Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

I welcome the Minister of State at the Department of Health, Deputy Butler. She may need to take bed and breakfast in this place, given how much time she spends in the Chamber.

Brian Stanley (Laois-Offaly, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I welcome the opportunity to raise this important issue. Day care services at the Abbeyleix community nursing unit, which were attended more than 100 people, have been closed. The hospital has ceased services to allow for its refurbishment and day care services were being housed in a part of the hospital that was being used for storage, but I am told it is not going to reopen. This has left a huge area of east and south County Laois without services, in areas such as Timahoe, Swan, Ballinakill, Durrow, Rathdowney, Borris-in-Ossory and, of course, Abbeyleix itself, as well as all the areas surrounding that. Abbeyleix hospital offered an excellent service. It also provided services for inpatients in the nursing unit, such as chiropody and physiotherapy, along with social activities, which are very important.

It is puzzling that Portlaoise day care centre is closed for refurbishment at the same time, and I do not see activity around it, or at least there was not up to one week ago. The doors just closed. I am not arguing against refurbishment or any investment in facilities such as this but we need to find out why HSE management takes these decisions. Mountmellick day care centre, too, is closed for refurbishment and extension, meaning the entire county has been left without day care services. Laois has no day care services and that is not acceptable. What kind of decision-making is this? Of course, we need to upgrade and invest in facilities and that is all overdue, but we should not close the whole lot to do that.

The importance of day care centres to the elderly cannot be stressed enough. I acknowledge Deputy Butler, as Minister of State with responsibility for older people issues, has a particular interest in this area and she is focused on the issue. They are vital for people, not least those who live alone in rural areas. We should try to support the elderly. There has been something of a change in thinking about this. Throughout the 2000s and the recession that ensued, people were inclined to say nursing homes were the first option. In fact, the first option should be to try to sustain people in their own homes. That is more cost effective, it is what they want and it will be far more satisfactory if we can do that. Those one or two days a week in the day care centre are vital, as families and elderly people tell both me and the Minister of State all the time.

Elderly people may feel they do not have a voice, so I convey to the Minister of State the feelings that have been expressed to me by many families and elderly people throughout the county. We have been left with no day care services. We are now out of Covid, and the Minister of State can imagine how important that one outing a week was, so we should try to provide for it. It is a part of the service, along with home care in some cases, that is needed to keep people in their own homes. Abbeyleix hospital needs to reopen, as do the centres in Portlaoise and Mountmellick, although I ask the Minister of State to focus on the one in Abbeyleix in her response.

Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Deputy is quite right; day care centres are very important. A focus I have had since September last has been on trying to get as many day care centres open as possible, and I have an update for him.

It is a key priority for me to allow more people to engage in services that allow them to remain independent and live in their own homes with dignity. The HSE has operational responsibility for planning, managing and delivering health, personal and social services, including day care centres. These services are fundamental to the health and well-being of our older population. Access to these centres can play a key role in enabling older people to live independently in their communities, as the Deputy noted. They provide invaluable support, advice and social interaction for older people, who may be experiencing isolation and loneliness for any number of reasons.

It remains my priority to ensure day care centres reopen as quickly and safely as possible following the necessary closures in 2020 in response to Covid-19. The process for reopening day care centres commenced in 2021 and the HSE continues to work actively on the reopening for older people as a priority. At the end of December, 237 centres for older people, or 73% of the total, had reopened and it is planned that a further 66 will open in 2022.

As the Deputy pointed out, Abbeyleix day care service has been closed since March 2020 due to Covid-19. Older person services in Laois are working closely with HSE estates to identify alternative suitable accommodation for the service to resume. The Deputy will be aware renovation works are under way to improve the residential services at the hospital. To facilitate work, these services were relocated to the part of the building where day services had previously been provided. These works, which were required from the perspective of infection prevention and control, public health and HIQA in light of the pandemic, are expected to be completed by quarter 1 of 2022. On completion, the residential service will be transferred to its original location on the ground floor. Portlaoise hospital proposes to have 18 intermediate care beds available as part its winter planning once this part of the building has been vacated by older person services. This is the area of the hospital where the day service was based.

