Dáil Éireann debate -
Thursday, 14 Jul 2016

Vol. 918 No. 2

Topical Issue Debate

Local Authority Funding

Deputy Pat Deering

I am glad to have the opportunity to highlight this issue, which is a problem for many small counties. I will articulate the views of Carlow County Council, the area I represent.

Carlow County Council collected €3.85 million in local property tax, of which €3.08 million is retained as the 80% contribution for the local authority. It receives a contribution from the equalisation fund of €2.27 million, which brings its total fund from the local property tax to €5.35 million, a reasonably small amount when compared with other counties of a similar population.

Roscommon County Council's 80% contribution is €3.2 million, but it receives a contribution from the equalisation fund of €5.99 million, giving a total contribution of €9.11 million. Sligo, with a population similar to that of County Carlow, receives a total amount of €9.99 million in contributions from the fund. It is almost impossible for a county of Carlow's size to provide the services required without proper funding. I believe this fund needs to be redistributed to take into account the small counties that do not have the same ability to raise their own funds.

The main source of funding for local authorities comes from commercial rates and in Carlow's case the commercial rate base is quite small. Unfortunately, in recent years a number of large industries, including the sugar factory which historically was the largest contributor to commercial rates in County Carlow, have now closed. Other large contributors, Braun and Läpple, have also closed. That income stream has now gone.

The commercial water charges will transfer to Irish Water in coming weeks as that process started on 1 July. Therefore that funding stream has also gone.

With the introduction of the housing differential rent scheme a number of local authorities, including Carlow, are losing funding from that point of view. This has resulted in a loss of approximately €250,000 to County Carlow in the coming year.

I ask the Minister of State and the senior Minister to redistribute the fund so that everybody would be on a level playing field. I outlined cases of counties with similar populations to Carlow being treated more favourably. We also need to look at the overall funding of local authorities to bring the funding stream back to where it was in 2008, 2009 and 2010. As with other local authorities, the overall budget for Carlow County Council has reduced by approximately €4 million since 2008. That €4 million could provide many extra services and the only way a local authority such as Carlow County Council can provide extra funding is through increasing the local property tax, which is not always possible to do. A 1% increase in the local property tax in County Carlow would equate to €38,000, which will not provide much of a service.

In his reply I ask the Minister of State to address the two issues I raised - the redistribution of the local property tax fund and a new funding model for local authorities. There may be other initiatives which might help local authorities, including the scheme to encourage people to come back to live in town centres. I am delighted the Minister of State visited Carlow in recent weeks to investigate some of the issues that could be helpful to Carlow and other counties. I hope that next Tuesday's announcement might contain some initiatives that could be helpful in that regard.

Minister of State at the Department of the Environment, Community and Local Government (Deputy Damien English)

I thank the Deputy for giving me the opportunity, on behalf of the Minister, Deputy Coveney, to outline the importance of the equalisation fund for local authorities such as Carlow County Council in the context of the local property tax allocations.

I was lucky enough to be in Carlow recently to meet up with the Deputy, representatives of the local authority and some Chamber of Commerce members. Carlow is a town that is in a hurry to get itself back to the pace it was at a few years ago and restore itself to those glory days. I have no doubt Carlow is well positioned to avail of schemes that I hope we will be announcing in the action plan for housing in the weeks ahead and that we will be able cater for some of the demands there along with the issues around this fund. There are other schemes that we hope to announce that might address some of the issues that were raised during my trip to Carlow. It was nice to be there turning a sod on a housing development. Apart from having action plans we need to have action on the ground which I see in Carlow. We want to encourage more of that as quickly as we can.

The local property tax was introduced to provide an alternative, stable and sustainable funding base for the local authority sector, providing greater levels of connection between local revenue raising and associated expenditure decisions. This reinforces local democratic decision making and encourages greater efficiency by local authorities on behalf of their electorates.

At the time when local retention of local property tax was introduced in 2015 and became a key funding line for the local government sector, the Government decided that no local authority should receive less in LPT than it had received as a general purpose grant from the local government fund in the previous year, which was 2014. A similar approach was adopted in 2016. Therefore, Carlow’s LPT allocation in 2016 is in line with its former funding level, as is the case for all local authorities receiving equalisation funding.

