Marian Harkin (Sligo-Leitrim, Independent)
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Many day centres in counties Sligo, Leitrim, Roscommon, Donegal and elsewhere have not reopened or only partially reopened since the Covid-19 pandemic. Before I go into detail as to the location of these centres, it is important to make clear why I am raising this matter. It is very simple. Day care centres are a lifeline for many older people. Above all, they provide company, a social setting and an opportunity to meet other people of a similar age in a social setting and to chat in a warm, safe and cosy space. Most day centres provide a meal and often a bit of entertainment, such as a sing-song, a few basic exercises or a game of cards. Crucially, most of them provide services like chiropody or shower facilities. It depends. They also provide people with information about their own healthcare. They also point them in the direction of other services that may help them.

I recently visited a day care centre in Ballymote, County Sligo, run by the Sligo LEADER group. It was just lovely. People were delighted to be there. They could not stop telling me how much it meant to them to have the centre for a few hours five days per week. It was a warm, welcoming and comfortable place. On the day I was there, there were musicians who I believe come regularly. Some people were brought to the centre by local bus services, while others walked and or got a lift. They got a great opportunity to have a chat about lots of different things, including with the staff. One of the things that struck me was that, for those few hours, two heated rooms of a decent size kept 20 people warm. People were delighted that their day care centre reopened. I will give a shout-out to the Sligo LEADER group and the HSE, which provided funding to make sure this happened. I asked person after person how much it meant to them because I had received various representations from people who were concerned about centres not reopening and every person was grateful to have this day care centre. I felt bad for the older people in other parts of Sligo and Leitrim, many of whom are living alone, who do not have such a centre.

I raised this matter with the Taoiseach during Leaders' Questions with specific regard to St. Patrick's Community Hospital in Carrick-on-Shannon, Arus Carolan in Mohill, the centre in Manorhamilton, which is down to two days, the Easky centre in County Sligo, those in Cliffoney and Carrigans, and the centre in Ramelton, County Donegal, about which I had a query. He said he would raise it with the Minister and, since then, I have received a response from the HSE.

St. Patrick's in Carrick-on-Shannon is a walk-in centre beside the old folks' home. Houses for older people were specifically built beside St. Patrick's so that people could be close to the day services. On any given day, 20 to 30 people might have dropped in. Sometimes people travelled by bus. Covid came and the service was closed. It never reopened. People want to know when the centre is going to reopen. In a response from the HSE, I was told that there was a number of other centres in Leitrim suitable for people and five were listed. Drumsna is 7 km away, Ballinamore is 28 km, Drumkeeran is 29 km, Carrigallen is 36 km and Ballinagleragh is 53 km away. Whoever sent me that response knows nothing about County Leitrim and older people getting to care centres.

What can be done about St. Patrick's and the Easky centre in County Sligo. The centre in Easky is still running two days a week only. We are told a recruitment campaign is under way. When can we hope for these centres to full reopen?

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this issue and I welcome the opportunity to discuss day care centres because they are such an important provision for older people. There are three key points in supporting older people to live well in their own homes: home care, day care centres and meals on wheels. When the three are working in collaboration with each other, it makes an important difference to an older person's life.

As the Deputy will be aware, the HSE has operational responsibility for planning, managing and delivering health and personal social services including day centres. A wide range of core services are provided for older persons, including home support, day care, community supports in partnership with voluntary groups, such as the Sligo LEADER group the Deputy mentioned, and intermediate care as well as long-stay residential care when remaining at home is no longer feasible. These services are fundamental to the health and well-being of our older population.

Access to day centres can make an important contribution by providing, as the Deputy said, invaluable support, advice and social interaction for older people who may, for many reasons, be experiencing isolation and loneliness. Older people also benefit from increased physical activity, cognitive stimulation, enhanced nutrition, healthcare monitoring and social work support. Day centres are also an important indirect resource for carers. They play a key role in enabling older people to live independently in their own communities.

The Deputy is as passionate as I am in wanting to see the resumption of day care services following their necessary closure in 2020 in response to Covid. In 2021, a general manager within older persons' services was requested to take the lead role on the resumption of day care services for older people. A day care focus group with both HSE and cross-organisational representation was established. During the pandemic, a risk assessment of each day care centre in the country was carried out. Some were not fit for purpose as regards infection prevention and control measures. Some did not even have hot running water in the bathrooms. We took this opportunity to reconfigure some day care centres. Key issues in reopening included staff being redeployed, some buildings no longer being fit for purpose under new guidance and others having challenges associated with HIQA requirements. The HSE allocated more than €6 million to the community health organisations between 2021 and 2022, within existing resources, to assist with the reopening of services and the expansion of existing services, where possible.

