Michael McNamara (Clare, Labour)
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Is the Minister of State, Deputy Coffey, rather than the Minister for Health, taking my Topical Issue?

Olivia Mitchell (Dublin South, Fine Gael)
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He is, yes.

Michael McNamara (Clare, Labour)
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I thought line Ministers would come to the House to be responsible to the Dáil. It was one of the reforms the Government included in the programme for Government.

Olivia Mitchell (Dublin South, Fine Gael)
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As the Deputy knows, if they are available they come to the House.

Michael McNamara (Clare, Labour)
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I appreciate the Minister of State, Deputy Coffey, coming before the House, but he is not responsible for health issues.

I wanted to raise the fact that last week, without any notice to patients, staff or anybody else, the rehabilitation ward was closed in St. Joseph's Hospital in Ennis, County Clare. It primarily provides services to elderly people in County Clare. There are equivalent hospitals in Limerick and Newcastle West, St. Ita's and St. Camillus's, respectively. I raised the issue with the Health Service Executive, HSE, when I found out about it and I was told there had been an incidence of mumps and on that basis one member of staff had to stop working temporarily lest he or she transmit it to patients.

I understand the term "cohort" was used. The HSE used many different words and assigned new meanings to words. I was told patients would have to be moved around the hospital, but there would be no reduction in services. A week later I visited the hospital and there was a padlock on the rehabilitation unit. Most of the patients had been moved to other units which were, to my non-informed eye, grossly overcrowded. Staff morale was low. It is entirely unacceptable that this happened in a week when the Government suspended the business of the Dáil for three days to congratulate itself on having saved the country, if not the world.

I appreciate that the country was in a very difficult financial situation and one cannot be in such a situation without a loss in services. As we are now coming out of that and the country's finances are improving, various tax cuts are being discussed. However, our services need to be addressed. I am not raising this issue in the Dáil to criticise the HSE or the director of nursing for the decision taken because I assume she took the only decision available to her, namely, to close the particular ward for reasons of patient safety. There simply are not enough staff on duty in St. Joseph's to keep the ward open. I speak as somebody who has had a family member in that ward in the past 12 months.

I know the service that is provided there and how essential rehabilitation is to people, in particular the elderly who have had accidents. The service is indispensable to their progress and their ability to leave acute hospitals and return to their homes. The patients have been dispersed to other wards and are now in with long stay patients and people who are in receipt of respite care. It is having an impact across the hospital.

The fact that it is closed at present is unacceptable, as are the nature and timing of the closure. It is not good enough in 2015 to announce one morning that a ward is to be temporarily closed, transfer the patients to other units and put a padlock on the door. Even now, nobody can say for sure when it is going to reopen.

Paudie Coffey (Waterford, Fine Gael)
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I thank the Deputy for raising this matter, which I am taking on behalf of the Minister for Health.

The overarching policy of the Government is to support older people to live in dignity and independence in their homes and communities for as long as possible. This is clearly what older people want and only those in genuine need of residential care should go down that route. Short-term beds, including rehabilitation beds, contribute to the provision of an integrated model of care for older people enabling them to return home following a period of hospital care or postponing admission to long stay residential care.

The Health Service Executive is responsible for the delivery of health and personal social services, including those at facilities such as St. Joseph's Hospital in Ennis. St. Joseph's is registered with the Health Information and Quality Authority. The hospital has a total potential capacity of 142 beds. This includes four separate residential units, a day hospital and a short stay rehabilitation unit. The rehabilitation unit comprises 22 beds which are consultant led. The occupancy levels of the unit are variable and quite often there are vacancies. As of 30 April the occupancy of the rehabilitation unit was 14 patients.

In recent days, in addition to the routine staffing pressures and limited agency availability, the HSE was presented with a significant additional staffing challenge at St. Joseph's. Unfortunately this has resulted in a number of staff being unavailable for duty in the short-term. As a result of this development, the director of nursing decided to temporarily move the 14 patients from the rehabilitation unit to other long stay units in St. Joseph's Hospital. The patients will continue to receive their rehabilitation in these units. This move will assist in providing appropriate levels of care to them, particularly at night. It is important to stress that this is not a closure of the rehabilitation unit but only a temporary measure for the shortest period of time possible which will not affect the patients receiving their rehabilitation care. The HSE expects the situation to be resolved within the next fortnight. It will continue to monitor and review the situation and any decisions made will be to ensure the best possible care for all of the residents currently in the facility.

The House will be aware that the management of resources and service planning is a matter for the HSE in the first instance. Quality care and patient safety come first and the director of nursing is obligated in discharging her duties to take the appropriate steps for the management of patient profile and the staffing resources available to her. The HSE has confirmed there is no intention to close services at St. Joseph's and this temporary cohorting of patients was considered in the best interest of their care. The Minister for Health will continue to monitor this situation carefully and has asked the HSE to keep him updated on progress.

Michael McNamara (Clare, Labour)
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I thank the Minister of State for his response, although it is a pity that a Minister with responsibility for health or with more than a passing interest in health has not come in. I wish to pick up on two points from the Minister of State's response. He said the House will be aware that the management of resources and service planning is a matter for the HSE in the first instance and that quality care and patient safety come first and the director of nursing is obligated in discharging her duties. I have no problem whatsoever with the director of nursing and commend her for the difficult job she does given the resources available.

This House allocates Exchequer funding and has a responsibility to maintain a level of decency in health care. What I saw in St. Joseph's last night does not reflect that level of decency. Like many services, St. Joseph's was not founded as a hospital but as a care facility. It did not look like a hospital to me last night, such was the level of overcrowding. I have argued in this House that the HIQA requirement that everybody be accommodated in one-bed or two-bed units is unnecessary. I am still of the view that there are many patients who do not want to be accommodated in one-bed and two-bed units. However, the level of overcrowding last night is certainly not what patients or the staff who care for them want, nor is it permitting the level of service staff were trained and wish to provide.

The Minister of State also referred to the overarching policy of the Government to support older people to live in dignity and independence in their own homes and communities. There are 2.7 hours of home help allocated in Limerick and north Tipperary for every person over 65, but only 1.6 hours in County Clare. Is there a difference? Are Clare people expected to be more resilient? Does it simply reflect politics? There is a Cabinet Minister in Limerick and one in north Tipperary and that is how we allocate resources in this House. It is simply not good enough. The people I am very proud to represent have exactly the same rights and expectations as those in north Tipperary or Limerick. There is a whole of baloney about how much the Government believes in equality but why not provide equality for the over 65s? I am sorry the Minister of State, Deputy Coffey, had to come into the House because I appreciate he is not the line Minister responsible. Let us have a little bit of equality for the over-65s in the mid-west. Let us have the same number of home help hours allocated to the people of County Clare as are allocated in Limerick and north Tipperary. Since there is no Minister in County Clare, there is nobody to demand it. That is how politics works in Ireland - so much for reform.

Paudie Coffey (Waterford, Fine Gael)
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While I certainly recognise the Deputy's concerns, I can assure him that all Ministers, including myself, certainly take more than a passing interest in health. I have come to the House to relay the information given directly to me by the Minister for Health, who is unavoidably absent. I am sure he would be happy to engage with the Deputy further. I wish to reiterate that there are genuine reasons for the decision taken by the director of nursing who, in law, is obligated to take decisions in the best interests of patients. That is what she did in this instance. The HSE has informed the Minister that it expects the situation to be resolved in the next fortnight. It is a staffing issue and the approach of the director of nursing is a responsible one.