Vol. 670 No. 4
67 Deputy James Reilly asked the Minister for Health and Children the way she can justify spending €78 million on a computer system to replace the PPARs computer system; the way she will guarantee that spending on this system will be controlled; and if she will make a statement on the matter. [45858/08]
There is no proposal to spend €78 million on a computer system to replace PPARs. The Deputy may, however, be referring to a draft business plan for financial and procurement systems received by my Department in September of this year. This included proposed capital costs of just under €78 million.
The draft business plan has since been discussed with the HSE and revised proposals involving lower investment levels are being developed by the HSE.
Notwithstanding the fine print around the €78 million, at a time when we cannot afford vaccines for children, will the Minister outline to the House how she proposes to ensure this does not end up being another fiasco like PPARs? It is extraordinary this issue is only now being dealt with given the Minister has held this portfolio for the past four years.
The HSE report was today leaked on the airwaves. I want to know why it was not laid before this House given it deals with issues that affect every man, woman and child. This is the proper place for that report to be released, not on the national airwaves. I remind the Minister of the failed launch, on three occasions at a cost of €2 million, of the HSE Portal website, which is now merely a myth.
Will the Minister comment on the remarks of her financial comptroller on the 1 o'clock news today that the HSE over-performed last year? How does she propose to sell this to the relatives of Graham Dempsey from Cork, who has been left on a trolley for 30 hours and whose nappy is being changed in public view; to the family of Beverly Seville-Doyle who died in accident and emergency at the Mater Hospital; to the family of 77 year old Peg McEntee who was left for three days on a trolley; to the lady in Cork left on a trolley for 48 hours whose oxygen ran out; or to a patient of mine who as late as last month was left on a trolley for 48 hours?
It beggars belief that we can have statements to this effect. I wonder how the Minister intends to reassure the public given the 400-bed reduction last year, the proposed cut of 600 beds this year, the fact that 750 beds are being blocked by patients needing discharge but who have nowhere to go and the review of eight accident and emergency departments in Dublin with a view to reducing them to four. Today, there are 390 people lying on trolleys at hospitals around the country, which is a disgrace.
Let Cinderella at it.
I laid the HSE service plan before the Oireachtas last week, as I am required to do by law. There is no question of the HSE plan being leaked. It was laid before the Oireachtas on 10 December 2008.
On technology, the famous PPARs initiated in 1995 by six health boards does not meet the requirements of a unified service. One of the difficulties with it was that it was not "specked" appropriately initially and the anticipated cost was not correct. Notwithstanding the experience with PPARs, we must not be frightened or run away from the need to invest in information communications technology within our health system.
The HSE spends €8 billion annually on pay and employs 70,000 people. Technology will be enormously beneficial in our ensuring we have in place an appropriate information and financial control mechanism. Any of the health systems which I have had an opportunity to view, and all of the Ministers with whom I have engaged, who have invested heavily in technology have reported huge efficiencies as a result.
Notwithstanding the inadequacies of PPARs, it did throw up the fact that there were more than 1,000 variations in work practices among those people covered by it. That is a fact.
At a cost of €180 million to the Exchequer.
Please allow the Minister to continue. I will call the Deputy again if possible.
As I stated, PPARs was initiated by a number of health boards in 1995 following the publication of the health strategy in 1994. It was felt by a number of health boards, including some hospitals, that we needed to invest in a payroll system. That payroll system, which later became known as PPARs, and which is currently operating in a large number of places, has brought to light many deficiencies, inadequacies and variations in work practices. Technology is important if we are to drive greater efficiency in the interest of patient care. I do not want the Deputy or anybody else to think we can operate a modern health service without investing considerably in technology.
The HSE is currently recruiting a director of ICT. Interviews in this regard are currently under way. This is important. There are new systems in place, involving the Departments of Health and Children and Finance, in respect of projects of this kind which require central approval.
The Minister said she laid the budget plan for the HSE before the House last Thursday yet, I have not seen it.
The service plan.
Where is it?
The Deputy can get a copy of it in the Library.
Should people not be advised of its availability?
I am not aware of the procedure in that regard. However, I did what I am required to do. It is a matter for the HSE to publish its plan.
