I welcome the Minister of State at the Department of Agriculture, Food and the Marine, Deputy Tom Hayes, and wish him well in his appointment.
Adjournment Matters
Decentralisation Programme Office Accommodation
It is a great pleasure to welcome the Minister of State in his new role at the Department of Agriculture, Food and the Marine and I wish him luck with his endeavours. He is well placed to serve in that office as he is very familiar with the issues. I am sure he is very familiar with the matter I wish to raise, namely, the decentralisation of the Department of Agriculture, Food and the Marine offices to Portlaoise.
Decentralisation was a good concept but was appallingly thought out. Its implementation and roll-out was even poorer and, in some cases, it ended up being a fiasco in that much of what was promised when it was first announced by the then Minister never came to fruition. However, I am glad to say Portlaoise has been one of the success stories. It is a suitable and central location for the Department of Agriculture, Food and the Marine offices but it is a victim of its own success in some respects. While many people work in the base in Portlaoise, the Department's offices are no longer just in the purpose-built office accommodation on the Old Abbeyleix Road in the town centre but are dispersed in six different rented office spaces throughout the town. That does not make for effective and efficient use of the offices and the personnel and it is not appropriate for the agricultural community which seeks to use the Department's services.
One office is over a pub and a fish and chip shop and is remote from the central office. I do not know why that is the case and it should not continue. I understand that as of November last, the Department is spending tens of thousands of euro on office accommodation in these dispersed locations. I am sure the Minister of State will agree that it would be far more efficient and effective if all the staff were housed in a purpose-built or a central unit in which they could all work together for the effective administration of the Department's business. This would save the taxpayer money and it would mean all the staff were housed in the one complex.
I thank Senator Whelan for raising this issue and for his good wishes. I also thank the Cathaoirleach for his good wishes. I started off in this House many years ago and I am delighted to be back. I never dreamt I would be back answering queries as a Minister in the Department of Agriculture, Food and the Marine.
Some 470 Department of Agriculture, Food and the Marine staff are housed between several different locations in Portlaoise. This situation, which is a legacy of the decentralisation project, presents many operational difficulties and is making it more challenging for the Department to carry out its functions in Portlaoise. Moreover, the fragmentation of staff and facilities is sub-optimal from the point of view of efficiencies and cost-effectiveness.
The temporary location of staff in small numbers in different locations - initially done to facilitate the decentralisation of the Department to Portlaoise - was undertaken on the basis that, in a relatively short period, all would be located in a new purpose-built headquarters. The different locations of offices which results in the spreading of single functions over several locations seriously impairs opportunities to gain operational efficiencies.
In this context, the Department has been working for some time with the Office of Public Works in reviewing its accommodation needs with a view to rationalising its property footprint in Portlaoise. From the Department's perspective, the principal priority in this consolidation is the redeployment of staff to reintegrate business areas split between different locations and, as far as possible, the co-location of different business areas that have cross-over functions or can exploit any existing operational synergies from such co-location.
Following on from this review, the Department and the Office of Public Works are examining the possibility of the construction of an extension to Government offices on Old Abbeyleix Road. These offices are State-owned. The extension, when taken together with the existing space, which would also be reconfigured, would result in all of the Department's staff being accommodated at that one location.
At least two years would be required to deliver the new building. Savings would commence upon completion as leases that currently cost over €1 million per annum could then be surrendered. Subject to a tendering process, full payback would be realised within a relatively short period of time after completion and occupation. A detailed proposal is being finalised by the Department and the Commissioners for Public Works and this will shortly be submitted to the Department of Public Expenditure and Reform for its consideration.
The consolidation of Department staff will derive many benefits both to the Exchequer and to the Department itself. As previously stated, the cost of providing temporary accommodation for staff in Portlaoise is in excess of €1 million per annum. Value enhancements will also be derived by the Department in terms of improved utilisation of resources and operational effectiveness and efficiency.
The public service reform plan provides that the Government will deliver greater value for money through efficient management of the Government estate owing to a smaller physical footprint meeting the needs of a reformed public service. The situation in Portlaoise represents a unique opportunity in terms of delivering on this commitment. It could be argued that the current situation in the location represents a microcosm of the issues that the reform of property asset management in the wider public service will attempt to address.
A recent review of the State's property asset management portfolio states that the cost of office accommodation, after salaries, represents the largest portion of central government's administrative overheads. In this context, economies must be found by Departments in their use of office space to contribute to the budgetary consolidation that must be found in the area of public service property. The review includes several key potential strategies to assist in exploiting savings and efficiencies in property. There is to be a reduction in expenditure on rent within the leasehold portfolio through lease surrenders. Existing accommodation must be consolidated through more intensive utilisation of space by way of standardisation of space allocation, space norms and accommodation fit out. Investing in the modernisation of owned buildings to realise efficiencies benefits over the longer term. The proposals outlined for rationalisation of the Department of Agriculture, Food and the Marine accommodation in Portlaoise ticks all those boxes. Rationalisation will lead to surrendered leases, consolidation of existing space and modernising of owned property will ultimately contribute considerably to budgetary consolidation in the medium to long-term. The Portlaoise project, if brought to fruition, has the potential to be exemplary for property rationalisation and set the benchmark for future projects of a similar nature. From dealings I have with those in Portlaoise, I know they are excellent staff and they need what will be delivered to them in the future.
