Community Hospital Closures: Motion

I move:

That Seanad Éireann:

condemning the disgraceful closure of Abbeyleix Community Hospital and Shaen Hospital in County Laois;

noting that the Minister for Health has not informed either House of the Oireachtas of whether it is his policy to close other community hospitals and public beds for the elderly;

recognising that the planned closure of 842 beds leaked to the press is a disgraceful way to treat patients in these hospitals;

noting that such leaks are causing anxiety and confusion to patients and their families in the locations affected, as they face being cast out of the only environment they know as their home at this stage of their lives;

recognising that there is no justification for the closure of these community hospitals for the elderly and there will be no benefit for the HSE as staff would have to be redeployed under the Croke Park Agreement to other HSE facilities in the region;

resolves to:

condemn the Minister's actions for his shameful handling of the closure of community hospitals which caused untold anxiety and distress to patients in these facilities;

call on the Minister to reverse his decision to close Abbeyleix and Shaen Hospitals;

call on the Minister to confirm whether he intends to close any or all of St. Brigid's in Laois, St. Brigid's in Crookslings, Lisdarn in Cavan, St. Joseph's in Louth, Cottage Home in Louth, St. Francis in Galway City, Lifford in Donegal, St. Francis in Fermoy, or Cluan Arran in Tipperary;

call on the Minister to confirm the other facilities that face cuts in the number of beds or other possible closure; and

condemn the Fine Gael-Labour Party Government for advancing the closure of public beds for the elderly and community hospitals given it is privatisation by the back door.

I welcome the Minister of State, Deputy Kathleen Lynch, to the House. It is a shame that we must deal with issues such as this. No one has articulated the seriousness of the matter in recent weeks more than my good friend, Senator Whelan. Others may have articulated it, but only in the privacy of parliamentary party rooms. Throughout the Houses, I do not doubt that Labour Party and Fine Gael backbenchers share my view. The only question is what, if anything, will be done about it. I fully understand that the responsibility of the Government is to make difficult decisions and the people understand that austerity is necessary at this time, but which of us or our families, people who are lucky enough to have jobs, would not gladly pay a little bit more for the care and relative security of the elderly and the young, the most vulnerable in society?

Fianna Fáil made difficult, unpopular decisions. When on the opposite side of the House, I was no less robust in condemning any wrong that was done. As Senator Whelan correctly pointed out, wrong is being done in this instance. The elderly, the young and the vulnerable are the most important people in our society. Fianna Fáil knows all about the medical card debacle. It was not my proudest day wearing the Fianna Fáil jersey. On that day, the elderly stood outside and told us it should not happen. With the benefit of hindsight, I can say that they were right.

The people focusing on this action are not able to congregate outside Leinster House or in the church on Clarendon Street to have a go at the Minister of the day. They depend on us, the Senators opposite, the Minister of State and the Minister for Health, Deputy Reilly, to say that this action is wrong. There is a crisis in the health service and a financial problem, but let us use our minds and efforts to find resources elsewhere. Could other budgets be shaved back, other plans be tempered or other ambitions postponed for a little while in the interests of the care of our elderly?

We have read about many people in recent days. For example, Ms Áine Campbell's 70 year old father is unable to speak following several strokes. According to media reports by Ms Marese McDonagh, he engages enthusiastically with his daughter when she comes to visit. At the mention of, in the Minister's words, the rationalisation of community hospitals, he can only close his eyes in disgust. People are crying themselves to sleep in the constituency of Deputy Fleming, Senator Whelan and others from County Laois. They do not deserve to be singled out. I look at the amendment from the Government and I see that decisions have been taken on Abbeyleix, Shaen and Brittas, which have gone, but no further decisions have been taken. Will it take the protestations of Senator Whelan and others to save hospitals throughout the country? Why should they be scapegoated? Another inexcusable problem with the Government on autopilot is the communication by use of leaks in theIrish Daily Mail. I read that various hospitals are set to close and lose beds. St John’s Hospital in Sligo and St. Patrick’s Hospital in Carrick-on-Shannon in the constituency from which Senator Henry and I come are set to experience bed closures. One wonders what happened to the manifesto which claimed that the devil and all would be delivered for the people. Like so many plans, another U-turn has been done on this. The Minister, Deputy Reilly, told us he would take control of the health service, fire the HSE board and manage it. It looks like headless chickens running around, closing hospitals, leaking details and floating ideas. They thought they would see what people thought if they closed Laois because there are not too many people there, Senator Whelan would not bother and Deputy Fleming was in Fianna Fáil. They just do not care. When Fianna Fáil did wrong, it was told by the elderly people in Kildare Street and at Clarendon Street church that it was getting it wrong. However, the sick, the elderly and the incapacitated are unable to tell the Government that it is getting it wrong. Just because the Minister for Finance, Deputy Noonan, thinks the low-hanging fruit has already been picked, does not mean he should focus on the most vulnerable in society.

This year we will borrow €750 million to live up to our responsibility in foreign aid. That is honourable and we all support policy that invests in our international responsibilities. Various interest groups, such as Age Action Ireland, have pointed out that moving elderly people over the age of 80 and taking them away from their families means that hundreds of people are going to die, to quote "Prime Time" yesterday evening. Is it not possible to postpone €50 million to €100 million of the €750 million in foreign aid for a year or two to assist with the survival of elderly people in this country? It is not a matter of being against foreign aid investment. Of course, we are in favour of it but I wonder how much it will cost. The amendment refers to a cost of up to €1 billion, which is a classic case of wording backing up the argument. We are told that it will cost €600 million to bring the beds up to the standard demanded by HIQA. The Government is giving away €750 million in foreign aid this year. Is it possible to postpone this for a number of years, even though it is honourable? This is my point of view and I am giving an example of other areas that could be examined. I am not saying that they must or they should but there are a number of voted expenditure areas and if €600 million must be found to prevent elderly people in this country dying, that is my responsibility and that is what my tax euro are for. Of course I want to help the people in receipt of foreign aid, more so than we do at present, but if people here are dying then we have a responsibility to them first and foremost. The responsibility of Government and of our very existence in these Houses is to the people. As we all pander to our European masters, there is a better way to care for the elderly than to put them out of what is effectively their home.

How many more will there be? The communications strategy on this matter is an unmitigated disaster. A list was leaked to theIrish Daily Mail on 24 November. In fairness to Senator John Whelan, he outlined the situation. I understand because I know what it is like when difficult decisions are taken but this is the worst I have seen. This motion should highlight the fact that this measure should be reversed pending a national strategy. What is the health plan? The pre-election commitment was for Senator O’Keeffe’s centre of excellence. We also had promises about care for the elderly and increased expenditure year on year. On the previous day, the Minister for Health said he was taking control of the health service and was responsible, but in recent days he has referred to the HSE, HIQA and the moratorium. The moratorium is too blunt an instrument, as is closing hospitals. The amendment to the motion suggests that the average cost is in the region of €1,250 per bed, but according to the Comptroller and Auditor General, the sum is between €900 and €1,200. If costs are the issue, this is what should be dealt with. If my business is losing money because costs are too high, I can bring down costs or I can close the door. The Government has opted to close the door but I suggest they put a little thought into it and bring down costs. Other areas of expenditure may need to be shaved back to help the people of Laois, Shaen, Abbeyleix and Brittas. The Government should not make decent, hard-working public representatives like Senator John Whelan the scapegoat to save all the other hospitals. That is what the Government is doing.

Government Senators should vote with us.

Fianna Fáil with a conscience is an awful idea.

Even if we succeed with this Private Members' motion, all that will happen is the Clerk of the Seanad will write to the Minister for Health to inform him that Seanad Éireann has resolved to agree the motion. What will happen then? Nothing. Senators should do the right thing and vote with us and with their conscience and make a statement on behalf of this House to say that we are in favour of protecting the elderly, whatever the cost. As a taxpayer, I will gladly pay more for the protection of the integrity of the elderly and the vulnerable.

I propose to share time with Senator Wilson. I second the Private Members' motion tabled by the Fianna Fáil group. Our spokesperson, Senator Marc MacSharry, has outlined earlier objections to this measure. I have a number of additional objections that the Minister should hear. I welcome the Minister to the House and I have the utmost regard for him and the work he does. I have a fundamental objection to the Minister for Health overseeing policy with regard to public nursing homes because of his and his colleagues' involvement in the private nursing home sector. This man should not be overseeing the nursing home bed closures when he is so closely aligned to the private nursing home sector. When the National Treatment Purchase Fund was asked to seek reductions in private nursing home costs, it sought reductions of €5 per week but the HSE was instructed not to seek any savings in public nursing home bed costs. The Minister sacked the previous HSE board and appointed his own people. Why did this happen? It was to ensure that public nursing home costs are seen as proportionately higher than private nursing home costs. Why is that? Then when you are looking for money the public sector says it should be put into the private sector. How can we have a situation where the Minister for Health is presiding over this policy and is so closely aligned with the private nursing home sector? He should step back from this area because he has a conflict of interest. I have no difficulty in saying that. There are 842 beds for elderly, sick and infirm people as in Senator John Whelan's constituency.

