Eamon Scanlon (Sligo-North Leitrim, Fianna Fail)
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I thank the Leas-Cheann Comhairle for giving me the opportunity to raise the important issue of St. John's Hospital in Sligo. The hospital looks after young disabled people and the elderly. The hospital has 195 high-dependency beds. I raise the issue because of concerns expressed by hospital staff, especially nursing staff, whom I met last week. They outlined to me some of the difficulties being experienced in the hospital. They told me that currently seven full-time nurses have not been replaced and five nurses are on maternity leave, which is a deficit of 12 nurses. A total of 12 care assistants have been let go. Two senior nursing posts have been vacant since last November, while a further 20 nurses who have been working at the hospital, some of them for 20 years, are currently on one-month contracts. Staff are concerned that such staff will leave if they get an opportunity for a full-time nursing job and it is difficult to blame them in the circumstances.

It is my understanding that under the PCCC, primary community and continuing care, programme, those services were not to be affected by the moratorium on employment. Will the Minister of State please confirm whether that is the case? If it is, it is not being applied in the case of St. John's Hospital.

Unlike many services the hospital has been operating within budget. There was a proposal for a new extension to the rehabilitation part of the hospital under the national development plan. What is the up-to-date position in that regard? I raise these issues because they are extremely important in the context of the services provided at the hospital. Patients range in age from 25 to 104, the age of the oldest patient in the hospital last year. It is important, even in the context of cutbacks, that such facilities where care is given to the most vulnerable people in society are protected.

Barry Andrews (Dún Laoghaire, Fianna Fail)
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I am replying to this Adjournment debate on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I thank Deputy Scanlon for raising this issue on behalf of his constituents. It provides me with an opportunity to outline the background to the current situation and to update the House on the action taken by the Health Service Executive.

As Deputy Scanlon is aware, Government policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible. Where that is not feasible, the health service supports access to quality long-term residential care. The Health Service Executive has operational responsibility for the delivery of health and social services, including facilities such as St. John's Hospital in Sligo. It is a community hospital which has provided continuing care services to older people since 1972. It comprises four continuing care wards, one rehabilitation ward, a day hospital, a physiotherapy department and an occupational therapy department. The facility has a total of 195 beds, which includes continuing care residential beds, dementia, respite and convalescence beds. As of 30 September 2009, all 195 beds were occupied.

A full-time medical officer is employed to provide medical services to all inpatients except those in the rehabilitation department, which is under the care of a consultant geriatrician. As part of a recent HSE review of "Medical services in the Acute Hospital, Sligo General Hospital and St. John's Hospital" it is proposed to implement a plan where a consultant geriatrician would provide additional sessions to the care of continuing care patients in St. John's Hospital. There has been no reduction in the provision of medical cover and the proposal will enhance that provision.

There is a funded complement of 106.5 nurses, as measured in whole-time equivalents, in St. John's Hospital. Currently, there are three staff vacancies while five staff are on maternity leave and three staff are on long-term sick leave. The director of nursing deploys staff to ensure that there is no clinical risk. There is a funded complement of 63 whole-time equivalent staff. Currently, there are three vacancies with an additional three staff absent due to sick leave. Again, the director of nursing redeploys staff to areas of greatest needs to maintain safe levels of care.

No beds are closed in St. John's Hospital. Management regularly reviews staffing levels to ensure that patient safety is not compromised. The capacity of the executive to provide approved levels of service continues to be reviewed in the context of overall resource availability. The local health manager has a clear responsibility to deliver services within allocated budgets and consistent with human resource directives. That includes any decision on prioritising resources and the impact it may have on providing cover at all facilities. That requires a stringent ongoing review of the application of the resources.

The Government is clearly committed to the development of comprehensive services across the country. As I have outlined to the House, the Department of Health and Children will continue to work with the Health Service Executive to advance that objective.