John Lahart (Dublin South West, Fianna Fail)
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I ask the Leas-Cheann Comhairle to convey our thanks to the Ceann Comhairle for selecting this very important topic for discussion. There is not a family in Dublin and the surrounding area that has not benefitted from the overwhelming gentleness and the unobtrusive caring and professional support of the hospice teams in Harold's Cross and Blackrock whether operating within the actual hospices themselves or through the home visiting teams. Last Sunday, I had the privilege of attending with a number of my colleagues the annual "Light up a Life" ceremony in Harold's Cross. There were over 10,000 people in attendance, most of them families of all ages. It struck me as I left that we talk about six degrees of separation whereas there is probably only one degree of separation when it comes to lives that have been affected and touched in a hugely positive way by the work of the hospice movement.

The backdrop on Sunday was a state-of-the-art education and research centre which is an indication that the hospice movement and the services it provides are moving from strength to strength and growing. The State is going to become ever-more dependent on what is, by and large and in particular in relation to the home-visit service, a voluntary service provided by the teams within the hospices. A new palliative section has been constructed which was not funded by the HSE. The hospice hopes the HSE will see its way to funding equipment grants up to €1.6 million and the second phase. My colleagues, Deputy O'Callaghan and Deputy Curran, will I am sure develop those themes.

Jim O'Callaghan (Dublin Bay South, Fianna Fail)
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I am very honoured to be given the opportunity to speak about Our Lady's Hospice in Harold's Cross, which is in my constituency. The hospice was founded by the Sisters of Charity back in 1879. Sometimes, the wonderful contribution that religious orders of all denominations have made to health care and education in the capital and beyond is sometimes forgotten. Even though it is described as being a hospice, Our Lady's provides a great deal more than care for those who are terminally ill. It also provides a service to enable elderly people to live independently as well as services in respect of rheumatology and other specialist palliative care.

The hospice is well aware of the challenges it faces into the future and the State needs to assist it in meeting them. Ireland's over-65 population is growing rapidly and is expected to triple to 1.4 million over the next 30 years. We need to prepare for that. Fortunately, the hospice is preparing and has commenced the process of constructing a whole new palliative care centre. It is also expanding the home care service. I had the benefit with other colleagues here to visit the hospice and receive a guided tour of the wonderful new building. It is an invaluable service and an institution that is loved by very many people in Dublin, as Deputy Lahart said. That was evident last Sunday. It is important that the State recognises the role of the hospice, not simply by talking about it, but by making some active financial contribution. The hospice needs to be assisted financially in respect of the work that is going on. The HSE did not fund the first phase of the build and I ask the Minister of State to provide some practical support financially.

John Curran (Dublin Mid West, Fianna Fail)
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I concur with the comments made by my colleagues. This time last year, I had an uncle who was in the hospice. He died at the end of December. From a family's point of view, I cannot speak highly enough of the care he received and the manner in which he was looked after. His immediate family feels likewise. That is why, in some regards, I feel compelled to speak on the subject.

Like Deputy O'Callaghan, I recently visited the new development. Rather than speak about the service, which my two colleagues have addressed adequately, I will address the funding issue. It is important to note that State funding to the hospice generally is down 25% on what it was in 2009. The application for funding for phase 1 was refused, specifically because the committee said it could not approve projects retrospectively and that each agency has to follow the same procedures and submit applications in advance of projects being progressed. Obviously, the hospice takes a different view and had been in touch with the HSE since 2014. It received sign-off from the national director of primary care in February 2015, so there was a level of engagement. In favour of what the hospice did, I note that it recognised the urgency and the reality that the facility was badly needed both to improve standards and, more importantly, to cater for a growing and aging population.

It did not get funding for phase 1 but has clearly indicated that phase 2 and equipment could be considered. As an organisation, the hospice is not in a position to continue to fund the capital. It is engaged in fundraising to subsidise the revenue side, in other words the staff costs. I appeal to the Minister to look specifically at this case. It is one of the few opportunities we have where the development has taken place and the asset is there. We are not saying we need this in five years' time. It is here now but it needs the funding. These people are not in a position to continue to provide that level of funding without State support.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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I thank Deputies Lahart, O'Callaghan and Curran for raising this important issue. It is the intention of the Government that people will be provided with the palliative care services they need regardless of their diagnosis, age or whether they die in a hospice, acute hospital, nursing home or at home. Significant progress has been made in recent years to improve access to specialist palliative care services. Currently, 93% of people receive specialist palliative care services within the community within seven days of referral while 96% have access to a specialist bed within seven days.

