Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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The three Deputies should have a total of four minutes. I will be as liberal as possible and I ask them to limit their remarks to two minutes each. We will make up the time as we go along.

Brian Stanley (Laois-Offaly, Sinn Fein)
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I thank the Ceann Comhairle for taking this issue so promptly. The closure of the facility at Shaen is a double whammy for County Laois. It is a devastating blow, coming as it does less than two weeks after the announcement of the closure of a similar facility at Abbeyleix, only 14 or 15 miles down the road. It is a black day for the health services in County Laois and the midlands in general. The only public nursing home in the county that is not under threat, in Mountmellick, already has closed wards. The proposed closure of the facilities at Abbeyleix and Shaen removes 70 out of the 200 public nursing home beds in the county at a time when there is an increasing demand.

In the past week I have tried to access services for someone in need of such a bed. This is happening under the Minister's watch. I heard him say that that he would grab the reins of the health services and would not allow the HSE to continue to flounder along. In the eight months since coming to power, the Minister has set about the destruction of public nursing home facilities in the county in which I live. During previous recessions these fine facilities in Shaen and Abbeyleix were kept open. However, the difference now is that the two parties in government are continuing with the disastrous policies of the previous Government-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Thank you, Deputy.

Brian Stanley (Laois-Offaly, Sinn Fein)
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----- which used taxpayers' money to bail out banks instead of providing services and jobs.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Thank you.

Brian Stanley (Laois-Offaly, Sinn Fein)
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The other major difference is that we are going down the road of a privatisation agenda here. Just to conclude-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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The Deputy is taking other people's time now.

Brian Stanley (Laois-Offaly, Sinn Fein)
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The overspend is just €7 million for the entire midlands area. I ask the Minister to consider how efficiencies can be obtained within this figure. As a representative of the area, I ask him to reverse this proposal.

Charles Flanagan (Laois-Offaly, Fine Gael)
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There is a crisis in the provision of long-term care in County Laois as evidenced by the second closure of a long-established unit in as many weeks. I must comment on the antics of Deputy Seán Fleming yesterday. He knows that his party contributed to the crisis in the county by dint of years of underinvestment in facilities when we had money. The hypocrisy of Fianna Fáil is breathtaking.

That said, I want this issue resolved. How does the HSE propose to reduce the number of beds from almost 300 five years ago to a mere 130 today? It is a crisis and we cannot expect the county to be denuded of institutional care for the elderly when at least 4% of the community have a requirement for such services. Why is County Laois being targeted for repeated closures? If these closures proceed, I ask the Minister to commit to reopening the closed wards at the sole remaining long-term residential care facility in the county at Mountmellick, where, as Deputy Stanley has said, scores of beds have been taken out of commission under Fianna Fáil. I want the Minister to commit to reinstating these beds, opening up that hospital and more than anything else providing quality long-term care for elderly people in County Laois.

Billy Kelleher (Cork North Central, Fianna Fail)
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If the Deputy wants to witness hypocrisy, he should go out to Merrion Square and see 40,000 students protesting. If he goes to Roscommon, he will see hypocrisy at its best.

Charles Flanagan (Laois-Offaly, Fine Gael)
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The Deputy is a disgrace and so is Deputy Seán Fleming.

Billy Kelleher (Cork North Central, Fianna Fail)
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Deputy Seán Fleming was obviously very passionate in raising this issue yesterday and has conveyed to me the depth of feeling and very strong anger in County Laois at the closure of Abbeyleix Community Nursing Home and now St. Brigid's Hospital in Shaen. The programme for Government clearly states that there will be annual increased funding for community care and home care. The projections for future funding indicate there will be a sustained attack by the Government on public nursing homes.

Charles Flanagan (Laois-Offaly, Fine Gael)
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The Deputy is a hypocrite. The Deputy sat on this for a year.

Billy Kelleher (Cork North Central, Fianna Fail)
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It is evident that this is the case.

Charles Flanagan (Laois-Offaly, Fine Gael)
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Hypocrite.

