Seanad debates
Wednesday, 28 January 2009
Care of the Elderly
7:00 pm
John Paul Phelan (Fine Gael)
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With your permission, a Chathaoirligh, I would like to allow Senator Norris to ask a few questions at the end. He raised the issue of Bethany House on the Adjournment last month. Would that be in order?
Pat Moylan (Fianna Fail)
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The Senator can give him a minute of his time.
8:00 pm
John Paul Phelan (Fine Gael)
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I will give him a minute or two. I am glad that the Minister of State, Deputy Hoctor, is in the House as the issue concerns care of the elderly and she is the Minister of State responsible. There has been a very serious and disturbing development in Carlow. Before Christmas Senator Norris raised the issue of speculation about the closure of Bethany House welfare home which is located in the middle of Carlow town on Barrack Street, the main street through the town. At the same time I received correspondence from a number of colleagues in County Carlow, including councillors Michael Abbey and Tom Kinsella, who raised with me the view circulating locally that the Health Service Executive was about to close this welfare home. Through the general channels provided by the HSE I sought reassurance as to what was to happen and Senator Norris raised the issue in the House. I was reassured through my contacts in the HSE that no decision had been made and Senator Norris was reassured in the House by the Minister of State, Deputy Hoctor, that no decision had been made at that time. That was in the middle of December. Lo and behold, on 15 January it was announced that Bethany House welfare home would close within the next few weeks.
This issue goes right to the heart of what our democracy is about. I never thought I would say it as a member of Fine Gael, but we need a revolution in how we deliver health services, particularly care of the elderly.
A level of hypocrisy has surrounded this issue for which I do not blame the Minister of State. She has been used by the HSE in the response she delivered to the House before Christmas when she was clearly given incorrect information. In that response the HSE claimed it had not made the decision and yet it was widely known in Carlow at the time that the decision had been made. The unit had been inspected in the middle of last year with a view to providing improved facilities for physiotherapy. The HSE would not agree to provide those facilities, obviously with the view at that stage that this unit would be closed.
Bethany House is approximately 30 years old and is in the middle of Carlow town. It is a 30-bed unit, 25 of which are occupied at present. I attended a public meeting the other night to hear the reasoning behind the HSE's decision. It claimed it was closing the home owing to health and safety issues and because all but two of the residents are high dependency. Of the 25 people who live there and whose home it is, 19 get themselves up every morning for breakfast and five of them managed to attend the public meeting in a hotel in Carlow a number of days after the announcement of the closure. I am sure the Minister of State would agree this indicates they are far from being highly dependent.
In her remarks before Christmas, the Minister of State correctly acknowledged that the residential patient — the elderly person in this case — should be at the centre of any deliberations by the HSE. Bethany House is a fine facility and is home to these people. I am sure we have all experienced nursing homes, many of them privately owned, which in many cases are appalling places. I know Bethany House pretty well and it is a fantastic facility with a real sense of community between the staff — who are also appalled by this decision — and the residents who are deeply upset.
As Senator Norris said on the last occasion when he raised the issue, it is acknowledged that moving home is one of the most traumatic things people are asked to do. One of the residents is 98 years of age and he is being asked to move home. Bethany House is an extraordinary place where the patients look after the garden and run messages throughout the town for staff and other patients. Its location in the centre of Carlow allows them to do so.
The HSE proposes that the residents be moved to a number of facilities, principally the Sacred Heart Hospital in Carlow. There is already a significant waiting list of people wanting to get into that facility before the possibility of moving people from Bethany House arises. I ask the Minister of State to use whatever powers and offices she has to ensure this appalling and disgraceful decision is reversed.
David Norris (Independent)
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I thank my friend and colleague, Senator John Paul Phelan, for so graciously allowing me to take part in this debate. He went right to the heart of the humanity of the matter and I am sure the Minister of State, who also has a warm heart and is a countrywoman, will appreciate these issues. I raised this matter on 17 December and the Minister of State undertook to get back to me. I have no record of her having done so, but perhaps she made an attempt to do so.
There is considerable disinformation about this issue, for which I do not blame the Minister of State. For example, more people have contacted me since I raised the matter, including a man from Scotland whose mother is in this facility. He consulted the website. On the website on 15 January 2009, along with the 2009 national service plan for the Health Service Executive south, there was a note from Gerry O'Dwyer, the network manager, stating: "The report is currently being discussed with a broad range of interested and affected parties and once dialogue is complete the report will be published in full at the end of February or early March this year." That was on the day when this man's mother was told by the matron that the home was closing. He did not even get a telephone call. The website was telling him something completely different. That is not acceptable or professional behaviour.
