Jack Chambers (Dublin West, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Minister of State, Deputy Catherine Byrne, is aware of St. Mary's Hospital in the Phoenix Park and the important role it plays in community healthcare across the Dublin region.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I know it well.

Jack Chambers (Dublin West, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

It provides an important discharge facility for patients of the Mater hospital, Connolly Hospital, Beaumont Hospital and other hospitals across the city. It acts as a bridge between the acute hospital system and people returning home after a stroke, people with dementia or an acute intervention in the hospital system. It helps people who are well but who need that bridge to facilitate their discharge into the community.

A combination of serious issues have arisen in recent weeks due to the cuts to home help being matched with the reduction in the number of beds. A total of 27 beds in St. Mary's Hospital have been cut. They include eight community respite beds that provide positive support for people in the community who might have dementia or a disability and 19 other beds that provide a spill-over for many of the hospitals across the Dublin region. The beds are a significant loss. The perception among staff at the hospital is that this is a cost-containment measure and another example of mismanagement on the part of the HSE of the overall budget whereby the acute hospitals absorb the majority of funding. The safety valve that exists for so many elderly people is now being removed. They will be left on trolleys in the hospital system for longer despite being medically well. What has the HSE done in terms of forward planning so that such beds are kept open? The very essence of Sláintecare and Government policy is to keep community beds open and to enhance the capacity for healthcare in the community not to undermine it. The cut is aggressive. It is a blunt instrument in terms of the approach to Sláintecare and it deserves a proper explanation. It requires a reversal of the cut or a replacement of beds because it will adversely impact on communities across Dublin.

Ruth Coppinger (Dublin West, Solidarity)
Link to this: Individually | In context | Oireachtas source

I wish to ask the Minister of State, Deputy Catherine Byrne, if this is what the Fine Gael recovery is about, that 27 medical step-down and respite beds in St. Mary's Hospital in the Phoenix Park will be closed by July. Staff have been told that will happen. Essentially, the reason is cost containment, in other words, cutbacks.

As Deputy Jack Chambers outlined, the patients who are catered for in the facility are from many hospitals, which will also be affected by the closure, for example, Connolly Hospital, the Mater hospital, and patients in need of emergency admission for social or other reasons. A significant number of patients are admitted for blood transfusions, treatment for infections, dementia, wounds, malnutrition and rehabilitation. In the absence of those beds, patients will have to remain in accident and emergency departments, adding to the acute crisis in them, and waiting on trolleys.

One member of staff who contacted me about the proposed closure of the unit, because they were so concerned, said they had no doubt some patients would die waiting for care. The effect on patients is obvious, but there will also be an effect on staff. We have just witnessed a major strike by nurses and midwives who were told that their conditions were of concern to the Government and the situation at St. Mary's Hospital will add to their demoralisation. When one combines this with the cuts to the home care package, people see it as a stark contrast to the overspends we hear about every week at the national children's hospital. In the past the Minister argued that bed closures were necessary, even though that was never the case. The top 300 in this country have €87 billion in wealth between them. It has increased 10% on last year. Meanwhile, ordinary, elderly patients are suffering this kind of humiliation in hospitals.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Unfortunately, the Minister of State, Deputy Jim Daly, who has responsibility for mental health and older people, cannot be here so I am taking this matter on behalf of him. I thank Deputies Jack Chambers and Coppinger for raising the issue.

Social care services, including home care, daycare and short-stay residential care are all important components in enabling people to remain living at home and participating in their own communities. They also provide valuable supports to carers. The Government is committed to supporting people to live in dignity and independence in their own homes and communities for as long as possible.

Where that is not feasible, the health service supports access to long-term residential care, where 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 meets the needs of individual clients, but also reduces pressures elsewhere on the wider health system such as acute hospitals or on long-term residential care.

Public nursing units provide 5,000 long-stay residential care beds nationally. There are also approximately 2,000 short-stay community public beds providing a combination of step-up and step-down care, intermediate care, rehabilitation and respite care. 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 or postponing admission to long-stay residential care.

The Health Service Executive has operational responsibility for the delivery of health and social services, including those at facilities such as St. Mary's Hospital in the Phoenix Park. The hospital provides 150 long-term residential beds, located across two modern, purpose-built units, and registered with the Health Information and Quality Authority, HIQA. That is the maximum number allowable under HIQA registration conditions.

The hospital also has 75 sub-acute beds or short-stay beds, located separately in the main hospital building, dating from the 18th century. They include ten specialist stroke rehabilitation beds, 22 rehabilitation beds to support step-down from acute hospital, 20 transitional care, eight respite and 15 community response beds.

