asked the Minister for Health if he will outline the main developments in community care over the last five years; and in particular, the financial allocations for this area.
Written Answers. - Community Care.
126.
The main developments during the period in question were as follows:
(a) In regard to psychiatric services the policy has been to bring about a change from a largely institutional based service to a service based in the community, as outlined in Planning for the Future which was published in 1984. There has been a continuous reduction in the number of in-patients in psychiatric hospitals and at the end of 1988 this number stood at 8,600. This has corresponded with the development of alternative community based facilities such as day hospitals, day centres and hostels. On 31 December 1987, the latest date in respect of which figures are available, there were 204 hostels in place with some 1,300 places together with 17 day hospitals and 46 day centres with approximately 1,300 attenders.
(b) A similar emphasis has been placed on the development of community based services for the mentally handicapped during the period.
(c) The development of a network of health centres throughout the country has been continuing and during the past five years more than 40 new premises have been completed.
(d) Day care services for children have been an important support measure for families under stress. The number of places available for children in centres assisted by health boards has risen considerably in recent years. There are now over 6,000 children attending centres funded by health boards, at an annual cost of over £1 million. The reported incidence of child abuse has risen in recent years. The Department published a new set of child abuse guidelines in 1987 which set out in considerable detail the recommended procedures for the reporting, recording, investigation and management of suspected cases of child abuse, including child sexual abuse. Special funds were allocated in 1987 to provide units in Dublin at Temple Street and Our Lady's Hospital, Crumlin, for the assessment and investigation of alleged cases of child sexual abuse. Additional funds in the region of £0.5 million were made available last year from the national lottery to enable the health boards outside of Dublin to provide similar services at local level.
(e) On the preventive side, the measles immunisation programme ran from October 1985 to October 1988 when it was replaced by the measles, mumps and rubella immunisation programme which commenced in October 1988. A range of measures designed to combat the spread of AIDS in the community has been put in place.
(f) Protracted negotiations have taken place in relation to the operation of the General Medical Service. A new method of payment for doctors has now been agreed, thus establishing a sound basis for the development of general practice in meeting the health needs of the population.
(g) The report of the working party on services for the elderly was published in October 1988. This provides a blueprint for the development of services for the elderly in future years.
Revenue expenditure for the Health Vote on community services is as follows:—
|
£m |
|
|
1985 |
284.2 |
|
1986 |
305.7 |
|
1987 |
316.2 |
|
1988 |
328.4 (estimated) |
|
1989 |
335.0 (estimated) |
In addition, approximately £6 million was allocated from the national lottery surplus in 1987-1988, and further funds will be allocated in 1989, to support a wide range of community based activities, including community based facilities for the physically and mentally handicapped; community based accommodation for the elderly; psychiatric hostels and mental health centres; community information and development services; and improved services for the assessment of alleged cases of child sexual abuse.