The Senator's time has expired.

I am sharing two minutes with Senator Wilson. Three people in their late 80s and early 90s have had to go to court to try to ensure that their own home in Abbeyleix remains open. This is a disgraceful decision. I commend Senator Gilroy for the stand he took and the comments attributed to him in theSunday Independent. He said, and he is correct, that this issue would be bigger than the medical cards scenario. I remember that well and I was not proud of what the previous Government did to the elderly.

Did the Senator vote for it?

We voted for change.

The Government can change this because Senator Gilroy's party chairman, Deputy Jack Wall, said the backbenchers are angry and will meet the Minister and tell him so. That will achieve nothing. He has not listened to them. He should not even preside over these decisions, he should step back and allow the Minister of State who does not have a conflict of interest deal with it. I ask the Minister of State to check the instructions the Health Service Executive gave the National Treatment Purchase Fund not to seek any reduction in public nursing home bed costs in order that it could show them as disproportionately higher than the private sector. This is creeping privatisation of the health service which was exactly what I said prior to the election when Fine Gael trumpeted this Dutch model. This Dutch model will mean that people in the State will pay thousands of euro more for less services. Even in the most difficult times if we cannot look after our elderly, the people who have built the State, but throw them out of their homes, as has happened in Abbeyleix, Shaen, and Brittas and 40 other homes, the Government should be ashamed of itself.

What is the Senator asking us to do?

I ask the Government to support the motion and tell the Minister he has got this wrong. One can say whatever one wishes in the newspapers. I trust Senator Whelan on this issue. I ask him to put his money where his mouth is and vote for this motion and I ask his Labour Party colleagues to do likewise.

I thank my colleague, Senator Darragh O'Brien, for sharing time. The words echoing around in recent days, since these reports first appeared in the national newspapers and emanating from Government, are that no decisions have been made yet. The same position pertained for six months in regard to Dun Uí Neill barracks in Cavan town and four other barracks in the Twenty-six Counties — no decision has been made yet — when the dogs on the street knew that those barracks would be closed. As we speak on the motion, vulnerable elderly people and their families in counties Laois, Louth, Galway, Donegal, Cork, Tipperary and Cavan are being cared for in community settings, run by the HSE, in comfort — as they should be — but not in peace and tranquility. This is happening because they do not know where they will be after Christmas. That is not good enough.

In regard to Lisdarn nursing unit for the elderly in Cavan town, about which there is a rumour of closure, there are 44 patients who are in desperate need of information from the Minister and the Department as to where their future lies. The reason for tabling this motion is to get clarity in respect of the future for these vulnerable people. I received a letter from Ms Margaret Basmajian and Ms Eileen Flynn — two ladies who have visited the unit for the elderly in Cavan town for the past 25 years.

The Senator should not mention the names of people outside the House. His time has expired.

They say that if this unit is closed it will destroy the lives of these people who regard the unit as their home and it will destroy the lives of their families and the community in which they live.

I plead with the Minister.

The Senator is using other Members' time.

I have great respect for the Chair but if I was not interrupted I would be finished by now. I say to Senator Gilroy, with respect, that this is a serious matter.

I thank the Chair for her patience. It is important that logical decisions are made. There is no logic in the decisions proposed.

I move amendment No. 1:

To delete all words after "Seanad Éireann" and substitute the following:

"— considering the need to take account of the current budgetary and fiscal situation facing the State; the current difference in price between public provision (weighted average of €1,260 per bed per week) and private provision (weighted average of €900 per bed per week); the fact that approximately 27% of public residential stock is over 120 years old, and 25% of stock is between 41 and 110 years old; the potential capital cost estimated to upgrade or replace existing stock (up to €1 billion) and the current demographic challenges facing the State — approximately 530,000 people over 65 today versus an estimated 750,000-775,000 in 2021;

acknowledges the need to have a viable and effective public service provision of long term residential care;

recognises that these nursing homes are now the homes of the people who live in them;

recognises the quality of care in public nursing homes, the dedication of the staff and the involvement of the local communities;

recognises that these homes are often also centres for extensive community services including day care, rehabilitation and respite;

notes that, aside from St. Francis in Galway, Abbeyleix, Shaen in Laois and Crooksling, Dublin no decisions have been taken regarding the future of any otherfacilities;

notes that the Minister and Health Service Executive will be examining the future provision of all public residential care in detail to assess ongoing viability and rationalisation with a view to securing the ongoing future of public long term residentialcare;

affirms this Government's commitment to retain a public provision of long term residential care subject to the ongoing resource and budgetary constraints".

Under the existing structure of public nursing homes it is important to note that 27% are more than 120 years old and 25% are between 40 and 110 years old. I remind those on the other side of the House what they did when in government.

Will the Senator deal with the motion?

The Government washed €400 million down the shore due to nursing home charges. It did not put in place legislation which allowed it to deduct charges in nursing homes. It deducted €400 million illegally.

The Government of which the Senator is a member will close 40 nursing homes.

When I brought that issue to the courts in 2004——

The Senator should be proud of himself.

——what did the Government do?

The Senator is in government.

It rushed legislation through and told the elderly it would not give back the money it took illegally from them, totalling €400 million.

The Senator is in government now.

That is the amount it took and was not prepared to give back.

I ask the Government to make decisions.

Some €400 million was taken illegally. That is what the then Government refused to deal with over 14 years.

The Members opposite were in government and denied the elderly the right to a refund of the money illegally deducted.

On a point of order, I think the Senator should be directed to speak to his amendment to the motion. He seems to be going back to a history lesson.

That is not a point of order.

The Senator made points——

That is not a point of order.

It is a point of order.

This is the truth. This €400 million could have been used to refurbish the nursing homes and, unfortunately, had to be refunded because it contravened the legislation. It is extremely important that nursing home care is provided for the elderly, that care is of the highest possible standard and that health and safety issues are taken into account when the Health Service Executive is making decisions in respect of nursing homes.

Was Abbeyleix community hospital substandard?

It is reviewing all of those issues in the same way as HIQA has dealt with it in respect of the private sector. The Minister has made his position clear in respect of the units to which the Senator has referred.

He did not preside over this at all — he has a conflict of interest.

There are more than 600 designated centres in Ireland dealing with elderly care, 121 are in the public sector. There are 7,941 beds in the public sector. There is a need to ensure all the care provided to the elderly is of the highest possible standard.

It is hiding behind HIQA.

We intend——

The Government is hiding behind HIQA. It is a bad decision.

HIQA said many of them were centres of excellence.

What is the Government going to do about it?

We are not hiding behind anyone, we are dealing with the reality and the real world. We are talking about the elderly being asked to leave nursing homes, of course that is a very difficult decision for people who have been in a nursing home for a considerable period. It is important it is approached in the proper way. It is also important there is help available to them if a nursing home is not in a position to meet the standards required and that there is adequate care. No one is going to be denied nursing home care under the package about which we are talking.

It is about private nursing homes.

The Senator had his chance to speak.

The Minister has made it clear that he is prepared to go to Abbeyleix once the budget has been announced to deal with the issues in a positive manner. It is interesting that the Senators opposite did not make a single constructive proposal.

There is a proposal that the decision be reconsidered.

When the people from Abbeyleix met the Minister, they made constructive proposals.

How did they get on?

The Minister has said he will talk to them.

It is also important that Cathal Magee, chief executive of the Health Service Executive, has said two thirds of current units need to be upgraded at a cost of between €600 million and €900 million.

Is the Government going to mothball all of them?

It is a pity we do not have available the €400 million Fianna Fáil wasted. That is why, unfortunately, we must deal with the here and now in a positive way.

That is a lie; that has nothing to do with it.

The Senator should withdraw that remark.

I am asking for support for the amendment; it is a constructive proposal that offers the right way to deal with this matter.

It is also about long-term planning. There are 550,000 people over 65 years. By 2021, there will be more than 750,000 and by 2031, more than 1 million. The first time there was long-term planning for the provision of elder care was when the fair deal system was introduced.

Fine Gael opposed it.

It was opposed by Fine Gael.

We need to move forward and plan for 2020 and 2030. We have a Minister and Ministers of State who will take the difficult decisions to ensure we will cater for those in need of nursing home care and those who will need it in the long term. I hope, therefore, that Senators will support the amendment.

I take it as a given that everyone in the House shares a concern for the elderly; it is not the prerogative of one side or another, it shared by the Minister, the staff and the Civil Service advisers. We all care about the elderly.

We must do something practical. It is a pity we must face this difficult issue immediately after having had some of the first public consultations on the care of the elderly in our community. There is a certain irony in this, as there is in the fact that I was one of the first to raise this issue on the Independent benches when Fianna Fáil was in government with reference to the Bethany Home in Carlow. Precisely the same issues were involved and it made me suspicious. The rights of the elderly were not respected. They have a legal entitlement to be consulted and agree, but this did not happen, rather they were evicted and taken away by ambulance. We all know that with elderly people, in particular, such a move can prove fatal; it is highly dangerous. Even for younger people, moving home is a time when heart attacks occur and there are other distressing physical symptoms. For an elderly person, such a move, particularly in traumatic circumstances, can prove fatal.

