Kevin O'Keeffe (Cork East, Fianna Fail)
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I thank the Minister of State, Deputy Catherine Byrne, for coming to the House. Over 12 months ago, I raised staffing problems at St. Patrick’s Community Hospital, Fermoy, County Cork. We seem to have bigger problems this time. There seems to be a big problem with maintaining staff levels in the hospital. I do not think the HSE is taking a hands-on approach to this job. I spoke recently to a potential applicant for a job in the hospital who was told six months ago their name would be kept on file. When they approached the hospital recently to see whether they could get a position, they were told to reapply.

I particularly want to highlight the non-attendance by a doctor or medical officer at the St. Patrick’s Community Hospital site. This has caused fierce problems for the community. Families who have loved ones at home sometimes put them into respite care at St. Patrick’s Community Hospital for certain periods. It is an invaluable service for them. The HSE has informed us that a solution has been put in place. I will give an example of a person living near Mitchelstown who needs 24-hour care. He was offered a bed in Mallow but this was not sufficient because even with the care and attendance of those who provide cover at St. Patrick’s Community Hospital, he still needs family members to travel and stay with him when he is in hospital. It is a total disgrace that this person and his family members have not received any respite in the past four or five months.

Why has the HSE not acted before now to find a replacement medical officer? I have asked this question previously. I acknowledge that we had an officer who resigned. The most recent officer retired. Anyone in business would have a track record of his or her employees that would indicate who is going to be retiring 12 months down the road, and not just in a couple of weeks or months. I am led to believe that a temporary solution has been found and I acknowledge that. In fairness to the local GPs, they have come together to try to organise a roster. That is no more than a temporary solution. It will not fix the long-term problem that will continue to arise.

There are 72 beds in St. Patrick’s Community Hospital. Previous Governments put tremendous amounts of money into the upgrading of the hospital. It is now acknowledged as one of the best long-term care facilities in County Cork. As I have said previously, this building was falling down some years ago. It was the last place to which one would want to sent a loved one. People seem to be dying to get in there now. We do not want to lose this facility but wish to keep it. The town has already lost the St. Francis Welfare Home, which also cared for elderly people and people of no means. I thank the Minister of State for coming to the House this afternoon. I await her response. I know she will sound positive. I want her to set out a longer-term solution that will get this matter resolved.

Catherine Byrne (Dublin South Central, Fine Gael)
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I thank Deputy O'Keeffe for raising this issue. My colleague, Deputy Jim Daly, the Minister of State with special responsibility for mental health and older people, cannot be here, unfortunately, and has asked me to take this issue.

The overarching policy of the Government is to support older people to live in dignity and independence in their own 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 respite and 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 to postpone 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. Patrick’s Community Hospital in Fermoy. The community hospital provides long-term respite, convalescent and palliative care. It was registered with the Health Information and Quality Authority on 28 June 2015 for a period of three years. The hospital normally caters for people over 65 years of age but also provides care to young chronically sick patients and palliative care to adults. The Deputy will be aware that the five-year capital programme announced last year includes refurbishment works at the hospital.

Challenges emerged in recent months in respect of medical cover at the hospital, which is provided by three local GP practices. One practice provided this service three days a week. The remaining two practices provided the service on the fourth and fifth days. Following the resignation of a medical officer in-----

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I am sorry to interrupt the Minister of State. Are there not seven days in a week?

Kevin O'Keeffe (Cork East, Fianna Fail)
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I counted.

Catherine Byrne (Dublin South Central, Fine Gael)
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There could be. Actually there is. I will read what is here and then I will come back to that question. I thank the Ceann Comhairle. Following the resignation of a medical officer in 2017, the HSE managed, with great difficulty, to engage another GP to provide the service. However, in September 2017 a second medical officer retired. Despite strenuous efforts to engage another GP in the area the HSE was unable to source GP cover for the fifth day. The HSE decided that it was necessary to protect the 54 long-stay beds and that the respite service affecting nine beds in Fermoy had to be curtailed. This service was to be provided by local nursing homes.

