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Dail Éireann · 2023-05-03

Hospital Facilities

SF Martin Browne · Tipperary

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Summary of this debate

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The HSE is committed to the development of a new community nursing unit for older persons in Cashel. A HSE-owned site in Cashel town is being reviewed by HSE estates for suitability for a new community nursing unit. No one intends not to build this community nursing unit run by the HSE in Cashel.

A community nursing unit will be built in Cashel. The HSE is committed to the development of a new community nursing unit for Cashel. There will be a community nursing unit built in Cashel.

Built by scoring every sentence in the debate on how distinctive its language is, then quoting the highest-scoring ones back word for word and in the order spoken. Nothing is paraphrased or invented — if a sentence appears here, it was said in the chamber. Drawn from 1,198 words across 10 contributions by 6 speakers.

Most used terms in this debate

How often each word appears across the whole debate, ranked by how distinctive it is to this debate rather than common to all parliamentary language.

cashel 28
unit 25
site 23
patrick's 14
nursing 18
hospital 23
community 22
hse 14
bus 11
drivers 8
parking 6
go-ahead 4

The full debate

All 10 contributions, start to finish, in the order they were made. The one you came here for is highlighted.

SF Martin Browne this contribution

We have had this discussion on numerous occasions in recent months. I want answers from the Minister of State, Deputy Butler, this evening because a public meeting is being held in Cashel tomorrow night. The public of the town and the staff in St. Patrick's Hospital deserve answers at this stage. Public representatives belonging to the party of the Minister of State and other Government parties have been giving false information, as far as I am concerned, in Cashel about money being ring-fenced and parking facilities being too small in the area.

Let us get this out there at the start. In 2019, this project went to design stage. Three weeks ago, we were told it was moving along. Now, the unit is being moved out of the grounds of St. Patrick's Hospital, Cashel. Last week, the Minister of State referred to commercially sensitive information. There is none. We were told this at a meeting of the HSE the other day, at which Deputy Mattie McGrath was present. The Government is talking now about a site the HSE owns. I can guarantee it, and I said this to the representatives of the HSE the other day, that no unit will ever go up on that site. I do not even know if the Minister of State knows where the site is located. There is not much more room there for a car, never mind an ambulance or anything like that, to get up to that site. This is all the misinformation that is out there in public. The people of Cashel and County Tipperary deserve better.

Last Friday, we discovered that no cost analysis was done regarding moving this unit from St. Patrick's Hospital. There also seems to be no engineer's report stating this unit is too small. I asked the Minister of State for this review last week, but I have still not got it. There must have been a meeting where it was decided to move the unit out of its current site at St. Patrick's Hospital. These documents have not been forthcoming. What kind of situation is going on in the HSE that meetings seem to be going on where vital decisions are being made about people's lives, but where there are no minutes? We are being told about reports from HIQA, etc., saying that the site is too small and that there is no parking. When St. Patrick's Hospital was going full pelt, there were 300 patients and staff on site and there was never an issue with parking. An issue with parking came up three weeks ago, and that was about the end of it. I will come back in after Deputy Mattie McGrath.

IND Mattie McGrath

I thank Deputy Martin Browne for letting me share time. We want answers about St. Patrick's Hospital in Cashel. We want reassurance and something definite in respect of this matter.

St. Patrick's Hospital is a wonderful institution. My late mum did some time there. I cannot say enough about the staff and all the people there, including in the chapels and the church. I often attended mass there, when we had a church. We were expecting a 60-bed community unit to be delivered. That is what we were told all the way along at meetings and briefings and everything else, until a bombshell landed two or three weeks ago regarding the site now being too small. This is simply not true. I cannot use the word "lie" here, but this is a porky of the highest order. As Deputy Martin Browne said, there were 350 staff and patients there, many of them driving, and there was plenty of room for parking. I ask the Minister of State to pick some other issue besides this one.