I am suspicious of HIQA. The home in Carlow was rudimentary. I watched the programme on television last night and it was perfectly obvious that the standards referred to were far off into the future. We are closing institutions on the basis of hypothetical standards of perfection we will probably not be able to reach anywhere because of the disastrous financial position.

Therefore, we should not try — is that what the Senator is saying?

We should try to provide the best possible accommodation for the elderly in whatever circumstances we can and that does not always mean closing buildings.

That is what we are doing.

I notice the amendment contains loose language such as "approximately 25% of residential stock is over 120 years old". Really. What a shock. I live in a house that is over 200 years old, but it is perfectly sound. This is the sort of crass argument one gets from bureaucracy, that a house has a certain lifetime. No, it does not, not if it is properly maintained, and some of these places have been properly maintained. Yes, additional facilities may be required as a counsel of perfection, but is it worth the trauma inflicted on those affected?

We talk about upgrading existing stock, at a cost of up to €1 billion. This has just been dreamed up, it is not a real figure. If it was, it would be something like €750,556.17, not "approximately" €1 billion. This is a scare tactic.

I do not foresee great agreement and would vote with my colleagues on this side of the House, but, unfortunately, I will not be able to be here. Given that they have used words such as "condemn the disgraceful closure", "disgraceful" and "shameful", it does not look as if there is much prospect of a meeting of minds. However, I look forward to being a situation where we can move forward together to improve matters.

I know some of the hospitals mentioned. I had an elderly relative, a most genteel elderly lady from Portlaoise, although that is not what she called the town.

She was in Queen's County.

Yes, her address was Beechfield, Maryborough, Queen's County. I did not want to say it because I did not want to offend the Senator's republican sensibilities because she is such a good friend.

We are a broad church.

My elderly relative was very well treated in the hospital. She had Parkinson's disease and I cannot speak highly enough about those who looked after her. I have seen the situation in Abbeyleix and heard elderly people say it is their home. It is their home and they will find their social connections destroyed. The Minister will be sympathetic on a case I raised with Senator Tom Sheahan in which the same thing is happening on Valentia Island. It has cost the Exchequer and is daft. People are being split up and placed in three different locations on the mainland, 100 km apart. I personally witnessed — I rarely get involved in hospital issues — people visiting individuals who did not receive any visitors. It is the most wonderful community. That is what I consider to be Irish values and what I like to see. If the equipment is not up to date or some of the paint flakes, so bloody what? If the residents believe it is good enough for them, who are we to quarrel with them?

On foreign aid, I understand Senator MacSharry's point, but I would not take anything from the figure for foreign aid. It would be mean-minded of us to do so because it is expressed as a percentage; therefore, it falls automatically as our income falls. When we ask who our neighbour is, it is not just the person who lives next door who shares our opinions, it is also the person who is most vulnerable. The most vulnerable and susceptible to debt — young people — are those who are being helped by foreign aid.

A salient point was made by Senator Darragh O'Brien about a conflict of interest. That is a most serious matter. If there is a conflict of interest — it seems from what the Senator said that there clearly is — the Minister has investments in private nursing homes and is administering a nursing home scheme, it is a very serious matter which needs to be clarified. Perhaps there is an explanation and he has legally distanced himself, but it represents a very unfortunate incident. This has been highlighted properly by Senator Darragh O'Brien in this House.

I welcome the Minister of State, Deputy Kathleen Lynch. I have no doubt whatsoever about her commitment to the care of the elderly and the provision of public long-stay beds. I am glad we are not going to personalise the debate.

I congratulate Senator Marc Mac Sharry and his wife, Marie, on the recent birth of their daughter, Isobelle.

I am glad to have an opportunity to voice my concern for the senior citizens of my community. I am grateful to speak out not on behalf of the Government but on behalf of the elderly and infirm in my locality to ensure they get a fair deal. I am thinking of people such as Catherine Kelly from Cullahill who is 93; Richard Phelan from Raheen who is 99 and will celebrate his 100th birthday in two weeks in Abbeleix hospital; Brigid O'Neill, a feisty 92 year old from Spink; and Jack Chester, an old friend of mine from Portlaoise who is 89. When I speak in defence of these people, they and their families know my form and that I am not trying to use them to score cheap political points or turn their plight into a political football. I remind the House that it was not me who was booed and jeered on the platform in Abbeyleix but those who tried to turn the event into a cheap political stunt to score political points.

We do not need, nor will I listen much longer to, more sarcastic sermons from the Fianna Fáil benches. I do not need their crocodile tears for the elderly.

What is the Senator talking about? That is a ridiculous comment.

I have seen at first hand the genuine tears, real torment and distress as elderly patients in their 90s cling to the rails of their beds for fear of being moved and not being allowed to return.

The Senator is speaking out of both sides of his mouth. Well done.

Let us put the record straight on a number of points. There has been no decision to close either Abbeyleix and Shaen hospitals. It is a flawed HSE proposal which is fundamentally wrong.

It is the Minister's decision.

It is short-sighted, penny wise and pound foolish and, as such, is under active review by the Minister for Health. I do not envy him his task, as he is between a rock and a hard place. As he stated so incisively this week, when he went to the cupboard, it was not just bare but was also full of unpaid bills. These bills had been left by Fianna Fáil——

——after its booze-up with the big builders and its ten-year jolly.

The Senator ought to talk about the property developers in his own party.

Senator Whelan to continue, without interruption.

The Senator should have a word with the Minister about development.

It is falling to the Government to clean up the mess and it will do so.

What is it about the Labour Party in east Galway?

Senator John Whelan has the floor.

I oppose strenuously and object to any attempt to make the most vulnerable in society, the elderly, pay the price of Fianna Fáil and HSE mismanagement.

Does the Senator know he is in government?

I do. We take responsibility for our decisions, unlike Fianna Fáil, which washed its hands of everything.

The Senator said in theSunday Independent——


I ask Senators to have respect for the House.

These old folk have been through more than one recession and the least they deserve is some comfort and consideration in the autumn of their years.

It is important that we act responsibly and take responsibility for our decisions and policies. When the time comes, the Government will be judged on its record. However, it is necessary to put the threat to the future of community nursing homes in context. First, the problem lies with a dysfunctional HSE to which there is no access; there is no adequate consultation or accountability.

It is the Minister's HSE.

Senator John Whelan should be allowed to continue, without interruption.

The HSE is, of course, a creature and creation of Fianna Fail——

It is accountable to the Minister.

——and Deputy Micheál Martin who, like Pontius Pilate——

——washes his hands of every decision and responsibility for everything, including the mess in the health service.

Senator Darragh O'Brien should please stop interrupting.

And blames his officials.

Many on the Fianna Fáil benches, when honest about the matter, share my concern about the mismanagement of the health service under the last Government and the vigour with which it pursued a privatisation strategy. The former Minister for Health and Children, Ms Mary Harney, was the champion of a two tier private health system.

The problems for Abbeyleix and Shaen hospitals and many other community nursing homes around the country, as in Edenderry and St. Vincent's in Mountmellick, did not start today or yesterday, or in the past six months. They have been run down for years. The standard practice is to run them down, wind them down and close them down.

What is the Government going to do about it?

The reality is that they have been under-resourced, under-staffed and undermined for years. All this happened in Laois-Offaly when there was a Taoiseach and a Minister of State responsible for the care of the elderly from the constituency. They could not even look after those on their own patch.

The Senator should release a best seller in fiction.

At the time, the country was awash with money.

The Senator does not take responsibility for anything.

To start with the crocodile tears over this matter——

Good man. We expect a revolt. Is this it?

——there has been a lot of huffing and puffing in this House in recent weeks over lies. I regard the language used as unnecessarily strong and provocative. When it comes to lies, the public has decided who the past masters are. I am not talking about fibs and venial sins; when it comes to lies, let us consider the original sin of all lies — the "mortaller", as it were — that the IMF is not in the country. Do the Senators remember that fiction? It was repeated by every Minister in the Fianna Fáil Government, right up to the Taoiseach himself.

I would like to conclude my contribution by reading a brief two-paragraph letter sent to the Minister for Health by Fr. Sean Kelly——

Why does the Senator not read what he said in theSunday Independent?

He stated:

Just a short note on my return from my weekly visit to St Brigid's Hospital, Shaen, Portlaoise for Mass and Pastoral care. I know that your Government administration has inherited a huge burden after the careless and irresponsible years of the outgoing group. Unfortunately, your job involves very difficult decisions.

Did the Senator get him to write that?

The letter continues: "However, I also know for certain that the impending closure of St. Brigid's Hospital is wrong and a mistake." It is wrong for the Senator to impugn Fr. Kelly who is not present.

I asked a question.

The reality is that he is the chaplain at the hospital.

The Senator's time has concluded.

Fr. Kelly also wrote:

We cannot solve the problems created by greed by such punishment of those with such special needs. I was not surprised at all today to be greeted by tears and confusion. I only presume that you are badly advised and wrongly encouraged to make such a decision. The costings of this decision cannot be measured in finance [alone]. I speak sincerely for those with no voice and now no home.

