Vol. 628 No. 6
45 Dr. Twomey asked the Minister for Health and Children if her attention has been drawn to further reports on Leas Cross or on the nursing home inspection system which have not been published by her Department or by the Health Service Executive; the steps she proposes to take to ensure the findings of these reports are laid before the Houses of the Oireachtas; and if she will make a statement on the matter. [41697/06]
The Health Service Executive recently published Review of Deaths at Leas Cross Nursing Home 2002-2005 that was commissioned by the HSE and written by Professor Des O'Neill. Separately, the HSE's complaints review group for Dublin north-east has written a report for HSE management on foot of complaints received from concerned families of patients at Leas Cross since May 2005. That report has not been published as it relates to individual complaints received.
The HSE working group on nursing home inspections completed an interim report in July this year. Although it has been referred to in this House and more widely, the HSE has not published this report as it considers it to be an internal document. Other reports prepared for the HSE are the normal inspection reports on individual nursing homes, and these are progressively being made available on the HSE website.
I take it the Minister of State is referring to the report by Dr. Dermot Power, a consultant geriatrician, written on behalf of the HSE. Does the Minister of State know the name of the report that has not been published? It is a significant report and I do not believe it relates to just one or two patients. I believe it is along the lines of the Leas Cross report. If it is not being published why is this the case? I do not believe the Minister of State fully understands whether this is the report to which he refers. It is important because at a time when the departmental officials are screaming at HSE officials to push patients into private nursing homes, another huge issue regarding the Leas Cross report is arising, which the Minister of State is not addressing. In the first place the Minister of State should clarify for the House that he knows the report mentioned in his response to the parliamentary question.
On the one hand we had the Leas Cross report written by Professor Des O'Neill and separately the HSE complaints review group for Dublin north-east has written a report for HSE management on foot of complaints received from concerned families of patients at Leas Cross since May 2005. That report has not been published because it relates to the individual complaints that were received by the HSE in respect of Leas Cross.
I do not wish to be awkward but is the Minister of State familiar with the author of the report to which he refers? I am referring to Dr. Dermot Power, a consultant geriatrician at the Mater Hospital who wrote a report for the HSE on nursing homes. Is that the report to which the Minister of State is referring? Has the HSE informed him that Dr. Dermot Power compiled a report in respect of nursing homes issues? Is the Minister of State familiar with the doctor in question and is he aware of the report to which I refer?
I am aware that Dr. Dermot Power was commissioned by the HSE to compile a report. I understand that this report relates to——
That is not the report to which the Minister of State referred. The latter report relates to a completely different issue.
There are a number of reports involved, the main one of which relates to Leas Cross. The HSE sought that the review group for Dublin north east compile a report and it relates specifically to individual complaints received and, for that reason, it has not been published.
Dr. Dermot Power's report has not come into my possession. I am aware that he was asked to compile a report by the HSE. I will follow up with the executive in respect of that report. However, I do not have the details relating to it in my possession.
One of the matters in Professor O'Neill's report on Leas Cross relates to the HSE seeking tenders from nursing homes in respect of the taking of high-dependency patients and the fact that such homes subsequently refused to take those patients. Professor O'Neill recommended that patients and families should be informed in this regard. If the Minister of State is not aware of the existence of a report commissioned by the HSE in respect of a similar issue and if he does not know whether his initial reply related to that report, how could he be in a position to know whether the recommendations are being followed up? That is extremely sloppy work, particularly when one considers the outcry that has taken place in respect of Leas Cross. This is the first priority question of the day.
To the best of my knowledge, the Power report is specific to Leas Cross. From what the Deputy stated, one would think that we were trying to cover up something.
The Minister of State is correct in that regard.
The main report that was commissioned was that which relates to Leas Cross. On the previous occasion on which this matter was dealt with on Question Time, the general view put forward by the Opposition was that we were trying to keep a lid on that report and that we did not want it to be published.
The Government was obliged to agree with us.
We did not. I have just explained the reasons for the delay in publishing the report. We were satisfied to have the report published. The Minister for Health and Children indicated that we had made every effort to encourage the HSE to publish the report. It was the HSE that commissioned the report. It is important that lessons are learned from this matter.
It would not be possible to learn anything from this.