As we all know, local authorities vary significantly from one another in terms of size, population, public service demands, infrastructure and other income sources, and their general purpose grant funding levels in the past have reflected this variety. It is not, therefore, possible to compare absolute levels of funding received in local authority areas as to do so could not reflect the vast differences that exist between them.

The 2016 local property tax allocations to Carlow County Council were made in accordance with Government’s decision that 80% of LPT is retained locally to fund vital public services, while the remaining 20% is redistributed to provide top-up funding to certain local authorities that have lower property tax bases due to the variance in property values across the State.

The estimated 2016 LPT yield in County Carlow is €3.85 million and so it follows that €3 million of this amount, representing 80% of the yield, is retained locally in accordance with the Government’s decision. The exact same rule has been applied to every other local authority in the State.

The Government also decided that no local authority should receive less income from LPT in 2016 than in the previous year. This decision, in effect, meant that the minimum amount of funding allocated to any local authority in 2016 would at least equal its general purpose grant in 2014. This was to ensure that no local authority would be any worse off from local retention compared with previous funding from the local government fund.

Carlow County Council received €5.35 million as a general purpose grant in 2014. Its locally retained LPT income of €3.08 million in 2016 is €2.27 million lower than its 2014 general purpose grant. Accordingly, it was entitled to receive €2.27 million from the equalisation fund in order to ensure that the year-on-year position of the authority is unchanged and the authority is consequently no worse off because of local retention of LPT. The same formula has been applied to all other local authorities that needed to receive top-up funding from the equalisation fund.

The overall level of equalisation funding required in 2016 is €108.3 million, of which €94.7 million is funded by local authorities from their 20% contribution, with the balance of €13.6 million from central State coffers. As the Deputy will appreciate, there is a finite level of funding available for redistribution to those local authorities, such as Carlow County Council, which require additional support to meet this requirement. It is important, therefore, that they are all treated in a comparable manner, which is the case currently. Any variation to that approach for one individual local authority would introduce an element of inequity and presumably lead to similar demands from all other authorities.

The Minister, Deputy Coveney, and I - based on my trip to Carlow - are aware of the funding pressures there have been in recent years on all public bodies, including local authorities, and on the competing demands for improvements in services. Local retention of local property tax has now established itself as an essential alternative source of funding for the local government sector. LPT broadens the tax base.

However, we recognise that the bodies in question are under pressure and we will do our best to increase the level of funding.

Deputy Pat Deering

I thank the Minister of State for his favourable comments about County Carlow and the possibility of some helpful incentives being introduced in the coming weeks. I wish to return to my initial point that there should be a redistribution of the fund. While I accept the rationale behind the decision to distribute the funds as they have been distributed, I would like to compare the distribution to County Carlow to the distribution to counties of a similar size. I mean no disrespect to County Leitrim when I mention that its population is considerably smaller than the population of County Carlow. County Leitrim has a population of approximately 30,000 and receives a total contribution of €8.28 million from this fund. The population of County Carlow is almost twice the size of that of County Leitrim, but it receives just €5.35 million. The figures do not seem to add up. While I accept the rationale behind what the Minister of State is saying, I stress that there is a need to look at details such as the population in each county and the size of the county towns in each county. I suggest that such an examination will reveal that differing approaches are being taken. It is not quite a level playing field.

I would like to mention one of the mistakes that could be addressed at this stage. In the past, towns over a certain size that had town councils received block grants to enable those councils to look after certain issues. That has been gone for the last few years. We have seen a negative result from that. The funding that was previously available through the block grant, which was used to deal with issues in large towns, is no longer available because of the disappearance of the town councils. There needs to be a re-examination of the whole funding model. It is obvious that incentives are very important. I welcome any incentives that may come on stream in the next week or ten days. Overall, something more definite needs to be put in place so that local authorities can plan for the future. Such an approach would enable regional towns that have suffered in recent years as a result of the downturn to build for the future and look forward to attracting the businesses that are required. I hope such businesses will be coming down the line. I have suggested what we can do to give them the incentive to go forward over the coming period.

Deputy Damien English

I understand the point the Deputy is making. When I went into this Department, I noticed some of the figures he has presented to the House. It seems that some counties do well for historical reasons. This is constantly being monitored.

