Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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It is a disgrace that two years after a €12 million community nursing home facility was completed in Inchicore, it has not yet started operations. This facility was to provide community nursing home beds in one of the most disadvantaged areas, which includes a large ageing population. The facility contains state-of-the-art facilities, yet it remains closed for its intended purpose. It was built as part of an overall plan to regenerate St. Michael's estate, as well as being next to the primary health care unit which is going well. The latter unit is a credit to those who had that vision. At the time, the community nursing home facility was part of an overall plan to provide public nursing home care not only in the 50-bed unit in St. Michael's estate, but also in Brú Caoimhghín where additional beds were to be built, and the Meath Hospital.

There was an overall plan that all these beds would surround St. James's Hospital, which is one of the busiest hospitals in the country. They were being provided to facilitate the release of patients who required convalescent aftercare, rather than being stuck in acute beds thus blocking the transfer of patients from accident and emergency units and elsewhere. Newspaper reports have referred to them as "bed-blockers". I do not believe they are bed blockers but they do need a different level of care. The facilities to which I am referring are within a mile of St. James's Hospital. It is illogical, economically and otherwise, to have a facility of this size sitting unused in an area that is crying out for it.

Over the past year, I have visited many patients in St. James's and Tallaght hospitals. Many of them needed to be transferred to a nursing home, but the system puts them into private health care. This is the privatisation agenda which has been carried on from the last Government to this one. I appeal to the Minister of State to announce that these beds will be opened, so that patients can be transferred from a public hospital to a public community health care facility.

It beggars belief why such a building is there. Anyone who visits it will see that it is a beautiful building on the grounds of the old St. Michael's school next to the primary health care centre. At some stage, this Government or a future Administration will have significant scope to regenerate the area, which has suffered the trials and tribulations of being disadvantaged and ignored for many years.

The financial logic of opening this facility is that it would allow beds to be freed up in St. James's Hospital so that it could become more effective and efficient in the use of hospital space. In that instance, one would not see the Minister for Health cutting €9 million from St. James's Hospital because it would prove it is well capable of delivering efficiencies.

We carried out a petition in the local area, asking local people what was happening. They had raised the issue with us on quite a number of occasions in the past few years. I will be presenting the Minister with a petition tomorrow containing over 600 signatures. That was just from the near vicinity and we did not go beyond that. We asked them what their demands were concerning this facility. The primary demand was to open it now and not leave it sitting there closed. It is a living disgrace.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Deputy for raising this issue. Apart from it being within my own remit, I know something about this particular community nursing home in Inchicore because Deputy Catherine Byrne is continually raising the matter. There is concern in the area as to how a state-of-the-art building - which cost €10 million, not €12 million, although it is a substantial figure - could remain closed.

The Government is committed to ensuring that patients receive the highest standard of care in the appropriate settings, be they acute, community or residential. As the Deputy is aware, these are challenging times for the Health Service Executive in respect of all services. In the case of community nursing units, these include challenges regarding staffing, funding and the age and structure of its units. In this regard, all developments have to be addressed in light of current economic and budgetary pressures. Any decision taken by the HSE must have regard to this and the current recruitment moratorium, which is significant concerning this particular unit.

The 50-bed community nursing unit at the former St. Michael's estate in Inchicore was planned as one of a network of units across the Dublin mid-Leinster region to address the projected demand for future long-term care provision. The public sector moratorium has severely limited the HSE's ability to commission new staff-intensive services and this has delayed the commissioning and opening of the Inchicore facility.

During 2012, the HSE proposed to move staff and patients from St. Brigid's Hospital, Crooksling to Inchicore thereby allowing for the closure of the older unit at St. Brigid's Hospital. However, having regard to the wishes of the patients at St. Brigid's Hospital and the need to maximise the level of service provision in the region, it was decided to maintain services at Crooksling and to explore alternative proposals for the Inchicore unit. I am sure the Deputy was involved in that as well.

