I welcome the Minister to the House.
Adjournment Matter. - Residential Accommodation for the Elderly.
I, too, welcome the Minster to the House.
In this Adjournment Debate I call on the Minister, and through the Minister, the Minister for Health, to provide funds for the provision of a permanent residential accommodation unit for the old and infirm of Wexford town and surrounding area.
The Minister is probably aware of the growing chorus of individuals, of families and of the Wexford Carers' Association pleading for the provision of such facilities in and around Wexford town. We urgently need long-stay residential units for the elderly in that area so that they can remain close to their families and friends in their twilight years. Wexford town and district area is the most populous area in the county and has a growing population of elderly, particularly within the borough. There is an urgent need for long-stay beds in the immediate location of those requiring this facility. At the moment people in need must travel either to St. John's Hospital in Enniscorthy or to the New Haughton Hospital or the Community Hospital in New Ross. Between them, those hospitals provide approximately 160 long-stay beds plus some rehabilitation and respite beds. The hospitals give excellent care and attention to their patients. The district hospital in Gorey supports the hospitals, particularly St. John's Hospital, with short-stay beds for patients awaiting long-stay beds.
We have an excellent geriatric assessment team in our county. While all long-stay beds are virtually always full, the team ensure that there is no undue delay in responding to the needs for a long-stay bed. However, there is a waiting list, especially for female beds. I suppose that statistically we live longer, so there are more women of an older age group around in need of institutional care when the family, for whatever reason, can no longer take care of them or when they are no longer able to have an independent existence of their own.
The South Eastern Health Board, as the Minister is possibly aware, have a discussion document on services for the elderly. This document is yet to be discussed and approved in part or in full by the Executive or the South Eastern Health Board. The document suggests an increase in the bed units at St. John's Hospital in Enniscorthy. I fully support that suggestion, because the beds are badly needed. The document also points to the need to build a unit of 30 or so beds in Wexford town to provide a comprehensive geriatric service at that end of the county.
Tonight I plead with the Minister for a commitment to immediate action on the provision in Wexford town of the facility I have outlined but it can be provided only if the Minister commits funding through the South Eastern Health Board specifically for such a unit. At the moment the South Eastern Health Board have enormous demands on their annual funding. Unless the Minister specifically earmarks moneys to give priority to what I am requesting, I am afraid we will be sitting in the queue for funds, along with the many others making demands on the South Eastern Health Board.
I put it to the Minister that Wexford General Hospital has a beautiful new surgical wing which is due to be opened shortly. That will allow for the closure of the old surgical wing — or the old hospital as we have known it — which is a very fine, if somewhat outdated, building. Could the old hospital be converted into a unit for long-stay beds for our elderly? I urge the Minister to seriously investigate that suggestion. There would need to be lifts installed and the fire escape facilities updated, but it is a beautiful old stone building which, with some modification, would serve the purpose of providing a long-stay unit for our elderly. The location of the old hospital would be ideal in that it is down town Wexford, an area quite accessible to the people in the south-east corner of our county.
The Minister probably knows also of a development by Respond, a voluntary co-operative, through a capital assistance scheme under the social housing programme. The development will involve the construction of some 40 units of sheltered housing with communal facilities. We welcome the facilities, which will be located at Westlands in Wexford town. However, that development will cater for a different sector from the one I am talking of this evening. I request specifically the provision of a long-stay residential unit for our old and infirm.
I do not have to emphasise to the Minister either the need for family and friends to visit the old and the infirm once they can no longer lead an independent existence, and the paramount importance of that factor. In rural Ireland we have little public transport. Public transport is not on a regular daily basis and it is virtually impossible for people from the Killinick, Rosslare and Killanne areas of south Wexford and, indeed, Wexford town to make regular visits or visits at night to their elderly, be they in the New Haughton Hospital or the Community Hospital in New Ross or in St. John's Hospital in Enniscorthy. In that regard, we are talking about round trips of 60 to 70 miles at minimum. The Lions Club in Wexford provide an excellent transport service from Wexford town to St. John's Hospital in Enniscorthy. They provide a voluntary bus every Tuesday night to allow those who do not have their own transport and cannot afford to pay for a taxi or to take advantage of the limited public transport that is available to at least once a week get to see their elderly in St. John's Hospital in Enniscorthy. The way in which we look after our elderly and our infirm is a test of civilisation.
