Richard Bruton
Question:12 Mr. R. Bruton asked the Minister for Health whether a specialist consultant will be appointed to the north side of Dublin before the end of February 1991 to deal with the problem of AIDS.
Ceisteanna — Questions. Oral Answers. - AIDS Policy.
Charles Flanagan
Question:32 Mr. Flanagan asked the Minister for Health if he will outline the planned growth of services to deal with the rapid growth in health care needs of patients suffering from AIDS; the extra allocation of funds he is making in 1991 to finance these extra services; and if he will make a statement on the matter.
I propose to take Questions Nos. 12 and 32 together.
I would refer the Deputies to the address I made to the House on 27 and 28 November 1990 — Official Report columns 220 to 549. As I indicated on that occasion, the AIDS strategy and services are being monitored, adapted and developed in line with the changing epidemiology of the disease and the services requirements which this imposes. In this context, services for AIDS/HIV are being developed immediately in the following areas. A significant proportion of HIV infection is initially diagnosed at STD clinics and in that context the appointment of a consultant in genito urinary medicine for the north side of Dublin was agreed by my Department in December 1990. Early approval of the post by Comhairle na nOspidéal is awaited.
In addition, a GP based project in the Dublin area, with the necessary support services to enable persons with the infection to be treated at community-primary care level, is being developed. This project will have a research component which will assist in the development of a protocol for a fuller involvement of GPs in the services than heretofore. A further imminent development in the AIDS services is the provision of a community-based walk-in centre facility for persons with HIV/AIDS to serve the north side of Dublin.
The Deputies can be assured that the funding necessary for maintaining and expanding services for AIDS/HIV will continue to be made available.
Will the Minister agree that it is very unsatisfactory not to have a proper planning of a service when it is known that there is a doubling of patients every 15 months? Will he also agree that it is unsatisfactory that voluntary funding has to be called in to provide staff in some of the existing facilities? The Minister has approved the appointment of a further consultant. What is the delay in the consultant taking up the appointment?
I do not accept that there is no planning in relation to AIDS. However, the Deputy will appreciate that the picture relating to AIDS has changed considerably over the last nine years since it was firsty diagnosed. For example, the numbers were doubling every six, seven or eight months but now, as the Deputy rightly pointed out, they are doubling every 15 or 16 months. There has also been a small shift to the heterosexual population which was not evident in the early years in western countries. We maintain the closest possible contact with our European partners and the World Health Orgainsation and every thing that we do is in line — and abreast of — what is being done in all other developed countries. On the question of the appointment of a consultant to the north side of the city, when we approve an appointment it is then a matter for Comhairle na nOspidéal who have statutory responsibility to approve it. We cannot appoint a consultant over their head as they have the statutory responsibility.
Will the Minister state whether there is a liaison between the voluntary bodies working with AIDS victims and the various health boards? If not, will he agree that there should be such a liaison?
Not alone is there a liaison with a number of voluntary bodies but a number of them are funded by money from the national lottery.
Will the Minister agree that there is now a need for an AIDS forum group in each of the health board areas which would draw people from the professionals and other voluntary agencies so that, at local level, there could be effective planning?
We have recently written to the health boards pointing out how we see the service developing for people with AIDS. I referred earlier to the changing picture of AIDS, it is now becoming a chronic disease with which people live, whereas formerly it was a fatal illness. We see the need to build up our community services and AIDS should be treated in the community as far as possible in the same way as other illnesses. This is the humane way to approach it from the point of view of the patient and it also makes good sense in terms of the delivery of health services.