Dara Calleary (Mayo, Fianna Fail)
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I thank the Ceann Comhairle's office for allowing me to raise this issue. I thank the Minister of State, Deputy Jim Daly, for being in the Chamber and for his engagement on this issue over the past week. As the Minister of State is aware, on 31 May last, which was the Friday of the June bank holiday weekend, temporary and agency staff who are currently employed at Belmullet District Hospital were notified by text message that their contracts would not be renewed when they expired. Three of the contracts in question were due to expire within two weeks of that date. Some of these staff have been working in Belmullet for many years. Many of them have been based there for more than two years. They started off as agency staff before being given temporary HSE contracts. Some of them were recruited earlier this year because of the level of demand for services at Belmullet District Hospital. That very fact gives the lie to the claim by senior HSE management that this facility is overstaffed.

All of the staff at Belmullet District Hospital and the adjoining Áras Deirbhle centre have given selfless service over the years. They have put patients and their families first. Since Belmullet District Hospital and Áras Deirbhle opened, they have had a tradition of putting patients' interests first. The care and attention provided at these centres is respected and supported within the community, as shown by the attendance of hundreds of people at a public meeting on Monday night that was organised by our colleague, Senator Conway-Walsh, to show support for the staff in question. Since 31 May, the temporary staff have been told they will be redeployed within the HSE network, but that is not very simple. As Belmullet and Erris are quite far away from other HSE facilities, such as Ballina District Hospital, St. Fionnan's unit in Achill and the McBride unit in Westport, some staff may face 100-mile round-trips to do their jobs at such locations. Staff who are not particularly well paid cannot be asked to take on additional fuel costs. What if staff members do not have access to transport? As the Minister of State knows, public transport is not an option in rural areas. The agency staff continue to be in limbo despite the service, care and attention they have given. They do not know where they will stand in terms of their employment prospects this time next week.

When I challenged HSE management on the impact of these staff reductions on bed numbers, they said the situation is under review. They also said the current number of beds is sufficient, but that is not true. Any analysis will show that the demand for beds in Belmullet is bigger than the number of beds currently being used. GPs do not have the right to access Belmullet District Hospital. Last weekend, this resulted in a patient having to be admitted into an acute bed at Mayo University Hospital even though four beds were available in Belmullet. That is happening all the time. One of the things being cited by HSE management is that the overrun of approximately €5 million in older people's services has to be paid for. Why are the people of Belmullet and Erris having to pay for that? What is the overrun in the acute bed budget because of the inability to use community hospitals like Belmullet District Hospital to their maximum potential? Respite beds are not being made available in Belmullet even though funds were raised for those beds locally. This was done with care and attention by families that want to use respite.

I would like to emphasise the geography of this issue. Those who want to avail of respite services will not want their loved ones to be two or three hours away from them. They will want respite in the community. The concept and the model here involves care in the community. Asking people to go so far away for basic care cannot be allowed. There is a great deal of potential in this complex. Physiotherapy is not being provided. X-ray services are erratic. The staff have established a committee from Belmullet District Hospital and Áras Deirbhle with a local action committee and local representatives, including myself; the Minister, Deputy Ring; Senators Conway-Walsh and Swanick; and local GPs. We want to work with the Minister of State on a plan for the development of the facilities in the locality.

4 o’clock

The Minister of State has committed to visiting the hospital, but when is that going to happen? Will the Minister give a commitment about the working conditions of the affected staff at Belmullet hospital, who do not know where they are going to be working next? Will he ask the HSE to freeze any changes until the Minister of State has the chance to visit the unit? Will he ask HSE management to engage with us properly in developing Belmullet Community Hospital?

Jim Daly (Cork South West, Fine Gael)
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I thank Deputy Calleary for his acknowledgement of our previous engagement, which also included the Minister for Rural and Community Development, Deputy Ring, Senator Swanick, and Councillor Gerry Coyle, who, like all representatives in the area, is very animated about this issue. I thank the Deputy for raising the issue. It provides me with an opportunity to update the House on this matter.

Social care services, including home care, day care, and short stay residential care, are all important components in enabling people to remain living at home and participating in their communities. They also provide valuable supports to carers. This Government is committed to supporting people to live in dignity and independence in their homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care where this is appropriate, and we will continue to develop and improve health services in all regions of the country to ensure quality and patient safety.

There is an obvious need to provide high-quality and flexible services that not only best meet the needs of individual clients but also reduce pressures elsewhere on the wider health system, such as acute hospitals or on long-term residential care. As of 30 April 2019, there were a total of 1,943 short stay public beds, which include step-up care, step-down care, intermediate care, rehab and respite care, which are used in a flexible manner to meet local needs at any given time. The Health Service Executive has operational responsibility for the delivery of health and social services, including those at facilities such as Belmullet Community Hospital. The district hospital in Belmullet and Áras Deirbhle, Belmullet provide, and will continue to provide, very important services to the people of north Mayo. I am advised that the HSE has been examining a number of measures which are aimed at bringing its expenditure on health services for older people across Community Healthcare West back into line with their allocated budget.

