I welcome the opportunity to raise this issue. Representations at Members' clinics in south Kildare have increased dramatically as a result of overcrowding in Naas General Hospital and the effect it is having on families of senior citizens who are in a position to return home but whose families are unable to provide the required care. They are unable to find accommodation in nursing homes in Kildare because the nursing home subvention does not meet the financial demands imposed by nursing homes and because the South Western Area Health Board closed the respite and assessment unit in St. Vincent's Hospital in Athy.
In the past four days, I have been visited by four different families who face pressure to bring their loved ones home from the hospital because it seeks to alleviate overcrowding. None of these families was in a position to do this so we sought the nursing home subvention. There are three rates for the nursing home subvention — medium, second and high rate — and they reflect the costs of nursing home accommodation. I presume that is because patients who are able to look after their own needs would be given the lower rate while those who are not able to care for themselves would be given the higher rate. That is not reflected in the costings given by the nursing homes. They give only one cost which does not reflect the different rates in nursing home subvention.
There is also a problem regarding the enhanced subvention. I learned from a reply to a parliamentary question that there was a waiting list for the enhanced subvention in south Kildare. We are trying to use the nursing home system to move patients from Naas Hospital to St. Vincent's for secondary care, but it is not possible because in practically all cases there is a shortfall in the payment of around €200 per week and the families are not in a position to meet that.
I ask that the 21-bed assessment and respite unit at St. Vincent's Hospital be re-opened. I spoke to the staff there and learned that there is a great demand for it to be re-opened. It is necessary for the Department of Health and Children and the Department of Finance, through the South Western Area Health Board, to provide the necessary funding to allow the director of nursing there to hire nurses to ensure that unit can be re-opened. That would immediately clear the overcrowding at Naas Hospital, whereby people in need of secondary care could move to Athy, as was the practice prior to the closure of this assessment and respite unit. It was a secondary care facility for such patients and freed up capacity in Naas Hospital.
In light of the amount of money that has been spent on Naas Hospital, it is crazy that some people still have to be cared for on trolleys and chairs. Members may have seen reports on television and elsewhere of 30 to 40 people being cared for in such circumstances during the past few weekends in that hospital which has been upgraded. There is an obvious solution. First, money must be provided to re-open the assessment and respite unit in St. Vincent's Hospital in Athy. Second, the Minister must revisit the operation of the nursing home subvention because it is not working. Nursing homes are not applying it as intended because the rates are too low in the first instance and there is a waiting list for the enhanced subvention.
The health system in Kildare is clogged up. Families are experiencing major problems in trying to facilitate their loved ones and bring them home or in trying to get them into a secondary care facility to get some respite to then be able to bring them home. I ask the Minister to examine the nursing home subvention, the enhanced subvention and, most importantly, the provision of funding for the re-opening of the 21-bed assessment and respite unit, which could be used to alleviate the overcrowding.