In January Wexford Corporation passed a motion which read:
This Borough Council calls on the South Eastern Health Board to provide in Wexford Town a long-stay residential unit for the elderly.
and
That this Borough Council calls on the Minister for Health to immediately make funds available for the provision of permanent residential accommodation for the old and infirm of Wexford Town and surrounding area.
The motions should have reached the Minister or, if not, they should have reached the new Minister for Health. I ask the Minister to accede to the request of Wexford Corporation for the Minister for Health to receive a deputation to outline the urgent and existing need for this facility in Wexford town, having particular regard to the increasing population of elderly persons in our borough.
I wish to conclude by reading extracts from just one letter I have received. This comes from a lady in Killinick, County Wexford, and was written on 10 February of this year. The woman writes:
Dear Avril
My mother is in great form and is very snug and cared for in the New Haughton Hospital in New Ross, but what I would like to know is when are we going to get a home of this kind in Wexford town or surrounding area. It's a shame that people, all from the south end of Wexford, have to go to either New Ross or Enniscorthy. Surely, with the new hospital opening in Wexford, a few wards could be opened up in the old hospital for the old people, to save people travelling to those other places. We can only visit my mother on a Sunday and how I would like to be able to visit her a few nights but I can't, because I don't drive a car.
The letter continues:
There are quite a number of people down this area, either in New Ross or Enniscorthy, and I've been talking to their relatives and they all feel the same as me. Why shouldn't Wexford town have a home for the old folk? Please see what you can do.
I hate to see Mam so far away and I would love to visit her more often. I know she misses us and I miss her a lot but I couldn't have looked after her any longer. I'm just coming to now, getting out a bit and I'm not so tired.
The woman signs off with a few pleasantries. That lady has looked after her mother, who is nearly 90, all of her married life and for the past ten years her mother was confined to bed with Alzheimers Disease and various other complaints that elderly people often suffer from, such as incontinence. In trying to care for her mother, the woman's own heart and health were broken. Only at Christmas this year a geriatric assessment unit in Wexford got a long stay bed for this lady's mother. She is not complaining. Her mother is getting excellent care in the new Haughton Hospital in New Ross. Having had the mother live with her all her life and be able to see her now for an hour only on a Sunday afternoon is not satisfactory for either the family or the old person concerned.
I put it to the Minister that that is but a sample of the dozens of problems represented to myself and other Members of the Oireachtas; I am not unique in this. Wexford town is the capital town of our county; Wexford town and district have a population of over 35,000 people; we have a huge visiting population, and many people from the banks and insurance companies retire to Wexford. It is a very popular location in which to retire. We have a growing population of elderly, particularly women, who need long stay beds. Even though I compliment the health board, particularly the geriatric assessment team and the medical and nursing staff of the Haughton Hospital, New Ross, St. John's Hospital and the Community Hospital in Enniscorthy what we need for Wexford town and surrounding areas is a geriatric unit so that we can keep our own people in our own district, visiting them daily if possible.
Perhaps the Minister of State will have good news for us. I urge him to ensure funds be made available to accede to this very reasonable request. Furthermore I urge him to accede to my request on behalf of Wexford Corporation to meet a deputation so that our case can be put first hand to the Minister for Health.
I thank the Minister of State for attending here this evening.
May I express my personal appreciation of Senator Doyle's words of welcome to me here this evening. I also want to take this opportunity to thank her for raising the issue and for affording me an opportunity to respond.
As we are aware, responsibility for providing services for the elderly in Wexford town and surrounding areas in the first instance lies with the South-Eastern Health Board, who are currently considering a plan to develop services for the elderly, as recommended by the Report of the Working Party on Services for the Elderly, entitled The Years Ahead — A Policy for the Elderly. I understand that a special board meeting has been arranged for 26 March at which that plan will be discussed in detail.
At present, there are 255 long stay places available for the elderly of County Wexford in New Ross and in St. John's Hospital, Enniscorthy. In addition, there are 266 places in private nursing homes, of which 42 are subvented by the health board and there are ten sheltered housing places. According to the draft plan, there is an over-supply of long stay accommodation for the elderly in the county. The provision of long stay beds in the county, at 51 per 1,000 elderly people, is generous by comparison with the national average of 49.7 places per 1,000 elderly people.