The Deputy should allow me to answer the question he asked. Reports have been compiled in respect of this matter. The Leas Cross report was published. Even before the latter emerged, a number of measures were taken in respect of how the inspection process works and we are putting in place a proper training system in respect of the inspection teams. For the first time ever, we are developing dedicated inspection teams, which are in place throughout the country. Proper training was not, however, in place. We will adopt a standardised approach to the way in which inspections are carried out.
That is a different matter.
The idea of publishing the report in this instance was to identify where the weaknesses lay and to ensure that we learned lessons and put in place a much stronger system, with improved structures, that will guarantee proper care for older people.
That is another matter. I hope the answers to questions in respect of it will be better than that provided by the Minister of State in respect of this question.
46 Ms McManus asked the Minister for Health and Children her views on a new report from the board of Our Lady’s Hospital for Sick Children in Crumlin, which called for a review of the decision to locate the new national children’s hospital, following reservations from Tallaght Hospital: if she will provide the full list of objections from these sources and address each; her further views on the fact that the Taoiseach appears to have given a commitment that the hospital would be located in his constituency prior to the decision-making process having been completed; and if she will make a statement on the matter. [41732/06]
47 Mr. Gormley asked the Minister for Health and Children if she has read the report from the board of Our Lady’s Hospital for Sick Children, Crumlin, on the proposal for a new national children’s hospital; her views on the conclusions; and if, in view of this expert advice, she will reconsider the decision to move the children’s hospital from Crumlin to the Mater Hospital site. [41668/06]
I propose to take Questions Nos. 46 and 47 together.
The objective of the Government is to ensure the provision of a world-class hospital to serve the children of this country. It was for this reason, and no other, that the Government strongly endorsed the recommendation of the joint task force group and the decision of the board of the Health Service Executive to locate the new national paediatric hospital on a site to be made available by the Mater Hospital. The decision was taken in the best interests of children.
The McKinsey report, commissioned by the HSE at my request, provided the original basis for the decision to co-locate adult and paediatric hospital services. The report is very clear. It demonstrates that best outcomes for children are achieved by having the necessary breadth and depth of services on a single site. Co-location of paediatric services with adult services and, in due course, with maternity services is in line with best international practice and this was widely accepted by stakeholders when the McKinsey report was published.
The collaboration of adult and paediatric specialists is of critical importance. It creates the necessary platform for sub-specialisation and improved outcomes. The optimum delivery of complex paediatric surgical services can best be achieved by creating teams of specialists covering both adult and paediatric patients. Co-location also offers the benefits of providing transitional care for children with complex illnesses who are now surviving well into adult life.
I am fully satisfied that the task group undertook a rigorous and robust examination of the key issues in making its recommendation. It is true that the site chosen for the new national paediatric hospital is in the Taoiseach's constituency. It is being suggested that the Mater Hospital, an internationally renowned adult teaching hospital, should have been disregarded as a possible site for the new paediatric hospital simply because of its location. Comments by the chairperson of the Mater and Children's University Hospital Limited at a public function a number of months ago were reported out of context. They related to the Taoiseach's long-standing support for the redevelopment of the Children's University Hospital, Temple Street, on the Mater site, which at the time was at an advanced stage of planning. This has now been overtaken by the Government decision to develop a national paediatric hospital.
It is perhaps understandable, in circumstances where services provided at three hospitals are to move, that the decision has not met with universal approval. However, some of the public comment has been misinformed. Not all paediatric services are moving to the new hospital. As is the case internationally, the new national paediatric hospital will be supported by a strategically-located urgent care service. The transition group will be advising early in the new year on the recommended scope and location of this service. The group is working to ensure that the widest possible range of services will be provided through the urgent care service.
The report commissioned by Our Lady's Hospital for Sick Children in Crumlin was submitted to the joint HSE-departmental transition group some weeks ago and has already been the subject of discussions with the hospital. I also received the report and met with hospital representatives to discuss their concerns. The transition group is overseeing the preparation of a high level framework brief to inform decisions in respect of the range of services to be provided at the new hospital and the specific site to be ceded by the Mater Hospital. I understand that the transition group is satisfied that the new hospital can be fully accommodated on the Mater site. The transition group has assured the Crumlin Hospital authorities that their report will be taken into consideration in the preparation of the framework brief.
