Joe McHugh (Donegal North East, Fine Gael) | Oireachtas source

I had a good conversation with the Minister, Deputy Varadkar, yesterday evening, and, as the Senator knows, I am taking this commencement matter on his behalf. Community hospitals are a critical and integral component of the overall health system. Even at the beginning of this month, when the conversations were focused very much on general hospitals and trolleys and blockages at accident and emergency departments, a key component was filtering and fluidity between the hospital and the primary community hospitals. For example, when I was in Letterkenny General Hospital last Friday we got a statistical breakdown of the demographics, which revealed that the vast majority of patients were over 75 years of age. It is important that we keep a firm focus on the critical need for community hospitals and that the Minister for Health is acutely aware of that.

I would like to thank Senator Cullinane for raising this issue, as it enables the Minister for Health to provide the House with an update on the plans for a new community nursing unit for Waterford. As Senators are aware, it is Government policy to support older people in living 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 appropriate high-quality long-term residential care, including the provision of financial assistance under the nursing homes support scheme. Providing public residential care for older persons forms a significant and crucial part of the services. The overall objective is to protect the viability of as many units as possible within the funding and staffing resources available. Therefore, improving the supports available for older persons is a significant commitment in our programme for Government.

As we are aware, all developments must be addressed in light of the resources available and based on priority of need. HIQA has indicated that a number of units do not fully meet the standards one would expect to find in a modern nursing home. This is not surprising, given the age and structure of many of our public nursing homes. Currently, funding for the community nursing unit programme focuses on the upgrading and refurbishment of existing facilities to achieve HIQA compliance.

The Health Service Executive is responsible for the delivery of health and personal social services. This includes provision of the appropriate infrastructure to support service delivery, such as the facilities at St Patrick's Hospital. Given that demand for capital finance for the community nursing unit programme far exceeds the funding available, investment must be allocated as objectively as possible based on the HSE's assessment of priorities of needs.

The HSE has identified Waterford city as a priority location for a new community nursing home unit. The design team has been appointed. Currently it is projected that a planning application could be lodged with the local authority in the second quarter of 2015. Following the award of planning permission, it is expected that the project will progress to the tendering and construction phases in late 2015.

As with all capital projects, the community nursing unit infrastructure programme, which includes this project, must be considered within the overall capital envelope available to the health service. There will always be more projects than can be funded by the Exchequer. There is limited funding available for new projects over the next multi-annual period 2015-2019, given the level of commitments and the costs to completion already in place. Therefore, the reason capital funding is not ring-fenced by project is to ensure the HSE has the flexibility to manage within its voted capital allocation in the event that one or more of the hundreds of construction projects under way at any time do not progress as scheduled. Indenting rather than ring-fencing enables the HSE to leverage its capital allocation efficiently, so that it delivers the maximum number of priority projects for the funding available.