Billy Kelleher (Cork North Central, Fianna Fail)
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Question 221: To ask the Minister for Health if he and/ or the Health Service Executive has made a policy decision to exclude the public sector from providing long-term nursing care in the future; if there is a preference to allow the private sector play a dominant role in this sector; and if he will make a statement on the matter. [4619/12]

Kathleen Lynch (Cork North Central, Labour)
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Government policy in relation to older people is to support people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care where this is appropriate.

While the Minister and this Government continues to reiterate our commitment to the future public provision of residential care for older people we must recognise that the HSE is facing challenges in respect of all services in 2012. In the case of Community Nursing Units these include challenges regarding staffing, funding and the age and structure of its units. It is clear that on a business as usual basis, the HSE would have to close further beds across a range of public community nursing units in 2012. In the absence of reform, this would increase the cost of caring for older persons within the public system, undermine the viability of public community nursing units and reduce the overall number of older persons that can be supported within the budget available for Fair Deal. This is not a sustainable way forward and would not meet the needs of older persons, local communities, the taxpayer or those working in the public service.

Instead, we need a more pro-active approach to the provision of community nursing home units which seeks to protect the viability of as many units as possible within the funding and staffing resources available, including smaller units where challenges of scale may require more innovative approaches to service delivery. This is likely to require a combination of actions such as consolidation of services, and changes in staffing, skill mix and work practices.

Consideration must be given to the different types of services required – such as long-stay and transitional – and the respective strengths of public and private community nursing units in that regard; the public and private capacity available within an area; the age and structure of public units; and the wider needs of the local community. Alternative options for providing a viable community nursing service including a possible role for local communities or other voluntary providers also need to be explored. The HSE is already examining issues in this regard and will be working closely with the Department to develop an overall set of proposals for the Minister.