Pat Buckley (Cork East, Sinn Fein)
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I raise two alarming issues in my constituency of Cork East. They concern Cobh Community Hospital and Castlemartyr Health Centre. On 27 August members of the Irish Nurses and Midwives Organisation, INMO, contacted me to inform me that the hospital was in dire need of additional funding and that its budget would run out in five weeks. That was six weeks ago today. I have been in contact with the office of the Minister for Health, but the only update I have received since is that the hospital is financially viable. However, there are no guarantees about this. The INMO has contacted me again because it is very worried. We have spoken here many times about primary care services and investing in local services. We are talking about a 44-bed residential unit. If it were to close, it would be devastating for service users, their families and everyone else, including the staff. There are an additional 15 staff employed.

The hospital is community owned by a trust. I have been told that the HSE has been chipping away at it and reducing funding year in, year out and that it is starting to struggle. Only a few weeks ago Liverpool Football Club and Cobh Ramblers played a game in Cobh. All of the moneys raised went to the community hospital. We have often said investing in the community and taking ownership is the best model of care. What is the position at Cobh Community Hospital? If it does close, where will all of the residents go?

We were told some weeks ago that Castlemartyr Health Centre would also close. Youghal is on the edge of the Cork East constituency. The centre covers Youghal, Killeagh, Castlemartyr, Midleton and Carrigtwohill. I was told two weeks ago that it would be relocated to Midleton, which is six miles away. I have now been informed that it will be relocated to Carrigtwohill. A centre that is working well will be closed and everything moved. It will involve a 30 km round trip. Most of the people affected are elderly and disabled and do not drive. I have tabled several parliamentary questions to a number of Departments, including the Department of Transport, Tourism and Sport because there is also a problem with public transport services on the Waterford-Cork route. A person would be very lucky to get on the service in Killeagh. Patients who need to attend the health centre in Castlemartyr may not get on the bus in Youghal.

There was a €300,000 fund and planning permission was granted for an extension to the centre and other associated works such as the provision of wheelchair ramps.

Now we have learned that somebody within the HSE has made the decision not to do it. I also asked whether more public health nurses will be assigned to cover the area, which is a large one. In Youghal, one cannot reach a doctor after 6 p.m. If one needsto access SouthDoc, one needs to travel to Fermoy or Midleton, and the primary care centres will soon be closed. All of east Cork, from Youghal to Castlemartyr, will be left with nothing. Why does the HSE not invest in primary care and care for those who need it most?

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Buckley for raising this important issue, which I will take on behalf of the Minister of State, Deputy Daly.

The Government's core stated objective is to promote care in the community in order that people can continue to live with confidence, security and dignity in their homes and communities for as long as possible, which is what older people and all Deputies want. There are patients in genuine need of residential care, whether on a long-stay or short-stay basis, and their safety and well-being is of paramount concern.

The nursing homes support scheme, NHSS, provides financial support for those in need of long-term nursing home care. Participants in the scheme contribute to the cost of their care according to their means, while the State pays the balance of the cost. The scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings. Residential care is provided through a mix of public, voluntary and private provision. The budget for the NHSS in 2019 is €985 million and more than 23,000 clients on average at any one time will access long-term residential care through the scheme.

Cobh Community Hospital is an independent facility providing residential care services for older people in Cobh and the surrounding area. The majority of the funding for Cobh Community Hospital comes under the NHSS for long-term residential care. The hospital also provides other services to older people in Cobh and the surrounding communities, including short-stay and respite care. Some 44 beds in Cobh Community Hospital provide long-term residential care for up to 41 people and short-stay respite care to a further three people. The HSE, through Cork Kerry Community Healthcare, provides funding for the short-stay beds, as well as funding for some of the long-term residential care beds.