Something else is going on here. The Minister of State closed the beautiful hospital in Carrick-on-Suir. It was shocking to do that to a community hospital with three hospice beds. I am worried too now about there being plenty of hospital beds in University Hospital Waterford. I worry because we were told the other day we are in competition now with Dungarvan, if you do not mind, for this community hospital. I am watching this matter very carefully. The Minister of State should not dare to take this facility out of County Tipperary, because it is needed. The community hospital is needed and the staff and everybody else is committed to it. Cashel lost too much back in the 1980s, when it lost to Clonmel, as well as the last time. It is not going to lose this time. The people there are ready for the Minister of State.

It has been stated that the greenfield site is suitable. It is not, and it is not accessible. We have a site. Just let us build on it. This is a listed building but it can be easily adapted. There was no problem before with engineers' reports or anything else. Costings in this regard have not even been done. What the Minister of State is overseeing in the HSE, along with the Minister, Deputy Stephen Donnelly, and the Minister of State, Deputy Rabbitte, is nothing short of outrageous. I refer to officials being able to do what they like and tell us what they want anytime they like and different stories then being presented by politicians from the Minister of State's party. This is just not acceptable. The people of Cashel deserve this facility and they are going to get it.

FF Mary Butler

I thank Deputies Martin Browne and Mattie McGrath for the opportunity to update the House on the new 60-bed community nursing unit in Cashel. I hope we are not going to make a political football out of a good news story.

The HSE is committed to the development of a new community nursing unit for older persons in Cashel. In early 2016, a capital programme for older persons residential centres was developed in response to the introduction of HIQA's national residential care standards. To date, 43 of these centres have been delivered. Both Deputies will be well aware that a centre is under construction in Clonmel and that we are going to build one in Cashel.

In 2019, the HSE engaged a design team, as the Deputy said, to progress a new 60-bed community nursing unit project on the site of St. Patrick's Hospital, Cashel. A design was completed in 2019, which was brought through stage one design, that showed a detailed layout to the rear of the site. This accommodated the 60 beds. This site, however, is very limited in size, with challenges regarding the number of parking spaces and access to the building.

The emergence of the Covid-19 pandemic in March 2020 interrupted work on this project. As a response to Covid-19 risks, upgrade works were carried out to make facilities located on the campus of the nearby Our Lady's Hospital, Cashel, suitable for long-stay residential use. Residents from St. Patrick's Hospital were moved to facilities on the Our Lady's Hospital campus in June 2020. HIQA registers all community nursing units for a three-year period. Six months prior to the registration expiring, a community nursing unit is obliged to submit an application to reregister the facility. This process is being undertaken with HIQA by Cashel residential older persons services to ensure reregistration for another three years from June 2023. This is to ensure continuity while the new community nursing unit is being built. An assessment and rehabilitation unit, and a day hospital for older persons services, continue to operate at St. Patrick's Hospital.

Many of the vacated areas of St. Patrick's Hospital have been refurbished to accommodate children's therapy services. In addition, it is planned to locate enhanced community care, ECC, services at the rear of the site at St. Patrick's Hospital, Cashel. Site options for the new 60-bed unit for Cashel are under consideration. A HSE-owned site in Cashel town is being reviewed by HSE estates for suitability for a new community nursing unit. Representatives of HSE estates have advised that this site review should be completed in the coming weeks. We can discuss this issue again then. A final decision has not formally been made on sites because optimum solutions for the provision of the services are still being appraised.

To put the concerns of both Deputies to bed, the capital plan will be launched in the next couple of weeks. I have seen it. The new community nursing unit for Cashel is included in it, in appendix 2, to go to the detailed design stage. It is there in black and white. No one intends not to build this community nursing unit run by the HSE in Cashel. What HSE estates is examining now is where this unit might be located. I said at the start of my reply that I hope this issue does not become a political football. I say this because the last thing I want to see is the new community nursing unit being held up in Cashel because the Deputies are arguing over the site. It is not up to politicians to determine where the nursing home will be built. The most important thing for me is that the community nursing home which will have 60 beds en suite in Cashel, which I know is needed, is built as soon as possible. The one in Clonmel and the crisis house there will both be finished next year.

Many community nursing units are currently being built. As I said, we have built 43 so far, and Cashel is next on the list. Nobody is going to stop the unit in Cashel from being built. A community nursing unit will be built in Cashel.