That was a comprehensive, constructive and positive answer. The Minister of State is right, the staff in Portlaoise are exemplary in carrying out their duties. It is unfortunate and not best practice that they are dispersed all over the place. There are 500 staff so it is an important employer in the region. I welcome the Department's commitment to the base in Portlaoise that it plans to draw up plans to construct an extended office that would be owned by the State with the advantage to the taxpayer of saving on expensive rental properties. If the saving of €1 million a year in rent that is being paid was rolled out and replicated around the country, there would be considerable savings with the added benefit that it would not impact on staff or services. That is how to make savings in the public service.
Hospice Services
I welcome the Minister of State to the House. My Adjournment matter follows a presentation yesterday and the publication of a report by the Irish Hospice Foundation entitled, Access to Specialist Palliative Care Services in the Place of Death in Ireland. The figures in the report reflect the need for action to be taken. I am not blaming the Minister or the Department because this is a policy that was developed over 12 years ago. Unfortunately, when times were good, not a lot of progress was made, and we must now look at that plan in 2001 and what we can do now taking into account that there are far greater financial restrictions. There is also an issue of demands.
It was striking that more than 2,500 patients are denied access to hospice inpatient care every year. There are 155 hospice beds in the country, with another 44 beds ready, 20 of them in Cork, along with an extra 36 staff. The number in Marymount will increase from 24 to 44. The figures, however, that frighten me are those stating that by 2016, around 12,500 will require hospice care of some degree during the year.
The report also highlighted that only 7% of home care patients in the better resourced hospice services in the mid-west die in acute hospitals in contrast with 32% in the north east. Where there is hospice care and support services in place, there is less need for acute hospital attendance, which leads to a huge saving. Now we have this detailed research available, how can we work towards planning for the future?
On behalf of the Minister of State, Deputy Kathleen Lynch, I thank the Senator for raising this issue as it gives us an opportunity to outline the current position.
Palliative care in Ireland is being developed on the basis of the following national strategic documents: Report of the National Advisory Committee on Palliative Care, published by the Department of Health and Children in 2001; Palliative Care Services - Medium Term Development Framework, published by the HSE in 2009; and Palliative Care For Children With Life-Limiting Conditions In Ireland - A National Policy, published by the Department of Health and Children in 2010.
The HSE acknowledges that the cost containments within the health sector over the last five years have meant that the implementation of the HSE medium-term framework has been substantially delayed.
Notwithstanding current budgetary difficulties, in 2012, approximately 35,738 people received specialist home care palliative services and 4,274 people received specialist inpatient care. There are currently 157 specialist inpatient palliative care beds in ten locations across the country. In 2012, there were 2,808 admissions to this service, a 4.4% improvement on 2011 figures.
That said, it is acknowledged that there is a wide regional and intra-regional variation in the availability of care and three geographic areas have no specialist inpatient units, namely, Wexford-Wicklow, the midlands and Cavan-Louth-Monaghan. All HSE areas have community specialist palliative home care teams in operation. Last year, 2,978 people accessed these services each month, which was a 4% improvement on 2011.
There are 38 acute hospital specialist palliative care teams. Again there is variability in service availability and composition of these multidisciplinary teams. Specialist palliative day care is provided in seven locations and an average of 330 patients used the service per month in 2012.
Some 817 new patients attended the service in 2012, which equates to an increase of 7.5% on 2011. There are over 170 palliative care support beds across approximately 80 locations. In 2012 the average number of patients per month in receipt of care was 150.
The 2013 HSE national service plan budget allocation for palliative care is €72 million, which does not include spending on palliative care provided in acute hospitals, approximately 170 palliative care support beds or home care packages. Furthermore, regional services continue to be developed. In HSE South, an additional 20 beds will be opened in 2013 in Marymount Hospice, to which the Senator referred. In Dublin-mid-Leinster, collaboration with primary care teams is being progressed to improve access to out-of-hours services and a plan for the provision of specialist inpatient beds for the midlands is being developed. The HSE has also met stakeholders to develop a specialist service in Wicklow. In HSE West, the HSE is engaging with Galway Hospice to discuss the expansion of capacity and is exploring the development of inpatient beds in counties Mayo and Roscommon. An additional consultant in palliative care medicine is also being appointed. In Dublin north-east, a business case and implementation plan are being developed for a 12 bed specialist inpatient unit at Our Lady of Lourdes Hospital in Drogheda. Meetings have also been held with St. Francis Hospice on the opening of beds in the unit at Blanchardstown.
While we are facing significant challenges overall in the health budget, the Minister is satisfied that every effort is being made to retain and improve palliative care services.
I thank the Minister of State for his very detailed reply. In view of the projected figures given for 2016 and the fact that when people are being cared for and supported under the hospice care and home care packages, significant savings are made, in real terms, in hospital services, is it time to look at the plan in view of the changes that have taken place to see how we can further improve it? I wonder if that could be done.
I will certainly relay those insights and comments to the Minister of State, Deputy Kathleen Lynch. The Senator referred to a presentation which I understood would be made this week, but I now know that it took place yesterday. I am sure the Minister of State would welcome an opportunity to consider it, as I am sure she has seen it and will have an opportunity to study it. I am sure it will be of assistance to her.
I have outlined for Members the outcome of a survey across the country, which is useful. Even in the present context, it shows that a good effort is being made. Some progress also is being made, notwithstanding the difficulties encountered.
I will pass on to the Minister of State the Senator's point on savings made elsewhere in the system as a result of having well developed palliative care services. I thank him again for raising the matter.
The Seanad adjourned at 5.15 p.m. until 2.30 p.m. on Tuesday, 2 July 2013.