Godfrey Timmins
Question:10 Mr. Timmins asked the Minister for Health whether sufficient facilities exist at sexual assault treatment units throughout the country; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Sexual Assault Treatment Unit.
Seán Barrett
Question:34 Mr. Barrett asked the Minister for Health if his attention has been drawn to the fact that a number of doctors at the Sexual Assault Unit at the Rotunda Hospital, Dublin 1, have tendered their resignation from the service; if he had prior knowledge of such an event; if he was advised of the consequences of such an event; if he approved of the situation culminating in what now appears to be the possible closure of the unit; if he intends to intervene at this stage with a view to confirmation in respect of the future of the unit; and if he will make a statement on the matter.
Frances Fitzgerald
Question:145 Ms F. Fitzgerald asked the Minister for Health if he has had discussions with the Rotunda Hospital in relation to the sexual assault treatment unit at the hospital; and, if so, the outcome of those discussions.
I propose to take Questions Nos. 10. 34 and 145 together.
In the Eastern Health Board area, the sexual assault treatment unit is at the Rotunda Hospital. The management of the sexual assault treatment unit is a matter for the Rotunda Hospital in the first instance. My Department has recently had discussions with the Rotunda Hospital on the early implementation of an agreed framework on the future development of the unit which is aimed at enhancing the level of service provided by the unit. In this context, the Master of the Rotunda Hospital is currently having discussions with the general practitioners associated with the unit. The threatened withdrawal of services has now been deferred and I am confident that issues raised by the general practitioners will be resolved to the satisfaction of all parties.
In other health board areas, immediate medical examination and treatment of victims of rape and sexual abuse are provided through either general practitioner or general hospital serices. Follow-up counselling is available through multi-disciplinary teams of health professionals from the health boards and from the voluntary rape crisis centres. The Deputy will be aware that earlier this year I announced an increase of over 77 per cent in funding in 1994 for rape crisis centres throughout the country. Some £458,000 was allocated compared with £258,500 in 1993.
Did the Minister consult with the staff working at the rape crisis centres before making the allocation? Did he consult with those involved in providing the service? Was he informed of the impending difficulties? Have the problems been addressed? My information is that they have not.
I had discussions with some rape crisis centres and I received submissions from others. Their views were taken into account in assessing the substantial increase in funding made available this year.
As regards the specifics of the Rotunda Hospital, I am not involved in the management of every unit in every hospital but my Department was in touch with the Master of the hospital who has responsibility in this matter. I have said I hope the outstanding issues can be resolved as I am anxious to enure that the facilities of the unit will continue to be made available.
Is there not a danger when the Minister delegates responsibility for the provision of services, such as the provision of a sexual assault unit and the provision of refuge accommodation, that there would be different levels of services? Does he agree that his Department should play a central role in formulating strategy in order to achieve uniformity of service? It would be on an ad hoc basis if left to individual health boards.
I do not agree with the Deputy. A central tenet of the national health strategy is that policy would be formulated by the new health boards. Health executives will carry out the policy against the backdrop of national policy determined by the Department and approved by the Oireachtas. It is impossible for a small policy driven unit to have a hands on approach to every unit. That was counter-productive in the past. The areas of health care are multifaceted and range from birth to death. We must have a supervisory role to ensure adequate provision of service throughout each health board area.
I do not disagree with the Minister but there is a problem with the sexual assault unit in the Rotunda. The number of doctors has reduced from 12 to four. Doctors on call there are paid £1.04 per hour. The doctors have threatened to withdraw their services, much against their inclination because it goes against the grain for any doctor to threaten to withdraw service. If the matter is not satisfactorily resolved by the doctors, staff and hospital, will the Minister intervene to ensure the service is continued at an appropriate level and that staffing levels are adequate to meet the unit's requirements?
The position has changed since the unit was established. Initially it looked after children. The review of the working group in 1987, on which the doctors were represented by Dr. Maura Woods, decided it was not an appropriate location for the treatment of victims of child sex abuse. Consequently two new child sexual abuse units were opened in Temple Street Hospital and Our Lady's Hospital in Crumlin. The workload has changed during that time and much of the counselling is now carried out by the rape crisis centres.
On the question of payment, it is important for me to allow the discussions between the hospital and staff to reach a conclusion and not to intervene in them. Approximately 260 persons attend the unit each year, approximately five per week, and of that number approximately 140 are acute cases, that is cases involving recent sexual assault or rape. The increase of 36 per cent for staff on call from Monday to Friday was rejected. I will give the Deputy the actual figures because sometimes percentages distort the picture. The proposed on-call fee from Monday to Friday is £34 per day while the proposed fee for weekends and bank holidays is £40, an increase of 33 per cent. The proposed initial call out fee is £34 and £17 for each subsequent visit. The discussions are ongoing and I hope a satisfactory conclusion can be arrived at.
The Minister seems to be suggesting that the need for the Rotunda unit is no longer as clear as it was. Does he recall his response to my Adjournment Debate matter on 30 March last when he suggested that this was the subject of some considerable exaggeration, outlandish claims etc., most of which have, unfortunately, come true in the meantime? Will he agree that I was right on that occasion and he was obviously wrong? Events have proved that I was correct. How does he propose to deal with the matter other than by hoping it will go away?
I have a copy of that debate and what I said was absolutely accurate.
What I said has proved to be true.
The dispute is about payment and I hope it can be resolved.
It is also about staffing.
Yes, and the structure of the unit. All these matters need to be dealt with. I am very supportive of the unit, which now provides a different mix of service. I have received observations from a variety of groups, including the Rape Crisis Centre, which is now included in the mix, on the best type of service. The staff have a genuine grievance. The rates of pay have not been increased for some years and this needs to be addressed. I have outlined my views on this matter to the hospital.
On the structure of the unit, I hope a resolution can be arrived at. The threat to withdraw services has been removed and the service is available. I hope that this matter will be resolved.
Why is the Minister so reluctant to intervene to ensure the continuation of this vital service in Dublin? His unwillingness to intervene in this dispute is most unlike him.
A hidden agenda.
This service is of critical importance. We are talking about penny pinching rates per hour. This service has to be continued and it is the Minister's responsibility to ensure that it is. We are not interested in hearing the reasons for his reluctance to intervene in this dispute; he is pussyfooting around the problem. He has responsibility in this area and I want him to give a clear commitment that he will intervene to ensure this service is continued.
As usual, the Deputy is able to face both ways at once on this and other issues.
That is nothing new for you lads over there.
She wants me to intervene while at the same time she wants subsidiarity and devolved authority. She wants more money to be spent and if money is not thrown at this matter immediately she says we are penny pinching.
The Minister, who presides over one of the largest spending Departments, is penny pinching on this matter.
The Minister without interruption, please.
At the same time she says I am a spendthrift Minister——
The Minister gave £100 million to the health boards.
——and when it comes to taxation matters we are a spendthrift Government. The Deputy should make up her mind. She cannot have it both ways.
The Minister is very profligate in other areas.
Does the Deputy support the increased funding for health services at every level, including the 77 per cent increase in money for the rape crisis centres this year and the tax burden required to fund that or does she want to face both ways at once on this issue?
This is a specific problem.
In regard to this specific matter, the Deputy wants me to intervene when the discussions are ongoing and there is no threat to the service.
There is a threat to the service.
This is bizarre.