that in mind, the HSE has decided that it is no longer viable to continue to accommodate patients in St Brigid's ward.

Patients accommodated in the ward will not be moved out of St. Patrick's Hospital but will continue to receive their ongoing care within the complex. As vacancies arise on the ground floor, in consultation with the patients and their families, patients will be relocated from St. Brigid's ward to other wards within the hospital. St Brigid's ward will no longer accept admissions.

The HSE has confirmed that it is taking steps to ensure that the closure of this ward will not result in a reduction in the number of beds available in Waterford City. The safety of the residents is our first concern. We owe them a duty of care. It is most important to consider what is in their best interests. Each hospital and local health office, the managers, clinicians and others working in the health services have a responsibility to ensure they strive to provide the best possible service to patients and other clients of our health services. The safety and well-being of older people is of critical concern. Quality care and patient safety comes first and all patients should receive the same high standard of quality-assured care.

It is a matter for the HSE to deliver services both nationally and locally within its budget and overall health policy priorities in line with the overall resources available to the executive. St. Patrick's Hospital will remain at the centre of public residential care for older people in Waterford City. The executive has a proposal for a new 50-bed community nursing home on the grounds of the hospital. It is proposed that the planned 50-bed nursing home unit will provide therapy, rehabilitation and medical care to older people who no longer need acute hospital care or who can no longer be maintained in their own homes.

The management of resources and service planning is now a matter for the HSE in the first instance but any new capital development such as the proposed community nursing unit at St. Patrick's Hospital will need to be considered in the context of the overall HSE capital plan for 2009 and beyond.

Patient safety is everyone's concern and I reassure the House that the decision to close St. Brigid's ward was taken with the primary focus on the care and welfare of each patient.