St. Ita’s Palliative

Dail Eireann Adjournment Debate on Palliative Care and Hospice Unit at St. Ita’s Hospital, Newcastlewest 30th April 2009 – Introduced by Dan Neville TD.

Deputy Dan Neville

I welcome the opportunity to raise the issue of the palliative care and hospice support unit at St. Ita’s Hospital, Newcastlewest, County Limerick. I recognise the work of the Friends of St. Ita’s in promoting this necessary service in west Limerick. This group has been fund-raising for the provision of a palliative care and hospice unit for west Limerick for six years, since May 2003. As a result of that fund-raising, the group has contributed €1.225 million towards the capital cost of building, furnishing and equipping the unit, which has been put at a cost of around €3 million. In addition, Friends of St. Ita’s has agreed to contribute a further €120,000 towards the final cost, which will bring the overall voluntary contribution to €1.345 million, – almost half the capital cost of the unit. This could not have been done without the overwhelming support and generosity of the entire community of west Limerick and beyond. We also recognise that included in that is generous funding of €0.75 million from the McManus Pro-Am, which enabled the unit to be upgraded from a four-bed to an eight-bed unit.

This was a very much a community project from the outset, as the facility was seen as being much needed for the region and was expected to augment the service already being provided by Milford Care Centre, which is up to a 50 miles distance from the homes of some people in the catchment area. This, together with the cause itself, were factors that motivated the community considerably in the drive to have the unit built.

As one might expect, with that enormous commitment, good will and generosity on the part of the community, and the effort put in by Friends of St. Ita’s over time, came an understanding and expectation that the hospice unit would be opened once ready for use. The unit has been completed, as has the final stage of furnishing and fitting, and a temporary nurse manager has been appointed internally, while the permanent post, which had been sanctioned by the Minister for Health and Children, Deputy Mary Harney, has not been filled, nor has it been advertised. The purpose of this appointment is to prepare policies and procedures for staffing and the running of the unit.

The purpose of my raising this is to impress on the Minister the requirement, because of the response of the community, that the unit be opened.

There is great disappointment and annoyance that this has not been done. There is an unwillingness on the part of all concerned in this project to accept the delay in opening the unit beyond mid-2009. The contract for the unit went to tender in 2007, with a commitment that it would open in 2008. Now we are told it will not open in 2009.

As I said, Friends of St. Ita’s has raised close to €2 million to date which, in addition to funding for the hospice unit, has also facilitated other projects in St. Ita’s Hospital, including a day room and a patient minibus service. There has been wonderful generosity and support from all sections of the community. The least that community can expect is that its hard work and generosity will be reciprocated by the Health Service Executive. It must honour its commitment to staff and patients by opening the hospice unit, which is ready for use, without further delay.

Deputy Michael Finneran

I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I thank Deputy Dan Neville for raising it as it provides me with an opportunity to update the House and to outline the background to the current situation and the action taken by the Health Service Executive.

The executive has operational responsibility for the delivery of health and social services, including the new palliative care facility at St. Ita’s Hospital. The hospital was built in 1841 and has seen significant development in recent times. In 1974, a new unit of 110 beds was built, which transformed the scale of services provided. A new assessment and rehabilitation unit was opened in 1989 and a day hospital came on stream in 1990. In 2004, the Friends of St. Ita’s received lottery funding of €100,000 to provide support bed and day room facilities, and a further €80,000 was provided last year to develop a therapy garden.

The new palliative care unit was delivered under the Health Service Executive’s capital plan for 2006-2010. It is an eight-place facility, comprising four beds and four day places, with ancillary living, dining, activity and day care facilities. The equipping phase has commenced and the building will be in use by the end of the year as the community palliative care staff and the recently appointed clinical nurse manager will operate from it. The total capital cost of the facility is some €2.3 million, with Friends of St. Ita’s contributing more than €1.2 million. The associated revenue costs are approximately €1.5 million. A new ambulant dementia unit is also scheduled to come on stream on the site. Representatives of Friends of St Ita’s met with the Minister for Heath and Children in early March to discuss a range of issues, including bringing the new facility on stream.

The overall spend on palliative care by the Health Service Executive in 2008 was in the region of €78 million. This included new funding of €3 million provided last year to undertake various service developments. The executive was asked to prioritise palliative care service developments in the context of a framework over the next five years. The resulting action plan document, Palliative Care Services: Five-Year Development Framework 2009-2013, was recently submitted to the Department of Health and Children and is currently under consideration. This document details the actions and initiatives necessary to address the gaps in palliative care service provision, against the recommendations set out in the national advisory committee on palliative care 2001. The Health Service Executive’s four administrative areas, with the full participation of voluntary and statutory palliative care providers, has developed a set of key priorities for addressing gaps in service provision in the next five years.

The Deputy will appreciate that all developments are now contingent on current economic and budgetary pressures. The Health Service Executive has been asked to undertake a rigorous examination of how existing funding might be reconfigured or reallocated to ensure maximum service provision is achieved. The Government is clearly committed to the development of comprehensive palliative care services. As I have outlined to the House, the Department of Health and Children will continue to work with the Health Service Executive and the voluntary sector to advance this objective.