John Whelan (Labour)
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I welcome the Minister of State at the Department of Health, Deputy Kathleen Lynch, to the House because I know she shares an interest in, a concern and a genuine regard for the issues we are discussing, namely, elderly care and the respect we must always show for our senior citizens.

Nothing defines us more as a society than how we care for young children and senior citizens in the autumn of their years. My colleague, Senator Cáit Keane, has raised this issue in respect of her area. We in County Laois have three community nursing homes, one in Shaen, Portlaoise, one in Abbeyleix, and St. Vincent's community nursing home in Mountmellick. I wish to address the situation in Mountmellick.

I had the opportunity and privilege of attending the annual general meeting of the friends and supporters of St. Vincent's community hospital. These are all decent local people who reflect the high standing and regard and respect in the community, not just in Mountmellick but in the greater Laois area, for St. Vincent's, Mountmellick. Its reputation goes before it as a hospital that provides genuine, tender loving care, regard and respect for senior citizens and a place where their families can rest assured they are being cared for properly and professionally. I accept there is constant pressure on resources and that the Minister of State is fighting her corner in this area. As has been indicated, the buildings in which our community nursing homes are located are very often historic and ageing buildings. That is no reason for failing to invest in them, uphold them and commit to them. We also have, as the Minister of State knows, an ageing demographic. While I clearly accept that the private nursing home sector has a role to play, it cannot do so without the State taking its responsibility by providing public community nursing home care for many of our senior citizens in the autumn of their years. There is concern that hospitals can come under pressure from these infamous HIQA standards. I am all for high and proper standards, but I am not always sure that the textbook and the theory matches the test of reality on the ground, such as the idea that every single person should be in a single room on his or her own. That is an Americanisation of elderly care, where everyone has his or her own television and a magazine. That is rather a lonely space to be. We have to work with different models of care, where people can socialise and fraternise with their companions, friends and visitors. I am not altogether sure that the HIQA standards are the bible we should adhere to at all times.

Will the Minister of State confirm to me that the HSE and the Department of Health are fully committed to the future of St. Vincent's Community Nursing Unit in Mountmellick in particular because I am told it requires in the region of €13 million in investment over a period of years? I accept it has to be done on a phased basis. It cannot all be done overnight but people will rest assured and be happy if they know that commitment exists and that it can be brought up over a period of years to match and meet any standard that is required.

It would be remiss of me, as we have discussed it many times, not to mention Shaen hospital in Portlaoise where there has been some movement this week in terms of a ward closure and redeployment of staff. A long-term answer is still eagerly awaited three years on by the people in Abbeyleix in respect of their community nursing home. My wish is that it would be possible for the Minister of State to give us clarity on that, too. I thank the Minister of State.

Kathleen Lynch (Cork North Central, Labour)
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I am not certain that I can give the Senator the answers to his two later questions but I will get the information for him. I am very conscious of his concerns as he has made them very clear to me over a long number of years. I think it has been his persistence that has ensured that negative decisions have not been made in relation to those areas. I will inquire further.

It is important that HIQA is centrally involved in terms of the care of the elderly and vulnerable adults of all descriptions and now in terms of facilities for children with disabilities. It is about choices, even when one is at an advanced stage, whether that choice for a single private room or that one would share a room. In the event of a couple in a long-standing relationship, they should be accommodated as well. I think that is the type of future we should be seeking to present for ourselves more than anyone else.

As Senator Whelan is aware, 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 2014, with a budget of almost €939 million, financial support will be provided to more than 22,000 people in nursing homes. I think that number has increased slightly in the past month or two. It is nearer 23,000 now. Providing public residential care for older persons forms a significant and crucial part of the services provided and our overall objective is to protect the viability of as many units as possible, within the funding and staffing resources available. This is to provide choice. The Health Service Executive is responsible for the delivery of health and personal social services, including those at facilities such as St. Vincent's hospital, which is located on the outskirts of Mountmellick town. St. Vincent's was registered by HIQA in April 2012 for a period of three years. The registration renewal process is under way. The current capacity is 100 beds, 89 of which are occupied at present. The numbers in community nursing units always fluctuate.

As the Senator will be aware, all developments must be addressed in light of the resources available and everyone accepts that fact in the current circumstances. Given that demand for capital investment for the community nursing unit programme far exceeds the funding available, investment must be allocated as objectively as possible based on the HSE's assessment of priorities. The same principle applies in the context of the previous Adjournment matter. Currently the funding for the community nursing unit programme focuses on the upgrade and refurbishment of existing facilities to achieve HIQA compliance. There have been ongoing capital works within the hospital to enhance the quality of the service. Earlier this year the HSE allocated €400,000 to address HIQA-compliance works at St Vincent's and some minor capital works are due to commence shortly on the infrastructure. This confirms, more than anything else, that there is a future for this unit.

Work is underway on the next multi-annual capital plan for the period 2015 to 2019. Needs and priorities across the community nursing unit programme will be considered again in this context. However, funding for new projects will unfortunately be limited and projects will be selected based on clear and objective prioritisation. I am sure that Senator Whelan would have it no other way. The Department is continuing to work with the HSE in addressing the ongoing need to meet service and safety standards. Every effort will be made within available resources to ensure that the highest standards of care will continue to be provided to all residents in a safe and secure environment and that we meet the needs of those who need our services in the best way possible.

John Whelan (Labour)
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I thank the Minister of State for her comprehensive reply. I am heartened to hear that a substantial and significant fund of €400,000 has been allocated for ongoing works at St. Vincent's Community Hospital. By any prioritisation standards or reasonable criteria, St. Vincent's in Mountmellick would be top of the list because it is at the heart of elderly care in the midlands. I am sure with the Minister of State's commitment and the support of this House, the hospital will be included in the next round of capital funding to ensure that the necessary investment takes place to upgrade the facilities and ensure that St. Vincent's has a bright and long future in caring for our senior citizens. I am grateful to the Minister of State for her response.

Kathleen Lynch (Cork North Central, Labour)
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Looking at community nursing units in the round and taking into account recent developments with the fair deal scheme as well as our ageing population, we can ill-afford to lose any bed. It is in that context that we must move forward. Clearly, there will be areas where safe environmental standards cannot be maintained, perhaps due to structural issues or a lack of resources such as staffing and expertise and that cannot be allowed to continue. In the round, however, as far as I am concerned, we can ill-afford to lose any bed in the context of our ageing population.