Seanad debates

Thursday, 12 January 2012

2:00 pm

Photo of Brian Ó DomhnaillBrian Ó Domhnaill (Fianna Fail)
Link to this: Individually | In context

The issue I raise is community hospitals, specifically Lifford Community Hospital in my locality. Built in 1789, the hospital is old but effective and efficient. It has 20 patients at present with a capacity to accommodate 40 patients. Most of those who stay in the hospital are elderly. The reduction in patient numbers in recent years arose from the implementation of HIQA standards which include the provision of patient care in one and two bedroom units as opposed to the previous system of wards. HIQA officials visited Lifford Community Hospital and produced a report showing that the facility met all standards. The hospital received the best report of all community hospitals on which HIQA reported in County Donegal.

Before Christmas I attended a public meeting on Lifford Community Hospital attended by up to 1,000 members of the local community. This was a massive, unified show of support by the local community for retention of the community hospital. County Donegal has 11 public community hospitals run by the Health Service Executive, all of which face difficulties for a variety of reasons. While HIQA standards present a problem, staffing problems are causing greater difficulties. The moratorium on recruitment in the HSE and other public bodies has resulted in the closure of beds in many community hospitals. Staffing reductions and declining resources mean the community hospital network in County Donegal is operating at only approximately 70% capacity. One often hears the Minister for Health state it is not cost efficient for the State to have people staying in public hospitals. However, comparing the cost of a private bed with that of a bed in a community hospital that is operating at 70% capacity is not comparing like with like. I invite the Minister, Deputy Reilly, or the Minister of State, Deputy Kathleen Lynch, to visit some of the community hospitals in County Donegal, including Lifford Community Hospital, to see at first hand the invaluable care being provided by health care professionals to local people. It is incorrect to claim the care provided in a community hospital is not efficient and I challenge the Minister in that regard, particularly in light of the position in County Donegal.

Community hospitals must be upgraded. HIQA standards are setting the bar in that respect. Anecdotal information from HSE officials suggest the overall cost of upgrading all 11 community hospitals in County Donegal to meet the new HIQA standards would be approximately €40 million. While this is a substantial sum, capital investment in community nursing homes would be money well spent. The State must be judged on the basis of how it deals with its elderly population. If we choose not to provide publicly funded community nursing units for the elderly by withdrawing services, it will be a step too far.

On decision making, the HSE is carrying out a review of community nursing units. I understand the exercise commenced at local level and is feeding into a national review. The findings will be submitted to the Minister for Health who will make the final decision on closing community nursing units. My message to the Government is to keep its hands off Lifford Community Hospital and other community hospitals in County Donegal. The hospitals in question are operating at only 70% capacity. People require the services they provide, especially in County Donegal which has one of the highest populations of people aged over 65 years in the country. Elderly people require public nursing units or, if they so wish, private units.

I am sure this issue has been examined in the HSE. Does the Department have a table prepared on the cost of upgrading all public nursing units in the country? Will capital expenditure be found to invest in these units? Upgrading them could act as an economic stimulus, not to speak of the benefits such facilities provide to elderly populations and local communities. I hope the Minister of State has some good news for me on Lifford Community Hospital.

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour)
Link to this: Individually | In context

I thank Senator Ó Domhnaill for raising this issue as it provides me with an opportunity to update the House on this matter and outline the background to the current position and the action taken by the Health Service Executive.

Government policy on older people is to support people to live in 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. We continue to develop and improve health services in all regions to ensure quality and patient safety. The Health Service Executive has sole operational responsibility for the delivery of health and personal social services, including those at facilities such as Lifford Community Hospital, County Donegal.

Lifford Community Hospital is one of 11 community hospitals in County Donegal. Established in 1799, the hospital currently has 20 beds, 11 of which are for long-term residents while the remainder provide convalescent, step-down and intermediate care for patients discharged from Letterkenny General Hospital. Both the moratorium on recruitment and compliance with national quality standards are impacting on the community hospital system in County Donegal. These pressures are mirrored across the country and are well documented.

I acknowledge there is considerable concern about the future of our community nursing units. There is no doubt we are facing challenges in this sector due to staffing, funding and the age and structure of existing units. However, I confirm that no decision will be made to close a public nursing home without a full consultation having taken place with all stakeholders. It is clear that on a business as usual basis, the Health Service Executive would have to close further beds across a range of public community nursing units in 2012. In the absence of reform, this would increase the cost of caring for older persons within the public system. Consequently, this would undermine the viability of public community nursing units and reduce the overall number of older persons that can be supported within the budget available for the fair deal scheme. This is not a sustainable way forward and would not meet the needs of older persons, local communities, the taxpayer or those working in the public service. Instead, we need a more proactive approach to the provision of community nursing home units which seeks to protect the viability of as many units as possible within the funding and staffing resources available. This includes smaller units where challenges of scale may require more innovative approaches to service delivery. This is likely to require a combination of actions such as consolidation of services and changes in staffing, skill mix and work practices.