SOME COMMUNITY nursing units around the State are going to be closed down, Minister for Health James Reilly has said.

However, he told the Oireachtas Committee on Health and Children yesterday that no hospitals would be shut either as a result of budget cuts or the reconfiguration plans for the health service.

Dr Reilly said that a rationalisation of community nursing units – which are essentially publicly run long-stay facilities – was “inevitable”. He said that the community nursing unit system had been hit by three factors: a shortage of money; the moratorium on recruitment in the public service; and the standard of the different units.

Health Service Executive chief executive Cathal Magee said that of the 5,880 long-stay public beds in units around the State, only 30 per cent or about 2,000 beds met the required standards in terms of physical environment.

He said that some of the facilities were 100 years old.

Mr Magee said that a capital investment of between €600 million and €900 million would be required to bring the units up to the required standards. He said there were “significant challenges around the viability of units when you get below 50 beds”.

Mr Magee also pointed to the differences in costs between community nursing home facilities operated by the HSE and those run by the private sector.

He said that under the Fair Deal scheme the cost per patient per day in a private nursing home was €850 while in the public system the cost was €1,350-€1,400 and in some smaller facilities up to €1,800.

The Irish Daily Mail yesterday published an internal HSE list of 12 community nursing units which it said were facing possible closure or reduction in bed numbers. It said that 840 beds could be affected by the plan. Dr Reilly said that all community nursing units were under review including some that were not on the list published in the newspaper.

Mr Magee said he had not seen the published list nor had it been considered by health service management or the HSE board. He said no decisions had yet been taken.

Dr Reilly said there was “absolutely no doubt” the health service was facing into its most challenging year to date and it was possible the HSE would end the year with a €300 million deficit.

He said “demand-led schemes” such as the provision of new medical cards or drug payments would cost €160 million.

He said a 2 per cent rise in VAT would cost more than €50 million and the introduction of the European directive on agency workers – which means they have to be paid the same as full-time staff – would also present “huge costs”.

Dr Reilly said there were new sick pay arrangements in place but there was no additional money to deal with this. He said he would not talk about budgetary issues for next year which were still before Cabinet. However, he said that introducing a charge for medical card patients “was an area we would prefer not to be going to”.