Terry Brennan (Fine Gael)
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Ar dtús, ba mhaith liom fáilte a chur roimh an Aire Stáit go dtí an Seanad.

Martin Conway (Fine Gael)
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Go raibh maith agat. Cuirim fáilte roimh an Aire Stáit go dtí an Teach arís.

I have raised this important issue because I was contacted by a family member of a patient who suffers from dementia. A pre-existing purpose-built dementia unit was located at St. Joseph's Hospital, Ennis, County Clare with significant support from the taxpayer. Unfortunately, the unit is still not operational and has not been staffed and activated. It was designed to house patients in need of respite care on a short-term basis and to provide care, on a long-term basis, to patients who suffer from dementia, particularly patients who have psychiatric and psychological challenges. The latter creates enormous challenges for families trying to care for loved ones who are patients. It is bad enough to suffer dementia but added complications means providing care can become very challenging. At present the high dependency unit at Ennis General Hospital is run by nurses, doctors and staff and they do a wonderful job. They try to accommodate patients but they are under enormous strain due to the significant number of people presenting for care.

Dementia is a condition that puts a lot of pressure on families and the number of sufferers is increasing which leads to a lot of pressure on the system. It is projected that there will be a dramatic increase in the number of dementia sufferers in the future. Part of this is due to an aging population. That poses health challenges even though an aging population is a good thing.

Dementia is also a condition that is close to the hearts of many people in the House. Many families have loved ones who suffer from it. Therefore, I would like an integrated support service provided. A key component of an integrated support service is the operation of the specially designated and purpose-built unit at St. Joseph's Hospital in Ennis. There is no reason for the unit to be left idle. It should have the necessary resources and be up and running. It would provide an important additional service for the people of County Clare, particularly those whose loved ones suffer from dementia with the added complications I outlined earlier.

Terry Brennan (Fine Gael)
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Go raibh maith agat, Seanadóir. An tAire Stáit, le do thoil agus tá sé ceithre nóiméad agat.

Seán Sherlock (Cork East, Labour)
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Go raibh maith agat.

I thank Senator Conway for raising the issue. While dementia can bring many challenges both for the person with the condition and people caring for them, thankfully there is an increasing recognition that people can live and live well with dementia for a number of years as long as the right supports are in place. I am pleased to advise the Senator that the first ever comprehensive strategy that is specifically dedicated to dementia in Ireland is at an advanced stage of development. Our overarching policy is committed to supporting people to live in dignity and independence in their own homes and communities for as long as possible and to support access to quality long-term residential care where appropriate. We will continue to develop health services around the country, wherever possible, to enhance quality provision and patient safety.

The HSE has operational responsibility for the delivery of health and social services, including those at facilities such as St. Joseph's Hospital, Ennis. St. Joseph's is predominantly an older person's public residential unit that provides a range of care including long stay, short stay, respite, palliative and consultant-led rehabilitative care. I must stress that the facility caters for people with varying levels of dementia also.

Currently in Clare, consultant-led mental health beds for older persons are used at Cappahard Lodge and in the acute psychiatric unit. Without question, the service is well aware that a more appropriate environment is desirable. In this context, beds used by the older person's service at St. Joseph's were refurbished for the intended takeover by the mental health service. The refurbished beds are not operated by the mental health service at present but they are open and being used to very good effect. The HSE is exploring every opportunity to redirect existing mental health resources to move the refurbished beds under the direction of that service. A sub-committee was put in place this year and will shortly determine if such is possible. It must be stressed that it was never intended or indicated that new additional resources would be available for such beds, as they were intended to replace existing beds and therefore would be resource neutral.

The HSE will have a definitive position on the matter by the summer. This is one part of a multidisciplinary response by mental health services to dementia in Clare. In the wider context of developments of old age psychiatry, Clare Mental Health Services has a dedicated consultant-led team for psychiatry of old age which caters for a potential population of approximately 14,500 older people aged over 65 years. This is based in Cappahard Lodge, Ennis and consists of a non-consultant hospital doctor, nursing, psychology, social worker and occupational therapy care.

As part of development funding allocated to the mid-west, an additional five staff were allocated and are in place in psychiatry of later life in Clare. There are advanced plans to develop a day care centre on the St. Joseph's site specifically for people with dementia, and the HSE is in the final stages of negotiations on this matter.

The needs of our older people are, and will remain, a very high priority. The resources that are available will be applied to provide the best possible mix of supports and services in a way that most effectively matches the needs and preferences of older people, with a particular focus on enabling people to live as independently as possible within their own communities.

Martin Conway (Fine Gael)
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Go raibh maith agat. While I am pleased with the comprehensive reply, I would like this service to open tomorrow, as I am sure would the person who contacted me, who has a loved one who needs the service. Nonetheless, I am realistic and realise it may not happen tomorrow.

I note the Minister of State's reply referred to a timeline of this summer which I welcome, although cautiously, as I would like to see that timeline honoured. I would like the Minister of State to communicate to the Minister for Health, who he is representing here today, that I would like further clarification on this timeline. I know a lot of work is taking place in the background and I note the Minister of State said it was expected that this service would be cost-neutral. What I would say in response is that, given the specialised type of care that would be required to support this unit, it would be very difficult to make it cost-neutral by simply having this service as a replacement for other services that were being provided at St. Joseph's Hospital. The other services that were being provided perhaps did not require the level of interaction and specialised care that this unit requires, and, therefore, it was probably being ambitious to expect it to be cost-neutral. I would like further clarification through the Minister of State on this issue because I will be revisiting it on the Adjournment, probably in six to eight weeks.

Seán Sherlock (Cork East, Labour)
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I thank the Senator for his response. I will certainly raise this issue, not only with the Minister for Health but also with the Minister of State, Deputy Kathleen Lynch, who has a specific area of responsibility in this regard, and I am taking the Adjournment on her behalf. I note the Senator said he would raise this matter again on the Adjournment in the Seanad within the next six to eight weeks. If I may advise, if the Senator was in a position to approach the Minister of State directly, I am sure she would be more than delighted to discuss this in person with the Senator.

I also note the manner in which the issue was raised with the Senator by a constituent of his whose family member is acutely affected by the provision of these services. We want to ensure that we supply these services appropriately and, as I said at the outset, bearing in mind at all times the dignity of the people who need these services. It is taking time. There is a timeline and we would be very hopeful of sticking to that timeline. I thank the Senator.

Martin Conway (Fine Gael)
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I will certainly speak to the Minister of State, Deputy Lynch, directly. I thank the Minister of State, Deputy Sherlock, for his time on this matter.