The reopening of day centres for older people as quickly and as safely as possible remains a priority for me. In budget 2023, I secured additional funding of €4.1 million for service resumption. The current target is to open 333 day care centres. At the end of October, 300 were open. Some 315 will have reopened by Christmas. We will also have 40 dementia-specific day care centres open by Christmas.

I have been working very closely with the Alzheimer's Society of Ireland to ensure that people with dementia can receive these supports. Like the Deputy, I have visited many daycare centres in the past few months and older people are so happy to be back and re-engaging again. Some of the centres are not open five days, four days or three days a week, like they were previously, because of staffing challenges but we are trying to work through that. The Deputy will be aware, as all Deputies will be, that many day care centres were dependent on community employment schemes to deliver some of the supports and because we are almost at full employment now, we have lost some of that resource that was available.

The reference to St. Patrick’s Community Hospital was not in the original question and, therefore, I do not have the detail on it but I will certainly look at it for the Deputy and I will return with more information in my supplementary response.

Marian Harkin (Sligo-Leitrim, Independent)
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I thank the Leas-Cheann Comhairle and the Minister of State. She mentioned, as I did, the importance of day care centres which is a social setting. It gives people an opportunity get out of their homes and makes such a difference to their mental health, as well as their physical health. That is all a given.

The Minister of State stated that one of the reasons that some day care centres were not reopened related to infection prevention and control. While that is important, we have to strike a balance. We cannot just say "No, no, no" to the positive benefits of reopening as quickly as possible. I am not asking the her or anybody in the HSE to reopen centres that they consider dangerous or that would not be beneficial for people, but if everything has to be perfect, A1 down the list of tick boxes before a centre can open, she and I know that instead of the 333 centres that she had hoped to have opened at the end of October, as she has said or the 315 centres she hopes to be open by Christmas, that will not happen. That is good progress and she is getting there with her target and I hope that St Patrick’s Community Hospital and some of the other centres that I spoke about will be among those.

That will certainly give me great courage to think that could have happened but we need to be practical about this. According to the information I received, St. Patrick’s Community Hospital needed toilets to be refurbished, painting and a new floor. That is the sort of thing that can be done fairly quickly. Carrick-on-Shannon is the county town and the biggest town in Leitrim but to think that it is without a day care centre, and to think that somebody sent me a response to say that there were centres open with the exception of one, a small centre 25 km to 53 km away is nonsense. Carrick-on-Shannon needs to be prioritised and the other centre that is causing a great deal of concern is Easky, County Sligo.

Mary Butler (Waterford, Fianna Fail)
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The Deputy is quite right in what she said. We all know the benefits of day care centres. It is one of my priorities to get them open as safely and as securely as possible.

One of the areas where we have seen challenges is in day care centres that were adjacent to or part of amenity nursing units, which were our old style community hospitals. Any place in which there was a day care centre, there were challenges. We still have approximately 70 nursing homes throughout the country with Covid-19. The difficulties were that we were bringing people from outside into an inpatient centre and most of the problems we had were where the day care centre was associated with the community nursing hospital in that particular area.

The Deputy is correct about infection prevention and control, which is important. We learned quickly that some of the day care centres were in community facilities and were not dedicated day care facilities. We have changed that now and the majority of them are now stand-alone day care centres with the correct supports that people need. The Deputy is also correct in that we have to find permanent solutions and that is what we are trying to do but there have to be certain standards.

One area about which I am also worried is that while many people have come back to day care and embraced it, we also have a small cohort who are finding it hard to re-engage and who have not come back to the day care centres. They may have lost their good friend during Covid-19 with whom they used to engage, and this is also an area on which we are putting a focus. I am asking communities to reach out to these people who always went to a day care centre previously and now do not have the heart or are probably afraid to re-engage. I will certainly check out those centres for the Deputy.

I agree with what she said in that it is not appropriate to ask somebody to travel 7 km, who may not have transport, and I believe the Deputy also mentioned a distance of 24 km. That is just not going to happen. I will check those two centres out for the Deputy and I thank her, as usual, for her interest in this matter.