The Minister, Deputy Coveney, and I are very conscious of the pressures on the county councils. Councils in the greater Dublin region, in particular, came under a great deal of pressure from housing developments in previous years and might not have the right base to match that now. We are aware of that. As I have said, we are coming forward with plans. The housing action plan will be published next week. Other plans will be announced as well. We will try to tailor programmes to help to deliver more funding into county councils that want to try to rebuild their town centres, put their town centres to better use and make their town centres more attractive to business so that jobs will be created.

The whole idea here is that if we can get more industry into counties like Carlow, Wicklow, Meath and Kildare, that will help to generate rates and thereby increase the funding available to local authorities for the provision of services. There is a great deal of pressure on county councils. During the boom years, a great deal of additional housing was developed in areas where jobs were not being created. I understand the major pressure that comes on the delivery of services as a result. We are noting that. The census figures that were published this morning will also feed into our thinking in this regard. If one compares the level of funding received in many counties to the population in those counties, one will appreciate the difference it makes when services are being provided. That is something we will be monitoring as well. I hope we can work on this in the years ahead. As the economy improves, funding is also improving, thankfully. We need to make sure it is channelled into the right places through the right Departments.

Irish Water Administration

Deputy Caoimhghín Ó Caoláin

I thank the Ceann Comhairle for selecting this item. I want to bring it to the attention of the Minister of State and the House as a whole that the process of transferring non-domestic water billing from local authorities to the entity known as Irish Water will commence by the end of next week. It has chosen counties Monaghan and Meath as the first counties to participate in the transfer process from local authorities. Irish Water will write directly to all non-domestic water customers in counties Monaghan and Meath shortly, after their account information has been transferred, to inform them of these changes.

It beggars belief not only that it has been decided to proceed with the transfer of responsibility from local authorities to the entity known as Irish Water now, but also that this change is coming into effect while the newly appointed water charges commission is readying itself to commence its work, which includes addressing the future of domestic water charges and the future of Irish Water itself. While some people would argue the toss on this decision and suggest it relates merely to the funding of Irish Water, I would contend that funding is the critical element of this entire issue. The question of whether to give Irish Water the oxygen of funding will determine whether it will continue to breathe as a structure into the future. The policy of proceeding in this manner at this point, thereby giving Irish Water what seems to be a lifeline, has not received any public attention of which I am personally conscious. I suggest that in light of this approach, it is no wonder that so many people have lost faith in politics and the political process. The process of allocating funding directly to Irish Water from the local authorities, which is getting under way, will be viewed by many people as a very inappropriate and underhanded move at this time, especially in light of the Government's decision to suspend the accruing charges for domestic water provision.

We have to recognise that the water charges commission is getting down to its work under its new chairperson, Kevin Duffy, who has replaced Joe O'Toole after his recent decision to stand down from that position. I agree with the views of those who have expressed understandable annoyance because they believe the so-called expert commission is structured to give a specific result. When the Minister, Deputy Coveney, commented on the appointment of Kevin Duffy, he said that the new commission will have "a wealth of experience in addressing complex, intractable issues". I suggest there is nothing complex or intractable about the issue of domestic water charges or the future of Irish Water. The people made their decision patently clear in February. I ask the Minister not to allow the transfer of the billing and accounting process to proceed at this point. We should await the outcome of the commission's deliberations and make an informed decision in the full light of what it may have to say.

Deputy Damien English

I thank Deputy Ó Caoláin for raising this issue and giving me a chance to bring some clarity to it. This process will affect his county and my county in the first instance. As it is rolled out, it will affect other counties as well. Irish Water has been responsible for public water services with effect from 1 January 2014. The Water Services (No. 2) Act 2013 provides that Irish Water shall collect charges from its customers in receipt of water services provided by it. Accordingly, the collection of water charges is now the statutory responsibility of Irish Water. Local authorities continue to bill for non-domestic water services as agents of Irish Water under service level agreements. Irish Water has recently begun the migration of account administration for non-domestic services on a phased basis from local authorities to its internal customer systems. Counties Meath and Monaghan are the first to migrate, with all others to follow on a phased basis.

The Water Services (Amendment) Bill 2016, which is currently before the Oireachtas, has been drawn up to legislate for water elements of the confidence and supply arrangement that was agreed with Fianna Fáil in the context of its decision to support a minority Government. It is clear from the arrangement document that Irish Water will be retained as a single national utility in public ownership for the delivery of water and wastewater services. It is very clear that Irish Water is here to stay. The Bill before the Oireachtas provides for a straightforward suspension of domestic water charges.