To date, no decision has been taken in respect of the range of services to be provided at the National Children's Hospital in Tallaght in the context of the development of the national paediatric hospital and the associated urgent care service. The Taoiseach has given an assurance to Tallaght Hospital that the Government wishes to see it thrive on a sustainable basis as a particular focal point for the involvement of the minority tradition in the health care system and as a key health provider to an expanding local population.
I am satisfied that the development, as planned, is consistent with international best practice. For example, I recently had the opportunity to visit the Children's Memorial Hospital in Chicago, which is an established secondary and tertiary paediatric centre. The hospital, which operates as a stand-alone facility, will transfer to a city centre site where it will be tri-located with an existing adult teaching hospital and a new maternity hospital. The hospital authorities considered other options, including a move to a greenfield site, but ultimately decided the clinical and other benefits of the tri-location model far outweighed any other considerations and would allow for the provision of an enhanced level and quality of care for children.
Does the Minister for Health and Children accept that the goodwill present at the start of the process has evaporated and that the Government decision to locate the paediatric hospital on the Mater site has now effectively been rubbished by Crumlin Hospital's report, which clearly states that it is too small? Perhaps the Minister might deal with those issues, both of which featured in my question. If Crumlin Hospital says that the site is too small for four hospitals to relocate there, how does the Minister address that? Her Minister of State has said that those issues will be addressed. How will she deal with the site that is too small? How will she answer the criticism that access is too difficult? What is her answer to the claim that there are too few beds, with 100 fewer than at present?
Those specific and very serious charges have been levelled regarding a Government decision about which doubts have been raised. However, she can deal with that political charge only if she can justify it and reply to the questions raised by Crumlin Hospital. Its chairman pointed out in an article in The Irish Times today that there is now real fear that care will be compromised and fragmented. Does the Minister accept that it is a very serious charge?
She seems now to have jettisoned a recommendation in the McKinsey report on urgent care units. The recommendation was that they simply be short-term facilities providing urgent care and that no child should be there for longer than 24 hours. The intention would be to stabilise the child and direct it to the tertiary hospital. Is the Minister not clearly stating that the part of the McKinsey report in question has been jettisoned? Is that also for the sake of political expediency?
If this were a matter of political expediency, we would continue building a new hospital in Crumlin and another in Temple Street. The original plan was for approximately 700 beds. McKinsey and Company examined 17 of the top tertiary children's hospitals in the world, on which basis it recommended a 380-bed hospital in the context of Irish demography. There will be fewer beds than at present because ever more children's services are being provided on a day-case basis.
Day beds.
The Chicago site will be 6,500sq. m.
Chicago.
The Deputy may laugh.
I can laugh, since I hope the traffic moves in Chicago; it certainly does not move in Dublin.
Please allow the Minister to speak without interruption.
We should learn from what is happening elsewhere, instead of trying to——
They have seen it in America, so it must work.
Does the Deputy favour a single hospital?
The McKinsey report could have been decided in a way that deals with the serious criticisms raised by those in Crumlin.
The reality is that the Deputy is on everyone's side.
The Minister is not yet in Opposition; we ask the questions.
Order.
The Mater site is 20,000 sq. ft. Before the decision on the location, every paediatrician in Dublin, including Dr. Doherty, with whom I had many discussions, said that it was fantastic. I remember him telling me that co-location with an adult hospital would be fantastic; there is no doubt about it.
Issues have arisen regarding parking and access. One must remember that the hospital is for the entire country, since 48% of the children will come from outside the Dublin area. It was generally thought that a city-centre site, with many children arriving by public transport, would be best. The metro station will be adjacent to the site. Their parents may have to stay for a long period, with other relatives visiting. It was thought that it would be more accessible than picking a site on either side of the city. Experts were involved regarding traffic and choice of site.
I accept that when one does not choose the preferred site of certain individuals, people may oppose it. However, it reassures me greatly that parents of sick children in Crumlin have said it is great and that I should implement the plan without delay. That is the greatest reassurance of all, and those are the words that I like to hear.