All documents laid before the House are listed on the Order Paper published daily.
Perhaps the Minister will answer the following question. Some €180 million was spent on PPARs. We all accept there is need for modernisation of our information technology. The Minister continually speaks of value for money. How will she ensure we receive value for money this time and that we will not be faced with another fiasco, as happened on previous occasions? The Minister has held this portfolio for the past four years. It is hardly this morning she woke up and discovered this problem. If so, were she chief executive officer of any other organisation or corporate body, she would not be permitted to retain her position.
I have confidence in the chief executive officer of the HSE and its board. The famous PPARs was "specked" and procured under the old model delivered by health boards. It was not an appropriate model. What was "specked" at the time was completely inadequate for the task at hand, which is the reality. We know that. Clearly, we must learn from that experience because at the end of the day that was taxpayers' money, whether spent by a unified organisation or by individual health boards. Considerable progress has been made by the Health Service Executive with the assistance of expertise in respect of its information communication technology requirements. They are currently in discussion with my Department and the Department of Finance in regard to investment in this area during 2009.
68 Deputy Jan O’Sullivan asked the Minister for Health and Children her views on the number of people who spend long hours on trolleys in hospital accident and emergency departments; the action she will take to relieve the situation this winter; if she will introduce some measure to provide alternative care for the 700 plus people who are ready for discharge but who have nowhere to go; and if she will make a statement on the matter. [45563/08]
The HSE has made considerable progress in improving the delivery of services in emergency departments. The vast majority of hospitals are now fully or substantially compliant with the 12-hour target for those requiring admission. The Health Service Executive introduced this target in October last year. Patient waits of longer than 24 hours, following a decision to admit, have been totally eliminated in 21 of the 34 hospitals concerned, while a further eight have infrequent waits of that duration. The HSE will continue to work closely with all hospitals to maintain their improvements and to address the remaining problems, which are largely confined to a small number of hospitals.
I have also asked the HSE to set a revised maximum waiting time target of no more than six hours from registration to admission or discharge in 2009 for all patients attending emergency departments and to introduce a measurement system in 2009 to record the total waiting time for all such patients. The HSE has committed to introducing those measures in its 2009 national service plan.
By the end of this year, 279 additional long-stay beds will have been made available to patients under the fast-track initiative. A further 503 new long-stay beds will be provided under the initiative next year. In addition, in early 2009, the HSE will provide 245 additional contract beds to alleviate delayed discharges pressure on the acute hospital system.
During 2009, the HSE will review the existing arrangements whereby 11 hospitals in Dublin and three in Cork operate emergency departments 24 hours a day, seven days a week. The review will consider whether it is necessary to maintain full emergency department services in each hospital beyond the peak hours of operation and whether that represents the best use of resources. The HSE will also continue the work which is under way in reviewing the configuration of hospital services, including emergency department services, in the north east, mid-west and southern regions. That will include a review of the operation of emergency department services in hospitals with low volumes of activity in order to ensure that such services are configured in a way that optimises clinical outcomes for patients.
The Minister has laid the HSE's plan before the House and it is on the Order Paper today. I find it extraordinary that it is not properly and publicly announced by the HSE or the Minister and that it is sneaked in on the list without any information to the public. It seems to me that is much of the problem with the health service currently.
In the plan the Minister intends to cut more than €500 million from the HSE's spending budget. Can she give a guarantee to the public that front-line services will be maintained in that context? Accident and emergency services are due to close down at various times in Dublin, Cork and other parts of the country. Given that yesterday, 339 patients were on hospital trolleys and, as Deputy Reilly indicated, even more patients are on trolleys today, how will accident and emergency services be provided when the problem has reached that level already? People on trolleys are unable to access acute hospital beds while other people occupy beds who could be cared for in the community. If services are to be cut next year with fewer hours of accident and emergency services available, how will it be possible to maintain services at their current level let alone improve the situation?
Deputy Jan O'Sullivan is familiar with the proposals tabled by the HSE to the various employee representatives. She was well briefed prior to the previous attendance of Professor Drumm at the Dáil committee. Essentially, the HSE has tabled a number of proposals requiring greater flexibility. We want to treat more patients next year on a day-case basis, in line with best practice not only in Ireland but internationally. Clearly, to do that we require changes in how people work. We need to reduce in particular the level of dependence on overtime by many staff in the health service and having people in hospital at weekends when they should be discharged.
