Dáil debates
Wednesday, 16 December 2009
Adjournment Debate
Health Services.
10:00 pm
Tom Sheahan (Kerry South, Fine Gael)
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Is the Minister for Community, Rural and Gaeltacht Affairs taking this matter on the Adjournment, or is the Minister for Health and Children coming into the House to take it?
Éamon Ó Cuív (Galway West, Fianna Fail)
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I hope I am good enough for the Deputy.
Tom Sheahan (Kerry South, Fine Gael)
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I do not know if the Minister really knows what is happening in Kerry regarding the provision of health facilities.
In Tralee we have a new 50-bed hospital for the elderly. It has been finished and ready for occupation for some time, but it has not been opened. The equipment for this hospital is being stored in the occupational therapy department of St. Finan's Hospital in Killarney. The occupational therapy unit in Killarney is defunct; on top of that, a CCTV system has had to be provided to safeguard the equipment for this hospital. The hospital was intended to be opened on a phased basis. I imagine this is due to the recruitment embargo in the public service; that is the only reason I can come up with. There is a new community hospital in Dingle that has been finished for some time and has yet to be opened. Again, we are advised that this is to be opened on a phased basis. There is a new building on the grounds of St. Finan's to cater for psychiatric patients, which also has been finished for some time and has yet to be opened. Again, we are led to believe the reason for this is the recruitment embargo.
To move to the psychiatric side, there was an agreement with the unions that St. Finan's would be closed in 2007, yet we are now going into 2010 and nothing has been done. The last time I raised this issue there were 52 patients in St. Finan's psychiatric hospital, with 65 staff to look after them. A new unit has been since built to house several of the patients, which has not yet been opened because of the recruitment embargo. It costs €1,000 per day just to heat St. Finan's.
The Sheppard report stated that if €50,000 was spent on upgrading Cherryfield House, another psychiatric facility in Killarney, it would accommodate the rest of the psychiatric patients from St. Finan's. Yet we maintain St. Finan's, which has 52 patients and 65 staff. In the budget, as the leader of my party stated earlier today when talking about alternative options, it was announced-----
Michael Kennedy (Dublin North, Fianna Fail)
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The Deputy has 20 seconds.
Tom Sheahan (Kerry South, Fine Gael)
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I am sorry, Chairman; you are throwing me off.
Michael Kennedy (Dublin North, Fianna Fail)
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I am just providing a reminder.
Tom Sheahan (Kerry South, Fine Gael)
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Deputy Kenny spoke of the waste that is going on within the health service, which is an absolute joke. To ensure the budget was passed, the Government promised a new 42-bed hospital for Kenmare, which I hope does happen. However, there are already three facilities in the county that have not yet been opened because of the recruitment embargo. I ask the Minister not to pull the wool over people's eyes. He should give them the truth about what is actually happening in the health service in Kerry.
Éamon Ó Cuív (Galway West, Fianna Fail)
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Ba mhaith liom buíochas a ghlacadh leis an Teachta as ucht na ceiste seo a thógáil tráthnóna. I am taking this Adjournment matter on behalf of my colleague, Deputy Mary Harney, Minister for Health and Children.
As the Deputy is aware, 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 possible, we support access to quality long-term residential care. The Health Act 2004 provides that the Health Service Executive is responsible for the management and delivery of health and personal social services. The provision of these services, including community hospitals at local level, is therefore an operational matter for the HSE, as a statutory body.
The current long-stay residential care needs for older people in the Kerry area are met by the provision of continuing care beds in community hospitals, public voluntary units and contracted beds in private registered nursing homes. On 27 October the new nursing homes support scheme, A Fair Deal, commenced. The scheme will equalise State support for public and private nursing home residents and ensure nursing home care is affordable for all who need it.
The construction of the Tralee community nursing unit was completed in December 2008 and it is currently at the equipping stage. This unit will provide 50 residential care places for older people in the Tralee catchment area when fully operational. An equipping-----
Éamon Ó Cuív (Galway West, Fianna Fail)
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Is the Deputy ready?
An equipping group has been determining the requirements of the unit and funding was made available earlier this year for this purpose. Despite the significant challenges imposed by the employment control framework and the associated moratorium on the recruitment of certain disciplines, the HSE is considering all options for opening the unit, including doing so on a phased basis, commencing in the first quarter of 2010.
The construction phase of Dingle Community Hospital was completed in late 2008 and the hospital is currently being equipped in the same way as the Tralee community nursing unit. The staffing requirements are currently being finalised. Despite the challenges faced in the provision of staffing, it is envisaged that the first phase of the opening of the new hospital will take place in the first quarter of 2010. This first phase will see the transfer of 43 residents from the current hospital to the new building. The total capacity will be 68 when fully operational.
When it was it was launched in 2006, A Vision for Change was universally welcomed as a progressive, evidence-based and realistic document which proposed a new model of service delivery that would be patient-centred, flexible and community-based. The report proposes a holistic view of mental illness and recommends an integrated multi-disciplinary approach to addressing the biological, psychological and social factors that contribute to mental health problems. Extensive consultation with service users, families and service providers informed this policy. The most pressing priority voiced was the need for an accessible and user-friendly mental health service in which users can be respected as active partners in their own recovery and where they can avail of interventions to enable them remain meaningfully involved in their own communities. The Government accepted A Vision for Change as the basis for the development of our mental health services over a seven to ten year period. Much has happened and much has changed economically since the report was launched, but it remains a progressive document and remains our roadmap, charting the way forward for our mental health services.
Mental health services are provided in many settings including acute inpatient facilities, day hospitals, day care centres, low support and high support community accommodation. A Vision for Change recognises that acute hospitalisation will be required to meet the needs of those who require care and treatment in an inpatient setting. However, service users, their families and carers want a range of mental health service options established in their local community so that comprehensive care can be provided.
The focal point of modern mental health services is the community and the community based service. A Vision for Change recommends a total of 50 acute beds per 300,000 population.
The HSE has for the past number of years been working towards the closure of the St. Finan's Mental Health Hospital and the provision of alternative modern state-of-the-art mental health facilities and other general primary care facilities for the population of Killarney and east Kerry. A range of mental health facilities and community services are being proposed as a replacement of the hospital as follows: Replacement facilities for current services provided in St. Finan's Hospital - 25 place later life challenging behaviour services to accommodate the current patient complement - this unit will become a dementia specific unit for the local health office in the future when the current population declines; 15 place interim low secure facility to accommodate the current patient complement - initially this unit will operate as a rehabilitation unit for current patients located in two secure wards; ten place community residence to accommodate the remaining patient population in St. Finan's Hospital.
A redesign of the existing acute psychiatric unit in Kerry General Hospital is also proposed, to provide a four bed, close observation unit in order to appropriately manage patients within the acute unit.
The proposals as outlined will be funded from the proceeds of the sale of mental health lands. The 2010 budget provided for a multi-annual programme of capital investment in high priority mental health projects consistent with A Vision for Change. In 2010 the HSE will proceed to dispose of surplus assets and reinvest an initial sum of €43 million in the mental health capital programme. Provision for continued funding of the programme will be made in the 2011 Estimates and subsequent years, in the light of the previous year's programme of asset sales.