Margaret Murphy O'Mahony (Cork South West, Fianna Fail)
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I acknowledge the fantastic care that is provided at all the district hospitals in Cork South-West. The background to this debate is that in recent years, even as the good care I have mentioned has been acknowledged, one hospital or another has always been in danger of closing. It seems to be Clonakilty Community Hospital's turn this time. I am raising this matter in the House so that this issue can be put to bed. Will the Minister of State address concerns about beds being closed at the hospital? Clonakilty Community Hospital is a public unit with 137 beds spread over three blocks. I am advised that block 1 of the facility may be closed shortly and that the first floor of the block has already been converted into office space. I am further advised that just 129 of the 137 beds available are currently in service and that 113 of the beds that are in use are earmarked for long-term use. In other words, they are for patients availing of the fair deal scheme. The other 16 beds are used as community support or respite care beds. There are no obvious issues with access to fair deal beds at present. The problem arises when a patient who does not need to access an acute hospital facility is denied a bed in a community hospital simply because only long-term beds are available.

I suggest that the current funding model needs to be addressed. Community hospitals are not in a position to facilitate additional community support or respite beds because they are not getting funding for such services. They are being asked to carry the ultimate cost of providing these beds, but this is not feasible. This is essentially what is causing the so-called "bed-blocking" in our main hospitals. Patients are entitled to specified amounts of respite care over the course of a year. Patients or their families may pay for further respite care. Patients or their families are often delighted to avail of this facility, only to be told they cannot be accommodated due to bed shortages. As I have pointed out, bed shortages are not necessarily an issue in this case. The matter is further complicated by HIQA standards, which have led to reductions in bed and ward numbers to comply with spacing regulations. While Clonakilty Community Hospital can work with these bed reductions in the best interests of the comfort of its patients, the hospital authorities need to be reassured that further beds will not be lost and that a funding model will be put in place to enable the number of beds in the facility to be maximised.

Finian McGrath (Dublin Bay North, Independent)
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I thank the Deputy for raising the important issue of Clonakilty Community Hospital. The HSE is responsible for the delivery of health and personal social services, including those at facilities like Clonakilty Community Hospital. The hospital, which was built in the 1840s, is situated on the outskirts of Clonakilty in west Cork. In addition to providing long-term care to older people, the hospital historically provided residential care to people whose primary needs arose from social difficulties. The hospital is registered with HIQA for 129 beds for the provision of continuing care, respite care, palliative care and community support to older people in west Cork. Services available to residents include physiotherapy, occupational therapy and speech and language therapy. Activities are arranged daily by a mixture of volunteers and paid therapists. Approximately 157 whole-time equivalent staff are based in the hospital. The HSE is in the process of recruiting an additional two health care assistants. This will be completed shortly.

I assure Deputy Murphy O'Mahony that there have been no bed closures and there are no plans to close beds at Clonakilty. That is good news for the Deputy. There has been reduced demand for continuing care beds, however, with up to 20 such beds remaining vacant over the past 12 months. This can be partly attributed to the opening of a number of new private nursing homes in the west Cork area. Over recent winters, a number of empty beds have been made available by social care to acute services to facilitate early discharges during times of peak demand. The beds provided by public nursing homes like Clonakilty Community Hospital are an essential part of our health care infrastructure. Without those beds, many older people would not have access to the care they need. While demand has reduced in recent times at Clonakilty, these beds will be very much needed over the coming years as the number of older people increases in line with demographic trends. Therefore, it is essential that they are put on a sustainable footing and that the fabric of the buildings from which they operate is modernised and improved.

The €385 million capital programme that was announced earlier this year is one of the most comprehensive programmes of investment in public nursing home facilities undertaken by the State. It provides for the replacement and refurbishment of 90 public nursing homes across the country over the next five years. Significant work was undertaken by the HSE to determine the most appropriate scheduling of projects over the five-year period from 2016 to 2021 within the phased provision of funding to achieve compliance and registration with HIQA. The good news for Deputy Murphy O'Mahony is that the plan includes refurbishment works at Clonakilty Community Hospital. It is anticipated that construction works will begin in 2019. They are scheduled to be completed by 2020. When these works are completed, they will ensure the hospital's long and proud tradition will continue well into the future.

Margaret Murphy O'Mahony (Cork South West, Fianna Fail)
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I thank the Minister of State for giving me a lesson on the geography and history of Clonakilty Community Hospital. I am very aware of its beautiful location and, as I said earlier, the great work carried out by its staff. I welcome the Minister of State's commitment that there will be no bed closures at the hospital. However, I wholeheartedly disagree with his suggestion that there "has been reduced demand" for beds at the hospital. People have come to my clinic because their relatives have been told they are on a list that is quite long. Maybe I will talk to the Minister of State about that some other time.

Finian McGrath (Dublin Bay North, Independent)
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Okay.

Margaret Murphy O'Mahony (Cork South West, Fianna Fail)
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I need proof of this reduced demand, to be honest. I can show the Minister of State evidence to the contrary. I welcome the news we have heard regarding construction works at Clonakilty Community Hospital. I hope I will still be here to make sure that happens.

Finian McGrath (Dublin Bay North, Independent)
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I will follow up on what the Deputy has said about particular issues and any other issues in respect of which I can be helpful. I assure her I have been told it is absolutely the case that there will be no bed closures and that there are no plans to close any beds at Clonakilty Community Hospital. I recognise the fantastic work the hospital has done in providing services to the local area. I will mention some of the details. The hospital is registered as having 129 beds for the provision of palliative care and community support to older people in west Cork. Its budget is €7.9 million and its current number of beds is 129. It has 118 residential beds, including 14 dementia-specific beds, and 11 respite and convalescent beds. The hospital's staffing level is 157, which is broken down as follows: 66 nursing staff; 71 health care assistants; 13.95 housekeeping and catering staff; three clerical support staff; and two medical officers.

Recruitment is currently in process for two additional health care assistants. This will be completed shortly.

I assure the Deputy that we are aware of the need to ensure that projects such as the Clonakilty district hospital are supported. We will do our best. I will revert to the Deputy on the issues she raised earlier.