John Whelan (Labour)
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I thank the Minister for the Environment, Community and Local Government, Deputy Phil Hogan, for coming at this late hour to take this Adjournment matter. There is a sense of déjà vu here in that I asked a similar question, with the tolerance of the Chair, on 24 April. I hope the Minister has some good news to convey tonight, as opposed to his having merely been handed a hospital pass, so to speak, in deputising for the Minister for Health, Deputy James Reilly.

I am seeking a commitment from the Government to the community nursing home sector, which is vital to ensure a balanced provision of care for our elderly citizens. The private nursing home sector, while it does provide an important service, cannot meet the demand arising out of a growing population of ageing citizens. Moreover, the private sector cannot cater for elderly people who require more extensive care, such as those suffering from dementia and Alzheimer's disease.

I was assured last April that a decision would be announced "shortly" and "soon" in terms of a future commitment by the Department of Health and the Health Service Executive to community nursing homes, including the Abbeyleix and Shaen facilities in County Laois. The latter is the only unit within the entire region which caters for high-dependency patients. The Minister will understand that, at this stage, patience is wearing thin among people in Laois. The initial announcement by the HSE to close the Abbeyleix and Shaen community nursing homes was made two years ago this week. To be fair, the Minister for Health did intervene and ask the HSE to review the decision and compile a report. That report was furnished a year later. Twelve months later, we are still anxiously awaiting a commitment from the Department of Health and the HSE to retain both Abbeyleix and Shaen. These particular facilities are typical of community nursing homes throughout the country, all of which are absolutely vital to ensuring that elderly citizens in need of residential care in the autumn of their years are cared for properly.

It is an absurd situation that only 16 patients remain in Abbeyleix community nursing home even though it has the capacity and scope to cater for up to 50. That makes no economic sense. I do not understand the HSE's strategy in this matter; nor do I support its policy in seeking to drive people into private nursing homes. It is not an acceptable position. Community tolerance is wearing thin after two years of waiting for a decision, which is understandable. It is high time we received a commitment, in no uncertain terms, to the community nursing home sector. These facilities provide a level of care and service that is central to our strategy of caring for citizens in the autumn of their years. I hope the Department of Health will finally bring this matter to an end and close off the uncertainty that has prevailed for two years. There is a vibrant role within the overall strategy of health care, in the midlands and throughout the country, for community nursing homes like Abbeyleix and Shaen.

Phil Hogan (Carlow-Kilkenny, Fine Gael)
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I convey apologies on behalf of the Minister for Health, Deputy James Reilly, who is unable to take this Adjournment matter. I thank Senator John Whelan for raising the 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.

Access to appropriate quality long-term residential care is underpinned by both the system of registration and inspection of nursing homes and the financial support available under the nursing homes support scheme. Essentially, our aim is to ensure that people are being cared for at the point of lowest complexity. People should only be entering long-term nursing home care when they have passed the point of being able to be cared for at home. This means that only the most highly dependent people should be in long-term nursing home care. One of our key priorities is the progression of a single assessment tool for older people. This standardised framework will ensure there is a robust, equitable standardised care needs assessment framework nationally. It will also allow resources to be targeted towards those with the greatest needs and enable supports and services to be designed in the most appropriate way possible.

The Department is working closely with the Health Service Executive to develop an overall plan regarding future public provision of long-stay residential care services. The plan will reflect both national and regional requirements and will have regard to the current severe financial constraints, restrictions on public sector staffing and recruitment, and the ongoing need to meet service and safety standards, all of which pose challenges for community nursing units across the country. The review of the nursing homes support scheme will also influence the future direction of residential care services. This review will consider the long-term sustainability of the scheme, as well as examining community-based services and how further development of those services might viably allow more older people to stay at home for longer. Work on the review is ongoing and is expected to be completed in early 2014. A longer-term plan for public residential facilities will follow on from that.

There are six public nursing units in counties Laois and Offaly providing 285 residential beds, of which 249 are long-term residential care beds and the remaining 36 are short-term beds. All six units were registered with the Health Information and Quality Authority in 2012 for a period of three years. In recent times, the future of St. Brigid's Hospital, Shaen, and Abbeyleix District Hospital have been under consideration by the HSE. Following a public consultation process carried out in 2012, all relevant information and submissions were presented to the designated officer on 16 August 2012. He, in turn, made a submission to the Department in December 2012, following consideration of which the Department sought clarification on a number of points. The HSE's response to that request for clarification is still awaited. The Department will finalise a submission for the Minister's consideration once the HSE has resolved any outstanding issues. This process is expected to conclude shortly. These decisions are being made in the context of the HSE's service plan for 2014, which will be published in draft form in the coming weeks for implementation in January.

John Whelan (Labour)
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I thank the Minister for the information he has put on the record of the House. However, I fear the words "shortly" and "soon", as I said back in April. I thought in April that would mean we would have a decision before the recess in July. We are one full year on since the original report was issued by the HSE to the Department. The public in Laois are entitled to clarity and a commitment to Abbeyleix and Shaen community nursing homes, as part of the matrix of caring for our senior citizens.

I agree with the Minister that the best place for senior citizens to be looked after is in their homes. That can only be done if there is also a commitment to the home help service and home help hours. That is where people prefer to be, although in some instances people cannot be looked after by their families in their homes. In such cases, they have to go into hospitals or hospital-type settings, which look after them in a fantastic way, such as in Shaen community nursing home - a high dependency unit and the only one of its kind in the midlands - and in Abbeyleix. It is high time that the HSE and the Department of Health drew a line under this and signalled that they are committed to Abbeyleix and Shaen and stopped dragging the matter out.

Phil Hogan (Carlow-Kilkenny, Fine Gael)
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I appreciate the Senator's genuine concern for the people of Abbeyleix and Shaen. He has articulated the community concerns, of which I am aware, living in north Kilkenny and a near neighbour of those areas. I assure the Senator that I will convey directly to the Minister for Health tomorrow the strong feelings he has expressed on behalf of the community.