I wonder what Senator John Whelan would say if this policy were being pursued by the former Minister for Health and Children, Ms Mary Harney, and it were stated on the register of interests that she had an interest in private nursing homes? I demand that the Minister of State, Deputy Kathleen Lynch, ask herself that question because she is an honourable person. Her Labour Party colleagues are not too happy.

Yesterday's edition ofThe Irish Times states Mr. Tadhg Daly, chief executive of Nursing Homes Ireland, which represents private nursing home operators, estimates there are up to 2,000 empty beds in the private sector. Mr. Daly says his “members have the expertise and capacity to accommodate many of those who will be displaced if public facilities close”. The two relevant paragraphs in yesterday’s article should be of the utmost concern to all people in all parties who value the provision of a public health service.

Senator John Whelan has announced the closures in County Laois are under active review. In last Sunday'sSunday Independent he implied there would be war, or that the Government could expect a revolt. He stated, “This will make the medical card for the over 70s row pale into insignificance.” Despite this, his example of a revolt is to come into the Seanad to note the decision to close Abbeyleix and Shaen hospitals. Will he go back to his constituents and say he noted the closures? Is that the battle he is fighting? Is that the revolt about which he is talking? Let us fight, be straight and bring the conversations which I know are taking place in the Labour Party parliamentary rooms onto the floor of the Seanad and the Dáil. Let us fight and let us be straight. The conversations being held in the Labour Party parliamentary party should be aired on the floor of the Dáil and the Seanad because some of us value a public health service. The objective of co-location was to open up public beds in public hospitals.

Fourteen years.

Where are they?

These nursing homes did not get a penny for the past 20 years.

The co-location legislation was never enacted. The manner in which the Government is now going about health policy is absolutely outrageous. When the people elected the Government they believed they were getting something new. An uncommitted voter recently told me he never thought this crowd would be as bad as the old crowd. I do not necessarily agree with him.

Or Mary Harney.

That is the message people are getting. The Government promised change but things are far worse.

When the elderly people woke up to theDaily Mail, which is a paper they would read because of its tabloid size, they became afraid for their lives.

That is absurd.

This Fine Gael-Labour Party Government is telling 1,000 people they will have to move nursing homes but Senator Whelan is laughing.

We are laughing at Senator Byrne.

It is a shame and a disgrace that the Members opposite are allowing this to happen. They are allowing the private sector to take over because it has excess capacity. It is not happening due to a lack of resources.

It is because of decades of neglect.

This country supposedly invested too many resources in the sector and the Government is now saying it is unaffordable and the private sector can do it cheaper. That is its reasoning. We spent not wisely but too well. Senator Whelan will have to say more to his people than merely note a decision of the Government. He will have to indicate whether he values the public provision of long-term care for the elderly or prefers to pass the responsibility to private operators.

Even though HIQA found that Ardee and Cottage Hospital in Drogheda were up to standard and that one was a centre of excellence, the Government is scaremongering with the claim that they cannot cope because only the private sector can do the job properly. That is wrong. We need a public sector and a public health service. It is time the Labour Party stood up for that public health service rather than going along with the privateers in Fine Gael. Fianna Fáil has always believed in a public health service.

That will be the debate this country needs over the coming years.

The only scaremongerers are in Fine Gael.

The claim that the Labour Party would stand up for the people is a joke.

Terrifying old people.

All the scaremongering on this issue in the budget has come via leaks by Ministers to their favourite journalists and daily newspapers. People wake up every morning to find out what is happening in the budget through leaks to the media. Is that the platform on which Fine Gael and the Labour Party Members were elected? Did they promise to govern by leaks? They promised transparency and a new way of governing. It is far worse than the old way and shame on them for it. Let us protect the elderly. I urge Senator Whelan to vote with us rather than merely note the decision.

All of us have mothers but some of us are less fortunate in that our mothers are no longer with us. My mother died a number of years ago and I am sure other Members have had the same experience. We are speaking about vulnerable people in society but just because they are vulnerable does not mean they do not listen to debates like this one. I am not certain that they read theDaily Mail.

If they do, I question——

Just because they are in nursing homes that does not mean they cannot read.

That is irrelevant. We can have a reasonable debate about how we care for the elderly in our communities, how we finance care for the 4.9% of our elderly population who end up in nursing homes and what level of care they should expect to receive. Sometimes they need care over a significant number of years before they die. I am not partisan in this debate. Senator Norris was correct to state that everyone is worried about this issue. The last thing that should happen in the debate is a personalised political attack.

The Minister of State attacked Mary Harney for years.

I am not saying who is responsible. I am merely making the point that it should not happen. We should not be stoking fears among people according to where they live because these places are their homes. They live in these nursing homes for up to 20 years. However, we cannot ignore the responsibility to maintain certain standards. If something happened to a vulnerable individual because of a lack of standards, Members on both sides of the House would be asking why something was not done earlier.

HIQA inspected many of these places and is happy with them.

We have to be careful with the language we use. I am referring to both sides of the House. People listen to what we have to say. Senator Mary White has a lot to say on these matters because she has an interest in them. I remind Members of the old adage that fear sells newspapers.

Who leaked the rumours to the newspapers? It was not us.

It does not matter who leaked the information. Our only concern should be about how we deal with our elderly people. I am responsible not only for older people but also for people with disabilities and mental health issues. Every day I am asked about job losses here or institutions there. That is not my job. My responsibility is to ensure these people receive excellent services but in some cases these services are not excellent.

The language we use can be damaging or it can be supportive. We need to stop what we are doing. As a practising politician, I understand the temptation.

The only Member present who put information in the newspapers is Senator Whelan.

I am not speaking about the newspapers. I am speaking about blaming others for the issue. That can be done when we have resolved the problems. The majority of our community-based, publicly funded nursing homes or continuing care homes — I am not certain of the correct term — needs upgrading and refurbishment. We will not be able to maintain some of them because of the moratorium. Others will be able to provide excellent care within the community or are convenient for visitors. Caring for our elderly population is not just about a good environment in terms of structure or care. It is a question of interconnections between these aspects. People need to feel comfortable, secure and well cared for within their communities but we also need to set standards.

I know from experience that it is lovely to have an organisation to kick. The flavour of the month is HIQA.

HIQA supports many of these nursing homes.

HIQA did not cause the trouble.

The Minister of State to continue, without interruption.

The Minister of State did not interrupt the Senators opposite.

We need an independent organisation to look at standards. We should not dismiss that because it is important. Not alone does it protect the people who receive the care in those institutions, but it also protects us as society. I agree with the Senator that the lack of communications in this case was appalling. It was inappropriate for people to find out through the media or the rumour mill. The people who are central to all this — the people who deliver the care, the families of the people in there and the people themselves who have the capacity to listen and make decisions — should have been involved in this process before anything came out in public. We are working on that.

I have the script of the official speech which contains all of what I am saying. As I said in this House a number of weeks ago, sometimes we forget about our own value and that we, as public representatives, can give the people, who chose us to represent them, access to those who make decisions. The decisions on the nursing homes were made by the HSE. The decisions are decisions of the HSE, not the Minister. Following a meeting in Leinster House with a delegation, including Senator Whelan, concerned about the planned closures in Abbeyleix and Shaen, the Minister gave an assurance that he would investigate the matters raised at the meeting. He also undertook to visit Abbeyleix after the budget. This is not empty gesturing.

I deliberately did not speak at the beginning of the debatebecause I felt it was important to listen and I hear what Senators are saying. Behind all the combat——

I did not say waffle.

We actually trust the Minister of State on this.

Behind all the combat, there is clearly a genuine concern on all sides. The person who has been in my ear most has been Senator Whelan. He has seriously bent my ear and not just within my office, but also at party meetings and in the corridors.

He said there would be a revolt though.

Senator White has heard me say this previously. I am the one who keeps saying we need more women in politics. I equally keep saying that if that is the case then those of us who get elected need to act differently. In these times we all need to act differently. We are making decisions over which we do not have complete control and we are making them in a multiplicity of circumstances. When it comes to caring for the elderly we need to be sensitive and do the very best for the person for whom we are caring.

I commend Fianna Fáil for tabling the motion. I also commend all those on the Government benches who have been campaigning on these issues. I agree with the Minister of State that the nature of Private Members motions, either in this House or in the Dáil, is that they can become combative and the issues can become political footballs. This is an issue on which there is cross-party support in order to get the best in terms of care, access, bed provision, and best practice in how we care for older people and the types of facilities we make available for older people.