As an interim solution, people who attended the day service in Abbeyleix hospital will be offered a place in line with infection prevention and control and public health advice at the day service on the Timahoe Road when it reopens following necessary renovation works. These renovations are also expected to be completed in quarter 1 of 2022. The HSE has confirmed to the Department that it is actively sourcing an alternative suitable building to provide a day service in Abbeyleix and the environs of Mountrath and Timahoe. The suitability of the options put forward will be considered by older person services as an alternative day service location for the people who previously attended Abbeyleix hospital. This is currently at the early stages of planning. The HSE has reassured the Department that the staff of the community nursing unit continue to liaise with people who previously attended the service on an ongoing basis.

Brian Stanley (Laois-Offaly, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State for the reply and agree wholeheartedly with much of what she stated. She set out the case in detail. Even so, when the HSE closes the door, it can be difficult to get it reopened, as the Ceann Comhairle will be aware. It closed the door of the day care centre in Monasterevin in 2014 and that has not reopened.

I have raised concerns, and I am sure the Ceann Comhairle and other Deputies from his constituency have too, about the issue of relocation. There is a site at the hospital and, where possible, there should be support to keep the service on site. HSE estates needs to re-examine this and try to keep the service on the same site as the nursing unit, as it is now called, or the "hospital", as it is referred to locally, given there are integrated services on the site. A building is being sourced and the HSE will probably end up leasing or purchasing a site. It may be a more cost-effective option to locate the service on site and that should be explored.

The Minister of State mentioned that in December, 73% of centres for older people were open, but zero per cent are open in County Laois. That is the point I am trying to get across. This is a serious situation. Portlaoise hospital is already oversubscribed, as I understand, without the tranche of patients from Abbeyleix hospital, given it is not being extended but rather only refurbished. Similarly, the Mountmellick service covers a huge area, into the Slieve Bloom Mountains, up to Clonaslee and that area. That, too, needs to be reopened.

I ask the Minister of State to take up the issue of these three locations with the HSE. When HSE estates indicates something is at an early stage, that sets alarm bells ringing for me. It needs to be pushed on. I acknowledge the point about day-to-day operational responsibility for planning and managing, as the Minister of State set out, but sometimes the HSE needs a push from a Minister’s office to get it moving.

It is not acceptable that a whole county is left without day care services.

Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I assure the Deputy I will keep a very close eye on this. As I said, we have 73%, or 237, of day care centres open. Where the challenges arose was in any day care centre that was part of or adjacent to a community hospital, that is, in the community nursing units, and this has happened all over. I will give an example. Even though most of the restrictions were lifted last Friday, there is still quarantine in nursing homes. There are 575 nursing homes in the country and 213 of them have a current outbreak. As I stand here today, 1,000 staff in nursing homes are out due to Covid-related illness.

I chaired an inter-agency meeting last week on nursing homes and community hospitals with the HSE, the Department of Health, HIQA and public health. The number of cases in community nursing units and hospitals seems to be running about two to three weeks behind the spike of 26,000 cases just after Christmas, so we still have to take a very cautious approach.

The problem is bringing people from the community into a community hospital when there are not multiple exits and entrances or multiple dining spaces and sitting room spaces. That is where the challenges are occurring. Of the nursing homes that are not open throughout the country, the majority are located in residential centres and there are challenges with regard to infection prevention and control. I was not aware there were none open in Laois and I give the Deputy a guarantee I will keep a close eye on that. To get older people back into the communities, it is vital they have day care centres. I will liaise with the Deputy again on it.

Brian Stanley (Laois-Offaly, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

It can be taken up with HSE estates and management.

Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Yes.