There is no question over how public water and wastewater services are to be delivered into the future. The approach is accepted and Irish Water will remain our national water utility. The Bill before the Oireachtas simply provides for the necessary space to allow an informed, balanced and rational debate on the funding of domestic water services to be undertaken, which is respectful of all positions. It does not have a predetermined outcome. The expert commission is there to examine international best practice and to advise members of a committee of this House on what is the best way to approach the delivery of water services and the costs involved in that. The Bill does not provide for any changes to the current water charging regime for non-domestic customers. Since 2001 national water pricing policy has required local authorities to recover the costs of providing water services from all non-domestic users of those services. This policy provided for charges based on actual metered consumption and is consistent with the requirements of the Water Framework Directive. Local authorities currently bill non-domestic customers on behalf of Irish Water and charges recovery rates are low.

Currently, there is variance across the country in how non-domestic customers are billed, both in tariff type and level of tariff. There are 44 tariff structures, with more than 500 tariff points in place for non-domestic water and wastewater services. The harmonisation of non-domestic tariffs should lead to greater certainty and simplicity for businesses and other non-domestic customers about the structure and level of charges. This will also help to make our economy more competitive. Harmonising tariffs should also ensure that businesses pay their fair share of the costs of providing water services in a fair manner across the country, not based necessarily on their address. However, it is a complex issue which requires considerable analysis and consultation. The Commission for Energy Regulation, CER, the economic regulator of Irish Water, will commence a public consultation on this matter in due course.

As I stated earlier, local authorities have continued to bill non-domestic customers for water services as agents of Irish Water under service level agreements. Irish Water is now commencing the process of migrating the responsibility for account administration for existing business customers from local authorities to the utility. This was always envisaged under the implementation strategy for reform of the water sector and having regard to Irish Water's statutory responsibility. Irish Water has engaged with relevant stakeholders and business representatives groups in advance of the migration and will continue to do so as the nationwide roll-out progresses. I also wish to reiterate that the draft legislation currently before the Oireachtas provides for a straightforward suspension of domestic water charges to allow time and space for informed discussion and deliberation on the future funding of domestic water services only. There is no question over the position of Irish Water as the national water utility, nor does the Bill propose any changes to the system of non-domestic water charging and billing.

Deputy Caoimhghín Ó Caoláin

The Minister's response is not only disappointing but also revealing in some respects. He made it patently clear that the Water Services (Amendment) Bill currently before the Houses is indeed a product of the Fine Gael and Fianna Fáil Government arrangement.

Deputy Damien English

There is no secret about that.

Deputy Caoimhghín Ó Caoláin

What we are seeing now is the outworking of this in terms of the transfer of non-domestic water provision and billing from local authorities to Irish Water. It is no wonder it is happening now when one considers the figures for payments to Irish Water for the first quarter of 2016, which show a reduction of 45% on the previous quarter of paid accounts for domestic usage. In fact, in the first quarter of 2016, it only managed to secure a 27% payment rate. In other words, 73% of domestic users across the State have withheld payment. It is a very loud statement to the Fine Gael Government supported by Independents and, as the Minister confirmed in his reply, by Fianna Fáil, which campaigned clearly and unequivocally in the general election campaign in February for the abolition of water charges and Irish Water. Fianna Fáil has clearly rolled back on its position and the Minister is clearly indicating that the future of the Irish Water entity is guaranteed into perpetuity. However, it is not guaranteed. One of the responsibilities of the commission is to consider the funding of Irish Water. That is the oxygen for whether it survives. It should not, and I again call on the Minister not to allow this process to proceed.

Deputy Damien English

To be clear, the Bill before the House relates to water, not to the Irish Water utility. The single water utility remains, and the Government has no intention of changing that. We strongly believe in the concept of a single water utility delivering the service and infrastructure requirements throughout the country, for both the domestic and non-domestic sectors. I have no doubt that in time, when people review this, they will see it was the right decision to establish a single water utility such as Irish Water to deliver best practice, efficiencies and effectiveness in this area and to bring the infrastructure in the country for water and wastewater up to the high standard required to facilitate growth in business, jobs and housing supply. I wish the Deputy would not try to confuse the matter because there is no doubt. The Bill before the Oireachtas does not relate to the future of Irish Water, the single water utility.

