Colm Burke (Cork North-Central, Fine Gael)
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I raise an issue I dealt with when I was Minister of State at the Department of Health. It is about having an integrated homeless health hub in Cork city. In October 2024, I arranged a meeting between the Department of Health, the Department of housing, the HSE in Cork and Cork City Council. It was agreed that we would all work together to establish a day centre where people who were homeless could go. At the present time, there is accommodation available to these people at night. The vast majority avail of that accommodation although some do not. However, during the day, there is no place for anyone to go. The accident and emergency department at Mercy University Hospital is under severe pressure. People tend to use that. Businesses are also under pressure because people need someplace to go, particularly in wet or cold weather. We have identified a site, a building, but the building's owners are getting concerned that, 12 or 14 months on, there is still nothing signed on the dotted line in relation to this development. Even if it were signed in the morning, it would still take anything up to 12 months before the facility came on stream while 600 people still have no place to go during the day.

There is also a huge advantage from the HSE point of view. It is currently paying out over €2 million in staff costs but these staff are in different locations, providing a range of services to people who are homeless. If there was one hub for all of this work, it would make it far easier for the health service, the city council and all of the support people within social services. This issue really needs to be prioritised. I certainly do not want further delay. There is another risk. There is a property identified in a very good location. It is important that we step up to the mark and progress the project now and that I am not back here again in 12 months' time making the same plea.

I know the Department of Health is not the Minister of State's area but I ask that this be brought to the attention of all of the Ministers. We need to prioritise this issue. We also need to take the pressure off Mercy University Hospital. It is providing an excellent service but it is restricted in the support it can give people who are homeless who are not necessarily looking for medical care but who need someplace to go. We really need to prioritise this project now. Cork is the second biggest city in the country. It is amazing that we do not have such a health hub in the city available for people who are homeless during the day. Obviously, our priority is to reduce the number of people who are homeless. This hub can help with that as well. It can help people to access housing that is suitable for them. At the moment, people who are homeless feel there is no one supporting them. They feel that they are on their own and that there is no dedicated service available to them. I ask that this now be given priority and that it not be delayed further.

Alan Dillon (Mayo, Fine Gael)
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I thank Deputy Burke for raising this important matter. I know how passionate he is about this integrated homeless health hub. I have heard him speak about it on many occasions, as he has again today. I welcome the opportunity to take this Topical Issue on behalf of the Minister for Health and to inform the House of the current position relating to the provision of an integrated homeless health hub in Cork city. Cork city has a huge population.

The Minister recognises that the health needs of people experiencing homelessness are complex and multifaceted. The Department of Health is committed to strengthening integrated care pathways for people who are, unfortunately, homeless and who have chronic health needs, based on an inclusion health model to achieve better health outcomes and reduce the incidence of premature death. The Department provided almost €50 million to the HSE for the provision of healthcare services for people who are homeless in 2025. This is an increase of €14 million since 2020.

The HSE national strategic plan to improve the health of people experiencing homelessness in Ireland out to 2027 prioritises integrated care and case management, assertive outreach supports and mental health and addiction supports in its provision of health services to people who are homeless. The HSE capital plan for 2025 provides €1.3 billion for healthcare buildings and equipment that are delivering benefits all over the country. This significant investment in health infrastructure underlines the Government’s commitment to providing quality healthcare in an equitable way to all those who need it. The plan commits to providing funding to expand addiction care facilities for people experiencing homelessness, under section 7 on cross-care services.

The integrated inclusion health hub in Cork City is a joint initiative between Cork City Council and HSE south west aimed at addressing the health and social needs of the growing number of people experiencing homelessness in Cork. As the Deputy is aware, this facility is designed to align with international best practice and to offer a comprehensive range of health and social services tailored to meet the unique needs of homeless families and individuals and those at risk of homelessness. This hub will provide a service centred around the basic needs of the clients presenting, but with a focus on homelessness, housing and migration, and it will be aligned with health. The provision of the service shall reduce the need for emergency department presentations. The integrated inclusion health hub would centralise all services for people who are homeless in one location, remove barriers and increase accessibility and engagement with healthcare services. It will also help to mitigate premature deaths among people who are homeless, with 20 such deaths recorded in the Cork region since 2020.

HSE south west has engaged with HSE Estates to assess the business case, with a view to securing funds in the capital plan. I am advised that HSE south west is working with Cork City Council to agree on a shared stakeholder funding model for the hub, with a view to ensuring optimal value for money. A revised proposal will be prepared once the funding model has been agreed by Cork City Council and HSE south west.

Colm Burke (Cork North-Central, Fine Gael)
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I am a little concerned that we are 14 months on and we still do not have a shared funding model. People who are homeless are in the same position they were in this time last year; the question now is whether they will be in the same position this time next year. The issue needs to be prioritised.

I met with the building owners recently. They are becoming concerned that this issue seems to be dragging on ad infinitum. They will not wait forever. This has been identified as the ideal location. In fairness to the HSE at local level and Cork City Council, they have worked hard together and the people in both organisations have put time and effort into identifying what is best for the people who need the support. We already have the staff in place so no additional staff will be required. The issue is about providing the funding for work to be done on the building to make sure it is adequate for the services that will be provided there. It is important the Department makes sure the HSE, the city council and the Department of housing deliver this within the next three to four months, which means prioritising the funding and then prioritising getting the work done. Quite a bit of work needs to be done on the premises but it could be delivered within a short enough period provided we make the decision now and not in six, nine or 12 months. I ask that this be conveyed back to the Department of Health and that the Department convey it back to the HSE and the city council.

Alan Dillon (Mayo, Fine Gael)
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I acknowledge the Deputy's advocacy for this important health hub. We all recognise the need to respond on a nationwide basis to the health needs of people who are homeless. That includes areas outside Dublin and, to the Deputy's point, including Cork city will be a critical investment for the HSE.

I will reiterate to all the Ministers in the Department of Health the need for support for this proposal. The engagement with HSE south west and Cork City Council is ongoing in terms of preparing a funding model. We will in the coming weeks understand the provisions within the new HSE capital plan and these decisions will be made. In budget 2026, over €1.5 million has been provided to improve access to health services for people living in emergency accommodation. That is not taking away from the importance of this capital infrastructure required for HSE south west. Securing funding under the capital plan will be critical to the decision-making process for this to proceed. I will take that back and I thank the Deputy for raising this important matter.