It is not right for anybody to create fear and we should deal in facts. However, some of the facts that have been put into the public domain have come from the Department of Health. Obviously it creates fear when people hear of the potential of 40 community nursing units closing. While I agree with the Minister of State on HIQA independently reviewing some of these facilities, I can give her the example of St. Patrick's Hospital in Waterford, where in 2008 the 19-bed St. Brigid's ward was closed. The local Labour, Fine Gael, Fianna Fáil, Sinn Féin and Independent representatives were unanimous that the closure of that ward was wrong. At the time a commitment was given by the HSE, the then Government and all the then Opposition parties — including Fine Gael and Labour — to build a new 50-bed community nursing unit on the grounds of St. Patrick's Hospital. I raised this with the Minister for Health at a recent meeting of the Oireachtas Joint Committee on Health and Children. His reply was that the executive of the HSE at the time of the closure of St. Brigid's ward indicated that it would examine the provision of a new 50-bed community nursing unit on the grounds of St. Patrick's Hospital. He also stated such a construction project would require capital funding and the HSE must prioritise all capital infrastructure projects nationally within its overall capital funding allocation.

I accept we are in difficult times and that all funding must be subject to the availability of money. We all accept that we must find the money somewhere. The difficulty for people in Waterford and people in other areas where units or wards may close with beds taken out of the system is that promises were made and commitments were given before the general election. I do not need to rehearse all those promises, but I say that as a statement of fact. That is what upsets people and results in the tabling of motions such as the one before us. While we do not need to be combative about the matter, we should certainly put on the record the facts, promises given and commitments made, and then ask what is happening now.

Under the heading of health capital developments, the programme for Government committed to prioritise step-down and long-term facilities, and community care facilities such as day centres for older people. I accept the bona fides of the Minister of State, who has come to this House a number of times. I accept she has a very difficult job with many pressures.

We had a discussion in this House last week during which Members form all sides were complimentary of a new process initiated by the Leader of the House — a petitions committee to listen to people. Representatives of advocate groups for older people appeared before the committee, including two experts one of whom works for the United Nations on new binding protocols to establish fundamental rights for older people. One of those fundamental rights must be the right to proper care. I regard this issue as bigger than simply community nursing units. First of all we need to ensure people are cared for in the home. We can all give examples of people, whose home help hours have been cut, making it more difficult. I could give the Minister of State countless examples of older people in Waterford Regional Hospital working with the hospital's geriatric liaison nurse in an attempt to get them into private nursing homes or St. Patrick's Hospital but no places are available because the ward was closed resulting in a shortage of beds. That puts more pressure on the acute services. This is about having a proper joined-up approach between the acute services and care for the elderly.

The Government amendment refers to a price difference between public and private bed provision. Are we comparing like with like? Are we comparing community nursing units with, for example, St. Patrick's Hospital, which is a geriatric care hospital and provides more than simply nursing home care as would happen, for example, in a private nursing home. If that is the case it is like comparing apples and oranges. There is a world of difference between the service provided in St. Patrick's Hospital and that provided in a private nursing home.

The public service recruitment embargo forces many public facilities to employ agency staff and is driving up their costs. This is happening not alone in our community nursing units but in our hospitals. The reason given by the HSE for the proposed closure of a ward, which decision was subsequently reversed, in a community hospital in Dungarvan was the cost of agency staff. These issues need to be dealt with. In some instances extra funding is not an issue. What is required is better management in terms of addressing problems. I acknowledge the Minister has undertaken to review these issues.

My grandfather, who died at the age of 99 years, was a patient in St. Patrick's Hospital where he received tremendous care. While he expected to be in the hospital for a few weeks he remained there for approximately four years, during which time he received tremendous treatment. Were he alive — I am sure this is true of many people in nursing homes listening to this debate — he would not be happy. These people want us to discuss the real issues and do the right thing. There have been many headlines in newspapers about the possible closure of particular hospitals. I do not want to get into the argument around alternatives but I could give the Minister of State some alternatives of where money could be found, including by way of extra revenue on higher earners and wealth, which money could be invested in ensuring our older people are looked after. These are issues about which I am concerned. It is hoped the Minister of State will take them on board and will address in her response some of the points made in my contribution.

I welcome the Minister of State back to the House. She is becoming a regular visitor here. The Minister's words of caution in terms of overly politicising the debate on the elderly are well founded. They are a particularly vulnerable group in society. While there are many other vulnerable groups of people in society older people do not have the economic freedom to make the choices they would like to make. We have a responsibility to ensure that the messages we send out are clear and thoughtful.

I support the Government's amendment which is prudent and well put together. I am a proponent of community facilities for the elderly. In my view, one of the best facilities for older people is in my parish of Ennistymon, County Clare. There are numerous similar facilities throughout the country which provide older people with an opportunity to remain in their communities while attending day-care centres Monday to Friday to have their primary health care needs dealt with. Much of this is the result of a great deal of local fund raising and a partnership between the HSE, hospital management and communities.

The Minister might consider putting in place a formal structure in respect of partnerships within communities where able volunteers are available and fund raising is possible, be it in respect of providing assistance or support, hairdressing, beauty clinics and so on. Many people in part-time work or unemployed are willing to work and engage with older people. There is a strong argument to be made for the putting in place of a formal structure to bring together with existing services people who are willing to help. I suggest that those wishing to see this type of operation in action should visit the three units in County Clare, particularly the one in Ennistymon which has worked well and is providing support for a couple of thousand older people in their homes. These facilities also provide respite care for older people being cared for in the home. We are now entering the Christmas season and there will be many parties and so on. It is not all bad. I believe an opportunity exists for other facilities in other parts of the country to replicate what is being done in Ennistymon.

We are living in extremely difficult economic times and must ensure we get the best value for money. This means making difficult decisions. I know that the Minister of State, Deputy Lynch, is not afraid to make those difficult decisions when they are the right ones. There are many facilities which are too old and in respect of which retrofitting is not an option and, as such, alternative arrangements will have to be made. However, the scaremongering that is taking place in this pre-budget period is most unhelpful and is causing enormous frustration. As I have stated before, next year the Government might consider holding a series of pre-budget discussions on health, education and so on so that the budget speech is only summing up what has been decided and debated extensively in Parliament. That system works in other European countries. We should consider commencing that process in September and finalising it in December as opposed to commencing this process with a budget speech in the first week of December, followed by the taking of the Finance Bill. Everything needs to be examined. What has been happening during the past three or four weeks is not good politics. It should not happen because it creates all sorts of speculation that is completely unhelpful.

I commend the Minister of State on the job she is doing. I have no doubt that in five years time care of the elderly will be better.

It was interesting to hear the Minister of State's comments. We had an informative academic event in this House yesterday in terms of the Tilda study and the rights of older people. This is reality. What we are talking about today is older people's human rights.

The Government recently announced the closure of St. Brigid's nursing home, Brittas, a public nursing home in South County Dublin. The home has 80 residents, the majority of these classed as high dependency and suffering from dementia and other physical ailments. Closure of this home is being fought by the residents and their families and relatives. This decision has received universal criticism.

Two main issues arise in relation to the closure of this home. I will first address why the closure should not proceed and, second, the lack of suitable provision for the residents upon closure of the nursing home.

St. Brigid's nursing home, Brittas, should not be closed. It is one of a diminishing number of public homes dedicated to providing residential care to the elderly. The decision to close the unit has been based on a misinterpretation of the HIQA report. While the inspection, which was undertaken in December 2009, found a number of areas which needed considerable improvement, the majority of these were structural. These issues can be resolved with extra funding. This will bring the building up to a suitable standard. The Minister of State stated in her contribution that the main problem with nursing homes is the age of the buildings.

St. Brigid's was constructed in 1935 as a tuberculosis hospital and was modified in 1959 into short-term emergency housing for elderly people. Nowhere in HIQA's report is it recommended that the facility be closed. The decision to close this facility is an ill-informed one. The trauma which this will cause for residents has clearly not been considered by the Minister. It is another prime example of our elderly being pushed aside and not given proper consideration and respect they deserve. Older people are marginalised in our society. The elderly people residing in St. Brigid's have no desire to leave what has become their home. The Minister, Deputy Reilly, is effectively evicting vulnerable, ill, elderly people from their homes. These residential care units are their homes.

Under Article 45 of Bunreacht na hÉireann, the directives of social policy state the Ministers and Government shall endeavour to give special protection to the elderly and infirm in society. The residents of St. Brigid's in south County Dublin are both elderly and infirm and require the Minister to vindicate their rights, not to forcibly evict them from their home with little notice and without consideration.

The second issue with which I wish to deal is the lack of alternative facilities. If the Minister continues with his plans to close St. Brigid's, there will be a serious lack of alternative places to which its residents can go. The Minister has stated the majority of them will be transferred to a new purpose-built unit in Inchicore, which was referred to in the Minister of State's script. However, as that script noted, this facility would only be able to accommodate a maximum of 50 people. This would leave 30 residents without definite alternative accommodation, while the best the Minister can say is they will be transferred to other facilities in Dublin or the Leinster region. Clearly, this is an unsatisfactory position. A spokesperson for Tallaght Hospital has stated the closure will result in some of the residents being transferred there. This will test a hospital at which, as Members are aware, resources already are very stretched. The Minister of State is aware that people who are transferred to a general hospital will not get the special care they receive at present at St. Brigid's.

