Maire Devine (Sinn Fein) | Oireachtas source

I welcome the Minister of State. This is a matter in respect of which I have a particular interest and about which I have particular concern as a proud member of the Oireachtas dementia group. It is via the latter that my colleagues and I work hard on this issue. I refer particularly to Senator Humphreys, who is also a champion for those with dementia. I have to confess, I feel a sense of déjà vu. These discussions bring to mind those we had in the summer of 2018 with regard to the closure of Linn Dara day hospital, which was to reopen. Is scéal eile é sin. It was promised, it just never occurred. I want to give a particular shout-out to the Alzheimer Society of Ireland in light of all the work it does in supporting the work of the Oireachtas group. We work well, creatively and cleverly together.

Last November, the St. Joseph's campus was a finalist for a nursing home award. These awards are a national celebration of outstanding care provided, innovative care and best practice. They are the Oscars of the nursing home sector. Testimony from carers, families, patients and the wider community acknowledges the massive difference the facility makes to their loved one's lives. Care is delivered in the best way possible for people living with dementia and their families. My office spoke with representatives of St. Joseph's earlier today and they told us the quite startling fact that use of psychotropic drugs in their service has dropped from a massive 78% to 23%.For too long, people living with dementia were chemically drugged with heavy doses of psychotropic medication, which hastened their physical and cognitive deterioration. These are great statistics, which show the great action taken by staff at the centre. Restraint mechanisms are not used to manage patients. This shows the high quality of care that is unique.

A few months ago, I had the privilege of hosting the writer, artist and anthropologist, Dana Walrat, in the audiovisual room. Ms Walrat wrote an amazing book, Aliceheimer's, which documented her mother's journey with Alzheimer's disease. She is a recognised international expert. We spent a lovely weekend roaming around Dublin. She was delighted that we in Ireland treat and care for people with dementia care using a social model as opposed to the medical model prevalent in the United States. She found that wonderful, a great way of looking at the person and his or her environment and needs as opposed to strict medical diagnosis and medical management. Under the social model, people are integrated in their community where they can socialise and be with others. This holistic approach is exemplified in the model adopted by St. Joseph's.

My colleague, Deputy John Brady, who met management and staff at St. Joseph's, described the ethos in the facility as patient centred and said it provided a class A1 standard of care. He also told me about the many volunteers who contribute to the running of the centre which provides this vital service. There are two parts to the St. Joseph's service, as the Minister of State outlined, its day care service and its residential facility. The Minister for Health, Deputy Harris, was reported in the Wicklow Timesthis week as saying he would not allow the centre to close. At a glance, that is a very welcome statement but if we dig a little deeper, we find concerns. The Minister indicated that the continuation of the residential facility is guaranteed under the National Treatment Purchase Fund. Is this the assurance he was giving when he said the doors would not close? The day care centre is funded by the HSE. Given our vision of moving away from loading the fair deal into community provision and allowing people to remain independent, day care services will become a vital part of providing that. If we close this facility, we would be shooting ourselves in the foot because there are so few such places around.

Last week the Minister said the HSE was intensively engaging, as the Minister of State reiterated today, to try to agree additional funding to keep St. Joseph's open. This is the crux of the worry. Intensive engagement is not enough. St. Joseph's engages in intensive negotiations every year just to maintain its services. The Minister appears to frown on the decision by management to alerting residents and their families to the situation. Management has a duty of care to notify if the service will not exist at the end of the year. These discussions have been ongoing so announcement of intensive engagement is nothing more than a distraction. If the Minister is serious about the service staying open, it will mean more than keeping the doors open. The management need and deserve a legally binding agreement on funding in order that it can fulfil its responsibilities to patients.

There is a wider issue here regarding private, public and not-for -profit services. There are serious question marks over whether there is a level playing field. We need to address this issue. A vital first step in doing so would be to have the National Treatment Purchase Fund review published. The review would give us some of the information we need and recommendations to tackle this problem in order that it does not continue to arise around the country.

Let us not forget in all this talk what this facility means to the families and the many residents who call it home. The fear they are experiencing is very upsetting for them and their loved ones. We should not disguise the truth. We need more than a commitment that the door will not close. There must be a full financial plan to secure the continuation of both the day care and residential services, as well as a plan to tackle the wider issues at play here. I look forward to contributing to that process. We must keep in mind that day care places will become a much needed resource when we implement the vision of allowing everybody allowed to stay in their own homes.