The new consultant contract will be a key to the reform of how hospitals operate because for the first time consultants will work as part of teams with a clinical director, working days will be longer, structured cover will be in place at weekends and seven-day discharges will be introduced. All of those elements are important in order to ensure we optimise the use of the acute hospital system. However, I have made clear that there will be challenges next year.
Specifically in relation to A&E, we have three children's accident and emergency units open in this city 24/7. It is expensive to staff accident and emergency departments 24/7, but during the night I think it is something in the region of 20 visits is the average attendance, between the three units, between the hours of 8 p.m. and 8 a.m. It would be in all our interests if we can reorganise our services better during those night-time hours.
Many of the attendances at accident and emergency units are not strictly accident and emergency cases and could and should be dealt with at primary care level. As Professor Drumm indicated at the committee, the hope is that more activity will be switched to the level of primary, community care rather than the focus being constantly on hospital attendance.
With due respect to the Minister, we cannot live on hope. It is a fact that people present themselves at accident and emergency units. What exactly will change? When people present at accident and emergency units they require treatment or to be dealt with in some fashion. If accident and emergency service hours are being cut back in some hospitals, how will they cope with the numbers of people presenting? The numbers of people presenting next year will not be reduced next year because the Minister has decided she would like them to. What exactly will happen?
It is a fact that in many hospitals in this city we have more staff than attendances on a daily basis at accident and emergency units. In some hospitals the ratio is 1:1. No health system in the world of which I am aware can sustain that ratio of staff level to patient care. In the context of next year——
That is not the reality we are hearing about.
Separate issues arise that relate to safety, who is on-call, and volumes of activity that are being dealt with in the context of the mid-west and the north east. The reality is that patient safety issues arise in those places where there is a low level of throughput. I can supply the Deputy with the figures for each of the hospitals in Dublin on a daily basis. I can show her that in some cases we have more staff than patients. If we can reorganise accident and emergency opening hours, especially late at night and during the night, in consultation with staff representatives, which is the intention, in the first half of next year, we can deliver better patient care in a more cost-effective fashion and we can allow more of the elective activity to proceed that has to be cancelled due to the pressure on accident and emergency departments in those hospitals that might not be on-call during the night-time hours.
69 Deputy James Reilly asked the Minister for Health and Children if her attention has been drawn to the fact that 400 children with disabilities in residential care are not protected by an inspectorate and that those children are three to seven times more likely to suffer abuse; the immediate action she will take to address same; and if she will make a statement on the matter. [45859/08]
Children with disabilities who require residential care may be accommodated, depending on their needs, in generic residential centres, under the Child Care Act 1991 or in specialist residential services for children with disabilities.
A total of 400 children are accommodated in generic children's residential centres, under the Child Care Act 1991. Those include some children with disabilities whose needs for residential care arise out of the responsibilities of the HSE under the Child Care Act rather than because of their disability. The centres are subject to statutory inspection. The Office of the Chief Inspector of Social Services in the Health Information and Quality Authority has responsibility for this function.
The statutory framework which underpins this work is laid out in the Child Care (Placement in Residential Care) Regulations 1995. In addition, national standards for children's residential centres, set down in 2001, have been in operation and are based on the requirements of legislation, regulation and findings from research. The standards allow inspectors to form judgments about the quality of services provided in those centres. Areas covered by standards include child protection and children's rights. Currently, 227 children are placed in specialist residential centres for children of which 200 children have an intellectual disability and 27 children have a physical and sensory disability.
All services for children with disabilities are covered by the national guidelines for the protection and welfare of children, Children First, published by the Department of Health and Children. Residential centres for children with disabilities are required to ensure that there are appropriate policies and procedures in place for the identification, reporting and management of any concerns in regard to abuse of children in those centres.
In November 2007, the HSE prepared a guidance document that sets out the standards expected from all residential service providers for children with disabilities who are not placed in such settings under the Child Care Act 1991.
Additional information not given on the floor of the House.