As part of this process the HSE has been examining the usage of beds in Belmullet Community Hospital and has established that, on average, just 12 short-stay beds are in use at any given time to support acute discharges. This is significantly fewer than the number of beds that it is currently staffing. For this reason, the HSE has notified a number of agency staff that their services will no longer be required. The HSE head of social care services in community healthcare organisation, CHO, 2 has informed the Department that when the contracts of employment for three temporary staff in Belmullet come to an end in the coming weeks, they will be offered redeployment opportunities in other community nursing units. The HSE has a clear responsibility to deliver services within allocated budgets while ensuring that the highest standard of care continues to be provided to all patients in a safe and secure environment. This includes any decision on prioritising resources and the impact any decision has on the integrity of the services provided.

The primary focus has to be on patients. Quality care and patient safety come first, and all patients should receive the same high standard of quality-assured care. It is essential to ensure that resources are appropriately channelled and that the changing needs of older people are adequately addressed. In light of the important role played by the district hospital and Áras Deirbhle in the delivery of care, the HSE will keep the situation under review over the summer months and will reconsider the position during the autumn in preparation for the busier winter period.

Dara Calleary (Mayo, Fianna Fail)
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There is great concern over the figure of 12 beds as that is not the reality at the hospital. The HSE has stated to me that there are 18 support acute discharge beds and two additional short-stay beds in the hospital. There is demand for more beds, and if GPs were allowed to admit patients, there would be further demand. I gave the Minister the example where, with four beds free in the hospital, somebody was forced to travel to Castlebar.

The staff are going to be redeployed many miles away and will not get any recognition or compensation for that. There is also the question of the development of facilities. The Minister has a policy paper relating to community and district hospitals. We often refer to Belmullet as a step-down facility for Mayo University Hospital, but we need to step up the services on offer, which would take the pressure off Mayo University Hospital which has been under inordinate pressure along with the regional hospital in Galway for the past 12 to 18 months. If we are to take the pressure off the two central hospitals, we will have to use Belmullet, Ballina and Swinford to their potential instead of cutting Peter to pay Paul. The HSE is spending extra money on acute beds when there are beds empty in Belmullet.

Will the Minister of State challenge HSE management on the figure it gave of 12 beds, because it gave us a figure of 20? Will the Minister be visiting the hospital? If so, when will he do so? I ask the Minister of State to walk in the shoes of the staff who are affected, who have given extraordinary service only to find out by text message on a Friday of a bank holiday weekend that their jobs are about to go. The agency staff are still in complete limbo and those on temporary contracts are going to be forced to travel 40 or 50 miles a day to work. That is completely unfair to people who give everything to their job.

Jim Daly (Cork South West, Fine Gael)
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I have asked Tony Canavan to provide me with an accurate list of bed occupancy for the two facilities, Áras Deirbhle and Belmullet Community Hospital, in the past 12 months and I expect to have that shortly. I will be happy to discuss the reply with Members to get to the bottom of it. There are two sides to this story and I do not want to play judge and jury but I want to have all the facts in my possession.

The Minister for Rural and Community Development, Deputy Ring, has invited me to go to the hospital and I am happy to do that. My ambition is to get up there before the end of the month, or on 1 July or 2 July at the latest. I will meet patients and their families, who are the most important people there. I will meet public representatives and will hear the views of staff. I assure the Deputy that there is no question of downgrading services and no question about the future of this facility, which is playing a vital role in the provision of services for the elderly. It is in a very remote rural area and I am very familiar with such areas. There is a need for facilities to stand alone and I guarantee that, as long as I am Minister of State, I will not oversee the downgrading of any facility for older people, and that includes Belmullet. However, I also have to support the HSE in any measures it takes to bring about efficiencies and ensure there is no waste. If the HSE tells me that beds that are staffed are lying idle, I would not support that either. I will not put the needs of staff above that by supporting empty beds with staff alongside them. I am told that is the situation but I want to see it for myself.

I accept that we need to upgrade the use of the facility so that it can take pressure off the acute facilities, and if we have to put more people in there, I will work with the Deputy to achieve that. However, I will not stand over empty beds, as it were. I have given my colleague, the Minister for Rural and Community Development, Deputy Ring, a cast-iron assurance that there will be no downgrading of services and I give a similar assurance to Deputy Calleary. I will work with the Deputy to utilise this wonderful facility to its maximum in the future.