It is quite correct to continue the process of collecting the non-domestic charges. The Deputy is trying to suggest that this is being done to improve its funds. The non-domestic water charges were being collected on behalf of Irish Water under a service level agreement with local authorities. The money was still coming in but now Irish Water will be billing directly for that service. That transfer begins with Meath and Monaghan.

Emergency Departments Closures

Deputy Peter Burke

I thank the Ceann Comhairle for selecting this critical issue for debate. Local and national media reports over the weekend reported that a number of emergency departments were earmarked for closure. In fact, the first paragraph in the report explicitly stated that the emergency department in the Midland Regional Hospital in Mullingar was one of nine departments earmarked for closure, despite the fact that a €5 million new accident and emergency unit is under construction. Workers are on the site and it is due to open later this year.

Scaremongering about this subject is totally out of place. It has a huge effect on people, their families and the nurses, doctors, health care attendants and staff working in challenging circumstances in those units. The Midland Regional Hospital in Mullingar has been earmarked for a cost-benefit analysis, which is almost complete, for an investment of more than €40 million for four new operating theatres, a new endoscopy unit, a rehabilitation unit and a new intensive care unit. There has been huge investment in the hospital under this Government.

The report concerned, which was on foot of the annual general meeting, AGM, of the Royal College of Surgeons in Ireland, RCSI, examines very serious trauma, which accounts for less than 1% of all cases admitted to accident and emergency units. The hospitals in Tullamore and Mullingar are operating at capacity. These reports that a hospital unit will close are based on a report that has not been seen by the Minister or the Department. It is a report relating to one sector in the health service. The decision maker in this regard is the Minister. I telephoned the Minister for Health, Deputy Simon Harris, last Sunday night on foot of the rumours that were circulating and he was very clear that no accident and emergency unit in Mullingar is to be closed. The opposite is the fact. When the new unit is opened later this year, I hope people will eat humble pie.

Deputy Brendan Smith

I am very concerned about the media reports that appeared last weekend about the status of the emergency departments in nine hospitals, including Cavan General Hospital. The huge number of people attending the hospital in Cavan every week clearly indicates the need for its emergency department to retain all services. Only last May, in parliamentary questions, I raised the need to provide new accommodation and additional facilities at the Cavan emergency department, given the large number of patients attending. Subsequently, the HSE replied to me and stated that Cavan and Monaghan hospital group is currently preparing a proposal regarding the expansion of adult and paediatric resuscitation space for the emergency department in Cavan General Hospital.

Indeed, I had a Topical Issue debate on this subject with the then Minister, Senator James Reilly, in the middle of 2014. At that time, the Minister indicated to me that the figures available to him indicated there had been a 33% increase in the number of patients presenting in Cavan General Hospital. I know from my own contact with clinicians and other staff in the hospital that the number of people presenting has dramatically increased since then, as Deputy Ó Caoláin and other Oireachtas colleagues will know.

I want the Minister of State to give us a firm assurance that there will be no change to the status of the emergency department at Cavan General Hospital. The hospital has a catchment area of 136,000 people. Thankfully, the population of counties Cavan and Monaghan is growing, as recorded in this morning's census figures. As the hospital also covers part of north Longford, south Leitrim and south Meath, this means there is a total population of close to 150,000 in its area. Thankfully, in the period 2001 to 2011 there was major investment, with the provision of new and additional facilities at Cavan General Hospital, including a special care baby unit, additional bed capacity of more than 21 beds, an MRI unit, a CT scanner, other diagnostic facilities, major expansion of the renal dialysis unit and an upgrade to a very high standard of the intensive care unit. With all the additional activity at the hospital, it needs to retain its emergency department and it also needs additional services and accommodation.

Minister of State at the Department of Health (Deputy Marcella Corcoran Kennedy)

I propose to take Deputy Burke’s and Deputy Smith’s issues together given they both refer to the same recent media reports concerning trauma services. I thank both Deputies for raising the issue, which I know exercised many people over the weekend, not only in the counties the Deputies are from but also in others which are referred to in the report. I welcome the chance to update the House on the actual position in light of these recent reports. At the outset, I would like to reassure the Deputies that the work underway in developing a policy on a national trauma system is about getting the best outcomes for a particular, small category of patients who sustain traumatic injuries. It is not about closing emergency departments or diminishing services.

