Frank Feighan (Fine Gael)
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I am asking the Minister for Health to confirm when the day-care centre for older people will open at the Ballinamore community nursing unit and primary care centre and if there are any plans to provide additional beds at the unit. I thank the Minister of State for being here today. I clearly remember five years ago turning the sod on the €6 million primary care centre and the 20-bed community nursing unit in what is a very impressive campus. It was a great privilege for me as a local Deputy back then to turn the sod on the wonderful development. We now have a modern purpose-built primary care centre and an interconnected 20-bed care managed unit.

The role of the primary care centre fits in with the Government's primary care strategy which is to provide a range of key services addressing the needs of local communities all under one roof. Using this approach, the primary point of contact between a person and the health system is through the local primary care team. The community nursing unit works in tandem with the primary care centre, acting as either a step-down facility for patients well enough to be discharged from general hospital but not well enough to go home or those who require additional therapies.

Regarding my first query over the day-care centre, it was clearly stated in the project's brief at the very outset that this campus would have a day-care facility. Unfortunately this is still to happen. I would like to establish when the facility will commence. It is certainly long overdue. Day-care centres provide a range of social and rehabilitative services for older people with disabilities, and are a vital lifeline for many elderly people. Ballinamore deserves one like any other area.The community nursing unit is a long-term care facility designed to meet the needs of dependent older people in south Leitrim and has been operational since May 2016. At present there are 20 residents in the facility. It is an extremely busy unit but, unfortunately, there is a long waiting list to avail of all its services. Given this situation, I want to ask Minister of State whether there are any plans to provide additional beds at the site. There is certainly more space in the site for a further build, which would provide more beds to cater for this demand. I will be interested to hear the views of the Minister of State on this issue.

Finian McGrath (Dublin Bay North, Independent)
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On behalf of the Minister of State with responsibility for mental health and older people, Deputy Jim Daly, I thank Senator Feighan for raising this very important matter. I also acknowledge his work on this issue and with regard to health and disability services and senior citizen services in his area.

The overarching policy of the Government is to support older people to live with dignity and independence in their own homes and communities for as long as possible, and to support access to quality long-term residential care where this is appropriate, and this appropriateness is the important aspect. Yesterday we announced €14 million for housing adaptation grants for senior citizens with disabilities and this is another step in the same direction, so we have more people living in their own homes, where possible, as long as they have the proper facilities and accessibility.

The HSE has operational responsibility for planning, managing and delivering health and personal social services. Home care and other community services provide a greater range of options to avoid admission to acute hospitals, support early discharges and, where appropriate, to rehabilitate and re-able patients after periods of particular difficulty.

Our ageing population is one of the most significant demographic and societal developments that Ireland has encountered in modern times. Not only are people living longer, but a great many people are staying healthier and living better for longer. Demand for community services is rising as more people are supported in their own homes rather than in hospitals or nursing homes. However, quality residential care must continue to be available for those who need it. I emphasise this angle to the debate. It is for those who urgently need it.

Primary care centres provide a range of key services to address the health needs of their local communities. Access to day centres can make an important contribution by providing invaluable support, advice and social interaction for older people who may, for any number of reasons, be experiencing isolation and loneliness. The Ballinamore primary care centre and community nursing unit consists of a modern purpose-built primary care centre and interconnected 20 bed community nursing unit. The community nursing unit has been operational since May 2016. There are 18 single bedrooms and one twin bedroom. Residents are supported by a full nursing team and support team, who provide nursing care and support on a 24-hour basis. Medical care is provided by a GP service Monday to Friday between 9 a.m. and 5 p.m. Outside these hours medical care is provided by NoWDOC. Multidisciplinary team members are accessible to residents through a referral process.

Ballinamore forms part of the south Leitrim complement of nursing home beds, which includes St. Patrick's hospital in Carrick-on-Shannon with 65 beds and Arus Carolan in Mohill with 36 beds. At present, there are no plans to provide additional beds in Ballinamore. However, as the Senator is aware, the national development plan acknowledges the need for additional capacity. It is expected that 4,500 additional short-term and long-term beds will be required across the public system in community nursing units and other step-down facilities, as identified by the health capacity review.

Health capital projects and programmes under way will continue, and these major priority projects will require the bulk of the notified capital allocation over the initial period of the plan from 2018 to 2022. The next planned phase of service provision for Ballinamore is the introduction of an integrated social day care service, which will further enhance day service provision in the south Leitrim area. It is envisaged that hot meals for clients who attend will be provided through the Ballinamore community nursing unit based on the same site. Social day services help to prevent social isolation, reduce possible hospital admissions and support early discharge from acute settings. The integrated social day care service will provide clients with opportunities to engage with their peers while participating in social activities. The HSE is seeking funding through the 2019 Estimates process to progress this plan and I will be very supportive of it.

Frank Feighan (Fine Gael)
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I thank the Minister of State for his, as always, considered contribution. I welcome the fact that integrated social day-care services are planned and I hope the HSE will get the funding through the Estimates in 2019. We should support anything that prevents social isolation, reduces possible hospital admissions and supports the early discharge from acute settings. There is a very elderly community in Ballinamore and it should get priority funding and attention.

The fact that 4,500 additional short-term and long-term beds will be required throughout the public system in community nursing homes and other step-down facilities was identified by the health capacity review. There is no better place to increase the number of beds than Ballinamore. The 65 beds in St. Patrick's Hospital in Carrick-on-Shannon and the 36 beds in Arus Carolan in Mohill are very welcome. Providing an extra 20 beds in Ballinamore would bring it on par with Mohill. It is not that one is competing with the other, but that these beds are needed in the south Leitrim area. I know the Minister of State will look favourably on providing these extra beds for Ballinamore, and I hope he does so.

Finian McGrath (Dublin Bay North, Independent)
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I thank Senator Feighan for his comments. I also welcome the fact that he welcomes the integrated care plan. With regard to the Estimates, it is very important that we are all very supportive.

The Minister and the HSE recognise that services provided at Ballinamore are a vital element in helping people to stay in their communities and homes. These services assist people who do not require emergency department hospital admission to be discharged as early as possible from acute care back to their communities. The level of funding available from the Department of Health in 2019 and the quantum of service to be provided by the HSE will be considered as part of the national estimate budgetary process and the national service planning.

The Minister of State, Deputy Jim Daly, would wish to acknowledge Senator Feighan's continued commitment on behalf of the community to improve services in the area. When we listen to this debate and see the work has started, there is a genuine issue with regard to Ballinamore. I commend the commitment of Senator Feighan to Ballinamore. There should be an increase in the number of beds. It is a genuine request from the Senator and it is very important that I bring this message back to the Minister of State. I will bring back all of the issues the Senator has raised with regard to the wonderful service in Ballinamore. We should develop it as part of the national plan. There is a genuine issue because, of course, we recognise the valuable work done for many of our senior citizens.