GP Eamon Ryan

The key problem has been in getting drivers at Dublin Bus, Bus Éireann, Go-Ahead and other private operators. Every bus operator will tell the same story. To address this challenge and help close the gap, we engaged with the Department of Enterprise, Trade and Employment and secured agreement for 1,500 work permits for drivers who are needed across the country. Deputies will have seen Dublin Bus's major advertising campaign, which I understand has been successful. Private operators, Dublin Bus and Bus Éireann are starting to get the staff they need. When speaking with Bus Éireann about this subject in recent weeks, it told me that it was starting to deploy more female drivers, which is helping it to close the staffing gap that caused the problem. Increasing permits and broadening the scope of advertising are the best ways of solving the problem.

SF Mark Ward

I understand the issue with drivers, but there is also a difference in parity between drivers at Dublin Bus and drivers at Go-Ahead. The latter do not have contracts or conditions as good as the former and Go-Ahead is not as attractive a workplace as Dublin Bus. This is an issue with the private provider.

Go-Ahead operates the 76, 18, L51 and L52 routes in Clondalkin, Palmerstown and Lucan. The 76 route goes to Tallaght. Residents contact me regularly having missed appointments at Tallaght Hospital because their buses did not turn up. BusConnects is not fully connected. There are residents in Lucan who watch helplessly as bus after bus passes them by full. Residents in Newcastle and Rathcoole, which have two of the fastest growing populations in the State, feel abandoned because of the lack of services.

I am all for getting people out of cars and onto public transport, but the Government must provide adequate public transport to do this. What will the Minister say to those in my area who are missing school, work and hospital appointments?

SF Martin Browne

When will the design stage finish? We were told recently that funding depends on the design stage. When did the issues with the suitability of the site first emerge? Will reports that back up the HSE's decision that the St. Patrick's site is too small be provided? Do they even exist? How much has been spent on the preliminary stages of St. Patrick's to date? How far along are negotiations on the greenfield site? Can any indication be given to us as to how close to the town the greenfield site is? Will the Minister of State give a commitment that other services such as the assessment unit and rehabilitation services are not lost in a couple of months' time?

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That is why we have the system of regulation and fines and of holding those companies to account. Despite all these problems, particularly regarding the difficulty in getting drivers, what we have seen in the past year is public transport numbers increase very significantly, beyond what they were before Covid. That is unusual by international comparison; most other countries have not seen that. I believe that the combination of the 20% and 60% reductions in fares and some of the priority measures we are only starting to put in place is starting to see these bus services really increase and expand.

We have a lot of work to do. It is critical that we get the BusConnects project through planning and that we start delivering it and, in the interim, look at other measures in Dublin city centre and elsewhere where we can reallocate road space in order that the buses get through. The best way of solving this problem is not just by having as many drivers as we can get but also by making sure the buses are not stuck in traffic and that is what we are committing to do.

FF Mary Butler

The HSE is committed to the development of a new community nursing unit for Cashel. Provision has been made in the capital programme 2023 to progress a 60-bed community nursing unit for Cashel. I cannot be clearer. A HSE-owned site in Cashel is being reviewed by the HSE for suitability.

SF Maurice Quinlivan

As part of the Limerick-Shannon Metropolitan Area Transport Strategy 2040, there was reference to establishing a Limerick commuter rail service. As an aid to developing the strategy, detailed assessment of rail proposals was undertaken. The assessment identified a programme for a commuter rail network to be developed. It included, in phase 1, stations at both Moyross and Ballysimon and the potential of other stations on the existing rail line that would include Corbally and the Parkway Shopping Centre area of Limerick. Will the Minister outline what steps have been taken to date by his Department or the National Transport Authority to realise this ambition?

FF Mary Butler

I am entitled to answer under Standing Orders. There will be a community nursing unit built in Cashel. The HSE is currently appraising a couple of sites and will have a report in the next few weeks. There will be a community nursing unit constructed in Cashel, comprising 60 en-suite bedrooms, to support older people in the area.