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Dáil Éireann debate -
Thursday, 13 Jan 2011

Vol. 726 No. 2

Adjournment Debate (Resumed)

Health Services

I welcome the opportunity to raise this important issue for south County Tipperary on the Adjournment. I am glad that my colleague, the Minister of State, Deputy Mansergh, is present.

I am deeply concerned about the HSE's plans for the Cluain Arann welfare home in Tipperary town. This home caters for 19 individuals who the HSE is planning to relocate without appropriate consultation with residents, their families or the wider community, which has supported and facilitated the delivery of services in Cluain Arann and made it an appropriate setting. "Welfare home" is probably the wrong name for it. It is a caring, friendly and warm centre. I have often met its residents around the town and in neighbouring villages. One resident who I met in Donohill but whose name eludes me came to play us a few tunes on an accordion on Dan Breen Sunday. The centre's residents are mainly in reasonable health, but are uneasy about staying at home because of a lack of facilities. They have been residents at Cluain Arann for a number of years.

There is no local area manager for Tipperary town. As a result of the recent redundancy scheme, some local managers have left. I pay tribute to two recent managers, Mr. Seamus Moore and Mr. Chris Monahan, both of whom I have interacted with and who were in negotiations with the HSE before leaving. I appeal to the Minister, Deputy Mary Harney, to ensure a manager is appointed. I have failed to make contact with Ms Breda Kavanagh. I have spoken with Mr. Monahan, but there is no clarity. All of this is causing the residents unease. I understand staff were consulted and told there would be no staff lay-offs, so I wonder what will happen to them.

If a model is not broken, why try to fix it? Cluain Arann is a wonderful facility adjacent to another HSE facility. Residents are happy to live out their lives in its environment. They are privileged to be residents of the home and finding somewhere even remotely like it to relocate them will be difficult. They have made friends, so their relocation will be difficult on them.

The HSE is conveniently using the quality guidelines of the Health Information and Quality Authority, HIQA, as an excuse to close the facility, but where were those guidelines when we were being told last week of 500 patients on trolleys throughout the country? Where are they when there is bedlam in accident and emergency units at night? Hiding behind HIQA when it suits the HSE is farcical.

The Cluain Arann facility should be used as a role model for other communities. The old adage is appropriate, namely, where Tipperary leads, Ireland follows. I am glad the Minister is present.

As with the working time directive in respect of doctors, we have quoted HIQA's guidelines. It is what we always hear when somewhere is to be closed. I do not accept this jargon and do not accept that we must obey these guidelines. They are used very conveniently. I met HIQA as one of a number of backbenchers and asked the same questions but the HIQA representatives shrugged me off; they were not interested.

How unsafe is it for patients to be on trolleys? There are hundreds of them around the country. Those involved are, however, well cared for and able to look after themselves to a great extent; they do not need specialised care. There is no staff shortage but the staff have been told they will be redeployed but we do not know where. I hope it is not like Cashel Hospital, which closed years ago, yet some of the staff are still there.

This is unnecessary. This welfare home should be a model and I ask the Minister to tell us who is in charge in that region of the HSE. The Minister of State now accepts there was no consultation in St. Michael's Hospital last year, despite what we were told by the HSE officials. There was consultation in this instance — to be fair the manager told me that — but we should be copying this model to put in place low cost facilities around the country.

Cluain Arann Welfare Home provides residential services to people over 65, with a range of dependency needs. Many of these residents are capable of living independently and require minimal assistance in a home-from-home environment. The management of Cluain Arann Welfare Home consists of a director of nursing and here are 7.5 full-time posts, with all staff reporting to the director, providing 16 hours nursing care per week.

It is located in Tipperary town, on the same site as Cluain Arann community nursing unit, which shares some facilities and is integrated into the same building. While both units are managed independently, they share the entrance and reception area, a large kitchen, dining room, sitting room, physiotherapy department, sluice room, cleaning room, laundry, records room and staff facilities.

The welfare home has 35 residential beds, 19 of which are currently occupied. These are configured into 20 single bedrooms with wash-hand basins and five three-bedded rooms with shared wash-hand basins and toilet facilities. There are three bathrooms, two with showers, and one with a bath. In addition there are four separate toilet facilities for residents' use. Each room has adequate storage space with a lockable wardrobe available in all bedrooms. The goal is to maintain an independent style of living with appropriate supports provided.

As the Deputy is aware, the care and welfare regulations for designated centres for older people currently require 24 hour nursing care. The home had been inspected in September 2010 by the Health Information and Quality Authority and one of the issues highlighted was the lack of 24 hour nursing care. In this context the HSE felt that it was necessary to close the home and provide the residents with alternative appropriate residential care.

The Department has recently commenced a review of the care and welfare regulations and one of the issues being considered is the level of nursing care that would be appropriate in designated centres. In anticipation of the outcome of this review, the HSE is reconsidering the options that may become available. The HSE will engage with HIQA to see what arrangements can be put place to enable the home to meet the regulatory requirements and remain open.

