John Whelan (Labour)
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I welcome the opportunity to raise this matter on the Adjournment and I am glad the Minister of State at the Department of Health, Deputy Kathleen Lynch, is in the Chamber to respond to it. I do not doubt her commitment, passion and common-sense approach to care of the elderly. Many groups such as Older and Bolder share my opinion of her, even though they are concerned and fearful about what is happening in the sector.

One year ago this week the HSE unilaterally announced the immediate closure of dozens of community nursing homes. It also circulated a list of 64 nursing homes earmarked for closure or drastic rationalisation, which put the fear of God into many communities.

Abbeyleix community nursing home and Shaen community nursing home in Portlaoise - two of the three remaining community nursing homes in County Laois - were on the list. Before the Minister of State took up her post, her predecessor had presided over the closure of 20 beds in St. Joseph's Ward in Mountmellick. The beds in question remain closed. If the HSE decision had been implemented unchecked - the Minister of State played a key role in intervening and having it referred back for review and policy consideration - we would have been left with just one community nursing home in County Laois. One of the biggest wards in the nursing home in Mountmellick has been closed and mothballed. Like the patients, families, staff who have been affected by the closures, I am most grateful to the Minister of State for taking the time to visit Shaen community nursing home in Portlaoise and Abbeyleix community nursing home. I know she was impressed with the quality of care she saw at first hand when she called unannounced to the homes in question. It was a genuine visit. There were no airs and graces following her arrival.

I am sorry to report to the House the sad news that two of the three elderly ladies who had showed great courage and guts by taking a High Court action against the HSE this time last year, Mrs. Maureen Delaney and Mrs. Catherine Kelly, passed away in recent weeks. This has caused no shortage of distress in the community. The third lady, Mrs. Bridget O'Neill, remains hale and hearty. She is a strong and robust woman. Does the Department of Health intend to smoke out the entire community and wait until there is no one left? One year on, we do not know what the outcome of the review is and we are not clear on the policy the Department is pursuing because it seems to be at odds with Government policy as set out in the programme for Government. In the last week I was shocked to learn in response to a parliamentary question in the Dáil that the HSE had presided over the closure of 1,200 further nursing home beds around the country. Essentially, it is closing hospitals down by stealth. If it has its way, it will leave us totally at the mercy of private nursing homes. I have no ideological problem with private nursing homes. Many of them are very good. However, those involved in such homes will admit that they are unable to, incapable of and unwilling to care for high dependency patients such as those with severe Alzheimer's disease and dementia who are cared for in Shaen community nursing home.

I hope the Minister of State can shed some light on what exactly is happening in this sector. What is the policy of the Government on this matter? What is the future of Abbeyleix community nursing home and Shaen community nursing home?

Kathleen Lynch (Cork North Central, Labour)
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I thank the Senator for raising this issue and giving me an opportunity to update him and others who have an interest in this matter.

The 2012 national service plan of the HSE which was published in January anticipated that between 555 and 898 beds would close during the course of the year. Some 492 beds had been closed by the end of September. It is not expected that the minimum projection of 555 will be reached before the end of year. Around the time of publication of the service plan, the Minister for Health asked the HSE to draw up a viability plan for its residential units for older people. The aim of the plan is to identify the maximum number of beds and public community nursing units which can be retained in each region within existing available financial and staffing resources. This will give a clear indication of the viability of all community nursing units across the country and the composition of public bed provision in the future. The HSE is finalising the plan which will form the basis for discussions between the Department and HSE with a view to submitting a final set of proposals to the Minister.

I wish to speak about the provision of services in the midlands region. The Senator will be aware that in 2011 the HSE considered a proposal to close Abbeyleix community nursing unit and St. Brigid?s Hospital in Shaen. My colleague, the Minister for Health, and I met local action groups and elected representatives to discuss these proposals. Both of us have visited each of the units in the last year. I was sad to hear the news the Senator gave to the House about two of the Abbeyleix residents who had instigated court proceedings in 2011 to challenge the proposed closure. Our sympathy should go out to the families of the ladies in question. When I met the women who were taking the case, it struck me that they were incredibly strong, forthright and clear in their thinking, despite their advanced years. On 7 December 2011 the HSE agreed to set aside its decision to close the Abbeyleix facility. Following the court proceedings, the HSE confirmed that it intended to carry out a comprehensive consultation process before making any recommendation to the Minister on the future of the Abbeyleix and St. Brigid?s Hospital units.

On 24 May last the HSE launched a public consultation process on the planning and provision of services for older people in the midland counties of Laois, Longford, Offaly and Westmeath with a view to ensuring the most efficient and effective delivery of its services within available resources. Part of this process involved a review of the HSE's current long-stay residential units, including the potential closure of Abbeyleix community nursing unit and St. Brigid's Hospital in Shaen. The consultation process has been completed. I understand all of the relevant documentation was presented to the HSE designated officer for consideration on 16 August and that the officer?s recommendation is expected presently. In accordance with the HSE protocol consultation document, this recommendation will be conveyed to the national director of integrated care and the chief executive. If the HSE concludes that full closure of any unit is necessary, a recommendation to this effect must be made to the Minister. I can confirm that both facilities are registered with the Health Information and Quality Authority as designated centres for older people. Service providers are legally required to provide six months notice for the regulator before a designated centre can close.

John Whelan (Labour)
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I am grateful for the Minister of State's informative response which includes some good and interesting detail. She has pointed out that the review was concluded on 16 August. Her suggestion that a recommendation is expected "presently" is a little vague for people from where I come. What does "presently" mean? How long is a piece of string? I would like to receive some indication of what is meant by "presently". It is causing undue distress and anxiety for elderly people, including some who are in their 90s, in the run-up to Christmas. A year has passed since the original proposal was made. As the Minister of State said, the Abbeyleix unit is registered with the Health Information and Quality Authority. It is able to cater for and cope with 33 clients, but it has just 22. It is not being utilised to its full advantage, which is not serving anyone well. Perhaps those beds might be used to care for people who are in acute beds in hospitals but do not need to be. If these resources are not being used properly, they are costing the Department of Health more money than is necessary. The unit is not operating at maximum capacity. I am glad to hear that the buck will stop with the Minister who will have the final say on the matter after the recommendation is made. It would not make sense to leave the region without sufficient community nursing home beds. The people of the area would be totally at the behest of the private sector. I reiterate that the private sector does not want to cater for high dependency patients and does not have the capacity to meet the growing demand for geriatric beds, of which I have strong evidence.

Kathleen Lynch (Cork North Central, Labour)
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We have had long discussions about the Abbeyleix and Shaen facilities for many months. I am sure the Senator will be aware that it is not strictly a question of the level of care provided. As he has rightly pointed out, the level of care provided is excellent. Other factors have to be taken into consideration. When I said a recommendation "is expected presently", I meant the report would be on the Minister's desk shortly. It will have to be discussed. I am sure the Minister will not take an arbitrary decision on it.