I emphasise the Minister's decision to close St. Brigid's is a short-sighted attack on the dignity of older people who cannot afford private medical care. The Minister has done nothing to ensure the protection of the rights of the elderly in that facility. Instead, he is trampling over the human rights of both current and future residents by not ensuring that adequate alternative measures are put in place prior to this closure. I recommend that the Minister should put a stop to his plans to close this facility and instead should designate enough funds to repair it and bring it up to a reasonable and acceptable standard. I appeal for these residents to be left in their own homes.

If it is in order, I wish to share two of my six minutes with Senator Kelly.

Is that agreed? Agreed.

I again welcome the Minister of State to the House. Members have been hearing a peculiar kind of politics in the Chamber today and I am a little disappointed that the Fianna Fáil Members have used their Private Members' time to frighten one of the most vulnerable sectors of Irish society.

That is an outrageous statement.

I understand the role of the Opposition is to hold the Government to account and it is correct that it should attempt to so do. However, it is my turn to wave photographs around today.

The closure of Wicklow community hospital on 2 November 2010 might prove instructive, as it did not raise a whisper from the noisiest boys in the room today.

That is good. Who wrote this for the Senator?

However, I have noticed there has been a distinct shift in the direction of the Opposition. Fianna Fáil surely feels embarrassed about the mess it has made of the economy and the country and it is right that its members should so do.

For God's sake, it is an international crisis.

Instead of asking legitimate questions and entering into constructive opposition, in this motion Fianna Fáil uses the most melodramatic language possible——

——and is raising dreadful fears——

——that surely are designed to terrify——

I am simply asking the Senator to clarify what is melodramatic.

——many elderly citizens in residential care.

What is melodramatic about the facts outlined in the motion?

Senator O'Brien, please. Senator Gilroy to continue, without interruption.

Apologies, a Chathaoirligh.

The language used by Senators MacSharry, Darragh O'Brien and Byrne betrays the real motivation behind this motion. I imagine it is customary to wait until decisions have been made before one condemns them.

Like with the Defence Forces. Go away out of that.

As no decision has yet been made, such condemnation is premature.

Did the Government Press Office have anything to do with the Senator's script?

Being premature, one must seek the real reason such condemnation is being made in the first place. Could it be that instead of being constructive, Fianna Fáil is engaged in popular political party point-scoring? Is it because Fianna Fáil is stuck in its denial mode, a mode all sensible people had hoped had been consigned to the political dustbin with the failed manner in which that party conducted politics over the lifetimes of the last three Administrations?

Is there any chance the Senator might speak to the Government amendment?

However, it does not appear as though this has changed.

Is there no chance the Senator might actually speak on the subject under discussion?

It appears as though Fianna Fáil is determined to take the most populist position.

Really. That is really good.

This surely is a peculiar type of politics.

Senator Gilroy to continue, without interruption.

Nor should the richness of the irony in this situation go unmentioned. The final point in the Fianna Fáil motion mentions "privatisation by the back door". These are the same people who foisted a failed and costly policy of co-location of private hospitals on public ground. This is also a peculiar type of politics.

As my colleague, Senator Whelan, reminded Members, this probably is the third recession they have experienced in the course of their lives. I refer to the 1950s, when Fianna Fáil's policies went halfway towards destroying the country——

Another history lesson.

——and the 1980s, when Fianna Fáil almost destroyed the economy——

The Senator does not wish to address any of the points set out in the Private Members' motion.

——and the present day when Fianna Fáil has completely destroyed the economy.

He cannot stand over it.

Will Members, please, allow Senator Gilroy to speak? He has only four minutes.

The Senator was a member of Fianna Fáil at the time.

However, he had the good sense to leave, as should Senator O'Brien.

Members should allow Senator Gilroy to speak.

I had hoped Members could have a proper debate on this issue today and the Minister of State was looking forward to a constructive discussion. While all Government Members are open to constructive ideas on how the health services might be improved, it is clear that Fianna Fáil has no interest in this.

Its interest lies in criticism for its own sake, party-political point-scoring and pettiness.

This is hardly what was envisaged when reform of this House was discussed. It was proposed that Members should generate and discuss ideas, including ideas about how to go forward with the health service, in ways that would benefit the country instead of the Seanad being used as a replica of the other House, where confrontational politics does no good at all. I am disappointed and I am sure that anyone who listened to Fianna Fáil Members today will share my disappointment.

Does the conflict of interest not concern the Senator?

Please, Senator Gilroy to conclude.

It certainly is unfortunate that Fianna Fáil has chosen to waste its precious Private Members' time in scoring party political points.

What about St. Francis's home in Fermoy?

The Senator has Fianna Fáil in his heart.

The Senator never mentioned St. Francis's home in Fermoy. Is that not in his native county?

Does the Senator's conflict of interest not concern him?

I call Senator Kelly.

I thank the Cathaoirleach. It is unfortunate that I was interrupted so often, as I had many more points I would have liked to make.

I welcome the Minister of State, Deputy Kathleen Lynch, and her replacement in the ministerial chair, Deputy Shortall. It is true that no one in either House is not seriously concerned about the elderly and how their health needs are looked after. However, if Members on the other side of the House think anything could be achieved by voting for their motion, I wish to know what that could be. The only achievement would be that they would have achieved a moral victory. I will cite the case of Deputy Naughten when he voted against the Government. Did that reopen the accident and emergency unit in Roscommon? No, it did not.

That was a general——

Senator Kelly to continue, without interruption.

One must learn from such situations. I agree that many discussions take place at parliamentary party meetings. I am sure such discussions took place in Fianna Fáil's parliamentary party meetings when it was in government. Naturally, in such meetings one tries to achieve what one can, for the elderly in this case or for the electorate at large. While no decisions have been made regarding the closures of any of the aforementioned community nursing homes at this stage, I agree on the need for consultation with the necessary stakeholders before any decisions are made. These stakeholders include Nursing Homes Ireland, the HSE, the Department of Health and the Minister, as well as patients' representatives.

I refer to a point made previously by Senator Darragh O'Brien to the effect there are 2,000 private nursing home beds across the country and the policy is to send all these patients into the private sector. I disagree with this suggestion because Senator Whelan and I were on a conference call at 9 a.m. this morning with Mr. Tadhg Daly of Nursing Homes Ireland. The point he made was he would be greatly concerned were 20 nursing homes to be closed down overnight and pressure thereby placed on his association's members, because they would be unable to cope with it.

Does Senator MacSharry have proposals for coming up with money in order that the elderly can be cared for?

Fianna Fáil is the past master at spinning; we learned it from it.

Senator Landy to continue, without interruption.

Fianna Fáil knows what it gave to the media also.

Will the Senator, please, stop interrupting? He has been doing it all night.

The Senator must not be allowed to speak at home because he cannot stop speaking here. Every time somebody stands up to speak, he must interrupt them. Will he let us finish?

He is doing his job as Leader of the Opposition.

Senator Martin Conway has made a good proposal which I ask the Minister of State to bring to the Government. We should have an open debate. There are choices to be made for next year and the year after. Let the public have a say on them. It would be good if the people had an opportunity to tell us what they want done and what they think is best for the country. I thank the Cathaoirleach for his indulgence.

Cuirim fáilte roimh an Aire agus cuirim fáilte roimh na daoine atá ag éisteacht sa bhaile ar an Idirlíon. I have been made aware that people in homes are listening to this debate. The closure of care homes has already commenced. It is clear the HSE has a policy of retreat from the care of older people and is cutting a swathe through the State's care facilities for older people. The latest victim of the HSE axe is St. Vincent's Hospital in Athy, with the closure of 24 beds, following on the closure of 26 beds in the hospital in 2009. As we have heard, in the past month we have seen the closure of the 32 bed facility in Abbeyleix, 28 respite beds in Thurles and Roscrea in County Tipperary and 30 beds in Shaen, County Laois, with 89 patients displaced through the closure of St. Brigid's home in Crooksling, County Dublin. In the cases of Abbeyleix and St. Brigid's home, the HSE had carried out extensive works on the facilities but then closed them.

The Minister for Health, Deputy James Reilly, and the Minister of State, Deputy Kathleen Lynch, are presiding over the closure of Abbeyleix and Shaen hospitals and I understand only 200 nursing home beds remain in County Laois. This is, undoubtedly, the outworking of a policy of retreat from the care of older people by the HSE. Older people are being abandoned to the private sector under the flawed so-called fair deal scheme and the lack of public nursing home beds has caused difficulties for other patients seeking a bed in the system.

The HSE and the Minister should call a halt to the closures. Failure to do so will mean he and his Government colleagues are following an unspoken policy of ending direct care of older people in the public health system. Unfortunately, the Minister and the HSE are in denial. HIQA is repeatedly cited with regard to the closures, but it has not recommended the closure of any of these hospitals. The people of Abbeyleix have shown their opposition to the closure. I hope other communities will do the same and encourage them to do so.

