Seanad debates

Tuesday, 29 September 2015

Commencement Matters

Hospitals Capital Programme

2:30 pm

Photo of Paddy BurkePaddy Burke (Cathaoirleach of Seanad; Fine Gael)
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I welcome the Minister, Deputy Varadkar, to the House.

Photo of Paschal MooneyPaschal Mooney (Fianna Fail)
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I thank the Minister for coming to the House. On a side issue, I compliment him on his appearance on "The Late Late Show". It looked like a very enjoyable one for him.

As the Minister will be aware, the background to this debate is the withdrawal by HIQA of the registration of St. Patrick’s hospital in Carrick-on-Shannon. This decision, which was made amid great controversy, received a negative reaction from the staff and supporters of St. Patrick’s hospital, particularly regarding the manner in which it happened. However, my understanding now is that steps are afoot to improve the situation at the hospital to comply with HIQA regulations. I also understand that the imminent opening of a new 20-bed primary care centre in Ballinamore, County Leitrim, which will result in the transfer of 20 patients from St. Patrick’s hospital to Ballinamore, will go a long way towards compliance. The view of the HSE north west is that St. Patrick’s hospital will be re-registered in a short space of time. That is the background and context to this debate.

The HSE has made an application for funding for the construction of a new 90-bed state-of-the-art unit on lands adjacent to St. Patrick’s Hospital that have been acquired. My understanding is that plans and proposals are at a very advanced stage and that a commitment from the Minister and the Department to fund the new facility is all that is required now. I am sure the Minister will confirm that or clarify the situation.

I might put it on the record that St. Patrick’s hospital was originally a Famine workhouse. As it has been there since 1841, plainly it is not fit for purpose. While I appreciate that there are similar establishments across the country with a similar history, I would like to think that the St. Patrick’s hospital facility is rather unique in this regard. It is a great tribute to the doctors, nurses and general staff of the hospital that they have maintained it to the highest possible standard.

Despite the conclusions of the HIQA report, the general view of the public and particularly of family relatives of those who are cared for at St. Patrick’s hospital is that it is a facility of the highest standard and that the commitment of the nursing staff and doctors is unrivalled. It is for that reason that the HIQA decision caused a great deal of local anger and was seen as an unfair portrayal of an institution that has struggled to maintain those high standards in the face of serious difficulties for a long period of time.

As I said at the outset, it looks like this particular situation is going to be resolved in the short term. I hope that will happen. The main purpose of my contribution is to plead with the Minister to provide the necessary funding so that the new state-of-the-art facility in the capital town of County Leitrim can go ahead forthwith.It is vitally important that such a facility be located in the county and I would hate to think anything would endanger the future of such a facility and that it would be due to lack of funding, given that all the t's have been crossed and the i's dotted in that regard.

Photo of Leo VaradkarLeo Varadkar (Minister, Department of Transport, Tourism and Sport; Dublin West, Fine Gael)
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I thank Senator Mooney for reporting this important issue. I am taking the debate on behalf of my colleague, the Minister of State, Deputy Kathleen Lynch, who is at another event. The Government's policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible. If it becomes necessary for an older person to move to a nursing home, appropriate accommodation must be available that meets his or her care needs and matches his or her wishes. The HSE is responsible for the delivery of health and personal social services, including those at St. Patrick's Community Hospital, Carrick-on-Shannon, County Leitrim. The hospital was built in 1841 and has been used as a care facility since 1928. The centre has an occupancy of 85 beds, comprising 63 continuing care beds and 22 short-term care beds used for rehabilitation, convalescence, respite or palliative care.

Since 2009, all nursing homes - public, private and voluntary - have been registered and inspected by the Health Information and Quality Authority, HIQA. The most recent HIQA report on the hospital was published last July. Although the report acknowledged that progress had been made and improvements were evident since previous inspections, some concerns were reported, including the physical infrastructure of the facility. I have been informed by the HSE that a substantial action plan has been submitted to HIQA. This sets out what has already been achieved since the inspection and provides identified dates for the actions required by HIQA to be completed. Part of the HSE longer-term plan for County Leitrim includes the opening of a newly-built, 20-bed community nursing unit in Ballinamore. The HSE has applied to HIQA to register this facility and is in the process of recruiting staff. It is expected that the unit will open before the end of this year. This will allow patients from the area who are currently resident in St. Patrick's to transfer to Ballinamore. As a result, there will be some reduction in bed numbers at St. Patrick's, allowing more space, privacy and dignity for the remaining residents, so addressing HIQA's concerns about lack of privacy for some residents in St. Patrick's. The opening of Ballinamore will ensure overall bed numbers are maintained in the south Leitrim area. The new unit will be operated and run by the HSE.

A number of community nursing units, CNUs, similar to St. Patrick's hospital are very old and it can be very difficult or costly to adapt them to modern standards. Discussions are ongoing between HIQA and the HSE about the conditions that will apply to public facilities across the country. Later today, I will announce the total funding that will be available for capital investments in the health sector over the coming years. This will allow the HSE to frame a capital plan that balances priorities across the health service with the available funding. The overriding objective will be to ensure, in so far as possible, that when older people need care in public and residential facilities, it is available for them. Although many public facilities are not in line with how modern residential units are designed and configured, the standard of care provided to residents is generally of a very high standard. Residents and their families frequently express their appreciation of the care they receive and continue to choose such facilities even when alternatives are available. My Department will work with the HSE to allocate whatever funds are available in the most effective way possible, with the safety and welfare of residents being our top priority.

The Senator is probably aware that the capital plan for 2016 to 2021 was published in the last hour or so. It allocated an additional €300 million to the Department of Health for community nursing units and disability facilities over the next six years, and this is in addition to what was already in the budget. Although I cannot say at this stage how it will break down and which projects will be funded when, the Minister of State, Deputy Kathleen Lynch, is working with the HSE on it with a view to making an announcement on a national basis during the next couple of weeks.

Photo of Paschal MooneyPaschal Mooney (Fianna Fail)
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I am very grateful to the Minister. It begs the obvious question, which he has partially answered, as to whether, as a result of the increased allocation in the community service sector, which is welcome, the new unit in St. Patrick's Community Hospital in Carrick-on-Shannon will go ahead. I understand it is not necessarily directly in the Minister's brief and that the Minister of State will make the allocations. When the Minister said it would be a matter of weeks, will it be before or after the budget?

Photo of Leo VaradkarLeo Varadkar (Minister, Department of Transport, Tourism and Sport; Dublin West, Fine Gael)
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Only today did we know for sure what was available in our capital envelope for the next six years. The Minister of State, Deputy Kathleen Lynch, with my oversight, will meet the HSE, go through it and devise a six-year capital plan for community nursing units and disability residential centres.It will certainly be in there, I just cannot tell the Senator today exactly when it will start and finish and so on. Obviously some of these will require planning permission. All that now has to be worked out. It is a bit like the schools programme which will be ready for publication in a few weeks. There will be a similar programme for community nursing units and disability homes.