Seanad Éireann díospóireacht -
Wednesday, 3 Mar 2010

Vol. 201 No. 5

Hospital Services.

Senator Pearse Doherty

Cuirim fáilte roimh an Aire Stáit. Iarraim uirthi freagra a thabhairt dúinn maidir leis na pleananna fadtéarmacha le haghaidh Ionad Sláinte Bhéal Átha Seanaidh agus Ospidéal Leifir, atá á fheidhmiú ag Feidhmeannacht na Serbhíse Sláinte an iarthair. I am seeking information on the long-term future of Lifford Community Hospital and the Rock Hospital in Ballyshannon. Through my colleagues in the Dáil, I tried to get an answer from the Minister for Health and Children, Deputy Mary Harney, on the future of these facilities but have not yet received it. As a result of the pay cuts introduced by the Government, it is unlikely we will receive a reply from the parliamentary affairs division owing to the ongoing industrial dispute. This is an opportunity, therefore, for the Minister of State to clarify the positon on the long-term future of these facilities.

The Rock Hospital in Ballyshannon and Lifford Community Hospital provide vital services in their communities. There was a debate earlier on the high levels of unemployment and lack of investment in County Donegal. Public sector jobs are very important in the county, even though many of them are at the lower end of the wage scale. They are a crucial lifeline for the county, which is not to take away from the services they provide, particularly for the elderly. Earlier I looked at a report on Lifford Community Hospital which outlines the capacity and usage of the hospital. There is 91.1% usage of the facility, while the total number of bed days in 2003 was 13,296.

In recent days a number of people have approached me with the suggestion that the future of these facilities is in question. I make no judgment on the validity of that suggestion but this debate offers the Government an opportunity to allay their fears. Some of the staff are also concerned about their positions and this issue will undoubtedly become a source of concern and speculation among the wider community as time passes. This is an opportunity, therefore, to put the matter to rest. I am hoping to receive good news from the Minister of State in that regard.

Minister of State at the Department of Health and Children (Deputy Áine Brady)

I thank the Senator for raising this issue, as it provides me with an opportunity to update the House on the matter. The Government is committed to supporting people to live in dignity and independence in their homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care where this is appropriate. We continue to develop and improve health services in all regions of the country to ensure quality and patient safety.

The Health Service Executive has operational responsibility for the delivery of health and social services, including those at facilities such as Lifford Community Hospital and the Rock Hospital in Ballyshannon. All developments must be addressed in the light of the current economic and budgetary pressures. The executive has been asked to make a rigorous examination of how existing funding might be reconfigured or reallocated to ensure maximum service provision is achieved. This requires a stringent ongoing review of the application of the resources currently available.

The integrated services directorate is the executive's directorate responsible for the delivery of health care services. I understand that, in line with what is happening throughout the country, the HSE in County Donegal is reviewing its use of resources and facilities for residential care in the county. The factors relevant to this process in County Donegal include compliance with the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 and the national quality standards for residential care settings for older people in Ireland; staffing and resource issues; residential care needs; the options available in public and private nursing homes and the HSE's capital programme to replace and-or upgrade existing facilities. On completion of the review, the executive will be in a position to outline any proposed changes arising for HSE facilities in the county.

The Senator will be aware that the Nursing Homes Support Scheme Act was signed into law on the 1 July 2009 and that the scheme commenced last October. The scheme equalises State support for individuals in public, voluntary and private long-term nursing home care. This meets one of the objectives of Towards 2016, namely, that State support be indifferent as to whether a person is in public or private care. Individuals contribute towards their care based on their income and the value of their assets, with the safeguard that no one will pay more than the cost of his or her care. The introduction of the scheme eliminates the financial need for people to seek public nursing home care. This allows older people to choose to receive residential care in a wider range of centres, including those which would be closer to their homes and families.

Senator Pearse Doherty

I deliberately worded my Adjourment Matter in such a way as to ask the Government to outline the long-term position of the two hospitals to which I referred and clarify if they would be closed in the future. The Minister of State did not say whether the hospitals would be closed. Her answer leads me to believe the information I have received, namely, that the HSE is planning to close the two facilities, could be accurate. I am aware of the average weekly cost in both facilities. At just over €900, the average cost at the Rock Hospital is one of the lowest in County Donegal. The figure for Lifford Community Hospital is just over €1,300. I am fully aware that a private facility, as the Minister of State mentioned, can provide a service at a cheaper rate. In the case of Lifford Community Hospital, ancillary services are provided; it is not just a nursing home. Can the Minister of State reassure the people of County Donegal, in particular the communities of Lifford and Ballyshannon, that the information I have received that the Rock Hospital and Lifford Community Hospital are about to close under new HSE plans is not correct? She has confirmed that a rigorous assessment is being undertaken. I have been told the two hospitals are on the chopping block. I, therefore, ask the Minister of State to allay my fears and those of the community.

Deputy Áine Brady

I can assure the Senator on the issue of costs. Public facilities were often more expensive because they dealt with patients with a higher level of dependance, which meant costs were higher. The cost to the client is now irrelevant because 80% of his or her income and 5% of his or her assets are taken into consideration. The issue of cost should not affect the ability of nursing homes or militate against a public facility; it only affects the State. There are waiting lists at public facilities in County Kildare. On the review taking place, the Senator can assure persons who wish to enter the facilities that we are trying to equalise support. It is the levels of their income and assets which matter.

Senator Pearse Doherty

Cost is a factor for the State when making a decision as to whether a facility should be closed.

Deputy Áine Brady

That is not what I said.