Following a recent health and safety assessment, issues have arisen regarding flooring and electrical works in one of the wards. To comply with legislative requirements, and in the best interests of patients and safety, the HSE needs to close the ward on a phased basis with effect from I July 2019. There will be some reduction in access to transitional care beds from acute settings, however, all patients will remain in the hospital until their current care is completed. The Department has also been assured that all commitments for booked respite care will be honoured and plans are being put in place to that effect. Staff were advised of this decision through their line management structure and they will be reassigned within the hospital.

The HSE has advised the Department that significant capital is required to address the health and safety issues and the HSE is developing a capital project plan to address the risks identified in this old building. The HSE has a clear responsibility to deliver services ensuring that the highest standard of care continues to be provided to all patients in a safe and secure environment.

The primary focus must be on the patient. Engagement with patients, their families, staff, union representatives and other relevant stakeholders is ongoing to ensure there is minimal impact on all concerned during the closure of the ward.

Jack Chambers (Dublin West, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Minister of State's words are the opposite of the reality. She stated that she will enable people to live at home and that she is committed to supporting people living in dignity and independence. These cuts are the opposite of that. The Government continues to do that, despite a €17 billion budget. The perception among the staff is that the health and safety report suited the cutting agenda when it came to community care beds. There is a reduction in the number of transitional care beds and that is a shocking development in community healthcare across the Dublin region at a time when we are aware of the level of demand and the necessity to facilitate discharges.

It was not last week, when the announcement was made, that the HSE first discovered that this is an 18th century building. Where was the forward planning unit? It knew that any 18th century building would give rise to health and safety concerns, but the HSE has allowed the building to fall into its current state and is using that as a means to facilitate the cutting agenda because it cannot manage its budget. Again, that is poor planning and evidence of a rudderless health policy. Sláintecare is further away than ever, particularly as St. Mary's is what Sláintecare means to the local community in west Dublin.

Ruth Coppinger (Dublin West, Solidarity)
Link to this: Individually | In context | Oireachtas source

With a sleight of hand, the Minister of State has tried to give the impression that the patients will be released on a phased basis. However, that will be the end of the ward. The Department is not even going to try to refurbish it if safety is really its concern. The staff member who alerted us to this is very experienced and has worked at St. Mary's for several years. As long as she has been there, the staff have heard about this safety issue, but they were told there was no money to refurbish. Now there is plenty of money. It was pointed out that there is no need for any patient to lose a bed or for patients not to be catered for because there are empty wards throughout the hospital. With very little work people could be put into them. However, the Minister for Health has decided that these 27 beds will be phased out or closed down. There has been no mention of refurbishment or updating them. Some 300 people are catered for in this unit. That 300 will have an impact on other hospitals. One of the fears is that they will no longer be able to have the transfusions carried out in the Mater Hospital and that the hospital will lose the link with the Mater Hospital, which will impact on the small hospital overall.

The Minister of State, Deputy Jim Daly, was mentioned. It is a pity he is not present. He is probably off getting his picture taken at one of these facilities, as I have seen him do in Clonakilty and other places. However, the current residents in the Phoenix Park will not be able to stay there.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

There have been no cutbacks to home help services. I work daily in my community seeking home help services and I and the people I represent have never been turned down so I do not know where that is coming from.

Ruth Coppinger (Dublin West, Solidarity)
Link to this: Individually | In context | Oireachtas source

It is from September.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I am very familiar with St. Mary's Hospital because members of my family stayed there in the past for long-term respite care. We can all agree that the quality of care for patients comes first. All patients should receive the same high standard of quality assured care. The decision to close the ward was based solely on health and safety concerns. I cannot emphasise that enough. It was not taken lightly and was not taken as a cost saving measure. The measures were taken to promote and protect service users' safety. That is very important.

The ward is in an old part of the hospital and significant capital development is required to address the risks identified. The HSE has confirmed that a capital development project plan will be drawn up as part of the normal capital planning process in order to address the issues and recommence services at this location. The HSE has assured the Department that engagement with patients, their families, staff, union representatives and other relevant stakeholders is ongoing in order to ensure that minimal impact on all concerned is achieved during the closure of the ward. The HSE confirms that staff will be reassigned within the hospital and all commitments made in respect of further respite care will be honoured. I do not know how more clearly the two Deputies wish me to put it.

Ruth Coppinger (Dublin West, Solidarity)
Link to this: Individually | In context | Oireachtas source

The ward is being closed.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

This is a health and safety issue and the ward is being closed for that reason. It is not a cost cutting matter.

Ruth Coppinger (Dublin West, Solidarity)
Link to this: Individually | In context | Oireachtas source

It will not be reopened.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

It is clear that the Deputies need to reflect on some the words that have been said. I am not responsible for the reply I have given, but I stand over it wholeheartedly. I know people who are being cared for in St. Mary's Hospital and the quality of care is exceptional.

Ruth Coppinger (Dublin West, Solidarity)
Link to this: Individually | In context | Oireachtas source

Why not reopen the ward?