Urgent care centres have not been compromised. Of the 25,500 child visits to Tallaght Hospital last year, for example, 19,500 were dealt with the same day, with no overnight stay. Thankfully, the vast bulk of sick children who require to attend a hospital are treated as day cases and do not require hospitalisation.
The new hospital will cater for very ill children with rare cancers and serious illnesses, many of whom will be in hospital for a considerable time. In the past, many such children would not have survived for more than a few days after their birth. That has changed, which is why co-location with maternity facilities, where high-risk pregnancies will be dealt with, was an important feature of the decision.
I do not know which parents of sick children the Minister consulted, but I have spoken to a fair number in my constituency, and I have yet to meet one who is happy with this decision.
I wish to return to certain points. Dr. Pat Doherty has been mentioned, and he is quite clear that no meaningful input or consultation with the paediatric community took place. That is his major problem, and perhaps the Minister might respond to that very serious charge. She says that she has held discussions, but he says that experts have had no meaningful input.
At first they welcomed the idea of a single hospital, but they now have serious reservations regarding access. Many parents have raised that question with me. The hospital may be too small but cannot expand, since there is no open space. The Minister seems oblivious to the litany of complaints. Perhaps she might answer this. The McKinsey report states very clearly that co-location with an adult hospital, while perhaps desirable, is not essential. However, certain criteria are absolute, and those concern the hospital's future expansion and accessibility by road and public transport. I hope that the Minister agrees that we ought to listen to the experts in this matter.
It depends how one defines experts. Dr. Doherty is the chairman of the medical board in Crumlin. He is an anaesthetist of considerable experience. I am not a clinician and therefore unable to question his clinical judgment. However, I spoke to Dr. Doherty when he was informed of the decision at a meeting organised by the HSE on the outcome of the McKinsey report. Like all others to whom I spoke, he was extremely enthusiastic. Dr. Doherty's preferred location was St. James's Hospital, but the decision to locate it at the Mater was taken for several reasons.
It is not true that there is no room for expansion. In addition to what I described, 10,000 sq. ft. will be made available at Temple Street, so the hospital can be expanded. We must stop thinking in narrow engineering terms as if we were construction experts. I am now being advised that it cannot physically fit on the site, but the experts assure me that it can. I am told that we should facilitate those coming by car, but the vast majority of cars at current children's hospitals are those of staff members. I hope that improved public transport in this city will lead to a reduced need for staff to use cars, particularly when the metro is to be located there.
Deputy Gormley asked me what parents I had consulted. It was the parents' group in Crumlin that told me to act and not let anything delay implementation. Above all those people, to whom we must listen, want a state-of-the-art facility for their sick children, believing that current facilities leave much to be desired. The original plan was to build a new hospital in Crumlin and another in Temple Street. However, we would not achieve good clinical outcomes, subspecialisation or the kind of hospital that we deserve if we split it over two or three sites. World expertise points to that.
Why was the paediatric community excluded, as Dr. Doherty states in today's The Irish Times article?
The paediatric community was consulted after the publication of the McKinsey review and was enthusiastic about its findings. Difficulties arose with some members of the paediatric community when the site was chosen. It is inevitable some people will be upset when one hospital must be chosen from among several. I understand that people have preferred locations. What is important, however, is that for the first time, we will have a world-class, state-of-the-art tertiary facility for sick children, collocated with an adult teaching hospital and, subsequently, a maternity hospital that will deal with high-risk pregnancies. This will be a major step forward in the treatment of sick children and it will be welcomed by the vast majority of people, notwithstanding the reservations of some that a particular site was chosen in preference to some others.
It is turning into a debacle.
One might wonder why Progressive Democrats Ministers in the Department of Health and Children are quick to make allegations and innuendoes about those who disagree with them.
What allegations have I made?
The Minister of State who is seated beside the Minister made a serious allegation, which he was unable to substantiate, on national television last night.
The Minister is correct in her observation that there was goodwill towards the McKinsey report among the paediatric community. Does she accept that Our Lady's Hospital for Sick Children in Crumlin has no vested interest in this matter? The notion that staff in that hospital are engaging in some type of obstruction is not convincing given the hospital itself will not exist in the future. Four hospitals will be crammed onto the site of the Mater Hospital, including that hospital's adult and private facilities, the children's hospital and a maternity hospital.
