If this man was to hurl, he would have to hurl for Offaly and not for his own county. His address is Riverstown, Birr, County Offaly, but this is actually physically in County Tipperary. This is where his problem lies.
The Health Service Executive for the midland area will not consider him for a bed in Birr as he is outside their area. However, even this is not clear cut. The former chief officer of the HSE midland area in a letter in regard to this case stated:
There is a need at all times to adopt a flexible approach to matters of this nature. In the past it was the policy of all health boards that where boundaries cut through natural catchment areas or indeed where individuals were disadvantaged by particular boundaries a flexible approach would be adopted.
I ask the Minister of State whether this was or is the case, which is the first point that needs to be clarified.
The chief officer then goes on to state that Birr was Mr. Keeshan's community focal point. The letter states: "With the Government decision to abolish health boards and health board boundaries there is an even greater emphasis on adopting a flexible approach to such matters into the future." Is this an accurate statement? His letter goes on to make it clear that these points form part of the general policy framework of the HSE. Like him, I thought the abolition of health boards would at least mean that decisions I can only describe as cold, heartless bureaucracy would no longer form part of our health service. Unfortunately, this has not been the case for this family.
I am aware the HSE has offered subvention for Mr. Keeshan to attend a private nursing home in County Offaly but the family have already tried this and found it totally unsuited to his needs. He is at his most content when he can be outside in a garden. He requires little care at these times but he does require to be in a place that he cannot leave. I do not want to use the word "escape", which would be accurate. Birr community nursing unit offers such a place. His family naturally want to see their father as often as possible and take a very active role in his care but they cannot do this while he remains where he is.
We were promised a people-centred health service but this case does not meet that standard. This is a decision based on nothing more than a line on a map showing a boundary when we supposedly have one Health Service Executive and boundaries were thought to be a thing of the past. Even if they still exist, where is the flexibility that we need to ensure a proper caring health service?
I raise this matter in the hope that the Minister of State and the Tánaiste can understand the sense of the argument I make. I am not asking for interference but for common sense to be adopted. If the line exists, at the least arrangements should be put in place for people living in boundary areas, as described by the former chief officer. This matter has been allowed to drag on for a considerable time and needs to be resolved for the sake of the patient concerned and his family. I ask the Minister to intervene.
