Seán Fleming (Laois-Offaly, Fianna Fail)
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I wish to share time with Deputy Stanley. I thank the Ceann Comhairle for allowing me to raise the issue of the closure of Abbeyleix Community Hospital. I wish to condemn the decision that has been made in this regard. The decision is wrong and it should be reversed. The 21 patients and the 60 or so staff at Abbeyleix Community Hospital were stunned when the decision was announced yesterday. The former were obliged to contact their families and relatives to inform them of it. No one saw this decision coming and, as a result, it caused major shock. It is not necessary to close Abbeyleix Community Hospital and if the decision is the subject of a proper re-examination, then I am of the view that it will be reversed.

The HSE is moving with indecent haste in this matter. It wants to transfer the patients from their long-term home - some of them have been there for a number of years - to alternative accommodation. Many of the patients are elderly and they have become accustomed to life in the hospital. I take this opportunity to compliment the staff at the hospital on the quality of care provided there. HIQA has had no difficulty with the facility in recent times.

While the HSE has not made any announcement in respect of the 90 people who attend the day-care facility for the elderly at the hospital or those who access the speech and language therapy, physiotherapy and meals on wheels services provided there, I am concerned that when the main unit is closed these services will be discontinued next year. The matter will be the subject of a fudge until all the patients are removed from the hospital. The decision to close Abbeyleix Community Hospital is purely financial in nature; it does not relate to making savings. I am of the view that it should be revisited because there are no real savings to be made in this instance. I ask the Minister to address this matter.

Brian Stanley (Laois-Offaly, Sinn Fein)
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I thank Deputy Seán Fleming for sharing time. The decision to close this facility, which was announced yesterday, is absolutely devastating, particularly for the people of south Laois. It is a top-class facility and there are no safety issues relating to it. We have been informed that the decision to close it relates to budgets. However, as of this morning, the local senior manager at the HSE was not in a position to indicate how much money will be saved through the closure of the hospital.

There are 45 staff at the hospital and they care for 32 people - 28 nursing patients and four respite patients. The Minister can lift the embargo because the number of staff is adequate. The issue of HIQA has been raised. Major refurbishments have taken place in that hospital in recent years. It is a top class facility and I do not believe that issue can be used. It is simply part of a privatisation agenda.

We have an ageing population and south Laois is not exempt, or is the county of Laois. Relatives of mine have been inpatients of that hospital. Friends, neighbours and family members have been in that excellent facility. I ask the Minister to reverse the decision. It is shameful that it was announced four hours after €711 million was handed over to unguaranteed bondholders in Anglo Irish Bank. I ask the Minister to revisit this decision. I believe the facility is viable and I ask him to reopen it, keep it open and ensure it remains in place in Abbeyleix.

Charles Flanagan (Laois-Offaly, Fine Gael)
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I too wish to express my disappointment in the HSE on foot of this decision which I regard as hasty and unnecessary. It is dressed up as a cost saving. I ask the Minister to inform the House of the efforts made by the HSE to save costs in administration in other areas rather than hit front line services in Laois.

I visited the regional hospital in Portlaoise last week and saw 21 people on trolleys by dent of the fact that all the medical and surgical wards are occupied by people who are undergoing long-term treatment, most of whom are elderly. Where are these people in Laois to receive long-term residential care? Abbeyleix must be linked closely with Mountmellick. St. Vincent's hospital, Mountmellick, is an excellent facility, where at least two wards have been closed for some time. I take it the staff in Abbeyleix will be redeployed to Mountmellick and that Mountmellick will re-open, expand and develop. I ask the Minister to reassure the residents who must leave Abbeyleix nursing unit that they will be looked after and to state where they will be looked after.

On foot of what study or information on long-term care of the elderly was this decision made? I understand there are more than 2,000 adults in Laois, all of whom are over 80 years of age. Most of those who needed care received it either in St. Brigid's hospital, Shane, the district hospital in Abbeyleix - which I understand is to close - and in St. Vincent's hospital, Mountmellick. There is a question mark over the future of St. Brigid's hospital, Shane, which I want cleared up and the matter addressed. I ask the Minister to assure the people of County Laois that care of the elderly will be such as is required by the thousands of people who have reached old age, most of whom have served the State well in terms of paying their taxes and their contribution to society and who have a question mark over their final years. This is a wrong decision which was hastily taken. I would like to see a full briefing note as to how the HSE decided to undertake this move in Laois at a time when hard-pressed families are experiencing grave difficulties.

James Reilly (Dublin North, Fine Gael)
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I thank the Deputies for raising this issue. It provides me with an opportunity to update the House on this matter.

Abbeyleix community nursing unit provides continuing care, day care and respite services to people in Laois and Offaly and the bordering areas of Kilkenny, Carlow, Tipperary and Kildare. It is a two-storey building, formerly a fever hospital, acquired by the Midland Health Board in 1960. Residents live on the ground floor which is divided into two separate units. The unit has a maximum capacity of 50 beds. At present there are 28 residents, all with maximum dependencies. Four respite beds are in use.

The Health Service Executive has advised that the reducing funding allocation being experienced across all HSE services, together with staff losses as a result of the public sector moratorium, combined with the anticipated losses of staff between now and the end of the year, make it essential that it now moves to consolidate the overall provision of long-stay care within the Dublin and mid-Leinster region.

