Paddy Burke (Fine Gael)
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I welcome the Minister of State at the Department of Health, Deputy Kathleen Lynch.

Michael Mullins (Fine Gael)
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I also welcome the Minister of State. I am delighted she could attend to discuss this matter regarding Ballinasloe Social Services. It is a wonderful organisation that provides an amazing service to the elderly in Ballinasloe and in the outlying areas of Kiltormer, Lawrencetown, Clontuskert, Kilconnell, Aughrim, Cappataggle, Taughmaconnell, Moore and Clonfad.

Ballinasloe Social Services has a minibus and it brings people to the centre four days a week. People who avail of the services are referred by the general practitioners, GPs, public health nurses, social workers and family carers. Ballinasloe Social Services has a range of activities. It provides lunch for the elderly, music every Tuesday, exercise programmes, computer classes, arts and crafts and card playing. A Health Service Executive, HSE, community physiotherapist visits on a regular basis to maximise the independence and support or improve the quality of life of the older person. A chiropodist provides a clinic on a monthly basis.

There are two elements in the service. There is a day care service which is availed of by 62 elderly people. There is currently a waiting list of 13 for this service. The meals-on-wheels service is availed of by 65 elderly people, 27 of whom also avail of the day care service. Approximately 100 elderly people can remain in their own homes and communities as a result of the service provided by Ballinasloe Social Services.

The centre is staffed by a HSE nurse and a part-time social services nurse. However, since January 2013 the HSE post has not been filled on a permanent basis. Cover is provided from St. Brendan's community nursing unit in Loughrea on a daily basis from a pool of seven or eight nurses. The inconsistency gives rise to uncertainty as a different person could be there every day providing the service. That is not the best type of service to provide to elderly people.

With regard to its funding, the section 39 grant from the HSE has decreased over the years from €146,700 in 2008 to €131,000 in 2015. In 2014, it cost approximately €259,000 to provide the service to the elderly. This figure is similar to the figure for other years as the centre watches its costs very closely. A balance of €128,000 must be raised through fund-raising and service charges. This is unsustainable in the long term and puts enormous pressure on the staff and volunteers. Much time and effort is spent fund-raising each year which could be better spent in providing much needed services to the elderly citizens.This is compounded by the fact that Ballinasloe is a RAPID programme town, in which there are high levels of deprivation and where the opportunities to fundraise are limited. We are looking for two things: for the nursing embargo to be lifted in this exceptional case to allow one person to be appointed to this post and for an immediate increase in the section 39 grant to enable Ballinasloe Social Services to continue providing the necessary services for the elderly people of Ballinasloe and surrounding areas.

Ballinasloe Social Services provides an amazing facility. The staff and volunteers are kind and caring and provide a warm and homely environment for the elderly persons in their care. I pay particular tribute to the staff but also to the large number of volunteers who give generously of their time to improve the lives of others. There is a wonderful atmosphere in the place which I have seen on the many occasions I have been there and I want it to continue to develop. Through this wonderful service, many elderly persons are enabled to remain in their homes, something the Minister of State and the Government are promoting very strongly and as a result of which, there are significant savings to the State.

To repeat my request, we want a nurse appointed on a full-time basis and an increase in the section 39 grant to enable the huge burden of fundraising that has to be borne by staff and volunteers to be reduced in the coming years. I thank the Minister of State for attending to deal with this matter.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Senator for raising the issue. The overarching policy of the Government is to support older 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 this is appropriate. The Health Service Executive is responsible for the delivery of health and personal social services, including home help an home care packages, meals on wheels, respite or day care and a range of other community-based services.

Day centres such as those provided by Ballinasloe Social Services provide invaluable support, advice and social interaction for older people who may, for any number of reasons, be experiencing isolation and loneliness. Ballinasloe Social Services has been operating as a social outlet in the area since 1972 and operates Monday to Thursday. Traditionally, the services provided have included services within the remit of what is now Tusla, Ballinasloe Social Services and the HSE. Personnel, including public health nurses and physiotherapists, have collaborated in the provision of services for older people.

The day care service is provided four days a week and staffed on a full-time basis by one nurse whole-time equivalent. This post is filled by a number of nurses from the pool at St. Brendan's CNU, Loughrea, as the Senator outlined. There is no embargo on the filling of this post. On the basis that the post of permanent, full-time nurse is a stand-alone position, the HSE has experienced difficulties in filling it. However, every effort is made to provide continuity of care through the pool of nurses.

Since 2011, the HSE has provided €131,000 annually for Ballinasloe Social Services through a section 39 grant. As we are all aware, the Health Service has been through a number of very difficult years, probably the most difficult in modern times. However, there is good news on the resources front and we have a little more money than previously. This year we secured the first increase in health spending in seven years and next year we will have nearly €900 million more compared to budget 2015. Notwithstanding the better economic news recently, resource availability remains tight across the health service. However, the Government remains fully committed to using the resources available in the most effective way possible and in a way that best matches the needs of service users. The HSE is continuously working to develop services on this basis. A priority for 2016 will be the development of an integrated model of care, with a strong emphasis on home and community care.The level of services to be provided by the available funding will be set out in the HSE's 2016 national service plan which is currently being prepared by the Executive.

While I welcome the increase in funding for the health services in 2016, I do not underestimate the continuing challenge of delivering the services required against a backdrop of growing needs. It is essential that we continue to focus on cost containment, productivity and efficiencies, as these will continue to be a major cost pressure on the health service into the future. These pressures include an increased and aging population, an increase in chronic conditions and new and expensive medicines and treatments.

The HSE acknowledges the significant and valuable contribution made year after year by Ballinasloe Social Services and it looks forward to continuing its collaboration in the future with the mutual goal of providing the best possible care for older people in that area. The negotiations on funding are always carried out between the service and the HSE on a service level agreement. The service provided is appreciated.

Michael Mullins (Fine Gael)
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I thank the Minister of State and I concur with her. The service is appreciated and I welcome the fact that there is no embargo on filling the post. I assume that efforts will continue to be made to fill the post on a permanent basis because it is not sustainable to have somebody coming every day from the service in Loughrea. I hope to see some progress there. I welcome the fact that there are additional resources available this year. I hope that the negotiations and discussions between the service providers, Ballinasloe Social Services, and the HSE management will result in a significant increase in the resources it receives in the coming year. I thank the Minister of State for coming in and I would like her to visit the service if she is in the area. It is a model service and is certainly something that can be replicated in other areas of the country.

Kathleen Lynch (Cork North Central, Labour)
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The difficulty in recruitment is not only in areas such as Ballinasloe. It exists across the range, including in some of our very high tech hospitals, where one would imagine nurses would want to work. It is getting easier. That is all I will say. There are still vacancies but not as many as there were. If the right person becomes available the post will be filled.