Does the Minister accept this is one of several serious flaws that have emerged from this decision of the Government? Will she consider an independent view of the plan? Let us all be proved wrong. If an independent review concludes that this is the best site for a children's hospital, I will have no problem admitting to the House that the Minister was correct and I was wrong. Until that happens, grave doubts will persist. If the Minister does not have the goodwill of those working in paediatrics, including those working in Our Lady's Hospital for Sick Children in Crumlin, it will be difficult to make this proposal work.
I do not accept the facilities will be crammed onto the site. I could list many hospitals elsewhere in the world where the space is substantially less than what is being provided here. I am neither a construction expert nor a clinician. It is clear to me, however, that once the site was identified, some people were not as pleased as they might have been if another location was chosen. The merging of hospitals has not been done often in the past and it is not always a happy experience. It can take a long time for all types of reasons. Difficulties arose when St. Luke's Hospital was being amalgamated with St. James's Hospital, for instance, but the merged facilities are widely accepted as offering the best care for cancer patients. Some of these decisions are not easy for staff or patients and their families. If they are made on the basis of sound clinical advice, however, the vast majority of people will accept them.
I am often criticised for arranging too many reviews but now there are calls for another. I do not accept the need for such a review. We must move on. I will shortly announce the appointment of the team to oversee the development of the new children's hospital. The Mater Hospital was selected from among three contenders, the others being Beaumont Hospital and St. James's Hospital, and was recommended as the preferred site for several reasons. It was understandable there would be a certain degree of disappointment that other hospitals were not chosen.
To suggest, however, that this decision was motivated by anything other than the best interests of children is incorrect and unfair. No allegations are being made against anyone. I have spoken to everyone who wished to raise the matter with me. I made clear to the board of Our Lady's Hospital for Sick Children in Crumlin that, where possible, the issues raised in their report will be addressed but that the decision on location is final unless something arises of which neither I nor the advisory group is aware. If we are to allow further delays because of uncertainty over the site, we will simply delay the provision of this state-of-the-art facility. It was the unit in Trinity College which provided advice on transport, location and access.
The Minister and Professor Drumm always repeat this mantra about how we will deal with the capacity problem. In view of the major increase in the child population, however, it is clear we should increase the numbers of beds in paediatric services rather than decrease them from 480 to 380. How will the services cope with this reduction? I ask the Minister not to pass my question off by saying more patients will be treated as day cases. Does she recognise there will be a serious capacity problem if she proceeds in this way?
No, I do not. Tallaght Hospital, for example, has a current occupancy rate of 40%, which means 60% of the beds are not in use.
Is it that simple?
No, the McKinsey report advised that this site can take a further 200 beds.
The Minister is blithely dismissing the problem.
I am advised it can be further expanded to provide 580 beds.
48 Dr. Twomey asked the Minister for Health and Children the basis on which her Department has estimated the sum of €111 million as the loss of revenue of private beds to public hospitals under the collocation plan; the breakdown of this figure by hospital; if she has estimated the additional costs patients will incur due to this plan; and if she will make a statement on the matter. [41698/06]
The figure of €111 million is an estimate by Health Service Executive of the amount the ten public hospitals selected as sites for collocated private hospitals charged private health insurers in 2005. I was informed by the HSE yesterday that, as a result of the ongoing public procurement exercise, the collocation initiative will not be proceeding on two public hospital sites at this time. These are Galway University Hospital and Letterkenny General Hospital. Leaving aside those two hospitals, the figure reduces to €88.6 million. I will arrange to have a table sent to the Deputy giving the breakdown of this figure for the eight hospitals concerned.
The loss of private insurance income to public hospitals arising from the collocation initiative must be seen in the context of the freeing up of 1,000 beds that are currently reserved for private patients and the significant benefits the HSE expects to receive in return for the concessions granted to private operators. Public patients will not incur any additional costs arising from this initiative. Whether private patients will pay more in collocated hospitals than they currently pay in private beds in public hospitals depends on the charges that may be set by the new private hospitals. In any event, it has been the policy of the Government since 1999 to move to full economic charging of private beds in public hospitals.
