Seanad debates
Wednesday, 6 March 2024
Nithe i dtosach suíonna - Commencement Matters
Hospital Closures
10:30 am
Eileen Flynn (Independent)
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I welcome the Minster of State, Deputy Butler, to the House. Senators Kyne and O'Reilly are going to share time. This will be interesting. I have never seen this done for a Commencement matter before.
Seán Kyne (Fine Gael)
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Gabhaim buíochas leis an gCathaoirleach Gníomhach. I thank the Cathaoirleach for choosing this matter. Cuirim fáilte roimh an Aire Stáit. Tá an Ospidéal Cheantar an Chlocháin dúnta le seachtain anuas gan aon fhógra ón HSE. Thug an tAire Stáit cuairt ar an ospidéal sin an samhradh seo caite agus chas sí le cairde an ospidéil agus le hionadaithe poiblí. Tuigeann sí chomh tábhachtach is atá na seirbhísí cúraim faoisimh. Tá éileamh ar na seirbhísí agus tá Ospidéal Réigiúnach Pháirc Mherlin faoi bhrú agus tá leapacha ar fáil sa Chlochán.
The Minister of State is welcome. I thank her for coming in to talk about the matter of Clifden District Hospital, or Our Lady of Fatima Hospital. She visited Clifden last August and met the Friends of Fatima and public representatives. The Minister of State has engaged on this matter and given commitments. I ask her, very upfront and straight, whether and when Clifden District Hospital will reopen. It cannot be a question of whether it will, as it has to reopen. It is absolutely vital for the area. We held a public meeting in Clifden in September 2022. It was packed. There was a huge crowd and great interest and as I said, the Minister of State visited last August. My colleague, Councillor Eileen Mannion, who has put a huge amount of work into protecting hospital services in Clifden, and I are holding a community meeting next Monday in Clifden Town Hall.
What engagement has the Minister of State had on this matter? I have engaged with Des Mulligan, the head of older persons' services in Community Healthcare West and obviously Damien McCallion will have a role as well as chief operations officer at the HSE. It has been suggested there is a staffing issue, that there has been a staffing embargo. Can the Minister of State confirm whether there is an embargo? These are funded posts that are already there. They are already committed to and are long-standing posts. There might be people out sick and people being promoted, but the posts are there. They need to filled and we need certainty on this in the next number of days.
Pauline O'Reilly (Green Party)
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I thank the Minister of State for coming in. As she is aware, Senator Kyne and I jointly submitted this Commencement matter. It is really important we all stand together when it comes to people of Clifden because once again confusion abounds when it comes to Clifden District Hospital. As Senator Kyne outlined, we have a public meeting which was packed. It was cross-party. We all want to work to try to improve things, but the frustration we feel is nothing compared to that felt by people on the ground, patients and families who were told one week the hospital was not closing, and the very next week it was closed. It is very difficult to answer any questions when we are asked about whether there is a staffing issue. We are told there is a moratorium in relation to staff, but we know full well there were staff there, so how can there be a moratorium on getting a staff replacement?How can there be a moratorium on getting a staff replacement? We want some clarity today. We understand that staff are under pressure, but this is ultimately about patient well-being and safety. It takes a couple of hours for a family to bring a loved one into another hospital. That is the reality in Connemara. Our county deserves better.
Mary Butler (Waterford, Fianna Fail)
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It is lovely to see Senator Flynn in the chair. I thank Senators Kyne and Pauline O'Reilly for raising this important issue. I want to be clear on this because I do not want people to be upset or worried. Admissions to Clifden District Hospital have unfortunately been paused due to lack of staff availability. For people listening who might not understand the situation in Clifden, the hospital has not been closed. I was delighted to visit last August and meet the Senators. Senator Kyne accompanied Deputy Ó Cuív and me to the hospital. It was important for me to see what we were talking about. I was struck because, while I know Connemara, I did not realise how vast it was and that people travel for almost an hour from town to town.
