Annie Hoey (Labour)
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I thank the Minister of State for coming to the House. Senator O'Loughlin has four minutes.

Fiona O'Loughlin (Fianna Fail)
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It is lovely to be greeted by the Acting Chairperson's smile when we stand up to speak. I welcome the Minister of State. I know how passionate and compassionate she is regarding services for older people. In this instance, we are talking about a specific service that is sad but needed. Dame Cicely Saunders, who founded the hospice movement, said, "You matter because you are you, and you matter to the end of your life." Those words are important. The hospice movement has given great dignity, respect and comfort to many at the ends of their lives, as well as to family members around them.

In 2001, the national advisory committee on palliative care stressed the importance of every region having a hospice. Sadly, there is one region that still does not have a hospice, namely, the midlands region of Laois, Offaly, Longford and Westmeath. It has been described as a black spot. In 2013, a joint study recommended that the hospice be on the campus of the hospital in Tullamore.

There has been some movement. Professor Humphrey O'Connor is the chair of the committee. I have had a number of meetings with him and facilitated a meeting with the Minister for Health, Deputy Stephen Donnelly, last April. Since then, plans have been drawn up and a feasibility study was formally assessed. These all agreed that Tullamore is the correct place for a hospice. Planning, funding and so on need to be put in place.

I referred to the Minister of State's passion and compassion at the start. We need urgent action and intervention. It is not acceptable to have a black spot for end-of-life and palliative care anywhere in our country. While the region is fortunate to have a well-developed palliative care service in the community, with an aim to care appropriately for people at home for as long as possible, the provision of specialist palliative care and patient beds will facilitate hospital avoidance and support families in end-of-life care for their loved ones. I know the tremendous service that St. Brigid's Hospice in the Curragh gives. A friend and neighbour of mine, Paddy Curran, passed away a month ago. I know the solace and support that the hospice gave to his wife and to all of his extended family and friends.

Hospices are places that any of us ever wants to be in or see our loved ones in, but they are vital. When the time comes and families in the midlands need to rely on these services in order to ensure that their loved ones are cared for with grace and dignity in the final period of their lives, this service is simply not there. We need to ensure that we are providing patients and their loved ones with adequately funded and resourced end-of-life and palliative services. These are already incredibly difficult and traumatic times for people. It is not acceptable that we add to that suffering by not providing hospice care in the midlands.

I hope that the update that the Minister of State is bringing us today will be a positive one from the Department and its officials. I hope that we will be able to provide some certainty to those in the midland counties I mentioned.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator for raising this important issue about an update for the plans for a midlands hospice. I thank her for the compassionate way in which she has dealt with it. Her statement at the start, "You matter because you are you, and you matter to the end of your life.", reflects exactly what a hospice does. The Government is strongly committed to the development of end-of-life services, which ensure the care and dignity of the dying person and the family are the focus. The Government is working to guarantee equitable access to specialist palliative care services in every region of the country and to ensure that we meet the palliative care needs of all who require it, as our population grows and ages.

In recent years there has been a significant increase in investment in palliative care services, with recent openings of new hospices in Mayo, Waterford and Wicklow. Along with the extension of St. Brigid's Hospice in the Curragh, there will soon be 276 specialist inpatient palliative care beds available for those who need them. Budget 2022 will provide for increased investment in palliative care services. An additional €2.4 million will be allocated for new service developments and €10 million has been allocated as once-off funding for palliative and end-of-life services to progress national priorities. As the Senator knows, there was another €10 million at the end of last year to support hospices and palliative care.The Department is also updating the palliative care strategy from 2001. The update will reflect the changes in end-of-life care and best practice over the last 20 years. The updated policy will aim to ensure the provision of high-quality, integrated and accessible palliative care services for all patients. It will also reflect increased demand for adult palliative care, the shift towards care in the community, the emphasis in Sláintecare on addressing geographic variations in the provision of both community and hospital palliative care services and developments in international best practice. It is expected to have the policy update published in 2022.

It is a commitment in the programme for Government to increase the number of specialist palliative care beds countrywide to ensure a hospice is serving every region of the country. That was the Senator's exact point. The Department of Health is actively engaging with the HSE to progress plans for the development of hospices planned for Drogheda, Cavan and the midlands. The development of these three units will mean specialist palliative care services will be available in every region of the country. It is recognised that the midlands is one of the three remaining regions without this specialist palliative care inpatient service in place. However, there is continuing progress to develop a new specialist palliative care facility, co-located to the Midland Regional Hospital, Tullamore. I noted the Senator said she met the Minister earlier in the year.

The HSE's palliative care services three-year development framework includes the development of a 15-bed specialist palliative care inpatient unit, or hospice, which will provide support to patients from across the four counties in the midlands. Fundraising from Offaly Hospice Group has recently allowed for architects to carry out initial plans and a feasibility study at the co-located site. The HSE has recently engaged with five hospice groups in the area, the Irish Hospice Foundation and Hooves 4 Hospice, to provide an update on progress regarding the midlands inpatient unit. The development will require collective working towards a specialist inpatient palliative care service in the midlands. HSE estates is developing a costed, timelined plan for the development to be ready by end of 2021, which is very short. In line with the vision of palliative care in the programme for Government, Sláintecare and HSE development framework for palliative care, this development aims to prioritise and protect the most vulnerable.

Fiona O'Loughlin (Fianna Fail)
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I thank the Minister of State for her response. I am pleased to see this issue is progressing. I point out that the HSE's palliative care service three-year development framework she mentioned, including the development of the 15-bed inpatient unit, was for 2017 to 2019. It is already two years out of date. I would have thought we would have proceeded with it. However, it is really good news that HSE estates is developing the costed, timelined plan for the development, which is to be ready for the end of this year. I assume that is going to be ready in about two weeks' time. I acknowledge it was fundraising by the Offaly Hospice Group that allowed the plans and the feasibility study to be in place. When we have the costed, timelined plan for the development I ask that the Minister of State have a meeting with me, the board and of course representatives for the area. I obviously do not expect that meeting to be in 2021 but it would be great if she could commit to facilitating it in 2022.

Mary Butler (Waterford, Fianna Fail)
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I again thank the Senator. She is quite right that HSE estates is developing a costed, timelined plan for the development, to be ready by the end of 2021. The Department of Health is actively engaging with the HSE and representative groups on this matter to improve equity of access to an inpatient unit for the midlands. We had this battle in Waterford for many years. The friends of Waterford Hospice did phenomenal work and raised a significant amount of money over so many years. We would not have seen the Dunmore wing built if not for that. As of the last month or so, and very quietly, the first service users are now in the hospital in Waterford. We were lucky to have that building for the last 18 months for Covid-related issues but it is up and running now and very welcome.

On the Senator's query, I have no problem with meeting her and others but this falls under the Minister for Health, Deputy Stephen Donnelly's brief. Under the delegation orders palliative care falls to him. However, I have no issue whatsoever supporting the Senator's ask here. It is long recognised the midlands area does not have that support and families need it. End of life is a very traumatic time for so many families and having to travel to an area that might be an hour or 90 minutes away is not feasible at all. I am happy to liaise with the Senator on this. I thank her once again for raising this really important issue.

Annie Hoey (Labour)
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I thank the Minister of State for coming in to address the matter and Senator O'Loughlin for raising it.