To put this in context, emergency departments provide 24-7 access for emergency and urgent presentations across the spectrum of medical and surgical conditions, and major trauma patients represent a very small percentage of total emergency department activity, as noted by the Deputies. A trauma patient needs access to the best service that has the right resources to match their often multiple and critical needs in the shortest time possible. The aim of developing national policy on trauma networks is to ensure that trauma patients are brought to the right place at the right time, for the right care, so they can make the best recovery possible. It is about building on the strengths of pre-hospital care so all of our acute hospitals and post-acute services can provide an optimal configuration of trauma services. The implementation of hospital groups provides an opportunity for hospitals to work together to enhance trauma services for patients and allows resources for trauma to be co-ordinated in a more focused manner.

The need for a national trauma system has been recognised for many years. Experience from other countries demonstrates that the establishment of trauma networks improves patient outcomes in terms of mortality and morbidity. In June 2015 the national clinical programme for trauma and orthopaedic surgery published the model of care for trauma and orthopaedic surgery and strongly recommended that a national approach to trauma services should be taken. The Royal College of Surgeons in Ireland, the professional body representing all surgeons and emergency medicine specialists, also called for its establishment at its annual scientific meeting last year. As these are the experts in this field, we must listen to them carefully.

Last year, the then Minister for Health appointed a national steering group to develop policy on a major trauma system for Ireland. This is a joint initiative from the Department of Health and the HSE, developed in recognition that we do not at present have a co-ordinated trauma network structure in Ireland. The steering group has been working with the Department of Health, the HSE and all relevant HSE national clinical leads, including pre-hospital emergency care, orthopaedics and trauma, surgery and critical care, on the development of the policy. I want to emphasise that the group has not yet reported and neither the Minister, Deputy Harris, nor I have seen any output from its work. The group's recommendations are not expected until later this year and the Minister and I look forward to receiving the report at that stage. Let me reiterate that this is not about reducing services and it is certainly not about closing emergency departments.

Deputy Peter Burke

I thank the Minister of State. I welcome the clarification that this is not about closing accident and emergency departments or reducing services, which is critical. The health service is famous for reports. However, every report that comes out of the health service should not be taken as read or exaggerated in the manner in which this one was, because it causes significant and unacceptable heartache to people.

This sector is focused on getting the best outcomes for patients. In the catchment area of Mullingar Regional Hospital, if a person breaks a leg and is stable, the person is brought to Tullamore Hospital because it is the orthopaedic centre. Patients are not brought to a hospital where they cannot be treated. That is called a bypass protocol, and such protocols have been in place for a long time. If someone has a serious brain injury, it is important the person is brought to the proper centre as quickly as possible to ensure they have the best chance of survival and the best outcome.

I thank the Minister for clarifying this issue. It is very important that all politicians are responsible in terms of their approach to these reports.

Deputy Brendan Smith

I thank the Minister of State for her reply. I take the opportunity to compliment the staff in Cavan General Hospital, many of whom I know personally. All the staff, regardless of the discipline they work in, work extremely hard under a lot of pressure and stress and they are diligent and committed to their patients.

As I said earlier, fortunately, there was major development and investment at Cavan General Hospital in the period up to 2011 but this extra capacity creates extra demands on the emergency department. An area I did not mention is the increased provision of oncology services, with linkages to the Mater Hospital. There have also been developments in the area of nephrology, with the development of a substantial dialysis unit.

It is extremely important that a message is given to the people through the Members of this House that there will be no diminution in the status of the emergency department at Cavan General Hospital. What we need, and what I and fellow public representatives have been arguing for, is an investment in new facilities at Cavan General Hospital because of the increasing presentation of patients. The hospital is under extreme capacity pressure. I hope the Minister of State will bring that message back to the Department and the HSE.

Deputy Marcella Corcoran Kennedy

I understand where both Deputies are coming from. Any person who heard this news at the weekend, whether one is a politician or not, was naturally concerned, not only for potential patients but also for staff and the people connected to the hospitals to which the Deputies referred. It is unfortunate there would be the type of confusion, concern and uncertainty raised as a result of a news report like this.

I very much welcome the comments of both Deputies about the fantastic care our front-line staff provide when any of us is unfortunate enough to have the need of the excellent staff in our hospitals across the country. They probably do not get enough recognition so I particularly welcome that both Deputies recognised the marvellous care we get when we need to avail of these services.

