Joan Collins (Dublin South Central, Independents 4 Change)
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I am disappointed that neither the Minister for Health nor any of the Ministers of State at the Department of Health are here because this is an important issue. I am sorry the other Minister of State is leaving because it is to do with the lack of services in Armagh Road primary care centre, which is linked to the special school on Armagh Road, Our Lady of Hope School. We were informed by activists in Drimnagh that, on Tuesday evening, an employee in the Mother McAuley Centre contacted them to say that all public health nurses were moving out of Curlew Road health centre to Armagh Road primary care centre due to staff shortages. She has had difficulty getting nurse services for the centre over the past week or so, the email said. All public health nurses will be gone by 1 April. Allied support workers, occupational therapists, OTs, and social workers have already moved to Armagh Road, so they do not know which services are left in Curlew Road. The employee was also informed that the sod on the new primary care centre, for which we have been waiting nearly ten years, will not be turned until quarter 4 2024. The email goes on to say that this is truly frightening news and something needs to be done about it urgently. Residents in Drimnagh feel they have been kicked in the teeth again and deprived of services. I hope we will get some clarification from the Minister of State this evening on this issue.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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It is disappointing there is no one from the Department of Health here. The issue for Drimnagh is the total neglect of the area. Moving nurses out of the Mother McAuley Centre on Curlew Road to Armagh Road is adding fuel to the fire. One could argue they are both in Dublin 12, so what is the problem. They are actually very separate geographical areas and there is no bus link joining the two areas directly or joining the two centres. It is important to remember that many of the people who use this centre are elderly. There is a dementia clinic there. It is mainly used by elderly people and there is also a mother and baby clinic. Transport is an issue. I understand they have been told there will be some transport link between them, but it is very vague and nothing is clear. The point is that it is another kick in the teeth to the people of Drimnagh and another diminishing of services. There is a shortage of staff, so Drimnagh is being picked on again. It is not acceptable. The shortages of staff are not acceptable. If they are to move all of the clients from Drimnagh to Crumlin and they are all to pile into the one area, we will probably be looking at an overcrowded, understaffed and very badly delivered service. It requires explanation and must be urgently dealt with.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Similar to both of the Deputies before me, I feel Drimnagh has been ignored. It is a community with an ageing population but also a very young population where young families have moved into the area and there are many young children. There is also a new community in the area and many developments. The public health nurse, in particular, has a huge role in outreach in that area. If somebody is moved across one of the main routes out of this city, it makes it much more difficult for those who want or need those services and for the nurses to stay engaged with the community they are moving to. The concern people have is that once they are in Armagh Road, the services they will be able to deliver to the Drimnagh residents will be diluted and their primary role will be to cater for walk-in patients, walking wounded or those nearby, rather than those who will now be farther away. That is their main concern. As Deputy Smith said, there is no direct bus route or connection, which many older people rely on. There is a need for a commitment that the public health nurses and services which have already been moved out of the area are retained in the area and that plans for the primary healthcare centre go ahead, rather than be continually delayed. Planning permission was granted in 2014.

Malcolm Noonan (Carlow-Kilkenny, Green Party)
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I am responding on behalf of the Minister for Health, Deputy Donnelly, and accept the comments made by Deputies Collins, Smith and Ó Snodaigh regarding this important issue. We all agree that public health nurses play an extremely valuable role in the community healthcare system, providing an extensive range of services vital to local communities across the country, including in Drimnagh, and that those communities would have access to public health nurses when they need them. However, consistent with recruitment challenges across the health sector nationally and noting statements in the Dáil this afternoon, the public health nursing service in Dublin south-west is currently dealing with significant staff shortages. These shortages are mainly due to reductions in the availability of staff due to retirement, internal movement and leave. Despite ongoing recruitment campaigns and attendance at national and international recruitment fairs, the recruitment of public health nurses continues to prove particularly challenging for the Dublin south-west area. The HSE has assured the Minister that it will continue to make every effort to provide the required nursing services to the population despite these recruitment difficulties.