The guidance document was prepared by a working group, comprising HSE staff, including an inspector of residential services, service providers and the National Disability Authority. The guidance document is currently being operated on a non-statutory basis.
The HSE is currently finalising a framework for the protection of all vulnerable service users, including children. This framework will include a revised definition of abuse along with standards and guidelines to ensure protection of all vulnerable service users, including children with disabilities. The proposed framework will be completed in February 2009.
The Health Information and Quality Authority which was established in May 2007, has responsibility for the development and monitoring of standards. HIQA has recently undertaken a public consultation on draft national quality standards with regard to residential settings for people with disabilities and is now in the process of finalising the standards and plan to submit them to the HIQA board in early 2009. These standards are intended for adults. HIQA has also developed a set of standards for children which has been circulated, for comment, to its national advisory committee on standards. It is expected the children's standards will be finalised in the new year.
In deference to my Labour Party colleague, Deputy Jan O'Sullivan, I did not wish to encroach on her time but the Minister just made an extraordinary statement. She has told this House that between 8 p.m. and 8 a.m. there are only 20 attendances at the accident and emergency departments of the three children's hospitals in this city. I find that very difficult to believe. I would like to see an input into this from the people who are working in those accident and emergency departments. Before I address the question, however, I want to say that cutting down on accident and emergency departments seems the most cynical move yet to reduce the numbers on trolleys. There will not be room for the trolleys in the four accident and emergency departments that are left. It is outrageous.
The Deputy may address a supplementary on the question that is tabled.
Turning to the Minister of State's response, the bottom line is that there are 400 children who remain in institutions that are not subject to any inspection. The Minister of State has been asked when this glaring deficit will be corrected because, statistically, these children are three to seven times more likely to suffer abuse, given the nature of their disabilities and their inability to report. I again ask the Minister of State when HIQA standards will be brought in and it is empowered to inspect and protect these children. We have a duty to them because they are the most vulnerable children in our society. The standards need to be introduced as soon as possible. If we can stay here all night and pass laws in relation to banks and guillotine health Bills to take the medical card off the over-70s, surely we can address this issue before Christmas and ensure the safety of these children.
I do not believe there is any need for the Deputy to raise the medical card issue again; the House knows his position on that matter. He should not rehearse all that again, since he changes his position so often. My position is very definite. I am making the very direct response to the effect that he should have known this because he attended the committee meeting recently at which HIQA representatives were present. They made it quite clear that while they are prepared to carry out the inspections, they are waiting on funding from this Department. The Department, in turn, is working with HIQA to ensure that the initiative will start some time towards the middle of next year.
It is mañana again.
No, it is not mañana, but it is a stance I have adopted and will maintain. I will not change my mind next Sunday, having said something else in the newspaper last Sunday.
The Minister of State's problem is——
We will not have a shouting match. Neither the Deputy nor the Minister of State will ignore the Chair. We will not have a screaming match in our national Parliament.
I apologise to the Leas-Cheann Comhairle. The Deputy finds it difficult to be reminded of things that happened six months ago. He prefers to concentrate on matters that might occur ten years hence.
Could I attempt, without interruption if at all possible, to avoid a balling match and just make the point that HIQA was quite properly set up by the Minister for Health and Children, recognising as she did the need for a quality authority, for which she has to be complimented? She made the position quite clear to HIQA regarding the standards that were to be brought in, first of all, for the elderly. Our priority now is to ensure that the people in such homes are properly supervised. That commitment is alive and well and will not be changed by an interview in some paper in six months' time.
I remind the Minister of State that we already have reports of abuse of children in these circumstances with the Brothers of Charity. We had those reports before the meeting of the health committee. This is his area of responsibility. I want him to show the same enthusiasm that he and his Government have for guillotining Bills to institute cuts and apply that enthusiasm and energy towards ensuring that these children are protected through law.
If we were dealing with people who have the patient in mind in every aspect of health and were not promoting certain disciplines, to get a greater slice of the health cake, we might be able to do things much quicker. I refer to Deputy Reilly's position.
I am talking about children who are being abused.
I did not ask for your usual ignorant interruptions, Deputy, if you do not mind.
We are talking about children who suffer——
Am I responding to Deputy Shatter? Did you ask a question on this issue?