Given the fact trauma makes up such a small percentage of the overall care the emergency departments provide, it is critical we at all times have skilled people to manage the horrendous injuries people suffer as a result of, for example, a car accident or a fire. With regard to the information we need, we currently have difficulty in getting good, robust population based data.

I very much welcome the fact a report is imminent and we will have it in the autumn. I know the Minister is anxious that the all-party committee on health will discuss the contents of the report. I look forward to the findings of the report. I reiterate this is absolutely not about closing or reducing services in emergency departments in any hospital in the country.

Hospital Closures

Deputy Kevin O'Keeffe

I am delighted to have the opportunity to raise this important issue in the House. I thank the Ceann Comhairle. Just over a week ago, the Sonas Ward at St. Patrick's Community Hospital, Fermoy was closed by the HSE. The ward consisted of 12 beds, where eight patients were receiving either respite or convalescent care while the remaining four patients were long-term permanent residents of the hospital. Those who were receiving respite and convalescent care were taken in on a short-stay basis, which normally rotates fortnightly. The ward also provided for those who required acute patient care.

Staff at the hospital were informed that the closure of the ward would be temporary and that some element of a service may be resumed in September. However, many hospital staff believe this will not be the case, and the ward may remain closed for the foreseeable future and even permanently. This is due to the pressure on staffing levels that exists in the hospital. It was because of the lack of staff in the hospital that the Sonas ward was ultimately closed. St. Patrick's Community Hospital, Fermoy has experienced problems relating to a lack of staff for some time. Staff shortages have meant that many of the current crop of the hospital's staff have been forced to work extra hours, meaning they were overworked, tired and unable to perform to the best of their ability owing to the fatigue that many of them began to suffer. The crisis has worsened over the past 12 months in that when some staff requested that their hours be reduced, this was refused and some chose to take early retirement. This further added to staffing issues at the hospital. At present, only three nurses are working in each of the remaining wards. Everybody knows that many other small hospitals, similar to St. Patrick's Community Hospital, Fermoy, suffer from staffing issues. However, the concern of staff in Fermoy is that there has been no drive recently to recruit new staff.

The closure of the ward will have a serious effect on Fermoy and its surrounding areas. The closure of the ward will cause serious stress to full-time carers in the area who have relied on the ward's service for respite for the people for whom they were caring and for themselves. At a time when there is great pressure on home help services, the closure of the ward adds further unnecessary pressure on those who require these specialist services.

Any argument by the Health Information and Quality Authority, HIQA, that the ward is not fit for purpose is without foundation. In January 2016, the then Minister of State, Kathleen Lynch, allocated St. Patrick's Community Hospital €2 million in funding under the Government's capital spending programme from 2016 to 2021. This was to ensure that the best facilities were available for the residents and their families. I would like to know when St. Patrick's Community Hospital will be able to avail of this funding. Was it just a ploy during the election? Will the Minister of State give a commitment that the closure of Sonas ward at St. Patrick's Community Hospital is only a temporary measure and that it will be reopened at the earliest possible date? Will she will address the lack of full-time staff and staff shortages at St. Patrick's Community Hospital, Fermoy at the earliest date possible?

Deputy Marcella Corcoran Kennedy

I thank the Deputy for raising this very important issue. I also convey the apologies of the Minister, Deputy Harris, and the Minister of State, Deputy McEntee, for being unavoidably absent. I hope the Deputy with be happy that I am responding. The overarching policy of the Government is to support older people to live in dignity and independence in their homes and communities for as long as possible. This is clearly what older people and their families want, and only those in genuine need of residential care should go down that route.

Short-term beds, including respite and rehabilitation beds, contribute to the provision of an integrated model of care for older people, enabling them to return home following a period of hospital care or postponing admission to a long-stay residential care setting.

The HSE is responsible for the delivery of health and personal social services, including those at facilities such as St. Patrick's Community Hospital, Fermoy. The community hospital provides long-term, respite, convalescent and palliative care. It was registered with the Health Information and Quality Authority on 28 June 2015 for a period of three years, with a maximum occupancy of 72 beds. The hospital normally caters for people over 65 years of age, but also provides care to young chronic sick patients and palliative care to adults.