I am pleased to advise Deputy O’Keeffe that, following a recent meeting with a local general practitioner, agreement has been reached to provide the necessary medical cover on a temporary basis. This will enable respite beds to reopen in the community hospital in Fermoy. I understand that this is expected to happen in the coming days and patients are booked in for next week. The public health nurse continues to liaise with the families. As I have said, this is a temporary measure and the Health Service Executive has confirmed to the Department that the Cork and Kerry community health care organisation will continue in its efforts to find a permanent sustainable solution. Officials from the Department will continue to monitor this situation carefully and the HSE has been asked to keep the Minister, Deputy Daly, updated on progress.

I will come in on some of the issues which the Deputy raised when I respond to his supplementary statement. I take note that the statement only covers five days.

Kevin O'Keeffe (Cork East, Fianna Fail)
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I thank the Minister of State for taking time out to deliver this statement on health. I received a similar response from the HSE to a parliamentary question which I raised in early October. The Minister of State has outlined the problems, but we do not seem to be getting any solutions. She mentioned that the beds would be opened up soon, but I am reliably informed that not all of the beds will be made available. I do not know if we will also have staffing problems. The ironic thing about this is that there are SouthDoc facilities less than 50 yards down the road from the hospital.

In this day and age and with modern technology, how can this happen? Yesterday I listened to a GP who was before the Joint Committee on Health speaking about technology and using Skype for consultations instead of people having to visit the GP in person. There was a headline in the newspaper this morning which said that it could take a week to get a GP appointment. These people just want beds and care in order that their family members can have a bit of respite for themselves. The Minister of State knows that people become accustomed to their surroundings. It is not fair to send them all over the county to different beds at different times. I will give the Minister of State an example. A while ago I mentioned the closure of St. Francis Welfare Home. It was forcibly closed and the four or five remaining patients were relocated. I would say that they had all gone to their eternal rewards within 18 months because they never became accustomed to their newfound locations. That is why I brought this matter before the Minister of State today. I know she will pass the buck to the HSE but, at the same time, she is in Government. The long-term situation is that we have the facility. Will the Minister of State please get it staffed properly?

Catherine Byrne (Dublin South Central, Fine Gael)
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First of all, I have been in situations, as has Deputy O'Keeffe, where services have been suspended for short periods of time. The difficulty is trying to get proper staff. I will, however, take on the Deputy's concerns. To be honest, I am not familiar with Fermoy. I will speak to the Minister of State, Deputy Daly, about the issue. I have taken down a number of the Deputy's points, and also the point which the Ceann Comhairle raised about the five-day service. I am not too sure what happened to the other two days. I will try to find out.

All I can say is that the solution in place at the moment is temporary. I think that has been identified by the Minister and by the HSE. There is a real effort being made to provide a proper service with permanent staff. We all know the pressure which rural GPs in particular are under in respect of staff and services. I am afraid I cannot answer some of the Deputy's direct questions, but I will ask the Minister of State, Deputy Daly, to come back to Deputy O'Keeffe on them. As I have said, I am not familiar with the service in the area in question, but I understand where the Deputy is coming from. It can be very upsetting not only for the patient but also for the family when older persons are shunted from one service to another. It can affect them greatly. We must all do our best on this matter. Unfortunately, it is difficult to get staff at the moment. We all understand that. However, that should not be an excuse for not providing people with a proper service. I will relay the Deputy's concerns to the Minister of State and I hope he will return to him. We might have a better outcome to this matter in a few weeks. I take on board the Deputy's concerns and I will take on board what the Ceann Comhairle has said about the five-day service. It could be a seven-day service.

Kevin O'Keeffe (Cork East, Fianna Fail)
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It is a good point.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I wish to make it clear that I appreciate the Minister of State being present and taking this question. I attribute no blame to her but one of my responsibilities on foot of Dáil reform is to adjudicate on the quality-----

Catherine Byrne (Dublin South Central, Fine Gael)
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That is fine.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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-----of answers that are produced. Whoever produced that reply, which suggested that care was available over five of the seven days, was certainly not addressing the real needs of the people of Fermoy.

Catherine Byrne (Dublin South Central, Fine Gael)
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I will take that on board.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I thank the Minister of State. We will move to the next item, in the name of Deputy John Brady. It is a question to the Minister of Transport, Tourism and Sport on what the Deputy describes as the downgrading of DART stations.