——and the Minister of State has a duty to protect them.
If Deputy Shatter will "excuse me, sir", as you are often quoted as saying, could I please have the right to respond?
I ask the Minister of State to speak through the Chair.
The Minister and I have a plan which it is intended to implement next year. These are not mere words about future intentions, but rather a statement of support for my senior Minister who set up this authority in the first place.
70 Deputy James Reilly asked the Minister for Health and Children her views on the financial impact the new private health insurance levy has had on health insurance premiums; if the recently announced price increases will force many young people and families out of the market due to the fact that health insurance has become unaffordable; when she expects to receive the EU Commission decision on the new levy; and if she will make a statement on the matter. [45860/08]
In reply to a priority question from Deputy Reilly on 25 November, I said that the measures announced by the Government the previous week should not, in themselves, lead to an overall increase in the €1.5 billion in private health insurance premiums paid by all health insurance customers as the new levy on health insurance companies will yield approximately the same amount as the enhanced tax relief for those aged over 50. However, I emphasised that it would be a commercial decision for individual health insurance companies as to how they chose to reflect the overall impact of the measures in setting their premiums. Since I last answered questions on this matter, Quinn Healthcare and the VHI have announced price increases for customers taking out or renewing policies from 1 January 2009. Quinn Healthcare is increasing prices by an average of 16%, VHI's increases average 23%, while Hibernian Healthcare has not announced any increase to date.
It is a matter for the individual companies to explain and justify the levels of the increases they are introducing. I do not believe the measures announced by the Government have had any significant impact on these decisions. There are several underlying cost pressures in private health insurance, including medical inflation, the ageing of the insured population, increased numbers of procedures and greater economic pricing of public hospital services to insurers.
I hope that young people and families do not leave the market. Health insurance cover in Ireland represents good value for all age groups. The Government will bring forward the lifetime community rating regulations for enactment in 2009. These will provide a powerful incentive for people to take out insurance cover earlier in life and to retain it. Anyone inclined to cancel their insurance now should consider carefully that they may have to pay a higher premium to re-enter the market at a later date. In introducing the measures announced on 19 November, the Government had to choose between allowing older people to be forced out of the market and trying to maintain the key principle of intergenerational solidarity whereby the young support the old.
I expect to have a response early in the new year to our notification of the measures to the Commission.
The Minister claims that if she did not take action, VHI premiums would increase by 60% for older people. This could not happen because we have community rating. It would have to increase by 60% for everybody. She claimed that the levy would not lead to any overall increase in the approximately €1.5 billion in private health insurance premiums paid, but she was wrong because VHI premiums have increased by 23% and Quinn Healthcare increased premiums by 16%, while stating baldly that 50% of that rise was accounted for by the levy. She claimed that certain insurers were tailoring their plans to suit younger people. So did the VHI, which has dominance in the 20, 30, 40 and 50 year old age group sectors — as well as in the 60, 70 and 80 age groups. It dominates the market.
When will the Minister bring the legislation before the House? What will she do about the dominance of the VHI in the marketplace? Will the money raised by the levy be ring-fenced to health insurance, or will it go into the Exchequer — that is a later question, but it may be taken now? Is the Minister not concerned about the estimated 200,000 people who are expected to leave private health insurance on foot of the introduction of the health insurance levy?
The market was segmenting. Citizens could see that some plans were geared to couples in their child bearing years, where maternity benefits were being offered and sports injuries were being included as well as teeth whitening. These products are not of interest to older people, so within a specific plan everybody will have to pay the same rate. However, the manner in which different products were being covered was leading to market segmentation.
This is not about protecting any company, but rather older people. The revenue implications of this are neutral. The money coming in will go back in the form of enhanced tax relief for those aged 50 and over. Obviously, it will be higher for those aged 60 to 70 and higher again for people older than that. The reality is that if one company has 320 times more 80 year olds than another, we know that health insurance costs associated with an 80 year old are twice those for a 40 year old — or a 60 year old will cost twice, on average, what a 30 year old costs. There is no getting away from that.
