Colm Burke (Fine Gael)
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I raise this issue in the context of Fermoy Community Hospital. While this facility is not in my own area of Cork North-Central, it does in fact accommodate some patients from that area for respite care. I understand that there are nine respite beds available in the hospital but that difficulties have arisen around GP cover there. I know that the hospital and the HSE have done everything possible to get new GPs on board, but what seems to have happened is that GPs who had been providing back-up support in the hospital have since retired.

The availability of respite care is extremely important both for elderly people and for families who are providing care at home and who need a break from this work that they are doing on a voluntary basis. I understand that a restriction was placed on the use of the facility and I would like to hear what efforts are being made to bring it back into full use and make the services there fully available to the people of Cork East and indeed of parts of Cork North-Central.

Finian McGrath (Dublin Bay North, Independent)
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I thank Senator Colm Burke for raising this very important health issue. I am taking this matter on behalf on my colleague, Deputy Jim Daly, Minister of State with special responsibility for mental health and older people. 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. This is clearly what older people want and only those in genuine need of residential care should go down that route. Short-term beds including respite and rehabilitation beds contribute to the provision of an integrated model of care for older people enabling them to return home following a period of hospital care or postponing admission to long-stay residential care.

The Health Service Executive is responsible for the delivery of health and personal social services, including those at facilities such as St. Patrick’s Community Hospital, Fermoy. St Patrick’s provides long-term, respite, convalescent and palliative care. It was registered with the Health Information and Quality Authority on 28 June 2015 for a period of three years. The hospital normally caters for people over 65 years of age but also provides care to a number of young chronically ill sick patients and palliative care to adults. These are important services.

The Senator will be aware that the five-year capital programme announced last year includes refurbishment works at St. Patrick’s Community Hospital. Challenges have emerged in the last few months, however, in respect of medical cover at the hospital which is provided by three local GP practices. One practice provides this service three days a week. The remaining two practices provide the service on the fourth and fifth days. Following the resignation of a medical officer in 2017, the Health Service Executive managed, with great difficulty, to engage another GP to provide the service. However, in September 2017 a second medical officer retired. Despite strenuous efforts to engage another GP in the area the HSE, unfortunately, has been unable to source GP cover for the fifth day. This is the core problem. Contact was made with GPs in and around Fermoy and as far as Glanmire and a general email to all GPs in the GP training scheme was also sent out through UCC. To date, no GP has expressed an interest in the post as they are unable to commit to the time involved due to the demands in their own practices. Nor has the HSE been able to get agency cover.

The HSE has assured the Department of Health that efforts are continuing to source a GP. In order to protect the 54 long-stay beds, respite service affecting nine beds in Fermoy has been curtailed for the moment.This service is now being provided by local nursing homes. The local public health nurse is liaising with families to accommodate their relatives in alternative facilities while efforts are ongoing to source GP cover. The Minister of State, Deputy Jim Daly, has asked me to reassure Senator Burke that the officials from the Department will continue to monitor this position carefully and I have asked the HSE to keep me updated on progress. I will bring the Senator's concerns back to the Minister of State, Deputy Daly, as well.

Colm Burke (Fine Gael)
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I thank the Minister of State for his comprehensive reply. This is a major challenge. There are nine respite beds not in full use. I am not clear about it but I know some people have had to transfer to Mallow and other areas for respite care. It must be prioritised. We are facing into the winter season and families face major challenges now. It is important that the respite facility that was there is restored. Is whatever is being offered to GPs to provide that cover adequate? Perhaps we should review why we can only get GPs for five days and how we can cover the final two days. It must be given priority because we cannot afford for this service to be curtailed in any way, especially with the large number of elderly people in the area, right up to Cork city. People are being looked after by their own families and they need a level of support. It is very important that we prioritise this.

Finian McGrath (Dublin Bay North, Independent)
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I thank Senator Colm Burke and I agree that it is a major challenge. We must consider this matter in Fermoy seriously. The Senator raised the point about respite care, and that is something the Government must prioritise, particularly in the severe and cold winter months. I reassure the Senator that while there is a crisis, cover comes from local nursing homes. I agree that we must examine this as a priority.

I will bring the Senator's other point back to the Minister of State, Deputy Jim Daly. It considers why it is difficult to get GPs, particularly on the fifth day. We must think about this as there is a broader debate in my Department about social care workers; I want to ensure there are well-paid, high-quality social care personnel working with people with disabilities. The same idea applies here. Is there an issue with payments or cover? I do not know the details but we must find out and see if the position can be improved. On a positive note, the local health nurse will work very closely with families in the local area to try to accommodate people and bring up alternative facilities. In the meantime, I will bring the Senator's concerns straight to the Minister of State.