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Care of the Elderly

Dáil Éireann Debate, Wednesday - 16 May 2012

Wednesday, 16 May 2012

Questions (8)

Brian Stanley

Question:

7Deputy Brian Stanley asked the Minister for Health if he will provide a guarantee that the decision to close Abbeyleix Hospital, County Laois, will be reversed, that the hospital will be retained and maintained by the Health Service Executive as a facility for older persons in the midlands; and if he will make a statement on the matter. [24202/12]

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Oral answers (13 contributions) (Question to Minister for Health)

I wish to reassure the Deputy and, more importantly, the residents of Abbeyleix community nursing unit, and their families, that no decision has been made to close the unit. During 2011 the Health Service Executive was considering a proposal to close Abbeyleix community nursing unit. However, following the instigation of court proceedings, it became clear that it was not appropriate for the HSE to make a decision to close the unit without a prior consultation process.

On Friday, 27 April 2012 the HSE issued a statement confirming that it will commence consultation on the planning and provision of services for older people in the midland counties of Laois, Longford, Offaly and Westmeath. I have been advised this consultation process will commence shortly. I understand this will include a proposal to consolidate nine of the community nursing units in the region into seven such units, with the possible closure of Abbeyleix community nursing unit and St. Brigid's Hospital, Shaen. This will involve engaging with residents, relatives, staff, public representatives and other stakeholders. The process will be completed within a period of three months from commencement. Should the HSE conclude that full closure of any unit is necessary, a recommendation to this effect will then be made.

The Minister of State is clearly aware that as recently as Monday last the HSE was still stating that the promised consultation process relating to Abbeyleix community nursing unit and the care of older people in the midlands has not yet commenced. This process was promised last year and it is now May 2012. Nothing has been heard about the process in all of the months that have passed. As the Minister of State indicated, on 27 April last, two days before a second major rally in support of the unit, the HSE advised the process would be commencing soon. We have heard this before and I am of the view that greater certainty is required in respect of this matter. I would also like an assurance to the effect that the process will take place.

Will the Minister of State admit that the policy of downgrading public nursing homes and of closing some is completely wrong and that it must be reversed? When addressing the annual conference of the Irish Nurses and Midwives Organisation, INMO, the Minister, Deputy Reilly, stated that not a single acute hospital bed that has been closed will be reopened any time soon. What is the position with regard to closing public nursing homes? Where are people who are being displaced to go? We are heading for a calamitous situation in the context of the closure of beds in acute hospital settings and also, perhaps, with regard to the imminent closure of public nursing homes in some circumstances. Ultimately, the position will become impossible.

I have always been of the view that when one is discussing people who are easily convinced of the doomsday situation, one must be very careful with regard to the language one uses. I refer here to the use of words such as "disastrous" and "calamitous" and to asking where people should go. We have not reached that point and I do not believe we will reach it. Families and communities in this country are extremely caring.

A recommendation has not yet been made. The consultation process will take three months to complete and if a recommendation is made at that point, then HIQA will have to be given six months notice in respect of it. It is all in Abbeyleix community nursing unit's favour that the process involved is slow. Neither the relevant files nor the consultations in which I have engaged with the Department have indicated there is a foregone conclusion in respect of this matter. When discussing older people who always feel a degree of insecurity with regard to their position, we must be very careful with regard to what we say. I appeal to the Deputy to allow the process to take its course. The process will take as long as it takes.

There is no policy in respect of the downgrading of public facilities. The Government is committed to ensuring there will be a sufficient number of public beds to cater for people who require long-stay care. In the context of two areas, namely, mental health and disability, I have been charged with removing people from institutions. There is a rush to place older people into institutions and I am of the view that we need to consider a different way to do things.

I sincerely hope that the situation at Abbeyleix will not present as being calamitous at any time in the future. However, the situation for older people across the State who are awaiting discharge from hospital settings and who cannot access nursing home beds is indeed calamitous for them and their families. I make no apology for using that language.

A question please, Deputy.

I am not trying to incite fear at all, I am merely attempting to spell out to the Minister of State and her colleagues in the Chamber the fact that we are dealing with a very serious situation. The Minister of State indicated that there is no policy. Will she impress that fact upon the HSE? In respect of the service plans that were announced earlier this year, the HSE stated there will be reductions in bed numbers at different locations throughout the State, including in the HSE area in which I live.

The Deputy should be aware that we have set aside a substantial sum of money, €28 million, in order to ensure that a programme relating to frail elderly people will be put in place. Such individuals are those who will require respite care when they come out of hospital and also access to physiotherapy services. They will also require to be assessed and it is important that assessments in respect of long-stay care patients be performed outside the hospital setting and in more familiar surroundings. In the past, such assessments were carried out in surroundings with which older people were not familiar and, as a result, they became quite confused. Half of the 40% of people who are in long-stay care settings and who do not need to be there could be accounted for in this way. We are definitely considering other ways of operating.

Not everything relates to long-stay care. However, I wish to reassure those who require such care that the necessary funds are available. I also wish to reassure those who will need a different type of care, namely, that which will facilitate them in the context of transitioning back into their own communities, that the relevant service will be available within the next few weeks. That is a good thing. This is a different way of operating and I know the Deputy will agree with me in this regard.

I put it to the Minister of State that in the case of Abbeyleix community nursing unit, the HSE is operating in the context of a preordained policy of closure and that the consultation process is no more than window dressing. Will she outline exactly what is meant by a consultation process which will involve public representatives? As a long-standing public representative for the county in which Abbeyleix community nursing home is situated, will the Minister of State indicate precisely how the consultation with public representatives will proceed and what will be the outcome of it?

As a long-standing public representative, I have great faith in the democratic process and I would never downgrade public representatives. The essential aspect is that families, residents and support workers within communities will be the priority. Consultation with the public representatives will be just one part of that.

It has not happened, however.

If we wish for something to happen long enough, then sometimes our wish will come true. The Health Service Executive is not preordained in this instance. I am convinced the best possible outcome that we could wish for will occur in this case. We need to reassure those with loved ones in nursing homes, not just Abbeyleix, that their best interests, as well as their will and preference, must be taken into account. The process will begin and all stakeholders, including public representatives, will be contacted and consulted on this. We all wish that at the end of this consultation process the best possible outcome will be achieved for those whose home it is.

I hope that model will apply to all homes.

It will apply in this case.

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