I do not believe the Government, in the light of the Supreme Court decision, had any alternative but to advance what we have advanced. It requires EU approval and I made it clear there would be no point in bringing the legislation before the House if we have either to change it or cannot proceed with it. As soon as there is a response from the EU, which we expect early in the new year, the intention is to bring the legislation forward if we are in a position to do so.
Many people would reject the Minister's assertion to the effect that she had no option other than to introduce the levy system. The VHI has considerable funds, made a considerable profit of €112 million last year and has raised its premia by 23%. Why was the legislative route offered by the courts not taken, which obviously left the door open for the Minister to bring in new legislation that would introduce a new form of risk equalisation? In the past, I have raised concerns about the level at which risk equalisation was set, given the dominance of the VHI in the market and the fact that with its huge database it no longer has any restriction on it from going into any market. Is this fattening the calf for sale?
The market here was liberalised in the mid 1990s and perhaps other decisions could have been made then, but they were not. At the time, some 37% of the population had health insurance and everybody thought we were at market saturation level. However, some 53% of people now have health insurance.
The VHI is required to be authorised during 2009 and must meet the same requirements as its competitors in terms of the reserves required. It will be a major challenge for the VHI to meet the requirements to allow it be authorised on the same basis. It is important that better consumer information is provided. The VHI, like other health insurers, is now required to send out renewal notices to consumers 30 days in advance of renewal and to notify them that they can switch insurers without penalty. Many members of health insurance companies do not know that. The provision of such information on motor insurance was very powerful in encouraging people to switch insurers. Any measures we can introduce to better inform consumers and encourage them to look at the different options, including the products offered by other companies, will be forthcoming from the start of next year.
With regard to the legislation, we will have it early in the new year when we get the response from the Commission.
Is the VHI for sale?
71 Deputy Alan Shatter asked the Minister for Health and Children the procedures in place in her Department to monitor, on an ongoing basis, the number of children who are the subject of reports to the Health Service Executive of either abuse or neglect and to monitor the timeframe involved in the commencement of an investigation and assessment of such reports; the progress reported to her in the implementation of the HSE National Service Plan 2008 which commits the HSE to collate reports on child care services in each administrative area; the number of notifications of child abuse or neglect to the HSE in respect of which there are children on waiting lists for full assessments; the average time spent on a waiting list for assessment following such notification; and the action she proposes to take to address the difficulties in this area and to ensure children are properly protected. [45581/08]
Since the inception of the Office of the Minister for Children and Youth Affairs, OMCYA, a key emphasis has been placed on improving the availability and quality of management information. Key components of this information management include the annual review of adequacy of children and family services, prepared annually by the HSE under section 8 of the Child Care Act 1991, and the monthly service plan monitoring reports submitted to the Department of Health and Children. The section 8 reports now include the data previously collected in the analysis of child care interim data set. The further development of this information strategy is set to continue with the completion and roll-out of the joint OMCYA-HSE knowledge management policy, which has been a key element of recent discussions between myself and senior management in the HSE.
As regards the specific areas of information mentioned by the Deputy, information currently available in this area of child welfare and protection is collated and submitted as part of the previously mentioned section 8 annual reviews. Owing to the need to put in place a new reporting structure and methodology to reflect the new unitary structure following the establishment of the HSE, reports in respect of 2005 and 2006 were delayed but have now been published. I am informed by the HSE that the 2007 report is nearing completion and that thereafter, reports will follow in a timely fashion. These annual reviews include, inter alia, details of reported child protection cases and outcomes, broken down into each of the four primary, community and continuing care, PCCC, regions. Under current systems in place in the HSE, there is a time lag in the availability of information requested by the Deputy. It is imperative that such information be available on demand and for this reason I have requested the HSE to prioritise the necessary development and implementation plans so as to have this information readily available for service delivery and monitoring purposes.
In addition to this annual report, the HSE National Service Plan 2008 committed the HSE to developing, from the second quarter of 2008, a mechanism for collecting quarterly information from each administrative area on the following indicators: the number of notifications made of child abuse or neglect, the number of assessments conducted following notifications, the number of children on waiting lists for assessments following notification of child abuse or neglect and the average time spent on a waiting list for assessment following notification of child abuse or neglect.
