Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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13. To ask the Minister for Health the way he can reconcile the programme for Government commitment that investment in the supply of more and better care for older persons in the community and in residential settings will be a priority of this Government and that additional funding will be provided each year for the care of older persons, including more residential places, with the Health Service Executive 2014 service plan which provides for no new residential places in 2014; and if he will make a statement on the matter. [6918/14]

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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How can the Minister reconcile a programme for Government commitment in regard to supports and the provision of beds in nursing home facilities for older people and the fact there is no new moneys in the 2014 HSE service plan for this very purpose?

Kathleen Lynch (Cork North Central, Labour)
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I thank the Deputy for tabling the question. We are looking at this issue intensively because we recognise the need in the future will be greater. I would like to assure the Deputy that the needs of our older people are, and will remain, a very high priority for me and the Government and that the resources that are available will be applied to provide the best possible mix of supports and services. Government policy is aimed at ensuring older people receive safe, timely and appropriate care and treatment at the lowest level of complexity, as close to home as possible and that they are facilitated and supported to stay in their own homes and communities for as long as it is viable. This is in line with the views expressed consistently by older people themselves.

Accordingly in 2014, there is an enhanced focus on home and community supports. Although the budget for long-term residential care has been reduced by €35 million to €939 million, it should be noted that €23 million of this reduction is being directly transferred to the community side. This allocation will strengthen community provision and allow more people to stay in their own homes for longer. While it is estimated that 900 fewer people will be supported in long-term residential care, this will be counterbalanced on the community side, where the €23 million will be used to fund the following: 190 intensive care packages to benefit 250 people annually; 25 intermediate-transitional care beds to benefit 650 people; 20 beds for complex cases to benefit 130 people; and maintaining the current level of public short stay beds provision of 1,860 beds which provide respite, rehabilitation and step down services. We are implementing the type of transformation we are trying to implement in mental health and disability in regard to older people and it is something about which we must be very conscious and sensitive.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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More older people are occupying acute hospital beds for longer as they await ever-scarcer nursing home places. The consequences of that are very clear in terms of straitened health budgets and beds in the acute hospital system. Has the Minister of State established the number of patients of senior years who have been retained in acute hospital settings beyond their medical care need, many for inordinate periods of time? I know of cases where it has been months because of the shortage of beds in our public nursing home network.

The dreadful term "bed blockers" is used by some but I find it offensive. These people are not there by choice and would much rather be in their homes if that was an option but clearly it is not and that is why they are waiting for residential care. It is a hugely important issue not only for the people concerned but for the hospital system because I have been told - the Minister of State can contradict me again - we are talking of the order of perhaps 600 beds at any given time. The number may fluctuate somewhat but one is talking about a huge number of beds across our already straitened acute hospital network. This needs to be addressed.

Kathleen Lynch (Cork North Central, Labour)
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I share the Deputy's concerns. It is offensive to people as they age to have a tag put on them which is clearly not of their own making. The number is not 600, although it is a substantial one. The number ranges from between 400 and 460 at any one time and we all know the significance of that in terms of the cost of an acute hospital bed.

The reason we are putting in the 25 intermediate-transitional care beds, which will benefit 650 people, and the 20 beds for cases that are more complex, which will benefit 130 people, is for the very reason the Deputy stated, that we should take a serious look at how we move people on. It is about transferring people to transitional beds and giving them the type of physiotherapy, the type of supports they need in order to transition back to their own community and the high-spec intensive care packages to support them in their own community.

We are very conscious that we need to do things differently and that the need will increase but we are convinced that if we do this properly, the outcome will be much better, not only for the State and the taxpayer but for the people who need the care and support.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Will the Minister of State indicate when she expects these additional packages and additional bed opportunities to be in place? It comes back to the point that acute hospital beds are being occupied by people whose real need is long-term residential care. I fully support care in the community. Make no mistake, if those people could return home, many of them would make that choice. I know some of the people of whom we speak. There is no doubt in my mind that a significant number of the 460 - the Minister of State said it is not 600 but the number clearly fluctuates - want to be in a different setting but they know a residential care place is the only future they have left. What the Minister of State announced is only tipping at it. The figure clearly demonstrates that much more needs to be done. The benefits would be considerable and it would be an investment.

Kathleen Lynch (Cork North Central, Labour)
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I am not convinced that all those in beds in acute hospitals would necessarily need to go into long-term care, although a proportion would need to do so. However, we believe that with the right interventions, such as physiotherapy, and with the home care packages and supports, many more people could live long and well in their own communities. The Deputy and I know the old saying that the journey of 1,000 miles begins with a single step. We are beginning to change the service and to recognise the needs. We have to start somewhere and this is where we are starting. The provisions will be in place this year.

We are extraordinarily lucky to have Mr. Pat Healy as director. He has an in-depth knowledge of this whole area, has been involved in it throughout his career and has realised where the blockages and the difficulties are and is now beginning to address them in a way we have not seen before.