Convalescent, respite, and palliative care will continue to be provided at Cluain Arann. There is a ten bed unit on the same site which, as I stated earlier, currently shares many facilities with the welfare home. I acknowledge this may have caused anxiety for residents and their families but at all times the HSE was acting to provide the most appropriate care possible for the residents.

Regional Airports

The decision to eliminate the public service obligation subsidies for all regional airports in the west is both wrong and illogical. The Minister has announced that he will close the regional airports on the north-western, western and southern coasts apart from Kerry and Donegal. His argument for retaining Donegal is the county's isolation and lack of interurban roads. Sligo and Knock are in the same position in that there is no direct road link to Dublin. It is amazing the Minister should retain Donegal when he knows there is another airport in the north-west, in Derry, because he used it to travel to the Glenties to attend the Magill summer school. The entire province of Connacht, however, will now be deprived of any Government subsidy for regional airports.

It is outrageous the Minister should be making an announcement of this nature. There were indications in the budget that the PSO would be reduced but the total elimination is not acceptable.

The Minister did not consult other relevant Departments, such as the Department of Finance or the Department of Enterprise, Trade and Innovation, to see what could be done in terms of connectivity for the isolated periphery of the country. We know these regions are economically dependent on airport accessibility and that foreign direct investment depends upon them. Multinational businesspeople need global transport structures to go about their business. Industries were attracted to peripheral areas because the IDA could promise accessibility that is now being done away with. The only part of the economy doing well at present, the export-led multinational sector, is having the rug pulled from under it. Personnel will not have the necessary connectivity. It is outrageous.

There is not much good land in the west of Ireland but the landscape is very attractive. The tourism industry is highly dependent on airport access, with regional airports in Sligo and in Knock, a place where we never thought an airport would survive. Effectively, Knock is now in a serious position and will find it difficult to operate on a commercial basis. The Minister stated in the document that it is not commercially viable. It could easily close.

The Minister for Transport is not operating unilaterally. This is not merely a transport matter, but a matter of the economy, tourism, foreign direct investment and accessibility. He should link up with the other relevant Departments and put together a task force to deal with the threat to the regional airports, ensuring the service that is so urgently needed continues to be provided in those areas.

I am replying to this matter on behalf of the Minister for Transport, Deputy Noel Dempsey. I thank the Deputy for raising it.

Having fully considered the conclusions and recommendations of the value for money review of Exchequer expenditure on regional airports, the Government has agreed to support the continuation of a public service obligation, PSO, route between Donegal and Dublin and between Kerry and Dublin. The necessary approval to continue these PSO air services will be sought from the European Commission. Once approved, specifications for the services will be settled and arrangements will be put in place for a tender competition in respect of these two routes.

In line with the review, the Government has also agreed to cease requiring PSO routes between Dublin and Sligo, Knock, Galway and Derry, from July 2011, recognising, inter alia, the improvements in alternative transport modes by rail and road which have taken place particularly with Government investment under Transport 21 in recent years.

The VFM review is part of the Government's value for money and policy review initiative introduced to secure improved value for money from public expenditure. The review initiative evaluates past Exchequer expenditure against the regional airport programme objectives and examines the scope for achieving those objectives more efficiently and effectively in the future. The review was published yesterday and is available for download on the Department's website.

Under updated EU legislation governing the PSO air services, more stringent conditions will apply in the future, having regard for example, to the availability of other transport connections and especially rail services with a travelling time of three hours or less. The change in EU legislation, the substantial investment in surface transport, the completion of the review and the requirement to make best use of scarce Exchequer resources, were all taken into consideration by Government in making this decision and it is not the Minister for Transport's intention to reverse that decision.

It must be borne in mind that there are many demands on the Department of Transport's Vote and trying to maintain a level of expenditure on the regional airports programme which is no longer justified or sustainable would impact negatively on other areas such as public transport provision and-or road maintenance. Overall, the Minister for Transport believes the combination of an improved surface transport network together with a more consolidated air service network to regional airports, along with the State airports at Cork, Shannon and Dublin, provides the necessary transport access to underpin Ireland's sustainable development.

Where a PSO route is being terminated from mid-July 2011, the route will be open to commercial air services from that date. In addition to the PSO scheme, there are two other schemes which provide Exchequer support to the regional airports, an OPEX scheme which provides money to airports to cover all or part of their operational losses in any given year and a CAPEX scheme which provides finance towards the cost of necessary infrastructure at our regional airports. The Minister for Transport is giving further consideration to these schemes and will revert to Government shortly with proposals.

If I might just add a couple of comments of my own, at some time in the past 20 years I have used every single regional airport, some of them several times. They are an asset to the country but they were constructed at a time when the road services in particular and the frequency of rail services were very different from what they are now. At least one regional airport, the south-east Waterford airport, was never in receipt of a PSO. I gather it has had discussions with the Department of Transport and it is satisfied with the outcome. I hope all the regional airports mentioned will continue to provide services but under other conditions.

The Dáil adjourned at 5.15 p.m. until 2.30 p.m. on Tuesday, 18 January 2011.
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