I am particularly troubled by two specific cases, one of which concerns St. Brigid's Hospital in Ballinasloe which is also a psychiatric hospital. I understand from my colleague, Councillor Dermot Connolly, that St. Luke's Ward which has 15 beds is to become a six bed psychiatric intensive care unit. This will mean the loss of nine beds and the remaining six beds are likely to be occupied for the forthcoming period. Another psychiatric ward, St. Dymphna's, may be expected to absorb admissions, which is of concern. While this would create difficulties and affect patient care, it would be far worse if the HSE were to close this ward also. There is fear about this in the region and I ask the Minister of State to shed light on the matter.

It is of concern that the HSE shows such little respect for psychiatric patients and the staff who work with them. It is a labour-intensive form of treatment and cutbacks are felt very severely, particularly to staff numbers. Staff are not being recruited in the HSE West region. I spoke to a staff member earlier today and was told there were once 370 medical staff but 100 front-line medical staff had been lost. Many nurses have left and no one has filled these positions. It is a small hospital and its status as a psychiatric hospital must be considered in this regard. This severely affects the ability of staff to carry out pre-discharge programmes, which means either discharge is delayed which further blocks up beds or treatment suffers.

As I stated, the recruitment embargo is a blunt and crude instrument which does not work on paper and certainly does not work in reality. If the Minister of State is to take anything from this debate, I ask that it be that the embargo is not working and people are suffering as a result.

Admissions are also being hit. It is understood some of the work will be transferred to UCHG. It is expected that the unit will not be maintained and is to be downgraded. However, surely the fact that some psychiatric admissions are referred from UCHG and Roscommon County Hospital to Ballinasloe is a sign that patient care will suffer, perhaps grievously. Will the Minister of State offer me, the patients, their families and staff reassurance that such a foolhardy exercise will not be undertaken?

The second case of concern to me involves St. Francis Home in Galway. As of September, the number on the active patient list for University College Hospital, Galway was 7,816. The word "active" is used which begs the question as to what other waiting lists there are. Many of these individuals had a waiting time of 22 months. This is a scandalous figure while beds and wards remain empty. Figures in local newspapers state more than 100 beds are empty.

On foot of questions raised by Councillor Catherine Connolly, it was revealed that 1,337 people in Galway city and county had been assessed under the fair deal scheme from its inception to 30 September 2011. However, she was also informed that no one had been assessed in Galway under the scheme since last June. Significantly, of those assessed, 63 had charges registered against their homes. Furthermore, 92 of those assessed qualified for assistance under the scheme but are still awaiting placement because of the mess the scheme is in and empty beds in public nursing homes. For example, St. Francis Home has had empty beds since the councillor's time on the forum in 2006 and is accepting no admissions. Of the 92 people assessed and waiting, 46 are in UCHG or Merlin Park Hospital occupying acute beds when they should be in nursing homes. However, the HSE West region under national direction is closing St. Francis Home which had a capacity of 38 beds, with only 19 now occupied. There are empty beds in practically every other public nursing home in the HSE area.

At the same meeting, it was clearly confirmed that agency staff cost €24.029 million in the nine months to September, which represents an increase on the figure for the previous year. Of this, approximately €12 million was spent on medical staff, €4.6 million on nursing staff, €2.4 million on paramedics and €4.8 million on others. It was admitted by the Minister on "Prime Time" that agency staff cost more than directly employing nurses and doctors. We must remember the figure quoted does not cover the €9 million given to run private companies such as that in Inverin, County Galway. Councillor Connolly was informed the breakdown of the €9 million paid to the individual companies contained commercially sensitive information. However, every euro in the public sector is scrutinised.

The Minister is singing a very different tune from the one he sang in May 2010 when he stated it flew in the face of evolved government policy that 33 beds to be closed were in a five day ward. These are the beds used to treat day cases and deal with short-stay procedures.

Tá go leor pointí eile le déanamh. Is díospóireacht dháiríre í seo; caithfimid an t-ábhar seo a thógáil dáiríre, ní ceart go mbeadh anonn agus anall ann, tá an tseirbhís dlite ag ár seanóirí, seirbhís cheart agus caithfidh gach taobh den Teach gach rud gur féidir leo a dhéanamh chun an HSE a chur i gceart agus aire ceart a thabhairt dár seanóirí.

I welcome the Minister of State. Senator Mary White blames international forces for our problems. She should read the Regling and Watson report which states Government policy exacerbated the banking crisis and that 70% of the problem was caused by the Government. We should put this issue to bed.

The HSE went out of control under the previous Government. Its costs went out of control under Fianna Fáil as it went from having a few dozen senior executive positions to a few hundred, while standards dropped in hospitals as the investment by the previous Government made in them reduced. I could continue in this vein, but I do not have two hours to speak about it.

I have a copy of a press release which states cuts to school budgets would mean teachers and other staff losing jobs. A letter outlining hard times was sent by the Department to school board governors last week. The release also states a reduction in funding would be unprecedented and present a significant challenge. This was not stated by the Minister for Education and Skills, Deputy Ruairí Quinn. It was stated by John O'Dowd, the Sinn Féin Minister in Northern Ireland. Sinn Féin changes its tune when it crosses the Border. When I cross the Border, I sing the same tune.

Will the Senator, please, address the Chair?

All my siblings and I were born in Lifford Community Hospital. The Minister of State is familiar with Lifford. The hospital has 20 beds and, because of my personal attachment to it, I would be devastated if it was closed. Some of my family passed away in it. If it is closed, I hope patients will be transferred to as good a facility or better. I ask the Minister of State to talk to local GPs who have a big influence in the community. They can bring people along and advise the Department if this is a good move because they have their fingers on the pulse of the community. In Lifford there is a very good medical practice with five GPs. As the Minister of State knows, the hospital is located on the Lifford side of the bridge from Strabane. On many occasions it had to be evacuated because people decided to place a bomb 200 m from it. I lived there at a time when the hospital was evacuated and the windows were blown in. Some said this was done in the cause of Irish freedom, but we know it was not. People died while crossing that bridge owing to the actions of certain individuals who, thank God, have gone away. The hospital was almost blown apart in several explosions, for which no one ever apologised. People should not tell us today how we should look after our nursing homes when scant regard was paid to patients. I remember patients being wheeled out and taken to people's homes in Lifford to protect them from an organisation I will not name, but we all know which one it is.

Most of the arguments have been aired on both sides of the House, but I find it difficult to bear Labour Party Members continuing to shed crocodile tears on this issue, while pointing the finger about what went on in the past. We are dealing with what is happening today and the term "Welcome to Government" might be the most appropriate one to use for those on the Government benches.

History began at the time of the last election.

Senator Mooney to continue, without interruption.

That is the reality.

This has been a bad year for Fianna Fáil.

The Senator can describe it anyway she likes, but all she has to do is turn on any radio or television current affairs programme to hear what ordinary people are saying about the Government's broken promises. I am not saying it, they are. "The Frontline" programme on Monday night was particularly difficult for one of the Labour Party backbenchers, a former Member of this House.

I thought he did very well.

I admire him for being there.

Try explaining away what happened during the 14 years the Senator's party was in government.

He will get a promotion.

Senator Mooney to continue, without interruption.

Senators can argue and bluster all they want, but the reality is that the Government is leaking like a sieve. It used to be said previous Fine Gael-Labour Party Governments were led byThe Irish Times on a daily basis. There is a song entitled, “There’s a hole in the bucket”, but the bucket is empty at this stage. One cannot put water in it because it has been leaking so much in the last couple of weeks.

The Senator's party emptied it. It poured the money out of it.

The contents of the most recent leak were reported in theIrish Daily Mail. I am sorry that I have to bring a Harmsworth-owned newspaper into this debate because I know I am lowering the tone of the discussion by referring to that newspaper. Sadly, however, it has listed not only the proposed 1,000 bed closures but has also gone into considerable detail. One of the hospitals is in my area, St. Patrick’s Hospital in Carrick-on-Shannon, where there is a proposal to shut down ten beds, of which Senator Harte should take note.

The Senator should speak for himself.

He and I come from the same region where the demographics show a significantly ageing population, much more so than in any other part of the country. I presume we can include it as being in the Wikileaks top ten, although we will have to come up with a new term for leaks from the Government because Wikileaks is used internationally.

I presume any proposal contained in the leaked document will be revealed next Monday or Tuesday. However, I am not sure if the Government has sorted out who will bring us the bad news.

The Senator should stop scaremongering.

Will the Labour Party or Fine Gael bring us this news? We will have to wait and see.

The Senator should stop terrifying the elderly.

I had to say that, considering the demographics of the north-west region and the fact that we have an ageing population. A wider issue is the treatment of elderly persons.

For which the Senator's party did not plan.

Senator Mooney to continue, without interruption.

Some €400 million.

There are question marks over a culture that has developed in the last while concerning the way elderly persons are treated. My own late, lamented mother was 86 years of age and in perfect health until a short time before she went into hospital. I am not casting aspersions, reflecting on the medical care provided or doing anything of that nature. In my experience, however, there is an attitude and a culture that seems to suggest that once a person has passed a certain age, there is only one way for him or her to go, that perhaps we should not be spending the time, expertise, technology or money on elderly people. I am not suggesting this is widespread, but I am talking about my own personal experience and that of my neighbours who are elderly. On a number of occasions they had to get a second or third opinion because the medical advice given was, "Well, there's not much we can do about this. Maybe she'll have to suffer with it and take a few tablets." I am not singling out parties, but the Labour Party has always projected itself as being the party of great compassion.

