Brian Ó Domhnaill (Fianna Fail)
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This issue relates to St. Joseph's Community Hospital in County Donegal, which provides respite and long-term patient care for elderly people in the greater Finn Valley area. Currently, following a number of Health Information and Quality Authority, HIQA, reports, it is under increasing pressure to maintain the complement of respite care within the hospital together with catering for the long-term patient care.

HIQA has identified a number of issues which the hospital must deal with, but these issues primarily pertain to the high level of admissions into the hospital last year, at over 700. Approximately 80% of those admissions were for respite care and HIQA is of the view that, given the high level of admissions and discharges, the hospital needs additional staffing to meet the demands of the long-term stay patients in the hospital. To cut a long story short, additional staff are required at the hospital. However, the moratorium on recruitment in the public sector is causing difficulties in this regard. Unless that is dealt with in the community nursing homes throughout the country, these difficulties will continue indefinitely. Obviously there are issues regarding the structure of the building and the need to develop it, but that can be done at a later stage. The most urgent matter at present is the need to lift the moratorium on recruitment for the nursing units in community hospitals throughout the country, including St. Joseph's, as well as those in Carndonagh and Dungloe in Donegal which were discussed in this Chamber last night.

I hope the Minister will give an indication of whether he is willing to consider lifting the moratorium on recruitment or providing some level of flexibility in the moratorium for the community hospital sector. According to the Health Service Executive, HSE, approximately 2.4% of the population aged more than 65 years is currently in nursing units. That will increase to almost 4% in ten years. If that is the case, what plan does the Department have in place to meet the increasing demand? There will be a requirement for additional staff if that demand is to be met. In addition, there will be a need for additional capacity in terms of new beds and facilities. However, the issue tonight is the need to lift the moratorium on recruitment. I thank the Minister for attending to reply on this Adjournment matter.

Alex White (Dublin South, Labour)
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I thank the Senator for raising this issue. Government policy is to support older 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 appropriate quality long-term residential care, including the provision of financial assistance under the nursing homes support scheme. In 2012, with a budget of almost €1 billion, financial support was provided to over 22,000 people in nursing homes.

The Health Service Executive is responsible for the delivery of health and personal social services, including those at facilities such as St. Joseph's Community Hospital in Stranorlar. As the Senator is aware, these are challenging times for the HSE in respect of all services. In the case of community nursing units, these include challenges regarding staffing, funding and the age and structure of its units. In this regard, all developments have to be addressed in the light of the current economic and budgetary pressures and Government policy to reduce the numbers employed in the public sector. This policy requires that by the end of 2013, the health service achieves a workforce of 98,955 whole-time equivalents. Staff appointments may be made only where an inescapable service need has been identified and which cannot be addressed by other means, such as the redeployment of staff or reorganisation of services. The recently concluded Haddington Road agreement has increased the working week of nurses to 39 hours from 37.5 and also provided for increased hours for all other staff who were working less than a 39 hour week. This will have the effect of increasing the overall staff capacity available to management to deploy in service delivery.

St. Joseph's Community Hospital was registered with the Health Information and Quality Authority in June 2012. The registration period is for three years and the current capacity is 75 beds. The hospital provides a range of services, including respite, rehabilitation, palliative and intermediate care and there are 27 beds available for long-term residential care. Day services are available from Monday to Friday and this supports the discharge planning processes at the hospital. Older persons can avail of personal care, assistance with medical care and meal provision. This provides respite to relatives and carers on a sessional basis up to five days a week.

The hospital was last inspected by HIQA in April 2013. Concerns were expressed regarding the complexity of the mix of residents and the level of activity within the unit. While the inspectors observed that staff provided care in acknowledgeable, competent and respectful manner, there was a concern that this complex mix of residents can make it more difficult for the staff to meet the needs of long-term residents. To address this issue, the Barnes View ward has now been designated for long-stay residents only. Dedicated staff have been assigned to the ward, which opened on 10 June last. I am confident that this response will facilitate improved compliance with national standards.

Arising from this reconfiguration, staff reassignments and revised rosters were required. These changes have been agreed and the revised rosters implemented with effect from 24 June. When all changes have been completed St. Joseph's will have an operational capacity of 67 beds, including the 27 long-stay beds. Residents and their families can be assured that management and staff will continue to work to provide the highest standards of care at St. Joseph's. The HSE has asked me to assure the House that the residents are receiving a safe and quality service. Bed capacity across all community hospitals in Donegal will be kept under ongoing review. However, although the moratorium on recruitment remains in place, there are no current plans to further reduce bed capacity.

Brian Ó Domhnaill (Fianna Fail)
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To be honest, whoever drafted that response does not answer the question. The line, "Bed capacity across all community hospitals in Donegal will be kept under ongoing review", is an insult to the communities in Donegal. Every community group in Donegal that is connected to a hospital is already doing that. Anybody can keep the bed capacity under review. The Minister said the moratorium on recruitment will not be lifted, therefore the problem will not be resolved. I realise the Minister is new to the Department and that he has conviction and passion, but I plead with him to look again at this issue. It is a train coming down the tracks that will go off the rails unless it is dealt with. The Minister should meet with the troika and tell it in no uncertain terms that there must be flexibility here. Otherwise, elderly people will be let down.

Alex White (Dublin South, Labour)
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There is no intention to insult anybody, be it the people of Donegal or the Senator. I am simply giving a response in straight, clear terms. The moratorium on recruitment must remain in place, regrettably, and everybody is aware of the reasons for it. If I can do anything else to assist the Senator regarding specific details of the issue he raised, I will do that. However, as regards the Senator's specific question about the moratorium, there are no proposals to raise the moratorium.