An inspection report published by HIQA in February 2011 concluded that the ratio of staff to residents at the Abbeyleix unit was not adequate to meet the needs of the mainly maximum dependency residents. It also noted that the building is old and has a number of multi-occupancy bedrooms which do not meet the requirements of the national standards. Taking all these factors together, the HSE took the decision to proceed with the closure of Abbeyleix community nursing unit. It will also consult and communicate with residents families, staff, public representatives and key people in the wider community including Friends of the Hospital, Age Action, local GPs, clergy and the Garda..

The selection of an alternative placement for residents will be informed by the medical and care needs of each resident as evaluated by clinical staff. The implementation plan will also take into consideration the proximity of the identified nursing unit to the relatives. It is intended that the residents will be transferred to public units, where appropriate, and that the remaining residents will be transferred to private nursing homes. Staff from Abbeyleix community nursing unit will be transferred to re-open closed beds and-or prevent the closure of other public beds resulting from moratorium losses in the area.

In relation to the other services provided at Abbeyleix community nursing unit, I can confirm that the day care services will continue to cater for the needs of the 90 clients - approximately 24 per day - who use the service, and there are plans to further enhance this service in the future. The respite service for the current eight clients will continue, but it is intended that this service will transfer to a private provider following consultation with the families concerned. I also assure the House that the primary care centrelocated on the grounds of the facility will also continue in line with the HSE primary care strategy.

The changes to the service I have outlined will help to ensure that the HSE will achieve the highest standards of care for the most efficient deployment of resources.

Seán Fleming (Laois-Offaly, Fianna Fail)
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I thank the Minister for the bland and general response and failure to deal with the issue. The decision to close Abbeyleix community nursing unit is exclusively a financial one. I ask the Minister to take this on board as the basic situation in Abbeyleix community nursing unit. The payroll bill is €2.6 million. All the staff can be redeployed to Portlaoise, Mountmellick and other areas so there can be no savings as a result of the closure. Most of the 30 patients will transfer to private nursing homes at a cost of approximately €1,000 per week for 50 weeks of the year, incurring an additional cost to the HSE of private nursing care of €1.5 million. This decision is solely about the HSE making a decision to replace one set of private operators, that is, agency staff, with another set of private operators, namely, nursing homes. This is purely a financial decision. The Minister did not deal with the figures. We want to see the case being made on financial grounds, as stated by the Minister. He said the decision was based on anticipated losses. Therefore, he is only guessing what might happen. That is not a reason to make a decision now.

In regard to where the residents will have to move he said the "selection of an alternative placement for residents will be informed by the medical and care needs of each resident as evaluated by clinical staff". In other words, they will be told where to go by the medical staff. That is not good enough and I ask the Minister to address the issue.

Charles Flanagan (Laois-Offaly, Fine Gael)
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I ask the Minister to reassure the House and, in particular, the Deputies who represent the area that the long-term health care needs of the elderly in County Laois will be adequately catered for, notwithstanding the decision of the HSE. I would like to know when and how this will be done.

Brian Stanley (Laois-Offaly, Sinn Fein)
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May I ask one question?

Michael Kitt (Galway East, Fianna Fail)
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Yes, just one question to the Minister.

Brian Stanley (Laois-Offaly, Sinn Fein)
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Has an examination of the building been carried out given that the Minister and the HSE has stated that it may not be adequate in 2015 to meet HIQA standards? Has a technical examination of the building been conducted? The last time I was in it, the building looked very well. I would like an answer to that question.

James Reilly (Dublin North, Fine Gael)
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I agree with Deputy Flanagan that we must provide for the needs of people as they grow older. That is something we absolutely endeavour to do. Those needs can be met through various mechanisms, including hospital services, home help, home care programmes, long-term care and sheltered housing. Our aim is to allow people to remain in their homes as long as possible and to ensure they are treated at the lowest level of complexity, subject to considerations of safety, timeliness and efficiency, and as close to home as possible. That is the underlying principle of policy in this area.

Deputy Stanley asked whether there has been a technical examination of the building. While there is nothing in my notes to indicate that such a review has been carried out, I have been informed verbally that assessments have been made in the past and that the cost of refurbishing the hospital and bringing it up to standard was found to be prohibitive. However, I do not wish to mislead the Dáil and will not depend on my memory in this matter. Instead I will come back to the Deputy with a written response.

To Deputy Fleming, and his time machine, I will emphasise two points. First, all of the clients will be looked after. They will certainly be assessed as to their medical needs, as is proper and correct. However, their placement will be decided upon in consultation with their relatives; that is an absolute. Second, the Deputy claims that no saving will arise because the staff will be redeployed. Staff are redeployed to keep other services open, so there is a considerable saving. As I indicated, it is my understanding that the cost associated with upgrading the hospital is prohibitive. I undertake to send a written report on that to the Deputies.

The Deputy opposite is well aware that the Government of which he was a member brought this country to financial ruin, that we are suffering as a consequence across all budgets, that we are forced into a position-----

Seán Fleming (Laois-Offaly, Fianna Fail)
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The Government is continuing the policies of its predecessor.

James Reilly (Dublin North, Fine Gael)
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The Deputy does not want to listen. There is none so blind as he who will not see and none so deaf as he who will not listen. The bottom line is that we are obliged to make difficult decisions. We do not make them lightly, but we have little choice given the poisoned chalice passed down to us. However, the situation has improved. In regard to the moratorium on public sector recruitment, the health sector has been responsible for 45% of the reduction in numbers, even though it is responsible for only 33% of the numbers employed. We have done our part. We will continue to seek to keep within budget while maintaining services. Deputy Seamus Kirk's question will afford me an opportunity to outline how that is being done through the special delivery unit.