Dáil Éireann debate -
Thursday, 4 Oct 2001

Vol. 541 No. 3

Adjournment Debate. - Hospitals Building Programme.

Mr. O'Shea

I thank you, a Leas-Cheann Comhairle, for giving me the opportunity to raise this important matter and I thank the Minister of State for coming into the House to respond. St. Vincent's Hospital, Dungarvan, is 180 years old and is a pre-famine building. There are 31 patients in the hospital with 14 each on the first and second floors. Over half the patients are non-ambulant and a high percentage are elderly.

The hospital is serviced by an outdoor metal fire escape. As far back as 1982 a South-Eastern Health Board report recognised that it would be difficult to evacuate patients from the premises in the event of a fire. I recently asked the chief

fire officer for County Waterford, Mr. Tony

McCarthy, to carry out an inspection of the building. I did so against the background of concerns expressed with regard to fire safety at the hospital. The chief fire officer carried out an inspection and his report is with the South-

Eastern Health Board.

If there is a fire safety problem in the building it should be rectified immediately. It is unacceptable that patients are exposed to any possible fire risk. It is equally unacceptable that staff should be forced to work in anything less than safe conditions. Unless complete safety can be guaranteed for patients and staff, immediate action must be taken to arrange alternative, suitable short-term accommodation within the Dungarvan area. However, it is imperative that the Minister gives immediate approval to put the project and design team in place for the new St. Vincent's District Hospital building. This project was contained in the South-Eastern Health Board's submission under the national development plan. The project has been approved by the board.

The Minister is aware that £160 million has been provided for the South-Eastern Health Board under the national development plan. When the submission was made in March 2000 the estimated cost of the new hospital building was £2.1 million. The estimated cost today would, perhaps, be £2.4 million.

It is unacceptable in this day and age that hospital patients, let alone those who are non-ambulant and-or elderly and who are not at ground floor level, should be dependent on an outdoor metal fire escape. The problems which would arise during inclement weather conditions underline the extent of how unsatisfactory is the situation.

The Minister must give the required approval so the appalling conditions which patients and staff endure at St. Vincent's Hospital, Dungarvan, are brought to an end as quickly as possible and that patients and staff are transferred to a modern, purpose-built hospital.

Minister of State at the Department of Health and Children (Ms Hanafin)

I thank the Deputy for raising this issue concerning St. Vincent's Hospital, Dungarvan. The policy of the Department of Health and Children is to maintain older people in dignity and independence at home in accordance with the wishes of older people, as expressed in many research studies. The policy is also to restore to independence at home those older people who become ill or dependent, to encourage and support the care of older people in their own community by family, neighbours and voluntary bodies and to provide a high quality of hospital and residential care for older people when they can no longer be maintained in dignity and independence at home.

Additional funding for the development of services for older people has increased significantly from £10 million in 1997 to an additional £36 million in 2000, including nursing home subvention funding, while an additional £57.427 million was provided in 2001. This has led to a number of developments for older people in 2001, some of which I will outline.

A sum of £2 million was provided for enhancing the scope of the home help service to cover more people and to provide more hours for existing clients, as well as providing training courses. A sum of £3.5 million was provided for the balance of the full year cost of implementing the minimum wage of £4.40 per hour from April 2000, including holiday pay. The rate is now almost £7 per hour.

A total of £5.49 million was provided for the improvement of community support structures, specifically geared towards the support of older people in their homes through a range of measures. A sum of £2 million was provided for carers support. This continues the initiative which began in 1999 to help carers through the provision of, or payment for, a specific service such as respite or assistance in caring.

A total of £0.6 million was provided to the Alzheimer's Society of Ireland for the provision of day care services, £0.23 million was made available to a number of voluntary groups such as the Carers Association and £3.65 million was provided for the improvement in staff ratios to help cope with the growing level of dependency in extended care facilities.

A sum of £14.267 million was provided for improvements in the nursing home subvention scheme and £10 million was made available for the contracting of beds in private nursing homes during the winter period. This has been identified as a measure which will help to reduce the effect of inappropriately placed patients on the acute hospital system. A sum of £15.72 million was provided for the improvement and enhancement of existing services, such as additional funding provided to community nursing units, day care centres and community services and for innovative approaches to the delivery of services for older people at local level.

A total of £2 billion has been made available by the Government for investment in the health services under the national development plan. This represents a trebling of investment compared to the previous seven year period. The purpose of the plan will be to create an infrastructure that will bring significant and tangible advances in delivering a more patient-centred and accessible service. There is a commitment to shift the balance of capital investment towards the non-hospital sector so that the £2 billion is divided equally between the hospital and non-hospital areas.

In the case of services for older people it is proposed to provide a greatly improved physical environment to ensure a high quality and client-centred service. Approximately £200 million will be available for the capital development of services for older people over the period of the plan.

The prioritisation and delivery of capital projects under the national development plan in the first instance is a matter for each health board. The South-Eastern Health Board has made provision for the replacement of St. Vincent's District Hospital, Dungarvan, in its proposals under the National Development Plan 2000-2006. The board has established a local group to prepare the groundwork for the project by identifying the services that it would be appropriate to provide in a district hospital and preparing the preliminary planning brief.

The board has submitted an application to my Department to appoint a project team to the development at St. Vincent's District Hospital. The proposal is being considered and continues to be the subject of discussions between the board and my Department in the context of prioritising and progressing a number of capital projects for the board's area under the national development plan. I am hopeful that a decision in relation to this matter will be made in the near future.

The Dáil adjourned at 5.30 p.m. until 2.30 p.m. on Tuesday, 9 October 2001.