In light of the public sector moratorium and significant additional reductions in staff numbers required over the next two years, one option being pursued is that of a public private partnership agreement. The HSE has successfully used this model to open a 100-bed unit for older persons at Ballincollig, County Cork. This unit delivers real cost benefits and value to the system which would not be possible through direct employment. It also deals creatively with the moratorium.

The current position is that a project team has been appointed within the HSE to progress this project, including representatives from general management, human resources, finance and procurement. A detailed draft specification has been prepared on the service requirement for the Inchicore unit, to be used in the tendering process with the preferred provider panel.

In addition, a detailed briefing note and associated documentation is being finalised at present in preparation for an engagement with the relevant trade unions in line with the requirements under the public sector agreement. The engagement with the unions, which must be completed before proceeding to tender stage, will commence shortly. Once the tender process commences, the HSE anticipates that a tender should be awarded within three months. The Inchicore building has been used by HSE services until recently and these services have been relocated in preparation for its opening as a community nursing home. I know this will be welcomed by the Deputy.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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I do not know who gave the Minister of State the figures on the costs associated with the nursing home. There were construction costs, site costs, site development costs and equipment costs of €8.6 million, €1.8 million, €1.4 million and €0.6 million, respectively, amounting to €12.4 million, not including whatever costs have arisen subsequently during the two years in which it has been sitting idle.

This unit was not originally meant to be a replacement for St. Brigid's Hospital and nor was it intended to be a replacement for the 50 beds located in Brú Caoimhghín. This unit was meant to provide an additional 50 beds into the system but now it appears as though it will result in the addition of 50 beds to the private system-----

Kathleen Lynch (Cork North Central, Labour)
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No.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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-----because the Minister of State has suggested it be run under a public private partnership arrangement. Would it not be more logical to grant the facility to St. James's Hospital, if the HSE no longer wishes to have anything to do with it, and allow that public hospital to run it to service its needs? I have to hand figures indicating that in October 2012, St. James's Hospital had more than 50 patients awaiting discharge and placement in long-term care beds and I do not believe the situation has improved greatly subsequently. These patients obviously would take up all the beds contained in this unit. Moreover, as it is located one mile down the road, were any issues to arise with those patients, they could be transferred quickly back to St. James's Hospital. In addition, more than 20 patients in Tallaght hospital were awaiting precisely the same placement in long-term care beds. All such long-term care beds are being facilitated in the private sector and this constitutes the privatisation of the health service. I appeal to the Minister of State, as a Labour Party Minister in particular, to oppose any privatisation, whether through public private partnerships or by way of subsidising private nursing homes in such a fashion. I appeal to her to open this facility as a public-run unit available to members of the public. It is illogical for it to sit there. While it is welcome that the Minister of State is contemplating action, I note the action is for it to be run not as a public facility but as a private facility paid for by the public.

Kathleen Lynch (Cork North Central, Labour)
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I recall that the last time I answered a question on this issue - for Deputy Catherine Byrne - the issue of having St. James's Hospital take it over as a sort of step-down facility arose. While I am open to correction, my recollection is that the hospital's licence to operate does not allow it to operate a facility off-site or off-campus.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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For the information of the Minister of State, it had one landing of beds in Brú Caoimhghín.

Paudie Coffey (Waterford, Fine Gael)
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We will have the Minister of State respond.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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The Minister of State was not informed on this point.

Kathleen Lynch (Cork North Central, Labour)
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I am fully informed but anyway-----

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Not on this point.

Paudie Coffey (Waterford, Fine Gael)
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Deputy, we will have the Minister of State without interruption please. You had your opportunity.

Kathleen Lynch (Cork North Central, Labour)
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It was because we investigated that issue.

This will not be a private community nursing unit. It will operate in the same manner as the unit in Ballincollig, County Cork. Deputy McLellan, who is sitting behind Deputy Ó Snodaigh, is aware that it operates very well and it is availed of by people from the public list. It is run on behalf of the State and is run highly effectively. If this unit could be opened and be of benefit to the community and to those who are in acute hospitals and clearly do not wish to be there but do not have an option, that would be a good day's work. I encourage the HSE to get on and do the job and to make sure space is available for people who could benefit from such a unit.