The draft plan proposed that a geriatrician will be appointed to Wexford General Hospital who would work closely with the existing assessment team for the elderly. It proposes that the present rehabilitation unit at St. John's Hospital be increased to 34 beds to meet the norm recommended for rehabilitation in the document The Years Ahead. The plan proposes to develop a comprehensive geriatric hospital service in Enniscorthy and Wexford town. It plans to replace existing, unsatisfactory accommodation at St. John's with two new 34-bed units. In the longer term, it is proposed to build a 34-bed unit in Wexford town. These units would provide convalescent, respite, terminal care and care for highly dependent patients. These facilities will be in addition to the existing ones at the Haughton Hospital, New Ross, the Community Hospital, New Ross, and the District Hospital in Gorey.
The plan refers to proposals to develop welfare accommodation for the elderly. The Years Ahead recommended that the elderlies' need for welfare accommodation be met in a variety of ways. One of the best ways of meeting that need is by sheltered housing schemes. These schemes are being provided throughout the county by voluntary housing groups with the help of grants from the Department of the Environment. The South-Eastern Health Board inform me that a sheltered housing complex is being developed in Ramsgrange. They understand that “Respond,” a voluntary housing agency, have plans for a further 40 units in Wexford town. The board hope to see sheltered housing complexes developed adjacent to day centres for the elderly, with Gorey and Wexford town identified by the board as the priority areas. I look forward to receiving the board's plan for the development of services for the elderly when finally agreed.
As part of the Government's commitment to improving health services for the elderly as recommended by The Years Ahead, substantial additional funds were made available to the South-Eastern Health Board in 1990 and 1991. These funds were repeated this year and amount to £846,276. In 1990 the board used the funds to enhance community services for the elderly in line with the Minister's priorities. The elderly in the South-Eastern Health Board area benefited from increased levels of home help, home nursing, day care, the introduction of a boarding-out scheme and the provision of additional paramedical staff. Last year, the board used the additional funding to open a 12-bed rehabilitation unit in Carlow, a unit for the elderly mentally infirm in Thomastown and to provide new day-care centres in Bagnelstown and Cappoquin. This investment in services for the elderly has led to a substantial improvement in services for the elderly which I hope will be maintained.
I should like to take this opportunity to point out to the Senator that for the past three years the South-Eastern Health Board have received a substantial proportion of the entire capital budget for general hospital developments, such as Ardkeen, Wexford and Kilkenny. In 1991 the board received £17 million for projects, or 56 per cent of the national capital budget. In 1992, the amount will be £15 million or 40 per cent of the budget. This substantial amount of funding reflects the board's priority to improve the quality of their acute hospital accommodation. As the elderly require acute hospital services more than other age groups, they will benefit greatly from the improved hospital services.
I referred earlier to the substantial number of nursing home beds in County Wexford. The South-Eastern Health Board subvent a proportion of these beds. The Senator will be interested to know that my Department are at an advanced stage with preparations to implement the Health (Nursing Homes) Act, 1990. That Act provides for a new relationship between health boards and nursing homes. The health boards will register nursing homes, both private and voluntary and will keep an eye on standards by six-monthly inspections. The provisions of the Act will also enable a health board to pay a subvention towards the cost of care in a nursing home for a person they have assessed as needing nursing care and who cannot afford to pay for such care. The Act will provide health boards with another option in meeting the needs of the dependent elderly, locally and flexibly. It is my intention to implement the provisions of that Act later this year.
Of course, I recognise that much remains to be done to improve services for the elderly in Wexford. Health board mangement have outlined proposals to enhance services, hopefully, to be adopted by the board at their forthcoming special meeting. I would ask the Senator on this occasion to accept the commitment of the Government to the development of services for the elderly in the south-east, as shown by the generous additional funding for services for the elderly provided in the last few years.
When the board will have considered their plan that might be the most appropriate time for the deputation — as requested by the Senator here this evening — to be received in my Department. Probably it would be preferable were they to come with the plan already agreed by the board and by the staff of the South-Eastern Health Board.
The Seanad adjourned at 8.30 p.m. until 10.30 a.m. on Thursday, 19 March 1992.