The voluntary and not-for-profit sector has a long tradition of providing care to older people in Ireland through nursing homes such as Cobh Community Hospital. This provision of care complements that delivered directly by the HSE and ensures that older people in our communities have a greater choice of long-term residential care, allowing them to stay closer to their communities, should they so choose. The HSE has engaged with the hospital board in respect of funding and the future provision of care in the hospital, and is continuing to provide support to the board on the issue. Based on its engagement with the Cobh Community Hospital board, the HSE is confident the facility is financially viable. The Minister of State, Deputy Daly, has engaged with the senior management of the HSE on the matter and is confident a resolution can be found. He acknowledges the significant role of private and voluntary providers in residential care provision and hopes the engagement between the HSE and the Cobh Community Hospital board will ensure the continued financial viability of the hospital.

I do not have a response to the question on the Castlemartyr community health centre but I will follow up on the matter. I will raise the Deputy's concerns with the Minister of State, Deputy Daly, and revert to the Deputy with details.

Pat Buckley (Cork East, Sinn Fein)
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I thank the Minister of State for his response and acknowledge he is speaking on behalf of the Minister of State, Deputy Daly.

The Minister of State began: "The Government's core stated objective is to promote care in the community in order that people can continue to live with confidence, security and dignity in their homes and communities for as long as possible." If he was to cut the sentence that followed and insert his own, he might say: "There is a possibility we will close a 44-bed unit in Cobh and remove a community care service from the community in Castlemartyr that services Ballycotton, Cloyne, Castlemartyr, Ladysbridge, Garryvoe, Killeagh, Inch and Youghal." One could go on and on because it is a large demographic area. The response was a pure contradiction. I do not mean that as an attack on the Minister of State but rather wish to put it on the record. If the decision is supposed to promote "confidence, security and dignity" in communities, it is a farce.

The Minister of State mentioned the NHSS and stated: "Participants in the scheme contribute to the cost of their care according to their means, while the State pays the balance of the cost." It is great that the State pays the balance of the cost but it is not State money; it is taxpayers' money. The Minister of State described it as Government funding but it is taxpayers' money. The people pay for their own care. Let us try to keep the discussion clean and factual.

I welcome the engagement with the HSE and the hospital board, and I hope it grows. I heard that the hospital was financially viable but my worry is that is like saying one can cash the thanks inside in the bank; but what bank does one use to cash the thanks? If there is not a good guarantee, there will be serious consequences.

I tabled a number of parliamentary questions to the Minister of State, Deputy Daly, on 12 September. While I understand the position of the Minister of State, Deputy Finian McGrath, I am disappointed with the HSE and whoever is responsible for having kept the matter quiet and closing the vital service in Castlemartyr, east County Cork. It affects everybody all the way to Cobh. We have spoken about primary care and community care but we should invest in a primary care centre in Youghal while keeping those in Castlemartyr, Midleton, Cobh and Carrigtwohill.

Finian McGrath (Dublin Bay North, Independent)
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I agree with the Deputy about the great contribution of Cobh Community Hospital and its staff, and acknowledge the service they provide to the community. I accept they provide a range of services for older people in the community and the surrounding areas.

I return to the core issue of the debate. The Government's core stated objective is to promote care in the community in order that people can continue to live with confidence, security and dignity in their homes and communities for as long as possible, which is what older people and all Deputies want. There are patients in genuine need of residential care, whether on a long-stay or short-stay basis, and their safety and well-being is of paramount concern. The HSE fully acknowledges, as do I, that the community hospital provides and will continue to provide important services to the people of Cobh and the surrounding communities. Furthermore, the Minister of State, Deputy Daly, has engaged with the senior management of the HSE on the matter and is confident a resolution can be found. I am optimistic about him doing so.

I trust that the Deputy will agree we need to ensure that the highest standard of care will continue to be provided for residents in a safe and secure environment, while providing high quality and safe care will always remain at the heart of any considerations. I accept all the Deputy's concerns about Castlemartyr and will convey them to the Minister of State, Deputy Daly.

On a lighter note, I commend what the Deputy stated about Cobh Ramblers, an excellent club of which I am well aware, for its contribution to the hospital following a game. On what was probably a sadder note for the Deputy, my local club, Shelbourne FC, recently signed two players from Cobh Ramblers and thanks to them, managed to win the first division league.

Pat Gallagher (Donegal, Fianna Fail)
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That information about sport was very important.