Cecilia Keaveney (Fianna Fail)

I thank Senator McFadden for allowing me to raise this issue now.

I thank the Minister of State for attending to respond on the impact the moratorium on public service recruitment is having on district hospitals and nursing units, particularly in Buncrana and Carndonagh. The absence of staff on maternity leave and so forth is putting many local facilities under pressure. I offer as an example Cardonagh Community Hospital in my locality which was the subject of a recent HSE report which offers a flavour of the work it does.

Carndonagh Community Hospital is operated by the HSE. The main hospital was built in 1956 and a badly needed new dementia care unit which has been a great addition to the hospital was added in 2007. The centre provides a broad spectrum of care services to meet the needs of the people of Inishowen and complements the work being done in the Buncrana nursing unit. Its services include short-term assessment, respite, convalescence, palliative care, continuing care and dementia-specific care. A range of services are being provided at the centre which includes a 39 bed residential unit and a 16 bed unit for dementia patients. Accommodation consists of multiple occupancy wards and five single rooms. Two palliative care suites are also available which allow family members to stay with their relatives at the end of life. I commend the voluntary sector for the work it has done, as well as the staff, from the matron Maura Gillen down, to ensure people can remain in the area and be supported by their families and friends to the end of their lives.

The recent assessment shows that the hospital provides occupational therapy, physiotherapy and podiatry services, offers a day care centre, X-ray service and other clinics. A general practitioner and the NOW DOC service also operates from it. On the day of inspection the hospital was catering for 55 patients on-site, of whom 48 were at maximum dependency level, five at high dependency level and two at medium dependency level. The hospital has a vital role to play. It is not just a place where people go to live but is a community hospital, in the real sense, catering for high dependency patients.

The Health Information and Quality Authority, HIQA, report was released in July 2009. Inspectors were satisfied that the health care and medical needs of the residents were well catered for and that good systems were in place to assess their needs. The centre was found to be well organised and managed and the person in charge had a good knowledge not only of the residents in her care but also of the new legislative requirements and her role in that context. Residents and relatives commented positively on the quality of care provided and most were happy with their quality of life, the staff at the centre, the food provided and the daily routine. However, people would welcome more activity, particularly at the weekend, to keep residents as occupied and challenged as possible. When one is dealing with older facilities, there will always be a negative commentary, as in the case of this report.

Four residents and 11 relatives completed pre-inspection questionnaires and a further nine residents and three relatives were interviewed during the inspection. Everybody felt well cared for and gave a positive account of life in the centre. The vast majority had a sense that the staff were more than nurses to the patients; they were friends who sat with them in the middle of the night and comforted them when they did not feel well.

I have tried to give a brief overview. My impression is the one that comes through in the report. The services offered by community hospitals and nursing units within communities, particularly in rural areas, are vital. However, they are under pressure as a result of the moratorium on recruitment. To a certain extent, they are also under pressure with regard to the decisions people can make about where they want to be cared for. If they choose to stay in community hospitals when perhaps they should move to nursing facilities, it could put pressure unnecessarily on community hospitals.

I look forward to the Department's response. There is controversy in County Donegal about the potential closure of the facility in Lifford. We want our community hospitals and facilities to remain open, but if they are allowed to become run down as a result of the moratorium, nobody will be able to replace the homely care being provided at these facilities in rural areas. Coming from a rural constituency, I expect the Minister of State will not think differently on the matter.