Ulick Burke (Fine Gael)
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I welcome the Minister of State to the House. My matter is to ask the Minister for Health and Children to indicate if, following her recent visit to St. Brendan's Hospital, Loughrea, County Galway, she is in a position to allow the plans submitted to her Department to advance to the next stage so that overcrowding and health and safety issues are complied with at this hospital for the elderly.

An excellent service has been provided at the hospital for patients through the years by dedicated medical, nursing and administrative staff. The problem in the hospital is that much of the accommodation is located on the upper level. When the Minister visited, she saw 32 immobile patients who are cared for in an upstairs unit, which is unsatisfactory. Following a recent fire risk assessment, it was indicated that this was an area of great concern to the management and staff of the hospital. As a result, the provision of additional accommodation at ground floor level was made a priority.

As far back as 2000, the Western Health Board indicated, under the national development plan, that St. Brendan's was a priority for funding to provide a 40-bed extension. Plans were approved by the previous Minister for Health and Children in 2003 but nothing has happened since. It is unfair on the management, staff and patients that they have been left in limbo. The number of patients in the hospital has declined steadily over the years because, as people died, their beds were removed, particularly those in the upper levels. Those beds were taken down, particularly those at the upper levels in the hospital. We currently have very serious waiting lists in the Loughrea area. I understand 35 females and 20 males are awaiting admission, all of them very elderly. It is important to note that in the west we have the highest percentage of elderly people — approximately 14%, which is far above the national average. That gap is increasing, which means there is increasing demand for the provision of such places.

It was proposed that a 40-bed unit be provided. Some 35 of those beds would be standard hospital beds, with five respite beds and one palliative care unit. Over the years, it was to have progressed in stages to an 80-bed unit for an extension to replace the existing hospital. The old hospital was previously a workhouse. It served its purpose well in the past but now, because of fire regulations and the advancing need for greater care for the elderly, it is important that we delay no longer. The Tánaiste and Minister for Health and Children, Deputy Harney, saw it herself and was astonished at the situation there. I ask that the plans, which have been with the Department since 2003, be advanced so that progress towards finalisation and completion of the proposed unit might be made.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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The current bed complement in St. Brendan's Hospital is 174 beds and 25 day care places. The health and safety co-ordinator undertook a fire risk assessment late last year which raised concerns regarding the upstairs accommodation at St. Brendan's. Several possible solutions are being explored by the Health Service Executive, western area, which is responsible in the first instance for the provision of health services in the Loughrea area including, in light of the report, the relocation of those patients most at risk to ground-floor accommodation while retaining the overall bed complement.

The Government has made services for older people a priority and is fully committed to the development of a comprehensive health service capable of responding quickly, fully and effectively to the health service needs of older people. In recent years, health and social services for older people have improved, both in hospitals and in the community. Since coming into office, the Government has substantially increased the level of funding, both capital and revenue, in respect of services for older people. Between 1997 and 2004, total additional funding allocated was approximately €287 million, and additional funding of €15.228 million was announced for this year. That serves to demonstrate the Government's commitment to improving services for our older population. Significant capital funding for the health sector has been provided since the commencement of the NDP in 2000. Total expenditure for the years 2000 to 2003 was approximately €1.7 billion.

Considerable progress has been made in addressing the historical deficits in health infrastructure and improving the standards and facilities required for quality, modern patient care. The NDP provides considerable capital funding to services for older people. Nationally, that will enable a comprehensive infrastructure of community nursing units and day care facilities to be put in place, as well as the refurbishment of existing extended-care facilities and the replacement of old, workhouse-type accommodation. Older people deserve first-class facilities, and we intend to provide such facilities in appropriate locations.

The implications of the Health Act 2004 providing for the Health Service Executive have been pointed out in many Adjournment replies. Under the Act, the executive has the specified statutory responsibilities, including for the proposed development at St. Brendan's, Loughrea.

The HSE, western area, has prepared a project planning brief for the development of a 40-bed community nursing unit in Loughrea, with expansion to 80 beds. That brief was prepared by a multidisciplinary team, and the group proposed several units based on the major population centres of Tuam, Loughrea and Ballinasloe as the east Galway centres set out in the Western Health Board strategy entitled "Health and Wellbeing for Older People". That proposal was one of several for capital funding submitted by the HSE, western area, to my Department for consideration. As responsibility for development of services now rests with the HSE, any decisions relating to that project will be a matter for the HSE, having regard to the western area's overall capital funding priorities in the context of its service plan for 2005.

Ulick Burke (Fine Gael)
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"Cat and mouse" and "pass the buck" come to mind.