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 Header Item Overseas Development Aid Provision (Continued)
 Header Item Community Nursing Homes

Tuesday, 5 February 2013

Dáil Éireann Debate
Vol. 791 No. 1

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(Speaker Continuing)

[Deputy Olivia Mitchell: Information on Olivia Mitchell Zoom on Olivia Mitchell] The MDG-5 target is now the furthest from being attained and progress is slowest in sub-Saharan Africa. Over 250,000 people are dying annually in childbirth due to the lack of maternity care. The awful thing is that instead of improving, the rate of progress is slowing down. Failure in this area is at least partly due to the fact that the target 5b, which was to ensure universal access to reproductive health, was initially omitted from the millennium development goals. This time it is essential that, far from being a tag-on, it is central to the new post-2015 development framework.

Deputy Brian Hayes: Information on Brian Hayes Zoom on Brian Hayes The Deputy has expressed the Government's view that if we are to deliver the desired progress, it is essential that the post-2015 goals have that as a condition for development aid. We are already in discussions on the multi-annual financial framework, or MFF, negotiations which is the financial envelope for the EU over the next seven years. Within those discussions it is crucially important that we continue to have the overseas development aid budget enhanced and supported in circumstances where there is real pressure on that expenditure.

As the Deputy has rightly articulated, there is precious little use in having that money unless one can tie it to the reproductive and maternal rights of women, in such countries and particularly in sub-Saharan Africa. Deputy Mitchell has articulated the Government's view and that is the position we will be advancing during the EU Presidency. It is something the Government holds dear, that with funding and support, rights must come for women in their own countries. In order to make the kind of progress we all want to see, those rights must be enforced by those countries that are giving the money in the first instance. It is something we take very seriously in the context of the negotiations of which we are a part.

Community Nursing Homes

Deputy Aengus Ó Snodaigh: Information on Aengus Ó Snodaigh Zoom on Aengus Ó Snodaigh It is a disgrace that two years after a €12 million community nursing home facility was completed in Inchicore, it has not yet started operations. This facility was to provide community nursing home beds in one of the most disadvantaged areas, which includes a large aging population. The facility contains state-of-the-art facilities, yet it remains closed for its intended purpose. It was built as part of an overall plan to regenerate St. Michael's estate, as well as being next to the primary health care unit which is going well. The latter unit is a credit to those who had that vision. At the time, the community nursing home facility was part of an overall plan to provide public nursing home care not only in the 50-bed unit in St. Michael's estate, but also in Brú Caoimhghín where additional beds were to be built, and the Meath Hospital.

There was an overall plan that all these beds would surround St. James's Hospital, which is one of the busiest hospitals in the country. They were being provided to facilitate the release of patients who required convalescent aftercare, rather than being stuck in acute beds thus blocking the transfer of patients from accident and emergency units and elsewhere. Newspaper reports have referred to them as "bed-blockers". I do not believe they are bed blockers but they do need a different level of care. The facilities to which I am referring are within a mile of St. James's Hospital. It is illogical, economically and otherwise, to have a facility of this size sitting unused in an area that is crying out for it.

Over the past year, I have visited many patients in St. James's and Tallaght hospitals. Many of them needed to be transferred to a nursing home, but the system puts them into private health care. This is the privatisation agenda which has been carried on from the last Government to this one. I appeal to the Minister of State to announce that these beds will be opened, so that patients can be transferred from a public hospital to a public community health care facility.

It beggars belief why such a building is there. Anyone who visits it will see that it is a beautiful building on the grounds of the old St. Michael's school next to the primary health care centre. At some stage, this Government or a future Administration will have significant scope to regenerate the area, which has suffered the trials and tribulations of being disadvantaged and ignored for many years.

The financial logic of opening this facility is that it would allow beds to be freed up in St. James's Hospital so that it could become more effective and efficient in the use of hospital space. In that instance, one would not see the Minister for Health cutting €9 million from St. James's Hospital because it would prove it is well capable of delivering efficiencies.

We carried out a petition in the local area, asking local people what was happening. They had raised the issue with us on quite a number of occasions in the past few years. I will be presenting the Minister with a petition tomorrow containing over 600 signatures. That was just from the near vicinity and we did not go beyond that. We asked them what their demands were concerning this facility. The primary demand was to open it now and not leave it sitting there closed. It is a living disgrace.

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch I thank the Deputy for raising this issue. Apart from it being within my own remit, I know something about this particular community nursing home in Inchicore because Deputy Catherine Byrne is continually raising the matter. There is concern in the area as to how a state-of-the-art building - which cost €10 million, not €12 million, although it is a substantial figure - could remain closed.

The Government is committed to ensuring that patients receive the highest standard of care in the appropriate settings, be they acute, community or residential. As the Deputy is aware, these are challenging times for the Health Service Executive in respect of all services. In the case of community nursing units, these include challenges regarding staffing, funding and the age and structure of its units. In this regard, all developments have to be addressed in light of current economic and budgetary pressures. Any decision taken by the HSE must have regard to this and the current recruitment moratorium, which is significant concerning this particular unit.

The 50-bed community nursing unit at the former St. Michael's estate in Inchicore was planned as one of a network of units across the Dublin mid-Leinster region to address the projected demand for future long-term care provision. The public sector moratorium has severely limited the HSE's ability to commission new staff-intensive services and this has delayed the commissioning and opening of the Inchicore facility.

During 2012, the HSE proposed to move staff and patients from St. Brigid's Hospital, Crooksling to Inchicore thereby allowing for the closure of the older unit at St. Brigid's Hospital. However, having regard to the wishes of the patients at St. Brigid's Hospital and the need to maximise the level of service provision in the region, it was decided to maintain services at Crooksling and to explore alternative proposals for the Inchicore unit. I am sure the Deputy was involved in that as well.

In light of the public sector moratorium and significant additional reductions in staff numbers required over the next two years, one option being pursued is that of a public private partnership agreement. The HSE has successfully used this model to open a 100-bed unit for older persons at Ballincollig, County Cork. This unit delivers real cost benefits and value to the system which would not be possible through direct employment. It also deals creatively with the moratorium.

The current position is that a project team has been appointed within the HSE to progress this project, including representatives from general management, human resources, finance and procurement. A detailed draft specification has been prepared on the service requirement for the Inchicore unit, to be used in the tendering process with the preferred provider panel.


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