Dáil debates

Tuesday, 16 April 2019

Saincheisteanna Tráthúla - Topical Issue Debate

Nursing Home Accommodation Provision

6:25 pm

Photo of Martin KennyMartin Kenny (Sligo-Leitrim, Sinn Fein)
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The Alzheimer's unit at St. John’s Hospital, Sligo, which has more than 30 beds, was closed down last year and all of the patients were moved out. The reasons given for the closure at the time were that the Mental Health Commission had issues with the unit and it also needed to be refurbished. No work has been done since and there is a rumour that the building is to be turned into office space.

I ask the Minister of State to reassure the House that it will not happen at a time of significant bed capacity problems.

6:35 pm

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent)
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I thank Deputy Martin Kenny for raising this important issue. 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. That 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 wellbeing is of paramount concern. The HSE is responsible for the delivery of health and personal social services, including those at facilities such as St. John's which is a 132-bed community hospital on the outskirts of Sligo town. Services provided include rehabilitation, convalescence assessment and long-term residential care. The hospital is registered with the Health Information and Quality Authority to provide 95 beds.

As the Deputy is aware, community hospitals like St. John's are an essential part of our national infrastructure and we are determined to maintain our public stock. While the standard of care delivered to residents in these units is generally very high, we recognise that many public units are housed in buildings that are less than ideal in a modern context. Without these units, however, many older people would not have access to the care they need. On that basis we need to upgrade our public bed stock and this is the aim of the five-year capital investment programme for community nursing units which was announced in 2016. The programme provides the framework to replace, upgrade or refurbish these care facilities, as appropriate. Significant work has been undertaken to determine the optimum scheduling of projects within the phased provision of funding to achieve compliance and registration with the Health Information and Quality Authority. This programme includes St. John's hospital.

The Alzheimer's unit referred to by the Deputy is located within the grounds of St. John's hospital. Historically, the unit admitted people who suffered with dementia related illness, mental health difficulties and acquired brain injuries. The unit was registered with the Mental Health Commission under the Mental Health Act 2001. This registration has ceased and the unit has only recently being vacated. This was in line with conditions set by the commission. Residents were facilitated in a number of different facilities, including older person services and nursing homes. The unit is now under the governance of the social care division's older persons' services. The plan for the immediate use of St John's is to facilitate the capital works in the long-term care area of the hospital which will require a number of residents to transfer from their existing wards to allow for the essential upgrade works to be completed. Once these works are completed, it is proposed that a designated dementia service will be developed in the existing Alzheimer's unit.

The Deputy will appreciate that all healthcare infrastructure developments require a lead-in time to complete the various stages. These stages include appraisal, project brief, design feasibility, a review of costing estimates and finalisation of financing. The project will proceed under the capital investment programme, which is part of Project Ireland 2040. The HSE's capital plan for 2019 is currently being finalised and will be submitted to the Minister for Health for consideration and approval. This will propose the projects that can progress in 2019 and beyond, having regard to the total available capital funding. All health capital projects, currently at various stages of development, are considered as part of this process.

Photo of Martin KennyMartin Kenny (Sligo-Leitrim, Sinn Fein)
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While I appreciate that some of these facilities are old and need a great deal of work, this one was built 25 years ago. It is not an old unit but is in fact quite modern. Shortly after it was built, it was recognised that there were issues regarding in particular the toilet and shower facilities, sewerage works which had not been done properly and air quality. Nevertheless, it operated for 20 years and people lived there and were happy. It was their home. Over a year ago, however, they were moved out because it was said these works needed to be done. I understand it is a more than 30-bed unit and that very little work would put it back into service. If it was only built 25 years ago, it is not an old building that needs a great deal of work.

In his reply, the Minister of State said a feasibility study and all of that had to be done and he referred to the finalisation of financing, which is the big one. We need to see the finalisation of financing because there are huge bed pressures in the general hospital in Sligo. We are trying to get people out of the hospital. It is an issue that is always being raised. We raised it in the last few weeks in relation to trolley numbers. All of this is having knock-on effects. The absence of these beds at St. John's hospital has a knock-on effect on trolleys as it is all part of the same system. We need to see the works done as quickly as possible.

The Minister of State did not refer to the story which is going around and which appears to have legs in the view of people in Sligo. That story is that an assessment has been carried out to convert the unit to provide office space for the HSE. In the context of huge pressures on beds in facilities locally, to do that would be counterproductive and contrary to what any sensible person would want.

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent)
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I thank the Deputy again for raising this very important issue. I want to reassure him on the points raised, in particular in relation to the toilets, the 30 beds, the financing, the bed pressures and also questions about office space. The national development plan is to provide for the continuation of the programme of replacement and refurbishment of community nursing units and long-term residential care facilities for older people. The Department and the HSE are engaged in the process to finalise the capital plan for 2019. This will determine what projects can progress in 2019 and beyond having regard to the total available funding and the relative priority for each project. The HSE and I recognise absolutely the value and importance of the services provided at St. John's. That is why a refurbishment plan is in place for the hospital in compliance with HIQA. Once these essential works are complete, the HSE advises that it is proposed that a designated dementia service will be developed in the existing Alzheimer's unit. I will raise the other points and concerns the Deputy raised with the Minister, Deputy Harris.