Members do not often make the case for private patients in this House, but it is important to consider everybody who will be affected by this strategy. When 1,000 beds are moved from the public sector to the private sector under the Minister's privatisation plan, an additional €110 million — or €86 million as we are now informed — of lost income to BUPA and VHI will have to be added to the €14 billion required to manage the health service.
It seems the Minister is valuing the loss of income from each of these beds at €110,000 per year. This is a totally false economy. No private hospital can operate a private bed for €2,000 per week. It is simply not possible.
I ask Deputy Twomey to put a question to the Minister.
I will. I estimate that each of these beds would require a contribution of between €5,000 and €10,000 per week if these hospitals are to survive.
On this basis, does the Minister agree the cost to VHI and BUPA will be between €250 million and €500 million, rather than the €86 million to which she referred? Does she accept her plan will make it absolutely impossible for young families and elderly people to maintain their private health insurance? We will have plenty of shiny new private hospitals but people will be pushed out of the health insurance market. Such developments will come at a massive cost to private patients. The Minister must concede that when one takes into account other costs that will arise in regard to private health insurance, this plan will double premia within three years.
I am confused by the Deputy's response. He asked me what it would cost to convert these beds to public beds. The cost for 85 beds in the ten hospitals would come to just under €90 million. It must be remembered all nurses and staff are paid from the public purse. I have a problem with the taxpayer heavily subsidising private beds in public hospitals. Those beds are only available for that cohort of the population.
Half the population has private health insurance. It also pays taxes.
I know that.
The Minister is basically ripping them off.
The Deputy is saying that the half with private health insurance should get preferential treatment in hospitals funded by the taxpayer, over and above other people who could be sicker. I do not agree with that.
They are not getting preferential treatment.
Yes, they are because only private patients can use those beds. Access to public hospitals should be solely on the basis of medical need.
The Minister should be honest on what it will cost to private health insurance patients.
The cost of providing these beds in the traditional way would cost €1 billion — €1 million per bed. The maximum cost of providing them in this way will be €480 million. From a capital cost perspective, the figure saved will be €520 million. We normally paid for all administrative, nursing and other health staff. These will be paid for by the private provider. No group of workers was paid for those patients' care except the consultants. It was not a good system and was not one which people could stand over.
There are competition issues for private providers. Legal and competition issues must be taken on board if a facility in a public hospital can supply a service at a considerably reduced cost because it is heavily subsidised.
The Minister has simply skirted around this issue.
No. The Deputy claimed it would cost €2 billion.
Private patients are already paying taxes. The Minister is turning her back on the public health system with the co-location plan. She does not care how inefficient it is or how much it will cost. She expects VHI and BUPA customers to fork out for her cock-up. How much will a private health insurance patient pay on extra premiums because the Minister turned her back on the public system?
I am usually accused by the Deputy of privatising the health service. It is ironic that he has changed his position. Until very recently he accused me of giving public land to private providers.
The Minister is giving it away.
Yes, that is what the Minister is doing.
We are not giving away the land. It will be leased. This is about getting a better deal for patients.
Giving away our tax euro.
We will wait and see.
Health insurance premiums will increase. Risk equalisation alone will increase them.
The Minister will also contribute to it.
As we increase the costs of private beds in public hospitals, which has been the Government's policy in the past seven years, so too will the price of private health insurance increase. In the UK, only 11% of the population belongs to a private health insurance scheme.
Is that the Minister's standard?
No, it is not a standard. I support private provision. That is why tax breaks have been provided for it.
Shame on the Minister.
Both the private and public health systems working together will provide better care for patients.
The Minister is fooling herself.
No, it will not.
At least Deputy Twomey agrees with Deputy Ó Caoláin.
We come from very different parties but the sentiments are the same.
It is time the Minister came around to this viewpoint as well.
Fine Gael's position on this is very confusing.
Order.
The purpose of this policy is to provide 1,000 more public beds——
At any cost.
——in public hospitals which have been funded by the taxpayer but are only available to half of the population. I do not believe that is fair.
It is only 20% of the beds. The Minister does not know what is happening in the hospitals.
I call Question No. 49.
Some 50% of the population has private health insurance.
We are not taking them all out.
The Chair has called the next question. Order.
