Aindrias Moynihan (Cork North West, Fianna Fail)
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The census confirmed our ageing population, as we expected. That is no surprise. There is a great need for people who are growing older to be able to remain independent for as long as possible and to live in their own homes with dignity. Day centres are a fundamental part and a key support in providing social interaction, advice and support to both the clients and also to their carers. Unfortunately, there is a big gap in these services around the Macroom area and the Lee Valley, in parishes such as Macroom, Kilmurry, Kilmichael, Aghinagh, Clondrohid and Aghabullogue, and even west of the town, in Ballyvourney and Kilnamartya.

Dementia services are an issue as well. There are more than 55,000 people with various dementia conditions and medical conditions. The Alzheimer Society of Ireland is supporting many families and their carers. In Macroom, we have an ambitious plan to secure dementia-friendly town status and an enthusiastic group is driving that forward. This is in order that people have the chance to live their best lives for as long as possible. A small-scale day-care service is provided on Wednesdays by the Alzheimer Society of Ireland. The organisation could expand that service if suitable facilities were available. A building on the hospital grounds in Macroom, which is no more than 20 years old, was vacated when the primary care centre was relocated down to the mart area. The Minister of State had the opportunity to see it and he was impressed with the facilities there. He will also have seen that during works on the nearby community hospital, which are at an advanced stage now, some services, including ambulance service, were relocated to this building. There is still a considerable amount of space available in the building to deliver services. It would be a great location to deliver day services and dementia services if the opportunity was available.

For over ten years, the HSE has been talking about and making different preparations to provide day services around the Macroom area. In the meantime, the demand and need continue to grow. The HSE should not wait until the nearby hospital extension is completed. As many efforts as possible should run in parallel to advance those services. I understand that some preparations are under way and plans have been advanced but they have still not moved on to tender stage. In the meantime, the Alzheimer Society of Ireland runs its day services on Wednesdays. If they could be facilitated in that building, it would also provide an opportunity to grow those services locally.

I am conscious of the need to provide services for older people, locally in their community, and to support the services front and centre, those people more so than the HSE, the Alzheimer Society of Ireland or any other organisation. It is the community priority.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this issue. His advocacy is constant in this area. It is not the first time we have spoken about dementia-specific supports in the Macroom area. It is a key priority for the Government to allow more people to engage in services that allow them to remain independent and live in their own homes with dignity and independence for as long as possible. As the Deputy is aware, the HSE has operational responsibility for planning, managing and delivering health and personal social services. A wide range of core services are provided for older people, including home support, day care, community supports in partnership with voluntary groups and intermediate care, as well as long-stay residential care when remaining at home is no longer feasible.

As the Deputy knows and has alluded to, we have an ageing population. We also have the highest life expectancy in the EU, as deemed by the World Health Organization. People want to live at home for as long as possible with the correct wraparound supports. I call it the triangle of supports - home care, day care and meals on wheels. It is hugely important to support people to age in place.

Access to day centres can make an important contribution by providing invaluable support, advice and social interaction for older people who may, for any number of reasons, be experiencing isolation and loneliness. We know that older people have found it hard to reconnect since the Covid pandemic. They find it hard to take that confident step to come back into the community. 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. While day centres provide a range of services for older people, many HSE day centres offer higher dependency day supports for people living with dementia who need more one-to-one support, including nursing support, and the development of this specialist day centre is based on local population need. Some 30 people per day are diagnosed with dementia. The current figures are that 64,000 people are living with dementia. Having dementia-specific supports in areas is very important. I have a good working relationship with the Alzheimer Society of Ireland. During the Covid pandemic, the opportunity was taken to do a risk assessment of each service in the country, including our day services to make sure they were fit for purpose from infection prevention and control measures. I announced the provision of an additional €3.5 million to support up to 330 day care centres throughout the country. I also secured an additional €2.1 million for dementia-specific community day care services. As I have said, 46 are now up and running in partnership with the Alzheimer Society of Ireland.

To turn to the Deputy's specific point, I visited the campus in Macroom where the community hospital is located. I have seen the works under way, some of which are completed. It is a fantastic facility. However, there is room to do so much more on the campus. Immediately across from that was the former health centre. At that time, the ambulance services were using it. My understanding is that they no longer are, or maybe they are using part of it. There is a huge opportunity here because when we try to put supports in place for people, we have to think outside the box and must utilise every empty building and make them all fit for purpose. I believe this is the plan. The HSE has advised me it is not possible to define a timeline for the day care centre project at this time, as allocation of capital funding is currently awaited. However, the HSE is supportive of it. It is something in which I will take a specific interest. Since I came into this House as Minister of State three years ago, I have often spoken about the postcode lottery. It is important, no matter of where you live, that you can access those vital supports.

Aindrias Moynihan (Cork North West, Fianna Fail)
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I thank the Minister of State and acknowledge the huge efforts and the work she has been delivering for dementia services across the country. Through that support, we have been able to get the Wednesday service up and running in Macroom. It could be so much more if it had that opportunity available to it. It is about being able to support families and clients right across that large area of Macroom and the Lee Valley. Building works are currently very advanced on Macroom's new community hospital extension. They should be finishing up towards the end of this year or into the start of next year. It is time to move forward with the plans for the other building. There is plenty of space in there at the moment or there will be in some months' time. The HSE have been making an excuse and we have to acknowledge that it is an excuse. We want them to move on. That will not be there for long more. We really need to make sure capital funding is available and the project can move along and put that service in place. Has the HSE sought capital funding for that project? Is it part of the forthcoming capital programme? If the HSE has asked, how has that request been received? It is vital for it to be put in place in the next capital programme in order that works can advance without further delay. In the meantime, it would be a great opportunity to grow the service that the ASI has been providing on Wednesdays, as it had access to that building. It would all serve to benefit older people and their families across the Lee Valley and Macroom.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for his articulation of how important this service would be. It is fantastic that there is a Wednesday service. However, I do not believe the service is in the most appropriate setting at present. Especially for people with dementia, it is important they have the stability of a centre that can provide supports for them and to which they can return every week. A lot of people need more than one-day support. It is great to have one day in place. It is a start. We know that service is there. Day support for people with dementia is an invaluable respite for the carer, as they have a few hours' support on that particular day. As I indicated, the HSE has advised that it is not possible to define a timeline for the day care centre project as allocation of capital funding is still awaited. Then, the HSE could then progress to the tender phase and once that had been completed, timelines could be set out. I must check whether an application has come in and can revert to the Deputy on that. Now is the time for the application to be submitted as we will be devising the capital plan for 2024. A lot of work will happen during the next six months in that regard. I am supportive of providing this service in that particular area. I believe this can be delivered through working with the Alzheimer Society of Ireland. There is great co-operation between the organisation, the HSE and myself as Minister of State. As I said, there are 46 services now up and running across the country but we still need to do more. Everybody acknowledges that, but I will take a specific interest in whether that request for capital funding has come in. Now is the time to do it. The day I was in the community nursing unit, that beautiful new extension was well under way. That whole campus can offer so much for the people of Macroom and the surrounding areas.