Rónán Mullen (Independent)
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With your permission, a Leas-Chathaoirligh, I might allocate a minute of my time at the end to my colleague, Senator Mullins.

Denis O'Donovan (Fianna Fail)
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Is that agreed? Agreed.

Rónán Mullen (Independent)
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The Minister of State is welcome to the House. I raise the important issue of funding for Galway Hospice because as I have said here in the Seanad previously, I believe there are some promises that ought to be kept in politics, and one of those promises was that given by the Taoiseach to the late Mr. John Cunningham, the former editor of The Connacht Tribune, when he said that the shortfall in funding for Galway Hospice Foundation would be addressed and that there would be support for expansion of the hospice in Galway. That commitment was given by the Taoiseach to the late Mr. Cunningham before his death in November 2011, and it was renewed by him some months later when he stated:

In due course you can take it that John Cunningham's words meant a lot to me that night when I was out there ... I tend not to forget things like that. If you like, in a personal sense to me, it was his last request and it is one that I'd like to see we can stand over.

I want to put on the record that Galway Hospice has done tremendous work. It has not expanded since its initial development in terms of its inpatient services, yet the demand for its services has increased greatly. Funding from the Health Service Executive, HSE, covers approximately 70% of its funding. Approximately ¤3.4 million was received last year, and I understand another ¤1.5 million is raised by the hospice to do its important work, apart from inpatient care, home care and so on.

It is a tribute to the Galway Hospice Foundation that it managed to raise so much money from a relatively small catchment area of about 250,000 people. It is a success story. It is true there are great needs across the country in terms of hospice care. However, the specific needs of Galway need to be emphasised at this point. There is talk of a funding cut of between 1.6% and 5% but that simply must not happen. There has already been a cut of about 10% in funding since 2009. More and more pressure is being put on a service which is giving much added value to the State, considering what it would cost to care for people in hospitals where the care would not be as good and as targeted. Thinking smart and working smarter and not harder, as the saying goes, would suggest that this particular effort needs to be made.

The Galway Hospice Foundation which has plans to develop to a 26-bed facility wants to get moving on its interim plan to add six beds to its current 12-bed inpatient facility. It needs to be assisted now. I realise the difficulty we face in terms of funding, even for very good causes, given the current crisis. The nature of that promise was such that it has to be honoured. These promises have to mean something. I know that concern is shared by the family of the late Mr. Cunningham and by the people of Galway Hospice and others people in Galway.

Michael Mullins (Fine Gael)
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I welcome the Minister of State, Deputy Alex White. If a promise had never been made to Galway Hospice Foundation for funding I would want to support a call that the facility be adequately funded and that the moneys required for its expansion would be made available as it provides an incredible service, with limited resources, to the community and surrounding areas. We all know families whose loved ones would not have coped in their final weeks and months without the support of Galway Hospice Foundation and its team of nurses. It would make economic sense to expand the Galway Hospice facility as it would free up many beds at University College Hospital, Galway, and take care of patients who should be treated in a hospice setting as distinct from a general hospital setting. There is a need for a broader debate on funding for hospice care. It is not right that Galway Hospice Foundation should be so dependent on fundraising and the goodwill of organisations and the relatives of patients who die in the hospice for the ongoing funding of the facility. I hope the Minister of State will have positive news. I understand we are in difficult times but I have reason to believe the news for Galway Hospice in the future is likely to be positive. We would like the funding for the expansion to be provided sooner rather than later.

Alex White (Dublin South, Labour)
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I thank the Senators for raising this important issue. The Galway Hospice Foundation is a voluntary organisation. It was established in 1986 when a group of local doctors and nurses developed hospice services for Galway city and county. At present, the Galway Hospice provides inpatient, home care and day care services. Its activities are funded by a combination of public donations and moneys received from the HSE.

Galway Hospice provides significant community services which are not funded from the HSE allocation. The HSE funds a 12-bed inpatient unit in Galway Hospice for which the allocation was ¤3.5 million in 2011 and ¤3.4 million in 2012. Funding allocations for 2013 have not been made yet by the HSE. However, the allocation identified for palliative care in the HSE service plan for 2013 has been reduced by 1.6% and a proportionate increase would, in the normal course, fall across the whole spread of service providers.

The HSE National Service Plan 2013 provides funding of ¤73 million for palliative care. Approximately 75% to 80% of this is provided to the main voluntary organisations. The palliative care priorities identified in the HSE service plan in 2013 are to support the delivery and improve the quality of generalist and specialist palliative care services in line with strategic policy direction and improve resource utilisation, including systematic assessment of need, access and referral, and progress the development of paediatric palliative care services.

The HSE commits in 2013 to the following access targets: 92% of specialist inpatient beds provided within seven days; and 82% of home, non-acute hospital, long-term residential care delivered by community teams within seven days.

A baseline study on the provision of hospice-specialist palliative care services in Ireland 2004 confirmed, on an objective basis, that there are regional variances in the provision of hospice-specialist palliative care in all care environments. The HSE accepts that the counties of the former Western Health Board, namely, Galway, Mayo and Roscommon, have a low per capita spend on palliative care services, but correcting this in present circumstances presents obvious difficulties, and other regions also face significant challenges. While funding is under pressure right across the health system, the HSE will actively engage with Galway Hospice to consider issues arising, including core funding deficits, service planning and regional palliative care requirements in HSE west. It is expected that further meetings between HSE management and Galway Hospice will occur in the next couple of weeks.

Galway Hospice has presented a discussion paper to the HSE regarding the future development of palliative care services in the Galway, Mayo and Roscommon areas. The discussion paper envisages a number of capital developments including: the building of a 12-bed specialist inpatient unit in Castlebar; an eight-bed intermediate bed unit in Roscommon; the provision of six additional interim inpatient beds at Galway Hospice; and an enhancement of the outpatient facilities and of the home care and day care services for County Galway.

Apart from the capital costs of these projects there would be a requirement for significant additional revenue allocations. Galway Hospice has held some preliminary discussions with the HSE in Galway on these matters and the expectation is that these discussions will continue in the coming months.
Through ongoing engagement and discussions between the HSE and the Galway Hospice and other stakeholders in the coming months, I would hope that progress can be achieved towards an optimal outcome.

Rónán Mullen (Independent)
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I thank the Minister of State for his response. I would hope that something positive and substantial will come out of those meetings between HSE management and Galway Hospice. In the context of the budget for palliative care, will it provide for the expansion plans of Galway Hospice over and above the question of core funding?

Alex White (Dublin South, Labour)
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I do not think I can go any further, except to reassure the Senator that these matters are being addressed. I would certainly hope that positive progress can be made on the issues the Senators have raised. I take the point raised at the outset in respect of what was said by the Taoiseach and his commitment. That reflects all our commitments in the context of the sad death of John Cunningham, whom I knew well as it so happens. Both Senators referred to the contact that people have with the hospice service in Galway. In recent years I have had close contact with the hospice service in Galway in respect of a family member, therefore, I know and value very highly the work of that organisation. Anything I can do, certainly that would be the case for the Minister of State, Deputy Kathleen Lynch, the Taoiseach and all of Government, to address the issues raised by the Senators will certainly be done.