Reporting against this measure is based on the phased implementation of standardised business process currently taking place through the HSE's child care information system project. I have been informed by the HSE that the first of the standardised business processes required for reporting against these measures were agreed and piloted during 2008 and will be implemented during 2009. At a recent meeting with HSE managers I was also informed that the HSE is seeking to provide additional resources to the standardised business process project. This should enable the HSE to provide my office with timely information relating to all of the areas mentioned by the Deputy.
Will the Minister of State confirm that the information on which his Department relies for an overview of child protection services is, essentially, the information contained in the 2006 report, which was only published last October? Does he agree it is an understatement to say there is a time lag in information and that it is scandalously unacceptable that the report for 2007 has not yet been published, two and a half weeks before we enter 2009? Will the Minister of State confirm that as Minister with responsibility for children he does not know how many files are currently on the shelves of offices of the HSE, detailing reports of children at risk of abuse or neglect, due to be allocated for full assessment to a social worker but which have not yet been allocated? Will he confirm there are many hundreds of such cases?
Since I came into this office, the 2005 and 2006 figures have been received. I have also received information on the 2007 interim data set and the section 8 reports arising from it. I have a commitment from the HSE that it will have the information published before the end of this year, which means the next few days. Furthermore, the HSE has committed to having the 2008 figures by April or May of 2009. The time lag referred to in my earlier response is a legacy or carryover from the old health boards and the difficulty presented in gathering the information.
We are moving towards a knowledge management strategy so we can standardise issues such as referrals and so we can, at any time, provide ourselves with an X-ray of what is happening on a contemporaneous basis, rather than having to hang around to collate the figures as we have done for so long. Therefore, we are making incremental progress on the issue, but I do not claim it is perfect. We do not have the up-to-date figures I would like to have, but over the past six months I have met the HSE on a monthly basis. One of the key issues has been to get on top of this issue so that we will be able to make proper assessments of where gaps and duplications exist in order to apply resources properly in this important area.
Would the Minister of State agree that for the eleven and a half years of Fianna Fáil in Government we have had a Minister with responsibility for children? Would he agree it is outrageous and scandalous that four years after the formation of the HSE he, who is supposed to have an overview of our children's services, is as he put it hanging around to find out how it is operating and cannot tell the House definitively how many cases of children reported to be at risk are currently awaiting full assessment by the HSE? Does he agree he is incapable of monitoring what is happening in our child protection services?
Can the Minister of State explain what happened to the child protection notification system, which was supposed to have been put in place some years ago and in respect of which there were various IT difficulties? What was the cost of that system? What were the IT difficulties? What work has been done to get the system up and running. By what definite date will the Department have any guaranteed contemporaneous information available to it on the working of our child protection services?
I have information from the HSE service plan in terms of its monthly monitoring reports, the latest of which is for October 2008. Obviously, the information that comes with the section 8 reports is more detailed and focused on the specifics. With regard to the IT projects, we are making significant progress. There are different IT systems in different areas, again a legacy and hangover from the health boards.
A four-year legacy now.
We are making significant progress on this and hope, in the HSE service plan for 2009, to ensure it is a priority and that we can deliver it. With regard to contemporaneous delivery and when it will happen, we already piloted the standardisation of the business process and therefore we will know the initial referral figures and the assessment figures at the same time. We undertook to do that through the service plan.
I raise a point of order. I asked a specific question about the cost to this State of the child care notification system and the IT system——-
The Deputy knows that is not a point of order.
——that I understand is not working and has cost millions of euro.
The Deputy will not ignore the Chair.
I asked this today in a direct question and as a legitimate supplementary question. I previously asked the Minister of State about the matter in a written question some weeks ago and was told that he would inquire about it, that he did not know the answer. I believe there is a defective system——
This is not a point of order, as the Deputy knows. We must move on to other questions.
——that has cost the taxpayer millions of euro. Why is the Government covering this up?
I will take Question No. 72.
Why is the Government covering up what is taking place with regard to this system?
The Deputy has had a good innings.
Or does the Minister simply not know?
The Deputy will not continue to ignore the Chair.
The taxpayer is entitled to know. Child protection agencies are entitled to know why this system is not up and running and how much has been wasted. Public money has been wasted and the Government is covering it up.
The Deputy rose on a point of order that patently is not a point of order.