Following a number of unexpected staff absences and early retirements, at present Fermoy community hospital does not have sufficient nursing staff to maintain safely the full range of services. Therefore, the HSE decided to close temporarily the 12-bed Sonas ward. The beds closed on 6 July. This temporary reduction will affect beds used for short-stay services and is expected to remain in place until the end of August. The nursing homes support office is working with local public health nurses in facilitating those patients who normally avail of respite in Fermoy to access respite in other facilities nearby.

The Minister and the Department have been assured by the HSE that this is a temporary measure only, which I know is the main point of concern for Deputy O'Keeffe. A recruitment campaign for nursing staff is in progress. Interviews which were originally to take place in early August have been brought forward to next week. Offers will be made to successful candidates as soon as possible, and it will then depend on how soon they are available to take up duty. I hope it will be as soon as possible after they are offered positions.

The director of nursing and the general manager have met staff representatives to explain why the decision needed to be taken and to outline the steps being taken to reopen the beds by the end of August. The House is aware the management of resources and service planning are matters for the HSE in the first instance. Quality care and patient safety come first, and the HSE is obliged to take the appropriate steps for the management of patient profiles and the staffing resources available. The HSE has confirmed there is no intention to close services at Fermoy, which I know the Deputy will welcome. This temporary measure was taken in the best interests of safety and maintaining services to long-stay residents and those availing of short-stay beds.

My colleague, the Minister of State, Deputy McEntee, will continue to monitor this situation carefully, and has asked the HSE to keep her and the Minister updated on progress. I hope this answer is helpful to the Deputy.

Deputy Kevin O'Keeffe

I thank the Minister of State for her response. She hit the nail on the head with the last sentence of first paragraph with regard to ensuring we keep our elderly at home as much as possible. However, we need to give respite to the carers and family members who mind them, which is why we need the beds in the hospital to be kept open.

Fermoy has taken a hit with regard to the provision of community beds for elderly people. Under the previous Government we lost between 35 and 40 beds with the closure of the St. Francis Welfare Home. This was a big hit to the town of Fermoy and its catchment area. With regard to the loss of the beds, it is all fine to say we are moving to private nursing homes, but the Minister of State must admit the community hospitals also provide ancillary facilities such as physiotherapists and occupational therapists. This is why it is important to keep community hospitals up and running.

I am concerned, and I am open to correction, but I feel that as well as the staff being overworked, a conflict has arisen between staff, management and the HSE and that morale is a bit low. I would like the Minister of State to investigate this. More should be put in place because while the staff are working hard, they should have the goodwill of the entire HSE management behind them.

Previous Government investment in the hospital must be acknowledged. The first time I went to Fermoy community hospital was back in 1980 as a member of the Legion of Mary, and by God it was not somewhere one would have liked to have walked through.

We used to visit other nursing homes in Fermoy, but Fermoy Community Hospital was the last choice on the list. However, down through the years - excuse me for the pun - people have been dying to get into St. Patrick's Community Hospital in Fermoy because the facilities have been so well upgraded. I thank the Minister of State for her response and her interest. I hope these wards can be opened and up and running again as soon as possible.

Deputy Marcella Corcoran Kennedy

The Deputy is right that the whole idea of respite beds is that the family at home, while they love their loved ones and want to care for them at home because that is their wish, needs a break. That is why it is critical that the HSE put in place alternative respite beds so that the families can continue to avail of the opportunity for respite. However, the other aspect of it is that there is a challenge in that older people like routine, they like knowing where they are going, they are used to it and they are used to the staff, so that certainly poses a challenge. That is why the HSE is committed to restoring the services so that people can get back to normal as soon as possible. The key thing here is the recruitment of the staff and getting the required number of nurses into the hospital as soon as possible. That is exactly the direction in which the HSE is going.

To make a general point on the kind of investment that has been secured for community nursing units, the Deputy put his finger on the title of it when he referred to community nursing units and public nursing unit. They are essential to the delivery of care for our older people and people who need palliative care or whatever across the country. We have secured €385 million in capital funding for a programme to replace and refurbish public nursing units across the country. I know the Deputy will welcome this because it will provide an additional 200 beds. The programme includes refurbishment works for Fermoy, the area about which the Deputy is most concerned, which should be finished by 2018.

Deputy Kevin O'Keeffe

I thank the Minister of State.