The Senator has a way with words.

He should have joined us.

It projects itself as a party which has been looking after the poor, the aged and the vulnerable in all of its attacks on successive Fianna Fáil Administrations. It now finds itself in government having to preside over this initiative.

Cleaning up the mess left by you boys.

Senator Mooney to continue, without interruption.

As for Fine Gael, it is a little like Fianna Fáil in certain respects in that it tends to go for number crunching on occasion.

We did not squander €400 million.

As Fine Gael continues in government — it reckons it will be there until the next millennium — I have no doubt it will find that as time passes, it, too, will succumb to the number crunchers. The sad thing is that the Government which has only been in office for eight or nine months seems to have succumbed to them already. It seems to be talking in economic terms rather than of compassion and humanity.

They way Fianna Fáil did for 14 years.

At the end of the day, that is what the issue is all about. It is about how we as a society care for the most vulnerable and the elderly. This is not a political point. I am not suggesting those on the Government side have any less compassion than we do on this side, but they are in denial.

Where was the feeling of indignation in 2010?

They are now in charge, whether they have copped on. The people elected them and want to know what the Government is going to do. They would also like to know whether it is going to discharge the promises made in the various manifestos.

It is listed under fiction.

I have the documents, but I will not go into them. Senator Jimmy Harte said it would take him two hours to give out about Fianna Fáil, but it would take me four to deal with the promises made in the various manifestos.

The Senator speaks a lot more slowly than I do.

In the light of all that has been said and despite the economic constraints under which the Government is operating which we all accept and acknowledge, I hope there will be some glimmer of hope for the elderly who are the most vulnerable in society.

Ní bheidh mé i bhfad. Ní raibh mé chun caint ar chor ar bith, ach bhí mé ag éisteacht leis an chaint ag teacht ón taobh eile, go háirithe ó Fhianna Fáil. Nuair a tháinig mise isteach sa Seand ar dtús, ar feadh cúpla mí. I was listening to the Senators opposite who were reasonable and said things had to be done. As there is an €18 billion deficit in the public finances which we have to address, let us forget the banking crisis which does not involve a shortage of money, rather it involves a want of money. All Ministers must address the deficit in the public finances by seeking efficiencies and savings and working out how best to use a small pot of money. I hope we can restore them and play in the premier division for a change. We should not go with a begging bowl but stand up for ourselves and become a nation once again. However, it is going to be difficult.

Sinn Féin is working the North while subverting the South politically. I appeal to the Fianna Fáil group which I consider to be politically reasonable not to lower its standards and start this carry on. It should work its way through this problem. When an election is held in a couple of years time, it can let rip, but for now the country is in peril. We have a unique opportunity for once in our lives to say we are playing in the Premiership in Europe.

The Senator should play in it with us.

I thank everybody who has contributed to this robust debate. All these debates should be robust.

I have one issue with what has been said by Members on the other side. The amendment to the motion "notes" that, aside from St. Francis in Galway, Abbeyleix, Shaen in Laois and Crooksling, Dublin, no decisions have been taken regarding the future of any other facility. That tells me these facilities are gone. While I appreciate that there may be some debate in Government about other institutions, these are gone. With the greatest respect to a much more learned man than I on health issues, the word is "condemn" in instances like this. The word has always been "condemn" when wrong things are done. Show me the savings. How many staff will be redeployed, what is the monetary value of the savings in closing Abbeyleix? Senator Norris was correct that the amendment makes the cost of these institutions a notional figure of up to €1 billion. The HSE expects to save €600 million. Show me the facts. If we close X number of hospitals in these places and another number of beds, it will save Y amount of money. I sat on the Government side and had to defend difficult decisions and I can do that as well as anyone and better than most, but this is ridiculous.

The medium of communication to the elderly and most vulnerable, not those who can march, but those who are bed bound and wheelchair bound, amputees who depend on others to speak for them, is the public representative. They depend on us to speak for them. They are the people who were told that their institutions will close. Show me the plan that will outline the money that will be saved, the decisions that must be taken in the interests of care of the elderly and I will vote with the Government. Where will the money come from? The Senator Harte argument that Fianna Fáil blew the boom will not work anymore. Bear in mind that the Government will put it all together next Tuesday. The Goverment will frame the budget.

In a context not of our making.

I never heckle people, Senator, as Members rightly know. Throughout this entire debate I did not interrupt one person. I expect the same courtesy.

The Senator deserves to be interrupted.

The first thing I have said to other Ministers on this issue is that we should reconsider the HSE budget. Deputy Michael Noonan suggested that he would find €200 million before the end of the day, or €600 million within the week to refurbish the nursing homes to care for our elderly people. If necessary, I will be happy to pay more tax for the relative care of our elderly and the vulnerable. The money will come from tax. I will condemn any Government, including the one I participated in, if I see it doing what is wrong. This is wrong. It is not a question of personalising it. Senator Whelan is a friend whose commitment and bona fides I do not doubt. I know he has worked night and day on this. This is wrong. If one person votes against, it may not amount to much, as Senator Kelly said, a single protest in Roscommon in the context of something that was done wrong. However, if a group of Senators do this, there will not be hell to pay. Nobody will lose the Whip.

Did the Senator do that last year when——

I did not have cause to do it.


Senator MacSharry to continue, without interruption.

Did the Senator ever vote against co-location?

And the bank bailout.

Show us a cohesive plan and I will support the Government. Show me how closing these four institutions, that were noted in the amendment, will save money. How much will it save? Show me the cohesive plan for the health service. Show me that the new manifesto on care for the elderly is a priority; that funding will be increased year on year to ensure that. The Government side has not shown anything. We are depending on theDaily Mail to show us Government policy. The programme for Government in the context of health is in disarray. That is a fact.

So long as we continue to do that we will continue to have motions.

Amendment put.
The Seanad divided: Tá, 26; Níl, 14.

  • Bacik, Ivana.
  • Bradford, Paul.
  • Brennan, Terry.
  • Burke, Colm.
  • Clune, Deirdre.
  • Coghlan, Paul.
  • Conway, Martin.
  • Crown, John.
  • Cummins, Maurice.
  • D’Arcy, Jim.
  • D’Arcy, Michael.
  • Gilroy, John.
  • Harte, Jimmy.
  • Henry, Imelda.
  • Higgins, Lorraine.
  • Keane, Cáit.
  • Kelly, John.
  • Landy, Denis.
  • Moran, Mary.
  • Mulcahy, Tony.
  • Mullins, Michael.
  • Noone, Catherine.
  • O’Keeffe, Susan.
  • O’Neill, Pat.
  • Sheahan, Tom.
  • Whelan, John.


  • Byrne, Thomas.
  • Cullinane, David.
  • Leyden, Terry.
  • MacSharry, Marc.
  • Mooney, Paschal.
  • Mullen, Rónán.
  • Ó Clochartaigh, Trevor.
  • Ó Murchú, Labhrás.
  • O'Brien, Darragh.
  • O'Sullivan, Ned.
  • Power, Averil.
  • Reilly, Kathryn.
  • White, Mary M.
  • Wilson, Diarmuid.
Tellers: Tá, Senators Paul Coghlan and Susan O’Keeffe; Níl, Senators Ned O’Sullivan and Diarmuid Wilson.
Amendment declared carried.
Question put: "That the motion, as amended, be agreed to."
The Seanad divided: Tá, 26; Níl, 14.

  • Bacik, Ivana.
  • Bradford, Paul.
  • Brennan, Terry.
  • Burke, Colm.
  • Clune, Deirdre.
  • Coghlan, Paul.
  • Conway, Martin.
  • Crown, John.
  • Cummins, Maurice.
  • D’Arcy, Jim.
  • D’Arcy, Michael.
  • Gilroy, John.
  • Harte, Jimmy.
  • Henry, Imelda.
  • Higgins, Lorraine.
  • Keane, Cáit.
  • Kelly, John.
  • Landy, Denis.
  • Moran, Mary.
  • Mulcahy, Tony.
  • Mullins, Michael.
  • Noone, Catherine.
  • O’Keeffe, Susan.
  • O’Neill, Pat.
  • Sheahan, Tom.
  • Whelan, John.


  • Byrne, Thomas.
  • Cullinane, David.
  • Leyden, Terry.
  • MacSharry, Marc.
  • Mooney, Paschal.
  • Mullen, Rónán.
  • Ó Clochartaigh, Trevor.
  • Ó Murchú, Labhrás.
  • O’Brien, Darragh.
  • O’Sullivan, Ned.
  • Power, Averil.
  • Reilly, Kathryn.
  • White, Mary M.
  • Wilson, Diarmuid.
Tellers: Tá, Senators Paul Coghlan and Susan O’Keeffe; Níl, Senators Ned O’Sullivan and Diarmuid Wilson.
Question declared carried.

When is it proposed to sit again?

Ar 10.30 maidin amárach.