asked the Minister for Health if he is aware of the concern throughout County Donegal at the proposed phasing out of the geriatric hospital at St. Joseph's, Stranorlar, County Donegal; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Stranorlar (Donegal) Hospital.
8.
The policy of the North Western Health Board in relation to the provision of geriatric hospital services is that these services should be provided in small locally based units and in line with that policy it is proposed to reduce the level of services in the central geriatric unit at St. Joseph's Hospital, Stranorlar. Discussions are being held between officials of my Department and officials of the board in order to make the necessary arrangements.
Where does the Minister propose to send those people if the number of beds is to be reduced substantially? Is he aware that there are no further units being built in the western counties because of the phasing out of the service?
As the Deputy is aware, Saint Joseph's was the only institution providing longterm nursing care for geriatric patients. The board took the view that they should have a programme of community nursing units in such places as Buncrana and Falcarragh—throughout the county. It is the intention of the health boards to develop this programme of community geriatric care throughout the country. I should point out that 52 elderly patients have been transferred from Saint Joseph's to community nursing units, ten of these in 1984. This year I have provided extra money for Buncrana. It has been possible, therefore, to reduce the numbers in Saint Joseph's from 242 beds to 190. We have a day hospital in Saint Joseph's for 89 persons.
Is the Minister saying that there will not be any reduction in Saint Joseph's below the 190 beds until further units have been built? The Minister announced section 31 cuts in the budget. Can he arrange the position so that the hospital will not be closed or phased out until adequate alternative facilities are available?
Section 31 has operated for some years. As the Deputy knows, budget situations are tight and we are trying to develop sufficient units throughout Donegal while we retain all the beds in Saint Joseph's. We cannot have it both ways. I am not in favour of large geriatric hospitals with up to 250 beds. I should prefer that people would live in the areas from which they come in community nursing units. It is far more effective and I do not think there is any dispute between us on that point.
Mr. Coughlan
Will the Minister give an assurance that adequate provision will be made and the patients retained in St. Joseph's until that provision is made? Can he give any guarantee regarding the amount of money he could make available for the provision of the community nursing homes all of us would like to see in the county?
The only assurance I can give is that I will work on a very regular basis with the health board, as will officers of my Department, in implementing that decision. We have always had the closest of relations with the board who have operated their policy with considerable effect. Generally speaking, the services in Donegal are extremely good and the nursing units are working effectively. I do not know of any major budgetary impact on those services.
I agree with the sentiments expressed by the Minister in relation to services for geriatric patients. Will he not agree that, unless funding is provided to the North Western Health Board, it will be impossible for them to implement the programme now on the Minister's desk? When does he envisage the go-ahead will be given for the Carndonagh development in relation to a community welfare home that would relieve the problem now confronting Stranorlar?
The original letter of allocation spoke about a reduction in the level of services provided in St. Joseph's geriatric hospital. That is part of the general policy of the Department. I do not know of any adverse impact on the number of beds in that hospital or in other community services arising out of the budget allocation. It is changing the system rather than trying to cut corners to save money. It has been possible since 1980 to reduce gradually the number of beds in St. Joseph's. I should like to see the development of further community nursing units throughout the region particularly in the Leitrim and Sligo area. Donegal has been doing quite well but there are areas in Sligo and Leitrim where the same policy could be implemented, and is being implemented to an extent.
May I ask the Minister——
I am moving to the next question. I have been very generous and reasonable in allowing supplementaries on this question.
If the Chair was as generous to people from Donegal as he has been to Dublin Deputies——
I do not want any lectures from the Deputy.
I am not giving any lectures. All we want on this side of the House is fair play.
I do not want any innuendo either.
I am afraid I say what I think.
Perhaps the Deputy should think before he says anything.
Perhaps all of us should do that.
I do not want any argument with the Chair.
I am disappointed that Deputies from Donegal cannot ask questions when one individual from Dublin is given 15 or 20 minutes and is allowed to make speeches. We cannot ask questions here about geriatric services. It is a great pity that people like myself are easy prey. The Chair can make me sit down or else throw me out. We just want the same privileges as anyone else.
I have allowed six supplementary questions. If the Deputy wishes to ask another supplementary question he may do so.
Will the Minister accept that we cannot have any phasing out of St. Joseph's until nursing units to which he has referred in Killybegs, Glenties and Falcarragh are available? Will he give this assurance to us today or, alternatively, will he meet with the Deputies from County Donegal to discuss the matter about which we are extremely worried?
The Deputy can be absolutely assured there will be no precipitous closure of geriatric services in St. Joseph's. The number of beds has been falling gradually and they have been phased out as the other units are opened. That is the policy and I do not think we should get unduly alarmed about it.
Perhaps the letter of allocation gave the wrong impression.
The letter of allocation was fair and reasonable.