The Minister does not understand what is going on in the health service. She should be more honest and tell VHI and BUPA customers how much they will pay in future.
Order, please.
Will we allow Deputy McManus to go to the Seanad?
49 Ms McManus asked the Minister for Health and Children her views on the lack of provision made for specialist medicine for older people in the buildings of three major Dublin hospitals; her further views on claims that departments of geriatric medicine are being marginalised and that, according to the Kennedy report, from the 1980s older people should hold a central place in general hospitals, which is not the case today; and if she will make a statement on the matter. [41733/06]
The Government's commitment to the development of a comprehensive range of services for older people has been demonstrated by the significantly increased resources made available in recent years.
The Mater hospital has 39 beds in a geriatric acute facility and four day beds specifically for older persons. The hospital has three geriatricians and appropriate staff support, including physiotherapists and occupational therapists. The geriatricians have links to St. Mary's Hospital, Phoenix Park, which provides continuity of care for older patients before and after acute care. The Mater is also participating in the proposed complex discharge for older persons project, the objective of which is to provide full medical, nursing, rehabilitation, allied health and social care services to patients over 65 years who have completed their acute medical episode of care.
The HSE has contracted the Charter Medical Group to provide a rapid access clinic to significantly improve access to services for older people. This new service at Smithfield will treat more than 2,000 Dublin patients annually.
St. James's has developed a proposal to build a centre of excellence for successful aging at the hospital. The HSE is examining the scope for including this project in its capital programme. St. James's is also participating in the proposed complex discharge for older persons project. In addition, St. James's Hospital opened a new falls unit for older patients in December 2005, which has treated 1,200 people this year.
The current phase of development at St. Vincent's Hospital provided for a new emergency department and ambulatory care such as outpatients and diagnostic facilities. All other redevelopment at the hospital, including inpatient care and a day hospital for medicine for the elderly, is planned for the next phase of the capital project. In the current phase of the building project recently opened, older people benefit from significantly enhanced facilities when attending for a broad range of conditions. Furthermore, in recent years there has been significant investment in medicine of the elderly for St. Vincent's patients. This includes the development of Leopardstown hospital and the Royal Hospital, Donnybrook. Consultants from St. Vincent's provide the specialist services for these two facilities.
On the previous question, will the Minister provide me with the same information that she will provide to Deputy Twomey?
Yes.
Does the Minister of State agree that Professor Des O'Neill has done a considerable service in his report on Leas Cross nursing home? It was a thoughtful and hard-hitting report. Has the Government accepted its recommendations? Does the Minister of State agree with Professor O'Neill's criticisms of the over-reliance on the private nursing home solution in care for the elderly? How will the recommendations on inpatient facilities be met?
The report clearly states that inpatient facilities both in medical and psycho-geriatric care are deficient and the issue has to be addressed. The Minister of State indicated there were some proposals floating around from the three major Dublin hospitals. Is he aware that the capital programme was underspent last year? What capital provision will be made in 2007 to meet recommendation No. 10 on inpatient facilities for the elderly in the report on the Leas Cross nursing home? The Kennedy report recommended that elderly people be central to the acute hospital service, but the only way they are central is when they are lying on trolleys in corridors and cared for in a most inappropriate way. What is the programme, timeframe and financial commitment to ensure inpatient facilities are in place to meet medical and pyscho-geriatric needs of the elderly?
Since 1997 the Government has shown a great commitment to improving services for older people. Last year's budget saw additional significant investment in the services. There are 39 beds in the geriatric acute facility and four day beds, specifically for older people. The hospital has three geriatricians, 47 physiotherapists, 12 occupational therapists and 19 social workers. These geriatricians have links and work with St. Mary's Hospital, Phoenix Park, which provides for continuity of care for older people before and after the provision of acute care. I mentioned the Mater Misercordiae and St. James's Hospitals, both of which participate in the complex discharge of older persons project which runs in line with the investment in home care packages we made in last year's budget when we increased the number from 1,100 in 2005 to 3,000 this year. That investment has worked well and it will be continued.
I agree with what the Deputy said about Professor O'Neill who did the State some service with his report. We are happy to work with its recommendations. I indicated a number of improvements that have been made and proposals under consideration in the HSE. These will be of significant benefit in the treatment of older people.
