Wednesday, 13 March 2019
Saincheisteanna Tráthúla - Topical Issue Debate
Respite Care Services Provision
I welcome the opportunity to speak on this issue and thank the Minster of State for taking it. I raise the threat of closure, which is hanging over Midleton Community Hospital respite unit and which is causing fear. One of my party's local councillors has been working on this and I will quote from a recent article on the subject:
Concerns have been heightened an elderly care unit in east Cork will be closed for good.
The respite unit in Midleton was closed last December by the Health Information and Quality Authority, HIQA, over fire and safety concerns at the community hospital.
The health watch dog found the internal doors were too narrow at the former 19th century workhouse.
The community facility that currently caters for 53 elderly was required to widen the entrance door to the respite unit for clients with walking aids and the wheelchair bound.
The article continued that the work was carried out soon after, but a follow-up inspection required additional double doors fitted in order to access the lift.
In a statement to theEast Cork Journalthe Health Service Executive said that it was committed to reopening the beds at Midleton Community Hospital as soon as possible and that it hoped to do so within a matter of weeks. While the HSE said the closure of the unit was a temporary measure, Sinn Féin Councillor Danielle Twomey said health officials fear HIQA will not allow the eight bed ward to reopen. She said uncertainty is part of the problem, fearing HIQA does not understand the devastating effect a permanent closure of the unit would have. The unit has given carers much-needed breaks from caring and elderly to socialise, which has been lost since December. Closing the short break unit permanently would pile even more pressure on already stressed cares of the elderly.
This relates to 53 elderly patients but there is also a knock-on effect on their families. This is a vital service. The Committee on Future of Mental Health Care discussed how we must keep families in their local areas and support local services for local people as did the Sláintecare report. I seek clarity on this as sometimes the left hand does not know what the right hand is doing. This is a fabulous community-based service which does great work and whose benefits to the elderly are incalculable. It is unimaginable that it might close over a couple of technicalities. It would devastate Midleton and the surrounding east Cork area.
In 2017 I tabled a parliamentary question for response by the Minister for Health, Deputy Harris. Under the residential care centres capital plan for 2016-2021, it was proposed to spend €10.3 million on a 50-bed community nursing unit within the grounds of Midleton Community Hospital, which was to be completed by 2021. I have seen no progress on this. I am worried about HIQA shutting down a centre that caters for 53 patients. It is necessary for that centre to remain open. On the other hand, the HSE and the Minister for Health have said they think it is appropriate to invest over €10 million in the same area for a 50-bed unit. I cannot understand what is being lost. I seek clarity and assurance for the people and service users in Midleton Community Hospital and the wider area generally that the unit will not close and that in coming years, we will see the new 50-bed community unit.
The Government’s core stated objective is to promote care in the community so that people can continue to live with confidence, security and dignity in their own homes and communities for as long as possible. This is clearly what older people and everybody in this House wants. We also have patients who are in genuine need of residential care either on a long-stay or short-stay basis and their safety and well-being is of paramount concern.
Residential care is provided through a mix of public, voluntary and private provision. It is worth highlighting that the budget for long-term residential care in 2019 is €985 million and over 23,000 clients on average at any one time will be in receipt of financial support.
Midleton Community Hospital is a 53-bed facility predominantly for the care of older persons. The current bed profile is 45 beds for continuing care, one for chronic young sick, five respite beds and two for community support. The hospital, which has access to a visiting consultant, provides 24-hour nursing care through a team of doctors, managers, staff nurses, multi-task attendants and other staff members.
As the Deputy is aware, community hospitals like Midleton are an essential part of our national infrastructure and we are determined to maintain our public stock. However, many public units are housed in buildings that are less than ideal in the modem context. It is important to note that, notwithstanding this, the care delivered to residents is generally of a very high standard. Without these units, many older people would not have access to the care that they need. On that basis, we need to upgrade our public bed stock and this is the aim of the capital investment programme for community nursing units. This programme includes a number of facilities in Cork, including Midleton Community Hospital.
Pending the building of the new facility in Midleton, we have to ensure that the highest standards of care are provided to all current residents in a safe and secure environment. On that basis, important upgrade works at the hospital are underway. These will be completed in a number of weeks. Once completed, the seven beds in St. Mary’s ward which unfortunately had to be temporarily closed will be reopened.
The HSE recognises the value and importance of respite care, and sincerely regrets that these beds had to be temporarily closed. However, there was no other way to undertake these important upgrade and fire renovation works.
As well as essential fire upgrade works, some improvements are being made at the hospital, including a new shower room, better storage facilities and an upgrade to a ward kitchenette. These works will be of huge benefit to residents and will enhance privacy and dignity for them.
Management at the hospital worked with public health nursing staff, who co-ordinate respite admissions to Midleton. I understand that every effort was made to keep families informed, to provide alternative arrangements where possible or to reschedule the admission dates for respite. Some clients have been facilitated in Youghal Community Hospital and others have been facilitated in nursing homes in the Midleton and Cork city areas.
The HSE has advised that it is committed to reopening the beds as soon as possible, and it is expected that this will be done in a matter of weeks.
I am delighted with the Minister of State's reply. It will give the people of Midleton and the surrounding east Cork area some solace that there is a full commitment to the unit. I also welcome what he said about the pending building facilities. The Minister of State said that some of the clients were facilitated in Youghal Community Hospital. The capital projects plan proposes spending €2.67 million on a 32-bed refurbishment there which I look forward to seeing in place. I welcome that the first line of the Minister of State's response referred to care in the community. I thank him for his response which has clarified a great deal. There can be fear in communities when rumours start and then snowball, especially when people are already in a distressed state worrying about elderly parents or loved ones. They need clarity so I thank the Minister of State for his response.
It is always good to have the opportunity to clarify matters where there concerns have been raised in a community. That is one of our responsibilities as public representatives. I visited Midleton Hospital some time ago with my colleague, the Minister of State, Deputy Stanton. It is a wonderful facility which is exceptionally well regarded by the local community. Its respite service is of equal importance to the families who depend on it as those who are staying there long term. The Minister of State, Deputy Stanton, keeps pressure on me to update him regularly on the future development of the project. A project advisory team and a technical advisory team have been appointed for the hospital's redevelopment at the site at the back of the hospital.
Indeed, my good friend and colleague, who I am sure was a former colleague of Deputy Buckley, Councillor Noel Collins, whom I sat alongside for many a happy day in County Hall in Cork when I was on the local authority, writes to me fairly often about Midleton community hospital as well to ensure that its future is secure. I am glad to be able to confirm all of that for the good people of Midleton who Deputy Buckley, the Minister of State, Deputy Stanton, and Councillor Collins have the honour to represent.