Imagine how confusing it is for these people. They are being thrown out of their homes because of bureaucratic concern about a building. It is a niggling bureaucratic matter. We are dealing with the lives of real people. Senator John Paul Phelan was absolutely correct when he referred to it as their home. He knows more about this than I do. It is in his patch, he has visited it but I have not had that privilege. He spoke about the way people behave, how all of them get up for their breakfast and several of them could attend the meeting in town, yet they are told they are all bedridden. They are not bedridden, yet they will be bedridden. They have independence in Bethany House but they are going to be put in a hospital where they will be made to go to bed, if they are able to get up, at 6 p.m. They are not given a choice of what they do or what television programs they watch. The Minister of State is a decent woman and this will go to her heart. This would kill them.
David Norris (Independent)
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This is not just the closure of a facility. A death sentence is being pronounced on elderly people who deserve better. Senator John Paul Phelan indicated there was a meeting in Carlow town. Was it last night?
David Norris (Independent)
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I received information on it. It seems to have been an energetic, positive and constructive meeting. I ask the Minister of State to work with those people. A committee has been formed to try to rescue Bethany House. The Minister of State should let it do it. If, as its membership believe, it is a matter of refurbishment, this could be done. The local community could be energised and the resources would not be wasted.
My original informant is a man with a degree in nursing. He is incandescent about this. It contradicts all good nursing practice. For goodness sake, the Minister of State should try to intervene. I know how difficult it is but I know the Minister of State is a woman of good will. She should try to see if this decision, which was denied, can at least be put in cold storage to allow the committee to get something done. In Carlow, with the goodwill and support of the community, they can rescue this facility. One of the residents is 97 years old and was streaming with tears. That is a terrible thing and the Minister of State should give them a chance to bring it back to life.
Máire Hoctor (Tipperary North, Fianna Fail)
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I thank Senators Norris and John Paul Phelan for raising this issue. At no stage have I misled the House on this issue, nor on any other issue when I have delivered a response to an Adjournment debate.
John Paul Phelan (Fine Gael)
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I did not say the Minister of State misled the house.
Máire Hoctor (Tipperary North, Fianna Fail)
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I want to make that absolutely clear. The Senator implied it or something of that nature. I am prepared to defend that.
John Paul Phelan (Fine Gael)
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I said that the Minister of State was used.
Máire Hoctor (Tipperary North, Fianna Fail)
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I was not used at any stage to relay a response to the Adjournment.
Máire Hoctor (Tipperary North, Fianna Fail)
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I ask Senator Phelan to withdraw the comment because it is absolute rubbish.
Máire Hoctor (Tipperary North, Fianna Fail)
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I deliver the truth to Senator Phelan, as I do to any other Senator in respect of information given to me. I stand by that.
Máire Hoctor (Tipperary North, Fianna Fail)
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I would like the opportunity to continue to give my answer. This Adjournment debate provides me with an opportunity to update the House on this matter and to outline the background to the current situation and the action taken by the Health Service Executive. I want to reassure the older people concerned and their families about the future.
The HSE has operational responsibility for the delivery of health and social services, including those at facilities such as Bethany House. Bethany House is a welfare home which opened in the 1970s. It is currently operating as a 30-bed unit, of which 28 beds are residential and two are respite. At present there are 25 long stay residents, with one long stay admission to the facility in the past six months.
In December 2008, I confirmed to this House that the HSE had commissioned a review of elderly services within the Carlow-Kilkenny region in 2006, which included Bethany House. The review was conducted in 2007. The report was received by the HSE in early 2008. Last December Bethany House was the subject of local and media speculation that it faced closure. At that time I confirmed that no such decision had been taken and that as soon as any decision was made in respect of the future of Bethany House, the HSE would inform residents and those directly affected by such a decision.
The HSE has now decided on the future of the facility. Following consultation with the general hospital manager and director of nursing, a decision was made on Tuesday, 13 Jan 2009 by the local health manager to relocate residents from Bethany House to alternative accommodation. This decision was put forward to the assistant national director of primary care and continuing services in the HSE south who approved it as part of 2009 HSE south service plan. On 15 January the HSE announced the service plan for the local health offices and hospitals in the southern area at the regional health forum. The plan identified a programme to address infrastructural deficits to meet new standards, health and safety and fire requirements.