St. Anne's community nursing unit in Clifden has 21 beds and had 21 residents yesterday. They are all under the fair deal scheme. It is important that we protect them because they are long-stay beds. In Clifden District Hospital there are seven beds currently operational for respite, as there were last week when agency staff were used. I spoke to Mr. Mulligan, head of older people in Community Healthcare West, at 9 o'clock this morning. He informed me that agency staff were used last week to keep the respite beds open. There were no agency staff available this week. The hospital is looking for agency staff. It is a concentrated effort every day.
On the other question raised, Mr. Mulligan has also sent a business case to the HSE seeking a derogation for three nursing posts. My position is clear on that. The hospital would have been funded for enough nursing posts for 21 long-stay beds and seven respite beds, which are really important. When somebody retires, is out sick or moves to another job, that post is already funded as far as I am concerned. I will be speaking to Mr. McCallion in the HSE later today to try to get certainty on that. I have answered questions on this matter before. When I visited Clifden last year I was aware that there were challenges in keeping both Clifden District Hospital and St. Anne's community nursing unit open as Community Healthcare West is currently unable to adequately staff both rosters. Staffing at St. Anne's is the priority because there are long-stay residential clients. It is their home from home. For many people it is where they will spend their last days and it is important that is maintained. I agree with prioritising that over respite in this instance. However, it is important that we deliver both.
To be fair, people cannot be expected to travel to Merlin Park University Hospital. It is too far for respite care and for families visiting. There are currently three people on a waiting list for respite in Clifden District Hospital. It is vital those three people get those particular supports. As the Senators know, when I was in Clifden last year I was delighted to announce plans for a total of 40 beds in a brand-new state-of-the-art community nursing unit, consisting of 20 long-stay beds, ten dementia-specific beds and ten short-stay beds, including respite and step-down care. There is no effort being made to close down what is available to the people of Clifden and the surrounding areas. The respite beds are hugely important and I will keep a focus on this every day until we have those beds back open.
Seán Kyne (Fine Gael)
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I thank the Minister of State for her response and welcome her commitment to have this unit reopened as quickly as possible. She is absolutely right that respite is hugely important to those families who need and deserve it. They work to keep loved ones out of full-time care and everybody needs a break from that level of work. There is unfortunately still confusion as to whether the posts are funded. That is the crux of the matter. There are two issues. The first is whether the posts are already recognised and funded and the second is to get the staff to ensure those posts are filled. I suggest that one is easier than the other. We need certainty from the HSE and the Minister of State that these posts can be filled and then there is the challenge of filling them. I understand the need to ensure St. Anne's is prioritised. However, at the same time we want to ensure the respite beds are available. I would appreciate continued engagement on this matter over the coming days.
Pauline O'Reilly (Green Party)
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There should not be a choice between one and the other. There should not be a choice between St. Anne's community nursing unit and Clifden District Hospital. When staff numbers are down in a large hospital like University Hospital Galway or Merlin Park it is not ideal but it can be absorbed. However, when staff are down in a small hospital like the one we have in Connemara the hospital closes. This is an ongoing issue. There does not seem to be any sustainable solution to this, so people do not have confidence that there will be a solution. There needs to be a reprioritisation. It is certainly at the heart of Sláintecare that we have local services for local people so that people are not travelling. There needs to be a reprioritisation, so that staffing is prioritised for these local hospitals and local services.
Mary Butler (Waterford, Fianna Fail)
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I thank both Senators for the way they have addressed this matter. We are all very conscious that this is home from home for many people and that respite is important. There is no bigger advocate in these Houses than me for community nursing units and HSE run community hospitals, whether they have 40 beds or 80 beds. I met yesterday with Dr. Emer Ahern who is the clinical lead for older people for the whole of the country. We had a long meeting in which we discussed respite and the resumption of respite beds, which has not occurred in some areas since Covid. We talked about transitional care funding and the importance of keeping older people out of acute hospitals and having throughput to the community. As Senator O'Reilly said, Sláintecare is about having the right care in the right place as close to home as possible. It is important that these respite beds are opened without delay.
To respond to Senator O'Reilly's question, there are two issues here. There is a dedicated focus on reopening these beds through agency staff but that is not ideal. There are no agency staff available this week, although they were available last week. That is the short-term solution. The long-term solution is to sort out whether these posts are funded and I hope to be able to provide some clarity on that later in the day.