Billy Kelleher (Cork North Central, Fianna Fail)
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We have put forward policies supporting public long-term care and private residential care working in unison. So far all we have had are reports from HIQA recommending closure in some cases and in cases where HIQA has not recommended a closure, budgetary constraints are being used as a reason. Clearly there is a crisis in public long-term nursing home care throughout the country. However, closing two facilities in County Laois in a few weeks rips the heart from the community. The Deputies in the House along with Deputy Seán Fleming have conveyed that adequately without me needing to add more to it.

James Reilly (Dublin North, Fine Gael)
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I thank the Deputies for raising the issue, which provides me with the opportunity to update the House on the matter. I point out to Deputy Stanley that there are 28 clients in Abbeyleix and 29 in Shaen. I do not know how he makes 70 out of that.

Brian Stanley (Laois-Offaly, Sinn Fein)
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There are 70 beds.

James Reilly (Dublin North, Fine Gael)
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Suggesting that they are fine facilities when one is a 1932-built sanatorium beggars belief. Fine people are working there and fine people are being cared for there. However, to describe the facility as fine is stretching imagination and HIQA would take a very different view. In answer to Deputy Kelleher, I say that we all know why we have the crisis we have. Abbeyleix Community Nursing Home provides continuing care, day care and respite services to people in Laois, Offaly and bordering areas of Kilkenny, Carlow, Tipperary and Kildare. While it might suit the purposes of the Deputies opposite to say it is closing, it is not closing. The long-term residential bed element is moving, but the day-care services are staying and will indeed be expanded.

St. Brigid's Hospital, Shaen, Portlaoise, is a two-storey building that was originally opened as a TB sanatorium in 1932 and is now a 28-bed residential community nursing unit with two respite beds.

The Health Service Executive is facing major challenges across all services owing to a reduction in funding allocation. This, together with staff losses as a result of the public sector moratorium and the anticipated loss of staff between now and the end of the year make it essential that it move to consolidate the overall provision of long stay care within the Dublin and mid-Leinster region.

The HSE has also advised that the physical infrastructures of both facilities are totally unsuitable for a modern service. It believes that without a rebuild it would not be possible to provide adequate care for the residents at these locations.

Taking all these factors together, the HSE took the decision to proceed with closure of both facilities. The HSE is committed to a full and meaningful consultation process with the residents and families through this difficult time. It will also consult and communicate with staff, public representatives and key people in the wider community. Staff will be transferred to reopen beds and-or prevent the closure of other public beds resulting from moratorium losses in the area. The HSE will ensure this transition process is managed professionally for the residents. Every effort will be made to minimise disruption to them and to ensure that long term relationships with fellow residents and staff will be maintained to the greatest extent possible. In addition, liaison persons have been appointed to support the residents through the process.

I would like to assure the Deputies that no service users will be placed in a more costly financial position in terms of their care. In regard to the other services provided at Abbeyleix CNU, I can confirm that the day care service 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. Respite service for the current eight clients at Abbeyleix will continue. However, it is intended that this service will transfer to a private provider following consultation with the families concerned.

I can also assure the House that the primary care centre located on the grounds of the Abbeyleix facility will also continue in line with the HSE primary care strategy. The changes to service I have outlined will help to ensure that the HSE achieves the highest standards of care for all residents affected.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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I will allow Deputies Stanley, Charles Flanagan and Kelleher one minute each for a supplementary question. I ask Deputies to be brief as we are way over time.

Brian Stanley (Laois-Offaly, Sinn Fein)
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I thank the Minister for his reply. With regard to the age of the Abbeyleix facility, the Mater Hospital is hundreds of years old and remains a fine facility. The Minister may not be aware that in recent weeks renovations have been carried out to the facility at Abbeyleix. I stand over what I said. These are fine facilities, both of which have been providing good care for people. I ask the Minister to meet with Members from the area and representatives of the staff to discuss the reasons for closure and how we can rescue this situation. Also, I want him to overturn this appalling decision until such time as this issue has been worked out, thus ensuring these facilities remain open.

