Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the three Senators for raising this important matter. It is great to have a collaborative approach. It is very effective. I am acutely aware of the significant healthcare role that Clifden District Hospital plays and the excellent level of care and support which it provides to patients and their families in the local community and surrounding areas. Just after the meeting the Senators organised on Sunday evening, Deputy Ó Cuív contacted me at approximately 6.10 p.m. to explain the issue to me, exactly as the Senators have done. I asked that evening for a briefing note from the HSE for first thing the following morning in order that I would know exactly what was happening.

As the Senators have said, in recent years, Clifden District Hospital has been primarily designated to provide convalescence care to patients stepping down from acute hospital. However, with the evolution of Sláintecare and the transition of care from acute to community settings, the need for step-down beds has reduced. In fact, the demand for step-down care is currently an average of less than one patient per day.

Clifden District Hospital also provides respite beds to allow family carers in the community a welcome break. Following a meeting with local politicians and residents in July, Community Healthcare West repurposed some of the convalescence beds to accommodate those requiring respite. I have been advised by the HSE that the average respite demand and occupancy is approximately three beds per night. This brings the total average occupancy of Clifden District Hospital to 3.2 beds per night.

In the Clifden area, St. Anne's community nursing unit is a designated centre registered with HIQA to provide a home for older people. My understanding is that it is approximately 1.5 km from Clifden. Unfortunately, St. Anne's has faced significant challenges over many years to secure sufficient nursing staff, despite national, international and local recruitment drives.

In recognition of service needs in the Clifden area and in order to seek to redress the nurse staffing shortage, HSE Community Healthcare West commenced a process two years ago under the Croke Park public service agreement. In August 2022, under the auspices of the Workplace Relations Commission conciliation services, Community Healthcare West informed the Irish Nursing and Midwives Organisation and SIPTU that it would be issuing a common roster, which commenced on 26 September, covering both Clifden District Hospital and St. Anne's community nursing unit sites in order that staff could be assigned across both sites, based on service needs. The change in rosters involves a change in shift start or finish times of a maximum of 30 minutes and working in one of two locations less than 1.3 km apart.

I have been advised by the HSE that one of the staff representative bodies communicated with the HSE on Friday, 23 September to suggest that it had instructed its members not to co-operate with the revised rosters. Community Healthcare West is committed to ensuring the safety of its residents and patients and, accordingly, put contingency arrangements in place in light of any potential action by staff from 26 September onwards.

Unfortunately, over last weekend, the HSE was unable to secure cover to fill the rosters due to gaps in St. Anne's community nursing unit which the HSE required to fill to ensure the safe care of residents and patients. Community Healthcare West therefore started to develop contingency arrangements for the patients in Clifden District Hospital. Patients and their families were contacted by HSE nurse management and all patients were offered the alternative option of Merlin Park University Hospital should they wish to avail of respite this week. I understand it is approximately 80 km away, which is a long distance. Day care services will continue as normal.

I will clarify that Community Healthcare West has not advised that respite services will end in Clifden District Hospital but simply took contingency measures following advice it received that staff may not co-operate with the new roster. The contingency measures will be implemented only if there are insufficient staff available. In these instances, alternate respite slots can be sought at a later date or patients can be accommodated with a respite bed in Merlin Park. There are no plans to cease respite services in Clifden District Hospital at this time. I have asked the HSE to keep me updated on any developments. I will come back with a further reply.