Adjournment Matters. - Edenderry District Hospital.

Society has a duty to organise itself in such a manner that its weaker sections are protected by the stronger and more affluent members of society. With profound regret I have to say that the Department of Health and its Ministers have failed to discharge their obligations to the people of Edenderry and its surrounding towns and villages of Bracknagh, Clonbulloge, Rhode, Clonygowan and Geashill. Edenderry District Hospital serves the people of those towns.

The Midland Health Board participated in the initial plan to locate hospitals of different specialities throughout the Midland Health Board area. Although the members have done a certain amount of work on behalf of Edenderry District Hospital, they must be criticised because the case for Edenderry District Hospital has not been pressed with the urgency it deserves. The members of the Midland Health Board should highlight this matter on every occasion.

Edenderry hospital was built in the last century. A number of hospitals were built at the time, including those in Tullamore and Birr. Edenderry hospital has the hallmarks of its time and, although it fulfilled its purpose then, the hospital now falls below standards required for such institutions.

I have visited the hospital on a number of occasions. It is divided into two sections: seven men occupy one section and seven women occupy the other. There is little space in each section and it is difficult to move between the beds. Many of the patients are elderly and incapacitated and the nurses have great difficulty discharging their duties in such confined space. Nevertheless, I have rarely seen patients so clean and in such good spirits. They are a credit to the nursing staff and the people who run the hospital. Although the hospital is clean and the patients are well cared for, the conditions under which they are expected to live are below standard. It is reprehensible that people are obliged to live in such circumstances.

The Midland Health Board produced a plan for Offaly in 1985 which provided for a 50 bed unit in Tullamore, a 50 bed unit in Edenderry and the Birr District Hospital was to receive an extra 40 beds. I am sory to say that no progress has been made. Edenderry hospital in view of its bad condition, was first on the list for improvement but nothing has been done. The hospital is part of the old workhouse system of the 1800s. At present the building is a borderline fire hazard. The walls are damp. It is neither sufficient nor good enough. When I see the way national resources have been spent over the last number of months it angers and upsets me. I feel indignant that money was wasted on unnecessary projects whereas Edenderry District Hospital is absolutely essential. The Department of Health's budget is in the region of £2,000 million. A hospital for Edenderry would cost approximately £800,000 but that money is not being made available.

I recently visited the Minister for Health, as part of a deputation and I was told no resources were available this year. I find that unacceptable. People are born into this world for a short time only and are entitled to live lives of dignity, especially in old age. A society which cannot organise itself to allow people to live in dignity, especially in their final years is failing in its duty. Irrespective of where is comes from money must be found for Edenderry District Hospital. The Minister has an obligation to obtain those resources. Millions of pounds can be found for other projects, yet the Minister cannot find the money necessary for this hospital.

Offaly County Council has discussed this matter and I have attended public meetings where righteous indignation has been expressed by the people of Edenderry. Other hospitals seem to have jumped the queue leaving Edenderry behind; it is not good enough. I demand that this hospital go ahead. The Minister has spoken about Tallaght hospital which is expected to cost £120 million. We do not want a big hospital in Edenderry, we had a hospital there in the past which accommodated 50 people. In 1985 a proposal for a 50 bed hospital was passed and I demand that moneys be allocated immediately to enable work to commence, not next year or the year after, but this year.

When Senator Enright said money was being wasted on certain projects, I wish he had identified those projects to the Department of Health. The Health budget this year is just short of £2,000 million, a considerable sum in a country of Ireland's size and resources. I assure Senator Enright that every penny spent by the Department of Health this year is well accounted for. Indeed, we could spend five times as much money if we had it.

Responsibility for providing a community nursing unit in Edenderry lies with the Midland Health Board. Traditionally, the needs of frail elderly persons were met by admitting them to long-stay hospitals. This practice is now generally held to be unsatisfactory. It is now accepted that greater attention needs to be paid to the development of community based services so elderly persons can continue to live in their homes, with assistance if necessary, for as long as possible.

The recommendations on services for the elderly contained in the Report "The Years Ahead" have been adopted by Government and are being progressively implemented. In the past few years the Government has allocated substantial additional funds to the Midland Health Board. During this time the board has considerably improved services for the elderly throughout the region. The home nursing, home care and home help services have benefited while liaison nurses have also been appointed. Respite care beds have also been introduced in all long-stay hospitals. Arrangements have also been put in place for assessing applications for places in the board's long-stay hospitals and welfare homes. These arrangements ensure that those people in most need of such accommodation actually get it. Overall, there has been much improvement in the services being provided for the elderly and in the co-ordination of these services.

It must be acknowledged, however, that some of our long-stay accommodation for the elderly does not meet modern day standards and needs to be replaced. As the Senator is aware, the provision of a new 40 bed nursing unit for the elderly at Edenderry District Hospital is regarded by the Midland Health Board as a vital element of their community care programme. This planned development is consistent with the recommendations contained in "The Years Ahead" Approval to go to tender will be conveyed as soon as I am satisfied that the necessary funding, in excess of £1 million, is available. I must also take into account competing demands for capital funding from all over the country and indeed the internal priorities of the Midland Health Board.

I would like to add that at present there are 1,005 public long stay places available for the elderly in the Midland Health Board which is generous by comparison with the norms recommended in "The Years Ahead", and by comparison with levels of provision elsewhere.

In addition to the health board homes there are 462 places in private and voluntary nursing homes of which 144 are subvented by the health board. The Senator will be pleased to know that I intend to implement the Health (Nursing Homes) Act, 1990 in the very near future. This Act provides a new legal framework for the regulation of nursing homes and, when the Act is implemented, a statutory duty will be placed on nursing homes to register with the health board in whose region they are located.

Also, a new system of subvention will be introduced for dependent persons who require nursing home care. Under the new subvention system, a health board may pay a subvention to a person whose dependency, means and circumstances have been assessed by the health board in respect of care in a registed nursing home. Draft regulations setting out the new conditions for the payment of subvention under the new scheme have been prepared and discussions have commenced with the nursing home interests on these draft regulations. The Act therefore, will provide the health board with another option in meeting the needs of the dependent elderly, locally and flexibly.

I would like to point out to the Senator that there has been a fair share of positive action insofar as services for the elderly in the Midland Health Board are concerned. I would ask him to accept the commitment of this Government to the continued development of services for the elderly in the Midland Health Board area as shown by the generous additional funding for services for the elderly in the last few years. I can assure the people of Edenderry and surrounding district that there is full appreciation of the need to provide this proposed new unit.