Charles Flanagan (Laois-Offaly, Fine Gael)
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I have three brief questions for the Minister. Can the Minister confirm if the HSE is a provider of beds or a commissioner of beds in constituencies such as Laois-Offaly and beyond? What is the position regarding the 110 bed community care long term residential unit in Portlaoise? Also, will he reaffirm his intention to reopen wards and beds in the Mountmellick unit which have been closed for some time?

Billy Kelleher (Cork North Central, Fianna Fail)
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I urge the Minister to reconsider this matter in the context of his statement that he is ultimately responsible for the health services. This is an attack on the heart of the community in County Laois. Patients and families continually say these facilities are providing excellent care. With a small capital investment these facilities could remain open and provide care for those most in need in their immediate vicinity and community.

Charles Flanagan (Laois-Offaly, Fine Gael)
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Fianna Fáil had 14 years to do this when in Government but it did nothing.

Billy Kelleher (Cork North Central, Fianna Fail)
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The Deputy should look at what Fine Gael in Government has done in eight months.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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I call on the Minister to reply.

Charles Flanagan (Laois-Offaly, Fine Gael)
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I am not a hypocrite.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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The Minister has two minutes to reply.

Finian McGrath (Dublin North Central, Independent)
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Fine Gael is in power now.

Billy Kelleher (Cork North Central, Fianna Fail)
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By the time this Government has been in office one year the whole country will be closed.

Finian McGrath (Dublin North Central, Independent)
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It will not be closing the Army barracks in Kilkenny.

Phil Hogan (Carlow-Kilkenny, Fine Gael)
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No.

James Reilly (Dublin North, Fine Gael)
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Excellent care is being provided in both facilities, of that there is no question. However, the facilities are not up to the standard described by Deputies. On Deputy Stanley's remarks in regard to the Mater Hospital, some €200 million is currently being spent on refurbishing the core of the old hospital. The facilities of which we are speaking, which were built during the 1930s as sanatoria, were not built to last the duration of time they have been in use. The Health Information and Quality Authority, HIQA, has strong views in this regard, which will come to the fore in due course.

Given the cost of refurbishing these facilities, it would be more cost effective to knock them down and rebuild them. I have been assured by the HSE - it is important the families are aware of this - that all patients in the Abbeyleix facility who wish to do so will be able to stay together and retain their community relationships. I acknowledge and accept that this facility has been home to people for a long time, that relationships have grown and that moving is stressful. We aim to minimise that stress. The facilities to which these people will be moved will be modern and well run. People wishing to stay together will be able to do so. They will have a choice. There will be consultation with them and their relatives.

Similar options will be made available to people residing in the facility at Shaen. We want to give people plenty of time to come to terms with this. As I have stated nothing can happen within six months and people can move within that time if they so choose. However, there will be plenty of time for people to consider this. The reality is that once a communication is made with patients or staff the information is out in the public arena, following which public representatives from the Opposition try to make as much hay as they can of it. That may suit their purpose but it does not help-----

Brian Stanley (Laois-Offaly, Sinn Fein)
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I am trying to save beds.

Billy Kelleher (Cork North Central, Fianna Fail)
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The Minister is the master of it. We learned it from him.

James Reilly (Dublin North, Fine Gael)
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-----the people in this situation. It upsets them more than needs be.

On Deputy Flanagan's questions, the HSE is a provider and commissioner of services. On the long term care issue, I will look into the position in regard to the unit in Portlaoise. As I understand it, beds in the Mountmellick unit will be staffed by the staff freed up as a result of the closure of the other facilities.

There appears to be some misinformation about. Using the 2006 census, the requirement in terms of the number of beds recommended for over 65s is 4.5%. This means there needs to be 45 beds per thousand for people aged over 65. This means there should be 744 long term care beds in the Laois-Offaly area. There are currently approximately 790 beds, public and private, excluding Shaen Hospital and the Abbeyleix Community Nursing Home in the area.

We will use all the facilities open to us. We want people to be cared for in modern conditions of a standard of which we can be proud while equally respecting people's right to stay together based on the relationships they have formed. Staff at Shaen Hospital will also have the option of moving so that there will be minimal disruption to patients.