To ensure any impact on service provision is kept to a minimum, the public health nursing service in Dublin south-west has taken the decision to pool resources as a short-term mitigation measure. Public health nursing services will be consolidated in Armagh Road, with a satellite clinic to be provided in Curlew Road. It is hoped the provision of a satellite clinic will ensure minimal impact on service users. It is also important to note the HSE has advised that this change will see no impact on those receiving domiciliary nursing services. The HSE expects implementation of this process to begin the week of 3 April 2023, with a communication letter to be issued to service users and relevant stakeholders in advance of this date. Importantly, the HSE has advised that this measure will be subject to daily monitoring to ensure continuity of care and to manage risk. The HSE has also reiterated that, as and when staffing levels increase, nursing staff will return to Curlew Road. The Minister, Deputy Donnelly, has also been informed that occupational therapy services, dietetics and addiction services will continue to be provided from Curlew Road health centre.

In addition, in response to the broader challenges of recruitment and retention of public health nurses, the HSE established a community nursing national oversight group last year.

The group is tasked with developing proposals and recommendations which will aim to address the issues in recruitment and retention of public health nurses and community registered general nurses. Of course, the Department recognises the stress and frustration caused by the shortages in public health nursing. The Department and the HSE encourage any service users with concerns to contact their local public health nursing service directly. I note the points raised by Deputies Bríd Smith and Aengus Ó Snodaigh with regard to transport links. It is a critical issue for elderly people and others accessing services or clinic appointments.

Joan Collins (Dublin South Central, Independents 4 Change)
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This is an absolute disgrace. It is similar to moving the chairs on the Titanic at this stage, from the point of view of the HSE. One primary care centre cannot retain or recruit staff and staff are being pulled out of Curlew Road to fill the gap in that centre. It is crazy. Elderly people are being left anxious about where they will get their care from. They are mainly people with mobility issues who use the Mother McAuley centre services and have ulcers, cataracts and all those types of things. We wish to see those services in our community in Drimnagh. I will register the fact that this is wrong. Those nurses should be brought back down, or else the Minister of State should give a commitment that there will be services between the two centres, before 3 April.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I will answer that. During the afternoon, there was a session here on safe staffing levels in our health service. Safe staffing levels are not just to do with staff. They are mainly to do with patients. We are putting the safety of the patients in Drimnagh, that is, the elderly and people who need mother and baby care services and people with the dementia, at risk by doing this. I can see why the Minister of State is saying the HSE is left with no choice, because of staff shortages, but these things are connected. The staff shortages are connected to the lack of housing. We are dealing with it all week and we will be dealing with it again next week. The lack of housing for staff in this State is an utter disgrace and it is putting the safety of patients at risk. Something urgent needs to be done. I doubt the people of Drimnagh will just accept that everything will close for Drimnagh on 3 April and everyone has to traipse over to Crumlin and back again. It is not acceptable and if that is the only answer we are to get here this evening, we have to go back to the drawing board with the rest of the community.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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This issue will not go away. It is a considerable extra burden on those who depend on these services, especially the many vulnerable people who depend on them, whether it is the elderly, those confined to the house with illness or young mothers coming out of the hospital. There is an extra workload on public health nurses in trying to get from the Armagh Road centre, across to Drimnagh and back again, as well as whatever additional workload will be put on them because of shortfalls on Armagh Road. The public health nurses do tremendous work. They are needed and respected in the community and the community in Drimnagh does not wish to lose them. There is a fear that once they move to Armagh Road they will not come back, despite the promises.

Malcolm Noonan (Carlow-Kilkenny, Green Party)
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I note the concerns of the Deputies. It is a short-term measure, while these recruitment challenges exist. There is a commitment to develop a new primary care centre at Curlew Road within CHO 7. By pruning public health nursing resources, the service can provide better continuity of care, while ensuring that those with greatest clinical need continue to be seen in the community. The HSE has assured the Department that this mitigation measure will be under daily review and will help to ensure delivery of a safer service. The population of Drimnagh will continue to be served, with Curlew Road acting as a satellite clinic and once staffing levels increase, nursing staff will return to Curlew Road health centre. While every effort is being made to address the recruitment challenges in the short term, including ongoing campaigns, longer-term recruitment challenges face a range of sectors, including the health sector.

It is expected that the recently established community nursing national oversight group will propose recommendations later this year that aim to address some of the longer-term issues with regard to recruitment and retention of public health nurses and community registered general nurses. The Minister, Deputy Donnelly, wishes to reassure all Deputies that the Department of Health and the HSE will continue to work together to review and monitor staffing and service levels and work to utilise all practical options to fill vacancies, whether they exist in Dublin South-West or elsewhere. I note the concerns the Deputies have raised, especially about transport and the inconvenience it is causing to service users within the health centre. I note the issues with transport raised by Deputy Smith, in particular, but this is a temporary measure while these recruitment challenges exist.