Brian Stanley (Laois, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I welcome the opportunity to address this matter directly with the Minister of State at the Department of Health, Deputy Finian McGrath.

The paralysis in Abbeyleix hospital is very serious. In 2011 there was a plan to close the hospital. A court case involving two of its elderly residents and a mass campaign locally were instrumental in stopping the closure, or putting the brakes on it. The hospital has changed from being mainly a long-stay hospital to a respite care hospital used as a step-down facility for patients from acute units such as that in Portlaoise. That is no bad thing; it is actually good. However, the hospital badly needs investment. It badly needs to be extended and renovated. Nothing has been done to it in the almost seven years since the closure was stopped. Not a shovel of concrete has been mixed and not a piece of timber has been cut. There is a large site, of which the existing building occupies only a small part. The hospital is centrally located in the town of Abbeyleix which is close to the centre of County Laois and in an ideal position to be utilised. As it is on HSE-owned land, there is no requirement to buy or lease land. There is very little development to be undertaken because the area is very well serviced with infrastructure. The land is ideal for the putting in place of a new or extended facility.

Population growth in Laois is faster than in any other county.

Percentage wise, it is even faster than in County Kildare which is close to the commuter belt. The population of County Laois is mushrooming, according to the latest census, and we must cater for this. In addition, we are all living longer; therefore, the number of elderly people in the county is increasing. There is a huge need for nursing home places. Private nursing homes will take low dependency patients but high dependency patients cannot be catered for in many of them. That is where the Abbeyleix unit comes in. It has always been available with an excellent staff to cater for high dependency patients whose care is costly and who need many supports and services. With the nursing home services, it also provides excellent day care services.

I have a pain in my head listening to all of the talk about primary care provision in the past 15 years. Abbeyleix hospital provides an opportunity to expand the primary care services in the town by adding chiropody, physiotherapy and GP services and so on, in which there is huge interest in the area. Seven years on, there is no plan. I met HSE officials, accompanied by representatives of the friends of the hospital committee, twice after Christmas, but there was no plan, design or cash because the upgrade had not been included in the capital plan. Promises have been made, but they have been recurring in the past seven years. The Minister of State will understand that even people like me who are optimistic by nature have become sceptical. We need to move the process on because it cannot be allowed to drag on at a snail's pace. The current capacity of the unit is 20 beds, but that needs to be increased. I am anxious to hear the Minister of State's response.

Finian McGrath (Dublin Bay North, Independent)
Link to this: Individually | In context | Oireachtas source

I apologise for the delay.

I thank the Deputy for raising this important issue which relates to Abbeyleix hospital. 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. That is what older people clearly want and only those in genuine need of residential care should go down that route. The HSE is responsible for the delivery of health and personal social services, including those in facilities such as Abbeyleix hospital.

Abbeyleix community nursing unit is registered with HIQA to provide care for 20 residents. It comprises 17 short-stay and three long-stay beds. All bedrooms are on the ground floor. In addition, a day service is provided for between 20 and 22 people from Monday to Thursday. The HSE is committed to the long-term future of the Abbeyleix facility which will continue to operate as a community hospital for the area. In that context, a meeting took place in January this year between the HSE and the friends of Abbeyleix hospital committee. At the meeting it was agreed that plans for the future development of services at Abbeyleix would be progressed in conjunction with local community interests. The HSE gave a commitment to the establishment of a project group in quarter 1 of 2018, representative of all stakeholders, to plan for future services at Abbeyleix community nursing unit. The project group has been established and its first meeting is scheduled to take place on 4 May. The HSE will also continue to meet the friends of Abbeyleix hospital committee. While the community nursing unit is not accepting long-stay residents, it is providing respite care services in County Laois and the extended area, in addition to day care, rehabilitation and meals on wheels services.

The HSE's plan for the long-term future of Abbeyleix community nursing unit is to develop a sustainable model of service which will see the unit operate as a community hospital, providing short-stay beds for step-up and step-down from Portlaoise acute hospital, as well as respite and transitional care beds for the area. Short-term 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, thus avoiding admission to acute hospital, or postponing admission to long-stay nursing home care. Both the HSE and I recognise that Abbeyleix community nursing unit is vital for the provision of community-based services that help people to stay in their homes and communities and that assist those who require admission to be discharged as early as possible from acute care back to their home environment.

Brian Stanley (Laois, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State for his reply. It is welcome that the project group has been established because we were told at the meeting I attended earlier this year that it would happen in quarter 1. This was reiterated in replies to parliamentary questions I had tabled. It is also welcome that the first meeting of the group will be held on 4 May. Which interests are represented on it? Are there people with technical expertise in the Department on it?

The community nursing unit is registered with HIQA and has a capacity of 20 patients. It had higher capacity in years gone by, but standards have changed and a huge upgrade is needed. However, there is also a need for additional places because people from the town and surrounding areas are in nursing homes in County Tipperary. The Minister of State referred to step-up and step-down facilities for those receiving acute treatment and the need for respite care. The respite care service provided by the unit is very much valued by the local community and much sought after. I receive many representations on it. Why can it not have more long-stay beds?

There is also the issue of ensuring the unit has enough staff to keep it operational. When something is being run on a 24/7 basis, a critical mass of patients is needed to maximise use of the staff and facilities. A total of 20 residents will not result in that happening. I, therefore, urge the Minister of State to think big and aim to have a capacity of 45 or 50 beds.

The friends of the hospital committee has raised a lot of money. It should not have had to do this, but it did anyway during the years and it is still active in that regard.

When is it anticipated that the project group will produce a plan? When will the plan be put out to tender? When will it get into the all-important capital programme to make sure there will be euro and cent in place? We need a plan, a timeline and funding. That is what the people of County Laois want to hear about because this has been an issue for a long time. It is welcome that we prevented the closure of the unit. I also welcome the Government's commitment to it, but we want the project group to bring forward its plan with a timeline and funding in place.

Finian McGrath (Dublin Bay North, Independent)
Link to this: Individually | In context | Oireachtas source

I thank the Deputy for raising the issue. I accept that public residential care units such as that in Abbeyleix hospital are an essential part of healthcare infrastructure. Demand for services is increasing as the population ages. The Deputy raised questions about technical expertise in the Department, the capacity of the unit and a target of 45 residents and more localised care services in the context of people receiving care in County Tipperary. He also mentioned the plan and a tender and timelines for them. I give a commitment that I will go back to the Minister and revert to the Deputy with the answers to these questions.

There is a need to develop hospital avoidance and early discharge facilities, particularly for the increasing elderly population. That is why the HSE is focused on developing a range of community services to best serve the people of Abbeyleix and surrounding areas. Such services can play a significant role in supporting older adults who are discharged from hospital with ongoing, non-acute care needs and preventing admission to hospital. I will get back to the Deputy when I contact the Minister about the issues he raised.

Brian Stanley (Laois, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State.