Victor Boyhan (Independent)
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I thank the Cathaoirleach for selecting this matter for discussion. Conscious of time, I will be brief. I welcome the Minister of State, Deputy Jim Daly, to the House although I had requested that the Minister, Deputy Harris, come to the House to make a statement on the closure of the paediatric inpatient service at the National Rehabilitation Hospital, NRH, in Dún Laoghaire. I have rehearsed this saga and related issues since January 2017. Today, I call on the Minister for Health, whom I am somewhat surprised is not here, although I acknowledge and accept he is a busy man, to explain why the NRH has not been provided with the necessary staffing, resources and specialist supports that are required to enable it to provide a safe and appropriate level of rehabilitative care to patients up to its full bed capacity and to commit to an immediate reopening of the 12 bed closures at this hospital.

Today, there are 12 beds closed in this hospital. The NRH provides a comprehensive range of specialist rehabilitation services to patients from throughout the island of Ireland, who as a result of accident, illness or injury have acquired a physical or cognitive disability and require specialist rehabilitation. The NRH in Dún Laoghaire has advised me that it has a multitude of programmes, including the brain injury programme, including strokes; the spinal cord system and care programme; the prosthetic, orthotic and limb absence rehabilitation programme - better known as the POLAR programme; paediatric and family-centre rehabilitation. It is on paediatric beds and consultants that I would like to dwell in the time available to me.

The Minister of State, Deputy Jim Daly, is aware of the situation, which I know because during my engagement today with the hospital I was advised that his Department had sought clarification on the matter yesterday. On 30 August 2018, a statement was issued relating to the closure of the paediatric inpatient service at the National Rehabilitation Hospital.On top of all of the other problems we have had in this hospital with closures, lack of resources for staff, patients, patients' families, the people queuing up and all the patients waiting in acute hospital beds, no Minister can stand over what is happening there. I really do not want any more lame excuses from anyone in the Department of Health. I have contacted the Minister's office throughout the summer offering to take up his initial invitation to me to meet him to discuss the NRH. He has not yet responded with a firm date to meet. That is disappointing to me and is perhaps a measure of the lack of commitment to and focus on the National Rehabilitation Hospital in Dún Laoghaire. It disappoints me to have to say that. In summary, the hospital says in this statement that it wishes to restore the much-needed paediatric cover for this hospital to allow it to get on with providing inpatient services and to resume as early as possible. In January 2017 the hospital had 12 beds closed. Despite promises to open them we confirmed in July that six had been opened. In August, another six beds to do with the inpatient paediatric services closed. It is unacceptable. The patients are unhappy. I have indicated to politicians in the constituency of Dún Laoghaire, members of all parties and none, that there will be a series of public rallies and meetings which I will lead to get a focus on this. I have been very patient - and I think every Member of this House will vouch for that - in consistently raising this issue but I am getting a closed door. Patients are disappointed but more importantly, so are the families. The final issue is that we have patients waiting in acute hospital beds to avail of the excellent services in the National Rehabilitation Hospital.

Jim Daly (Cork South West, Fine Gael)
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I thank Senator Boyhan for raising this issue and for giving me an opportunity to respond. The NRH in Dún Laoghaire in Dublin provides complex specialist rehabilitation services to patients who, as a result of an accident, illness or injury, have acquired a physical or cognitive disability and require specialist medical rehabilitation. The hospital has a reputation for excellence, as Senator Boyhan said, and provides patients with every opportunity to meet their rehabilitation goals through personalised treatment plans delivered by consultant-led interdisciplinary teams expert in their fields.

Services provided at the hospital include a paediatric programme which is delivered by a paediatric team based on campus with clinical oversight provided by a consultant paediatrician who is based off-campus at another hospital. Until recently this consultant paediatric oversight had been provided by a paediatrician at Our Lady's Children's Hospital, Crumlin, whose contract includes a seven-hour clinical attachment to the NRH. I am advised by the Health Service Executive, HSE, that the consultant paediatrician in question has recently gone on unplanned long-term leave and arising from this unforeseen development, Our Lady's Children's Hospital is not in a position to provide consultant oversight to the National Rehabilitation Hospital's paediatric programme. In light of this, the NRH has reluctantly closed its inpatient paediatric service on the basis that it is not possible to appropriately assess and triage new paediatric referrals and medically manage paediatric patients without consultant paediatric input.

I am aware that the parents of children requiring inpatient and day care services at the NRH are very concerned and I assure them that all is being done by the HSE to address this situation. The Children's hospital group has confirmed that officials have been working to identify another consultant paediatrician with an interest in disability to fill the vacancy to provide appropriate clinical paediatric oversight to the services provided in the NRH. I understand that a meeting between officials in the HSE community healthcare organisation, CHO, 6, the NRH and the Children's hospital group is being arranged imminently to discuss possible options required to affect the resumption of a sustainable service as soon as possible. In the interim, the paediatric team at the NRH will continue to carry out assessments and provide therapies and outpatient services to existing paediatric patients.

The Government recognised the excellent rehabilitation programme which the NRH delivers and the hospital's excellent patient outcomes. A key priority at the moment is delivery of replacement accommodation at the hospital. This development will see the existing ward accommodation replaced by a new fit-for-purpose ward accommodation block of 120 single en suite rooms with integrated therapy spaces, a new sports hall, a hydrotherapy unit and a temporary concourse, as well as clinical and ancillary spaces. It will be a major enhancement to rehabilitation services in the country and will have a direct and significant impact on patient recovery by providing an optimal ward and therapeutic environment for patient treatment at the NRH. Construction work is currently under way and the new development is expected to be operational in 2020. Funding for phase 1 and phase 2 of this major redevelopment project was included in the Government's recently announced Project Ireland 2040 policy, part of an overall €10.9 billion strategic investment in health.

Victor Boyhan (Independent)
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I thank the Minister of State.

Denis O'Donovan (Fianna Fail)
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The Senator must be brief because we are up against the clock.

Victor Boyhan (Independent)
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We do not need a history lesson on the construction of a new hospital as part of the national rehabilitation facility because we know about the matter. I have a folder that contains all the ministerial responses and that can prove this is the same old cut and paste response about a new facility. I am not talking about a new facility at the National Rehabilitation Hospital site in Dún Laoghaire. Can the Minister of State guarantee that consultant paediatric cover for the children in the hospital will be restored? Only six beds have been designated for use by children in that hospital. When can he guarantee that the six beds that were closed will be re-opened? When can he guarantee the other six beds will be provided?

Earlier today I issued a letter to the Minister but I would like the Minister of State to convey four demands to him. I want the Minister for Health to meet me and a delegation. I also put him on notice that a campaign will be launched this week to focus the attention of politicians on the hospital. I want the 12 beds re-opened in the hospital. I also want consultant paediatrician cover to be restored immediately at the hospital.

Jim Daly (Cork South West, Fine Gael)
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I am more than happy to convey the demands made by the Senator. One of my favourite attributes in any politician is consistency. The Senator has been more than consistent on this issue on numerous occasions in the House.

Victor Boyhan (Independent)
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I thank the Minister of State.

Jim Daly (Cork South West, Fine Gael)
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The Senator has been a loyal and consistent supporter of the work that takes place at National Rehabilitation Hospital. I shall support him in any way that I can to address the challenges faced by the hospital. I will convey his sentiments to the Minister for Health.

Victor Boyhan (Independent)
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I appreciate that.

Denis O'Donovan (Fianna Fail)
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I thank the Minister of State. I know that we are almost up to our starting point but I must suspend the House until 3.30 p.m.