Catherine Byrne (Dublin South Central, Fine Gael) | Oireachtas source

On behalf of the Minister, Deputy Simon Harris, I thank Senator Burke for raising this matter. Although it is Government policy to facilitate older people to remain in their own homes for as long as possible, there will always be a cohort of people who need long-term care. Quality residential care must continue to be available for those who need it. Residential care is provided through a mix of public, voluntary and private provision. The Health Service Executive is responsible for delivering health and personal social services across the country, including at facilities such as Millstreet Community Hospital and Kanturk Community Hospital. Public residential care units are an essential part of our healthcare infrastructure. They provide approximately 5,000 long-stay beds, amounting to approximately 20% of the total stock of nursing home beds nationally. There are also approximately 2,000 short-stay community public beds.

While the care delivered to residents in our community hospitals is generally of a high standard, many of these services are delivered in buildings that are less than ideal in the modern context. It is therefore important that we upgrade our public bed stock and this is the aim of the capital investment programme for community nursing units. This provides the framework to allow for an enhanced programme to replace, upgrade and refurbish these care facilities, as appropriate. Significant work was undertaken to determine the most optimal scheduling of projects within the phased provision of funding to achieve compliance and registration with the Health Information and Quality Authority. The investment programme includes a number of facilities in Cork.

The Senator will appreciate that all healthcare infrastructure developments require a lead-in time to complete the various stages. These stages include appraisal, project brief, design feasibility, a review of costing estimates and finalisation of financing. The HSE has informed the Department of Health that upgrade works have already been completed at Bandon and Bantry hospitals. Other projects are at appraisal and design stages and are proceeding according to capital planning guidelines. The community hospitals in Millstreet, Kanturk and Fermoy are currently advancing collectively and are referred to as the north Cork bundle. A full design team has been commissioned by the HSE estates division. The HSE project team has also been commissioned to advance the service needs assessment and is reviewing existing layouts and accommodation for regulatory compliance.

It is expected that planning applications for Kanturk and Fermoy will be made by the end of the year, with Millstreet to follow in early 2019. Subject to the successful completion of the design, planning and tendering stages, it is expected that the projects could commence construction in 2020 and be completed by the end of 2021. The development of Midleton Community Hospital and St. Finbarr’s community nursing unit in Cork city are currently being advanced for delivery by means of a public private partnership mechanism, which is at an early stage of the development. Unfortunately, it is not possible at this point to give a detailed timeline for the delivery of each stage of the project. It is, however, expected that the facility will be operational by the fourth quarter of 2021.

The national development plan acknowledges the need for additional capacity. It is expected that 4,500 additional short-term and long-term beds will be required across the public system in community nursing units and other step-down facilities, as identified by the health capacity review. Health capital projects and programmes currently under way will continue and these major priority projects will require the bulk of the notified capital allocation over the initial period of the plan for 2018 to 2022. It is important to recognise that this is a long-term plan which will roll out over ten years and includes provision for a large number of developments across the country. As is to be expected with a ten-year plan, many proposals are at an early stage and, as with all capital development proposals, will require further appraisal, planning, design and tendering before a firm timeline or the funding required can be established. Appraisal and planning across all community healthcare organisations, in line with health strategies and demographic needs, will inform the selection of projects for delivery of these new beds and this additional capacity.