Kathleen Lynch (Cork North Central, Labour)

I thank Senator Ó Domhnaill for raising this issue as it provides me with an opportunity to update the House on this matter and outline the background to the current position and the action taken by the Health Service Executive.

Government policy on older people is to support people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care where this is appropriate. We continue to develop and improve health services in all regions to ensure quality and patient safety. The Health Service Executive has sole operational responsibility for the delivery of health and personal social services, including those at facilities such as Lifford Community Hospital, County Donegal.

Lifford Community Hospital is one of 11 community hospitals in County Donegal. Established in 1799, the hospital currently has 20 beds, 11 of which are for long-term residents while the remainder provide convalescent, step-down and intermediate care for patients discharged from Letterkenny General Hospital. Both the moratorium on recruitment and compliance with national quality standards are impacting on the community hospital system in County Donegal. These pressures are mirrored across the country and are well documented.

I acknowledge there is considerable concern about the future of our community nursing units. There is no doubt we are facing challenges in this sector due to staffing, funding and the age and structure of existing units. However, I confirm that no decision will be made to close a public nursing home without a full consultation having taken place with all stakeholders. It is clear that on a business as usual basis, the Health Service Executive would have to close further beds across a range of public community nursing units in 2012. In the absence of reform, this would increase the cost of caring for older persons within the public system. Consequently, this would undermine the viability of public community nursing units and reduce the overall number of older persons that can be supported within the budget available for the fair deal scheme. This is not a sustainable way forward and would not meet the needs of older persons, local communities, the taxpayer or those working in the public service. Instead, we need a more proactive approach to the provision of community nursing home units which seeks to protect the viability of as many units as possible within the funding and staffing resources available. This includes smaller units where challenges of scale may require more innovative approaches to service delivery. This is likely to require a combination of actions such as consolidation of services and changes in staffing, skill mix and work practices.