Colm Burke (Fine Gael)
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I thank the Minister of State and welcome her to the House. I am raising the issue of the refurbishment of community hospitals in the Cork area, particularly Millstreet Community Hospital and Kanturk Community Hospital. They provide an essential service in the communities of Kanturk and Millstreet but there are also other community hospitals around the county. People are concerned about the stage we are at in getting refurbishment carried out in order to bring these hospitals up to the standards required by HIQA. When are contracts likely to be put in place? When is the work likely to occur not only in Kanturk, but in community hospitals around the county?

Catherine Byrne (Dublin South Central, Fine Gael)
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On behalf of the Minister, Deputy Simon Harris, I thank Senator Burke for raising this matter. Although it is Government policy to facilitate older people to remain in their own homes for as long as possible, there will always be a cohort of people who need long-term care. Quality residential care must continue to be available for those who need it. Residential care is provided through a mix of public, voluntary and private provision. The Health Service Executive is responsible for delivering health and personal social services across the country, including at facilities such as Millstreet Community Hospital and Kanturk Community Hospital. Public residential care units are an essential part of our healthcare infrastructure. They provide approximately 5,000 long-stay beds, amounting to approximately 20% of the total stock of nursing home beds nationally. There are also approximately 2,000 short-stay community public beds.

While the care delivered to residents in our community hospitals is generally of a high standard, many of these services are delivered in buildings that are less than ideal in the modern context. It is therefore important that we upgrade our public bed stock and this is the aim of the capital investment programme for community nursing units. This provides the framework to allow for an enhanced programme to replace, upgrade and refurbish these care facilities, as appropriate. Significant work was undertaken to determine the most optimal scheduling of projects within the phased provision of funding to achieve compliance and registration with the Health Information and Quality Authority. The investment programme includes a number of facilities in Cork.

The Senator will appreciate that all healthcare infrastructure developments require a lead-in time to complete the various stages. These stages include appraisal, project brief, design feasibility, a review of costing estimates and finalisation of financing. The HSE has informed the Department of Health that upgrade works have already been completed at Bandon and Bantry hospitals. Other projects are at appraisal and design stages and are proceeding according to capital planning guidelines. The community hospitals in Millstreet, Kanturk and Fermoy are currently advancing collectively and are referred to as the north Cork bundle. A full design team has been commissioned by the HSE estates division. The HSE project team has also been commissioned to advance the service needs assessment and is reviewing existing layouts and accommodation for regulatory compliance.

It is expected that planning applications for Kanturk and Fermoy will be made by the end of the year, with Millstreet to follow in early 2019. Subject to the successful completion of the design, planning and tendering stages, it is expected that the projects could commence construction in 2020 and be completed by the end of 2021. The development of Midleton Community Hospital and St. Finbarr’s community nursing unit in Cork city are currently being advanced for delivery by means of a public private partnership mechanism, which is at an early stage of the development. Unfortunately, it is not possible at this point to give a detailed timeline for the delivery of each stage of the project. It is, however, expected that the facility will be operational by the fourth quarter of 2021.

The national development plan acknowledges the need for additional capacity. It is expected that 4,500 additional short-term and long-term beds will be required across the public system in community nursing units and other step-down facilities, as identified by the health capacity review. Health capital projects and programmes currently under way will continue and these major priority projects will require the bulk of the notified capital allocation over the initial period of the plan for 2018 to 2022. It is important to recognise that this is a long-term plan which will roll out over ten years and includes provision for a large number of developments across the country. As is to be expected with a ten-year plan, many proposals are at an early stage and, as with all capital development proposals, will require further appraisal, planning, design and tendering before a firm timeline or the funding required can be established. Appraisal and planning across all community healthcare organisations, in line with health strategies and demographic needs, will inform the selection of projects for delivery of these new beds and this additional capacity.

Colm Burke (Fine Gael)
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I thank the Minister of State for her comprehensive reply. We will have major challenges in the whole area of healthcare because of changing demographics. As the Minister of State is aware, the number of people over 65 is currently 637,000 and within ten years will be 1 million. Therefore, we will have huge demand and will need to dramatically increase the amount of care being provided in people's own homes. However, we must also make sure that we have adequate facilities in our community hospitals and nursing homes across the country. I thank the Minister of State for the reply but we need to fast-track some of these projects and make sure that we plan, develop and deliver all of these projects on time. Again, I thank the Minister of State for her contribution.

Catherine Byrne (Dublin South Central, Fine Gael)
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I understand Senator Burke's concerns around the reply. In general the Government is committed to keeping people at home as long as we can and facilitating their needs. As the Senator has already said, over the coming years the population will get older and there will be more people who may need to avail of services, particularly long-term care and short-term beds. I understand the Senator's concerns, however, according to the national development plan, there will be a considerable number of new initiatives around older people's residences around the country over the next ten years. Some work has already begun on some of the facilities which have to be refurbished. I will convey Senator Burke's concerns to the Minister. I know the reply does not give him any definite times or dates, but I will ask the Minister, Deputy Harris, to come back to him.