Dáil Éireann - Volume 673 - 04 February, 2009

Adjournment Debate. - Community Care.

[544]   Deputy Tom Sheahan: I welcome the opportunity to raise the issue of the closure of the Rowan male ward in St. Columbanus Home, Killarney. A total of 21 beds have been closed in the community hospital and I cannot understand why this is happening. On a weekly basis I am in contact with St. Columbanus Home trying to secure beds for elderly people in need of long-term care. It has been the case for a while that one cannot get somebody admitted to the Rowan ward, or to any ward, in St. Columbanus Home. That is euthanasia by the back door whereby the Government is closing those wards.

The fair deal scheme is being introduced under which the Government will be able to take 5% of a patient’s estate over a three year period to use towards their care. With the closure of the Rowan ward, 21 beds are being closed and there have not been any admissions to that ward or to St. Columbanus Home for some time.

St. Columbanus Home has 150 beds but with this ward closure that number is reduced to 129. The concern among staff and patients, particularly those who have been there for six, seven and eight years, is that they will be moved. They have not been informed to where they will be moved. There have not been any further admissions to St. Columbanus Home but the patients who have made it their home have not been informed to where they will be moved.

I cannot understand why beds are being closed in a community hospital. The implication for my area is that people will not be able to find long-term care in a community facility. Also, what will be the implications of that on staffing numbers?

  Deputy Seán Sherlock: I wish to record my utter disgust, as well as that of the staff and patients of the Heatherside Hospital in north Cork, at the HSE’s unilateral decision to close the facility which has housed 42 patients for many years. The decision is illogical and without any common sense basis. It was taken without any consultation with the stakeholders, the nursing staff or the patients. This is a facility that has looked after patients with mental health issues for several years. What is happening in society is disgusting. These 42 patients will be moved into a facility that was already closed down, unfit for human habitation and with Dickensian conditions.

I do not know what the Government or the HSE is at, particularly when they give us much rhetoric on how well they look after mentally ill patients. I am calling on them to put a stay of execution on this decision until such time as there is consultation with the patients’ representatives, the families and the community to ensure everyone’s rights and entitlements are vindicated. If we have any sense of decency, this issue will be re-examined. I call on the Minister for Health and Children to intervene directly with the HSE to ensure the rights and entitlements of the affected patients are protected and common decency prevails.

  Deputy Barry Andrews: I am taking these Adjournment matters on behalf of the Minister for Health and Children, Deputy Harney. I thank both Deputies Sherlock and Sheehan for raising these issues which provides me with an opportunity to update the House on these recent decisions and outline the background and the action taken by the Health Service Executive. I also want to reassure the older people concerned, and their families, about the future of their care.

The Government’s policy for older people is to support people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, [545] the health service supports access to quality long-term residential care where appropriate. Health services in all regions continue to be developed and improved and quality and patient safety are ensured.

The Health Service Executive has operational responsibility for the delivery of health and social services, including those at facilities such as Heatherside, north Cork, and St. Columbanus Home, Killarney. The executive is working on an action plan to prioritise a phased programme of refurbishment and replacement of existing public homes, where necessary, to meet the proposed new national standards for residential care facilities for older people. Ongoing reviews are essential to ensuring resources are properly channelled and the changing needs of older people are suitably addressed. The executive continues to address infrastructural deficits to meet standards, together with health and safety and fire requirements.

Heatherside is a facility for older adults with enduring mental health issues located remotely in Doneraile, north Cork, but serving the needs of the South Lee population. Staffed by general trained nurses with support from the South Lee mental health team, the current facility falls short of the requirements to meet residential care standards and would require significant and ongoing capital investment to meet fire and safety standards. Heatherside is no longer able to provide appropriate services due to the increasing levels of dependency of its residents. The executive proposes to relocate this service to more appropriate modern accommodation in St. Stephen’s Hospital Campus, Sarsfield Court, Cork.

The relocation will provide a higher quality of service to the residents. The majority of these, with a small number of exceptions, originated from the South Lee catchment area. Only two of the existing 42 residents are from the north Cork area, with the remaining 40 from South Lee. The number of residents in Heatherside has decreased from 130 in 1992, to 80 in 2000 and 42 in 2009. There have been no recent admissions and a significant number of families have refused the option of admission to Heatherside on the basis of its location in north Cork. St. Stephen’s is closer and much more accessible to residents, their families, relatives and friends. In addition, access to and support from specialist services in South Lee for residents and staff will be much improved.

  Deputy Seán Sherlock: That is factually incorrect.

  Deputy Barry Andrews: St. Columbanus Home, Killarney, provides 150 continuing care beds in Killarney. The building dates back to the 1850s. The Rowan ward is an 18-bed male unit and is situated on the ground floor of the home. The executive has advised that the environment, design and layout of the unit are unsuited to meet the proposed standards published by the Health Information and Quality Authority last year.

  Deputy Tom Sheahan: Despite a large investment in it.

  Deputy Barry Andrews: The executive has decided to reduce the bed complement in the home to 132 beds by closing the unit. This will take place over an appropriate period. There are three additional beds located on the first floor which are occupied by ambulant patients. These will also need to be reconfigured in the overall provision of beds in the unit.

The priority capital developments for long-stay care approved for County Kerry are the new community hospital in Dingle and the new unit at Killerisk, Tralee. In Dingle, construction has been completed at the community hospital and the unit is being commissioned. It replaces the existing 43-bed unit and will also provide an additional 25 beds for the catchment area. A new 50-bed community nursing unit at Killerisk, Tralee, has also been provided which is also being commissioned. This will cater for the Tralee catchment area. The overall capital costs of these [546] developments is in excess of €25 million, with revenue costs of €7.6 million, representing a major commitment to support the development of services for older people in the Kerry area.

The provision of additional beds in both Tralee and Dingle during 2009 provides the executive with an opportunity to reconfigure residential services for older people in Kerry. With the provision of these additional beds, there will be an opportunity to provide residents accommodated in St. Columbanus Home with alternative accommodation closer to their own community if they so wish.

  Deputy Tom Sheahan: New beds in Dingle and Tralee will not suit the needs of the people of east Kerry.

  Deputy Barry Andrews: There will also be a lesser requirement for the concentration of long-stay beds in the Killarney area as the future needs of north and west Kerry residents will be met in the new units.

The reduction in bed numbers in St. Columbanus will be effected as beds become vacant during 2009. Movement in the home will be minimised and the wishes and requirements of the patients on the ward will be taken into account during the process.

This is an unsettling time for all residents of Heatherside and St. Columbanus. We owe them a duty of care and must ensure our primary focus is on each one of them. Each hospital, each local health office, managers, clinicians and others working in the health services have a responsibility to ensure they strive to provide the best possible service to patients and other clients of our health services. I am confident the executive will continue to work with the residents, their families and representatives to ensure they are relocated to the facilities which will best meet their needs.

  Deputy Tom Sheahan: This was all decided without any consultations.

  Deputy Barry Andrews: The House will agree the safety and well-being of older people is of critical concern. Quality care and patient safety come first and all patients should receive the same high standard of quality-assured care.