Specialist palliative care is now provided in 11 locations countrywide and the number of specialist palliative care beds will reach 217 once all 15 beds in Kerry Hospice are open.

The successful development of palliative care service in Ireland has been based on a long-standing tradition of positive engagement between the voluntary and statutory sectors. Organisations such as Our Lady's Hospice have played a vital role in this work by collaborating with the HSE in a very positive way on a range of fronts to strengthen the provision of palliative care. Those who have experienced hospice care personally or for a family member almost invariably describe it as one of the bright spots in what can be a very difficult stage of life.

On a personal note, and no more than many in this House who have experienced the type of palliative care that can be provided across the country, I know very special people work in the service. They prepare those of us who will live on and those who are dying for death. It is something we need to do a little bit better in our society.

In late 2015, Our Lady's Hospice embarked on a redevelopment of its palliative care unit in Harold's Cross to provide single rooms to ensure the dignity and privacy of patients and their families. The rooms will be built in clusters of six around a courtyard and will be designed to allow family visits and overnight stays.

In addition, the current palliative care area will be refurbished to house the day hospice and community palliative care team. The total cost of the redevelopment will be around €20 million and the hospice has now suggested that the HSE provides a contribution of just under €5 million to fund the redevelopment.

John Lahart (Dublin South West, Fianna Fail)
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It is a shame the Minister of State cannot read her entire reply because there is a positive paragraph. We will await the second part of the reply.

As I said, everybody has a personal story. The nurses and care team in the hospice in Harold's Cross held the hand of my late father as he passed from this world during his dying days. The hospice outreach team helped us to care for my late mother until she passed away at home.

The HSE would win many friends if it provided funding for outreach teams. Additional funding for the second phase would allow the hospice to reach out to far more families. One hospice nurse can visit 550 families a year. Additional funding would be very helpful.

I have fundraised on a number of occasions for the hospice, and it is the easiest thing in the world to raise money for the service. That should not excuse the State or HSE from providing funding for a service that has saved the State hundreds of millions of euro over the past number of decades and which provided the best, most comprehensive and professional care for people in their dying days.

Jim O'Callaghan (Dublin Bay South, Fianna Fail)
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It is important to put on the record that the reason why my colleagues and I put this issue on the agenda today is because on 21 November the HSE refused the application that was submitted by Our Lady's Hospice for funding. The agency did so on two grounds. First, it said it could not approve it because the application was made retrospectively. Second, it said each agency has to follow the same procedures and submit applications in advance of the project being progressed.

In respect of the first reason, the hospice was within the timeframe for submitting the application - it was not retrospective. The HSE has been aware of the project for over two years. In terms of the second reason, the conditions in which people were living in the hospice palliative care unit were degenerating. The build and fit-out had to take place as a matter of urgency in order to ensure patient comfort and safety and the best possible environment for end-of-life patients.

In the circumstances and in light of what the Minister of State has said, I urge the HSE to consider the next funding stage positively as it is an invaluable service that provides help to all of the people of Dublin.

John Curran (Dublin Mid West, Fianna Fail)
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Unfortunately, the Minister of State did not get to read the last line of her reply, but I will read it. It states: "However, it may be possible to consider a HSE contribution to future phases of Our Lady's redevelopment subject to funds being available at the relevant time and normal procedure of and governance conditions being followed." We should take some encouragement from that.

Our Lady's Hospice in Harold's Cross has funded the redevelopment to a large extent itself. In addition to that, it is also subsidising current expenditure in terms of staffing and so forth. The situation is not tenable.

I would like to leave here today with just one commitment from the Minister of State. If the HSE planned the way forward for the hospice I would feel a lot happier. The HSE should examine the entire funding stream, whether revenue, capital or current expenditure. If the Minister of State could give such a commitment today, I would greatly appreciate it.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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Our Lady's Hospice and Care Services receives €23.7 million in annual funding from the HSE to fund all of its services. The HSE is responsible for the management of the health care of the State and the delivery of approved capital projects, all of which must be approved in advance of development commencing and comply with normal public service governance and accountability requirements.

The capital funding, the HSE has told me, is now already fully committed and unfortunately at this point there are no additional uncommitted funds available to meet the current request from Our Lady's Hospice. However, it may be possible to provide a contribution to future phases, and I believe the HSE could encourage it, subject to funds being available at the relevant time and normal procedure and governance conditions being followed.

I am glad to note Our Lady's Hospice management team and the HSE are fully engaged. Any future information and documentation will be provided within the timelines for future relevant funding decisions. I will, of course, commit to bringing the concerns of Deputies to the Minister for Health, Deputy Simon Harris, in regard to ensuring that the next phase is positively considered.