Mark Daly (Fianna Fail)
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I know this item will be of interest to the Leas-Chathaoirleach and to everybody in County Kerry. I thank the Minister of State, Deputy Finian McGrath, for taking the time to come to the House to give us an update on the issue of staffing levels in Kenmare Community Hospital. As the Minister of State will be aware, the hospital has been open since 2013 and, in fact, the official sod-turning by Senator Reilly, then Minister for Health, happened on 3 February 2012. Yet, despite the Government spending €8 million on this new facility, only 19 of the beds are open at this stage and 21 remain to be opened. We must bear in mind we have been waiting six years for the opening of the second floor of the hospital.

The excuse that has been given time and again in this House is the issue of recruitment. We are producing far more nurses per head of population than most European countries yet we are exporting most of them. They are being offered jobs in England, Australia and the Middle East, and they are taking up those jobs. For some reason, the offers that are being put out by the Government every year or six months are not being taken up, and that reason is that the pay and conditions are simply not good enough.

The excuse applies not only to Kenmare Community Hospital but also to Dingle Community Hospital, on which €14 million was spent and where 60 beds were provided but only 43 are open, again, due to the lack of nurses being recruited by the HSE.I hope the Minister of State does not give me the same reply I got six months ago, a year ago, two years ago, two and a half years ago or any time I have been allowed to ask this question that it is still trying to recruit. It is six years on and if it is still trying to recruit for this hospital and all the other hospitals that have vacancies, the Government obviously has not identified the true problem, which is the Government, in that it is the one that is not giving the proper terms and conditions, and that is why people are not taking up the positions in this hospital and in all the other ones. I thank the Leas-Chathaoirleach.

Paul Coghlan (Fine Gael)
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I thank Senator Daly and I call Minister of State, Deputy Finian McGrath.

Finian McGrath (Dublin Bay North, Independent)
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I thank Senator Daly for raising this very important issue, and of course I share his concerns about this particular issue. I am taking this matter on behalf of the Minister of State, Deputy Jim Daly. Residential care is provided through a mix of public, voluntary and private provision. It is worth highlighting that the net budget for long-term residential care in 2019 is €985 million, and more than 33,000 clients on average at any one time will be in receipt of financial support. Over the last two years, an additional €45 million has been provided to the nursing homes support scheme, NHSS, budget. In 2020, the NHSS will see a further investment into its budget of €45 million, bringing the total annual budget for the NHSS to €1.03 billion.

Public residential care units such as Kenmare Community Hospital, County Kerry, are an essential part of our healthcare infrastructure. In total they provide about 5,000 long-stay beds, amounting to 20% of the total stock of nursing home beds nationally. There are also about 2,000 short-stay community public beds.

The Health Service Executive is responsible for the delivery of health and personal social care services, including the Kenmare Community Hospital. HSE community healthcare organisation, CHO, 4, which includes County Kerry, is committed to delivering services for older persons through a community-based approach that is supporting older people to live in their own homes and communities and when needed in residential care, such as Kenmare Community Hospital.

Currently, there are 19 beds open at Kenmare Community Hospital with the potential to open up another further 21 in the future. While the HSE had planned to open a number of additional beds at the community hospital on a phased basis, it has unfortunately faced challenges in recruiting the extra nurses needed. The existing nursing staff complement for the 19 existing beds is 8.66 nursing whole-time equivalents along with 7.86 healthcare assistants. However, in order to open an additional nine beds, a further 5.11 nurses, whole-time equivalents, WTEs, are required, so another five nurses are required to open the nine beds.

I have been assured that the increasing capacity of Kenmare Community Hospital remains a priority for the HSE and that it is continuing to make intensive efforts to recruit nursing staff. I am also informed that the executive has run three recruitment campaigns in the last year alone, the most recent recruitment campaign being in September 2019, when every effort was made to recruit the necessary staff. Unfortunately, no suitable candidates were recruited at that time. The HSE fully understands the importance of Kenmare Community Hospital to the local community and appreciates the excellent care provided by the staff there.

I note that the recent inspection report published earlier this year by the Health Information and Quality Authority acknowledged that the centre was warm, bright and comfortable and met the needs of the residents, so we have great confidence in the hospital. In general, the inspector observed that the care and support given to residents was respectful, relaxed and unhurried. Staff were familiar with the residents' preferences and choices and facilitated these in a friendly and respectful manner.

The local HSE management has assured the Department of Health that it will continue to work to extend the services in Kenmare. The HSE has informed the Department that the hospital has an excellent reputation locally as a care facility and that the welfare of its residence is a priority for staff and management and that they are deeply appreciative of the support the hospital receives from the families in the wider community.

In line with the usual process, the HSE will continue to review all of its services to ensure the continued provision of high quality, value-for-money residential care with the older person at the centre of all decisions made. I will bring the Senator's genuine concerns back to the Minister of State, Deputy Daly.

Mark Daly (Fianna Fail)
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I thank the Minister of State for taking the time to come here to give the reply on behalf of the Minister of State, Deputy Daly. I will focus on the value-for-money element. There is no value for money in having a facility that cost €8 million with half of it empty for six years. While the Minister of State pointed out that no suitable candidates were recruited at the time, the real issue lies with the terms and conditions the HSE is offering staff. This is not just an issue for Kenmare or Kerry, but is nationwide. In talking about value for money, agency nurses are being brought in at a cost of hundreds of millions of euro per annum to fill the void in the hospital services. The terms and conditions for nursing staff is the problem for Kenmare community hospital.

People in Dingle are being sent outside the peninsula. A 90 year old woman cannot be cared for in her local community because the beds are not opened. The beds are not opened because the nurses are not hired. The nurses are not hired because the terms and conditions are not as they should be. Britain, Australia and other countries are benefiting from the nurses we are training but not willing to pay adequately. That will continue and I will be back here in six months, but hopefully not asking the same question and getting the same answer. I again thank the Minister of State for coming to the House.

Finian McGrath (Dublin Bay North, Independent)
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I accept the valid points the Senator has made about Kenmare hospital. I acknowledge, as does the HSE, the importance of the role facilities like Kenmare community hospital provide to the people in the region. The welfare of residents is a priority for the staff and management who are very appreciative of the support the hospital receives from families and the local community. However, the HSE cannot open additional beds unless the appropriate level of nursing staff is in place to ensure the service provided is safe and of the optimum quality for elderly residents who require professional nursing care.

I take on board the Senator's point about highly trained nurses leaving the country along with his value-for-money economic argument on the €8 million it cost to build the hospital with the wards half-empty. He also spoke about the nurses' terms and conditions, and the high cost of agency nurses. I regularly say to Government that a lot of the resources could be spent in that direction. I will bring the Senator's concerns back to the Minister of State. The HSE will continue to make every effort to recruit the nursing staff for Kenmare community hospital.