Nicky McFadden (Longford-Westmeath, Fine Gael)
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I thank the Minister of State for agreeing to take this Adjournment matter. Athlone district hospital, as it was known, is now a care centre for the elderly but it encompasses physiotherapy, occupational therapy, X-ray services, visiting consultant services, mental health services, primary care and MIDOC. As matters stand, the centre has 18 long-stay patients on one floor and 22 on the lower floor, which is a result of HIQA standards. Particularly in light of the Rostrevor nursing home case, I appreciate that HIQA must be a serious watchdog. However, we must get value for money. There are nurses and care assistants who are not only prepared but tripping over themselves to care for the elderly. I am deeply concerned that as patients are dying, new patients are not being admitted, which is why I have put down this Adjournment matter.

I agreed fully with the Minister, Deputy James Reilly, when he said today that 95% of elderly patients stay at home, which is proper because they live with dignity and respect in the home. However, there are people who need to be cared for and some need specialised nursing care. I would advocate that new admissions be accepted at Athlone hospital. I have taken up this issue with the HSE and have spoken to the relevant manager. I am aware there is new management in the hospital and I look forward in the near future to new admissions being taken in.

The care, compassion and the understanding the elderly are treated with in Athlone hospital is phenomenal. A four bed hospice unit attached to the campus of Athlone hospital has been newly built following the raising of a lot of money by the community. It is urgent and necessary that there would be new admissions. Families of the existing patients are worried that it will be gradually closed down. As a politician, I know of great numbers of people who want to be cared for in this excellent centre.

I await the Minister of State's reply and hope it is positive.

Fergus O'Dowd (Louth, Fine Gael)
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I thank Deputy McFadden for raising this issue. The Government is committed to supporting people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the HSE supports access to quality long-term residential care where this is appropriate. We continue to develop and improve health services in all regions of the country to meet this objective and to ensure quality and patient safety. The HSE has sole operational responsibility for the delivery of health and social services, including those at St. Vincent's Hospital, Athlone.

St. Vincent's Hospital was built in 1946 and occupies two floors. It is located on a campus with a variety of community care facilities, including a public health centre, mental health services, an out-patient clinic and an out-of-hours GP service. The hospital, as of today, has a capacity of 40 long-stay beds and four palliative care beds. The current capacity is directly related to the number of staff available to provide services within the confines of the public sector moratorium and allocated budget.

As the Deputy will be aware, significant work has been undertaken over the last 18 months to bring the services provided in line with recommendations from the Health Information and Quality Authority. This required some strategic decisions to ensure the sustainability and viability of St Vincent's, including the development and opening of a four-bed level 2 palliative care unit in September 2010. The decision, for clinical reasons, not to allow further admissions was taken to allow necessary capacity to be created to facilitate the transfer of a prioritised client with complex needs from a hospital in Dublin to Athlone. This situation is being monitored on a regular basis. Once the transfer is complete, it is expected that beds will become available.

The Deputy will appreciate that all developments have to be addressed in the light of current economic and budgetary pressures and any decisions taken by the executive must have regard to this and the current moratorium. The executive has been asked to make a rigorous examination of how existing funding might be re-allocated to ensure maximum service provision. In particular, we need to ensure that the highest standard of care will continue to be provided to all residents in a safe and secure environment.

The employment control framework for the health sector gives effect to Government priorities on employment policy in the public sector and provides that there will be a net reduction in employment to 2014. The framework is designed to maintain tight control on the cost of providing public services while protecting front-line services as far as possible. It is necessary to ensure that there is sustainability in the cost of providing public services relative to the Government's revenue.

The framework does allow for the targeted growth of certain grades which are exempt from the moratorium on recruitment, including medical consultants, physiotherapists and social workers, in order to deliver on key priority services. It also provides for the filling of non-exempted posts on exceptional grounds in order to maintain essential services and to meet priority service change or re-organisation requirements. However, given the overall requirement on the health services to achieve the target employment reductions and to live within the overall funding available, the number of exceptions is minimal.

The HSE has confirmed it is committed to the future of St. Vincent's Hospital and it has indicated that there are no plans or proposals to close any beds. The Department of Health is currently reviewing the provision of public long-stay care in light of the need to meet national standards and regulations, local demographic pressures and public and private provision. The review will inform the development of an overall strategy on how the HSE should continue to provide this service in future in view of current budgetary and other pressures. It is expected the review will be completed later this year.

I would like to confirm to the House that following his appointment as Minister for Health, Deputy Reilly requested that the HSE suspend any current plans to close or withdraw residential care beds until he has had an opportunity to review the position. I should make it clear, however, that the HSE must maintain appropriate staffing levels to meet the needs of residents. Providing quality and safe care will have to remain at the heart of any considerations.