The HSE advised the forum that the 30-bed Bethany House welfare home is no longer able to provide appropriate services owing to the increasing levels of dependencies of its patients. The independent review highlighted the lack of facilities to provide appropriate care and the home's inability to support high-dependency patients. This inadequacy increases demands in terms of maintenance, standards and health and safety issues, including infection control.
The HSE decided it was necessary to discontinue admitting patients to the home and to arrange for the current residents to be accommodated in facilities more appropriate to their needs. The director of nursing met all 25 residents on Thursday, 15 January. She explained the situation to them and said that every effort will be made to ensure a comfortable move for residents to facilities that will meet their care needs. Family members were contacted by telephone to give assurances that a further meeting with each resident and their family will be arranged to discuss and agree the facility most suited to each resident. Options outlined include Sacred Heart Hospital, a modern setting which is purpose-built to cater for highly dependent patients, private nursing homes or other welfare homes in the Carlow area for the few more independent residents.
After consultation with residents and their families, all 25 will be relocated to better and safer facilities that are purpose built to cater for their health and well-being. The immediate next steps for the HSE are to consult each resident, the families or representatives to explain the options available with a view to agreeing preferences for relocation.
This is an unsettling time for all 25 residents. We owe them a duty of care and we must ensure our primary focus has to be each one of them. Each hospital, local health office, manager, clinician, etc. working in the health services has a responsibility to ensure they strive to provide the best possible service to patients and other clients of our health services.
I am sure this House will agree that the safety and well-being of older people living in nursing homes is of critical concern. Quality care and patient safety comes first and all patients should receive the same high standard of quality-assured care. Bethany House will continue to be used as a health care facility and preliminary discussions have commenced with the Alzheimer's Society with a view to day care services being provided from the facility.
John Paul Phelan (Fine Gael)
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I did not accuse the Minister of State. I quite like her and think she is very good at her job. To mislead the House, not only would incorrect information have to be delivered, she would have to have known the information was incorrect. I was trying to make the point that the Health Service Executive provided incorrect information regarding the closure of Bethany House. The Minister of State was not to know this information was incorrect.
I refer to the final paragraph of the reply concerning alternative uses of the building by the Alzheimer's Society. I have continually supported the work of the Alzheimer's Society but it is projected that it would cost €100,000 to upgrade Bethany House so that it would be suitable as a day care centre for the Alzheimer's Society. I suggest this sum would make Bethany House perfectly suitable for the needs of the 25 people who reside there are and whose home it is currently. If the money were invested in the building, the residents could stay where they are.
In Ireland we have an attachment to our homes, which is understandable, and terrible dislike of the notion of eviction. The HSE is proposing to evict these people from what they consider their home. I attended the meeting, along with a few hundred people who were very angry. I do not see why that €100,000 could not be spent to provide the necessary equipment to make it safe for the 25 people who live there instead of upgrading it for the Alzheimer's Society.
Máire Hoctor (Tipperary North, Fianna Fail)
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I forgot to acknowledge the questions of Senator Norris, which I recall clearly from December. I have not received a response but I will reactivate the matter for him because he raised specific matters at that time. I will raise the question of €100,000 exactly as suggested and will revert to Senator Phelan.
David Norris (Independent)
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I thank the Minister of State for her gracious reply. Events have marched beyond what applied at that time so those questions are no longer relevant. Would the Minister of State or her representatives meet the committee to investigate the possibility of whether it is a better employment of money, with the assistance of the local committee which could fund raise, to preserve the building? I am just afraid that the shock of the move and the dependency that will be created in the hospital circumstance will kill off some of those patients. I know that is not what the Minister of State wants to happen. Perhaps either she or her officials would be prepared to meet the committee. I see the Minister of State is nodding in agreement.
Máire Hoctor (Tipperary North, Fianna Fail)
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With the permission of the Cathaoirleach, on a point of clarification, is Senator Norris referring to the newly formed committee or the Health Service Executive committee?
David Norris (Independent)
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I mean the newly formed committee of the supporters and relatives. I really would appreciate that. I did not say that the Minister of State had misled the House. All I would say is that the material on the website which the relatives of one of the patients read on-line in Scotland completely conflicted with the situation on the ground. The Minister of State is not directly responsible for that but it is an unfortunate situation. I thank the Minister of State very much.
Máire Hoctor (Tipperary North, Fianna Fail)
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I will agree to do that.