David Cullinane (Sinn Fein)
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In 2009, the 19-bed St. Brigid's ward in St. Patrick's Hospital, Waterford, was closed by the HSE on foot of a report from HIQA which cited concerns in regard to health and safety. At the time, many public representatives, including myself as a councillor for Waterford city, as well as the Friends of St. Patrick's, a support organisation that was in place, and a campaign group which had been established met senior figures in the HSE and the then Minister for Health and Children. We were given a clear commitment by the then Minister, the HSE and the parties in government locally that when the ward was closed, it would be replaced with a new 50-bed unit on the grounds of St. Patrick's Hospital. The ward was closed and, since then, there has been a desperate attempt by the campaigners to ensure the HSE and the current Government live up to the commitment made by the previous Government and deliver the capital funding necessary to build this new 50-bed unit.

I asked Deputy Caoimhghín Ó Caoláin to table a Dáil question in respect of this matter and the response of the Minister is interesting:

The Executive, at the time of the closure of St Brigid's ward, did indicate that it would examine the provision of a new 50 bed Community Nursing Unit (CNU) on the grounds of the hospital. Such a construction project would require capital funding and the HSE must prioritise all capital infrastructure projects nationally within its overall capital funding allocation.

The Minister accepts the commitment was given, but now states it is subject to the capital funding being made available. I call on him to deliver on the commitment given. The campaign group holds a weekly vigil, comprised of family members of people who live in St. Patrick's Hospital, in an effort to get the unit.

The Minister cites the Prospectus report, which deals with the total number of nursing home places, public and private, across the south east. The report, published in 2008, states that no additional nursing home places are needed before 2013. However, the Minister fails to acknowledge that St. Brigid's ward was closed in 2009, after the report was published. He also does not recognise that St. Patrick's is a hospital, not just a nursing home. It is unfair to compare bed provision in a private nursing facility with bed provision in a public hospital such as St. Patrick's. I urge the Minister of State to take this strong argument back to the Minister for Health and to urge him to listen to those people who have been campaigning and to what the HSE had to say and the commitments it gave and to honour those commitments. I urge him to ensure the capital funding is provided for the older people who need these places. There are long waiting lists for beds in St. Patrick's Hospital. My grandfather was a patient there for four years and I know the quality of care patients get in the hospital, a fantastic facility. However, the closure of St. Brigid's ward created a deficit in terms of bed capacity. The only way that can be fixed is if the capital funding is provided by the Government. I urge the Minister of State to relay the message to the Minister for Health that he should deliver on the commitment given and release the funding.

Ciarán Cannon (Galway East, Fine Gael)
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I thank Senator Cullinane for raising this issue as it provides me with an opportunity to update the House on the matter and to outline the background to the current situation and the action taken by the Health Service Executive.

As the Senator is aware, Government policy is to support older people to live with dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care where this is appropriate. The HSE continues to develop and improve health services in all regions, ensuring quality and patient safety.

The Health Service Executive has operational responsibility for the delivery of health and social services, including those at facilities such as St. Patrick's Hospital, Waterford. St. Patrick's Hospital is a Health Service Executive residential facility for older people in Waterford City. It has 96 beds, consisting of 72 continuing care beds, 20 rehabilitation and four respite beds. The residential services are located on the ground floor and consist of three wards, St. Patrick's ward, St. Malachy's ward and Our Lady's ward. During the year St. Patrick's operates with a small number of vacancies, which vary from day to day. Concerns had been expressed with regard to health and fire safety at St. Brigid's, a 19-bed ward, which was the last remaining ward on an upper floor of St. Patrick's Hospital, Waterford. As a consequence of these concerns, the HSE decided that it was no longer viable to continue to accommodate residents in the ward and it was closed on a phased basis in 2009. The primary focus of the decision was the care and welfare of each resident.

I am sure the House will agree that the safety and well-being of older people is of critical concern. Quality care and patient safety come first and all patients must receive the same high standard of quality-assured care. Patient safety is everyone's concern and I reassure the House that the decision to close St. Brigid's ward was taken with this in mind. In view of the closure of St. Brigid's ward, the HSE took steps during 2009 to ensure that there was no reduction in the number of public beds to support older people in Waterford City. Arrangements were made for a total of 30 private nursing home beds to be made available. This was prior to the commencement of the nursing homes support scheme.

At the time of the closure of St. Brigid's ward, the HSE indicated that it would examine the provision of a 50-bed community nursing unit, CNU, in the grounds of the hospital. Such a construction project would require capital funding and the HSE must prioritise all capital infrastructure projects nationally within its overall capital funding allocation.

The Prospectus report, which was prepared for the HSE in 2008, assessed the provision of nursing home places across the country and the need for additional places to meet demographic change. The report found that there were sufficient places in Waterford at that time and additional places would not be needed before 2013. The Department is currently engaged with the HSE in planning the provision of long-term care places, taking account of public and private nursing home provision. This will give further consideration to the Prospectus report recommendations and the requirements to upgrade facilities to meet the standards for nursing homes. It will also consider local demographic pressures and the extent of existing public and private provision, with a view to developing an overall strategy on how the HSE should continue to provide this service in view of current budgetary and other pressures. The House will appreciate that such reviews are essential to ensuring that resources are properly channelled and that the changing needs of older people are suitably addressed. The future provision of long term residential services for the Waterford area in general will be considered in the context of this review.

David Cullinane (Sinn Fein)
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The last line of the Minister's response states that provision will be considered "in the context of". Every time I hear a Minister or Department member state something will be considered "in the context", I am concerned that the "context" will be that funding will not be available and that all sorts of reasons will be cited as to the reason for that.

I pointed out earlier that the ward was closed in 2009, but the response cites the Prospectus report which was published in 2008 and refers to bed capacity. Does the Minister of State accept that the Prospectus report should not be cited as the ward was closed after the report was published? There is an anomaly in the response the Minister needs to address. Also, the Minister has not addressed the question of when the capital funding will be released. He accepts a commitment was given, but he has not given any indication as to when the funding will be delivered.

Paddy Burke (Fine Gael)
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There is no provision on the Adjournment for debate. The Senator is abusing the privilege he was allowed. There is no allowance for questions, but I allowed the Senator put a brief question.

Ciarán Cannon (Galway East, Fine Gael)
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The Prospectus report concluded in 2008 that there were sufficient places in Waterford and that additional places would not be needed before 2013. Following on the closure of St. Brigid's, I understand arrangements were made for 30 nursing home beds to be made available to replace the 19 beds closed as a result of the health and fire safety concerns at St. Brigid's. Therefore, the bed shortages were more than adequately addressed by the HSE at the time. I accept Senator Cullinane's bona fides in making the case for the construction of a new ward. All such demands will be reviewed in the context of an overall national review on the provision of long-term care places. That is the only commitment that can be given at this time.