Vol. 459 No. 3
17 Mrs. Geoghegan-Quinn asked the Minister for Health if he will provide additional funding to the hospice movement in view of the excellent work carried out by this movement; the studies, if any, he is currently undertaking regarding the way in which the work of the hospice can be fully integrated into the health services; and if he will make a statement on the matter. [18150/95]
, Limerick East): I am aware of the very important contribution of the hospice movement in the provision of in-patient and home care for the terminally ill. The health strategy document, “Shaping a Healthier Future”, Acknowledges the important role that palliative care services in general, and the hospice movement in particular, play in the delivery of services and improvement of the quality of life of terminally ill patients. It is my intention to promote the continued development of such services. Indeed, I was pleased in the current year to provide direct funding in excess of £500,000 towards the development of new services in this sector. In addition the local health boards are continuing to support the delivery of services by the hospice movement on a regional basis.
A major focus of the hospice movement is the provision of services to cancer patients. On taking office, I set as a priority, the development of services to combat cancer. Accordingly, I have established a review group to examine the existing cancer service infrastructure and to prepare a policy statement on the development of services. This group's work will include a review of the role played by palliative care services and the hospice movement throughout the country in respect of cancer patients and set out recommendations for their future development as part of an integrated service to cancer patients. When the proposals of the review group are to hand, I will be in a position to decide on priority areas for development within the palliative care service and hospice movement as a whole.
As the Minister knows, I welcomed his commitment to prioritise services for cancer patients while Minister for Health and I support all his efforts. I welcome the review group because we need to set out clearly where we are going. Does the Minister intend on receiving a report from the group, to create a permanent national co-ordinating body which would draw up and continually review and update guidelines and recommendations on the development of palliative care nationally, including in-care, home care and day care?
(Limerick East): When the report is complete, I intend to study it and formulate proposals which I will take to Government. Depending on the amount of money available to me in the 1996 Estimates, I will draw up a programme for the implemenation of the report. I addressed the annual meeting of the Irish Association for Palliative Care on 24 November. It acts as a co-ordinating voluntary group and has a good relationship with my Department. I intend to continue to allow that voluntary group act as a co-ordinator with the full support of the Department.
Would the Minister accept that funding for the hospice movement generally is haphazard in that it does not appear to be equitable or regionally based? Would the Minister accept that it would be much better if his Department, in conjunction with the health boards, worked out a policy whereby the essential services of the hospice movement and palliative care would be dealt with on an equitable basis to ensure the proper functioning of hospice care facilities throughout the country?
(Limerick East): As the Deputy is aware the hospice movement is driven by voluntary groups in different parts of the country who come together in a loose alliance to share information. Because it is driven by the strength of voluntary groups in certain parts of the country, it is not possible to have an even regional distribution. The Department and the health boards match funds to back up the voluntary effort. However, I am aware of the need and demand for palliative care; its availability is part of the health strategy. I hope I will be in a position to refine policy on the area as soon as the report of the review group on cancer services comes to hand and ensure that palliative care facilities are directed towards people who are terminally ill with cancer.
I accept that the health boards have been trying to match the funding provided by local voluntary groups in each of the hospice areas. However, the Minister must accept that there seem to be huge inequities in the system of providing finance to hospices. A number of hospices have raised huge amounts of money through voluntary work — this is sometimes in the region of millions of pounds — and little or no money had been provided by the Department of Health through the health boards. Would the Minister support the establishment of regional planning committees, involving the health boards, the voluntary agencies and the professionals involved in medical, nursing or other health care in hospices, to facilitate the removal of this inequity?
(Limerick East): The hospice movement developed more quickly in some parts of the country than in others. This was not due to Government policy operating on an unequal basis but rather the strength of voluntary organisations in places. I would have no objection to any health board setting up co-ordinating committees along the lines the Deputy suggested. It is a good idea for health boards to have strong relationships with local voluntary organisations. It is part of the health strategy that the direct funding arrangement that the Department of Health has with both the voluntary hospitals and the voluntary organisations would be devolved to the health boards. The new relationships would be between the voluntary agencies, voluntary hospitals and the health boards rather than with the Department of Health. The Deputy's suggestion is in line with Government policy.
Does the Minister have a fundamental objection to the Department of Health being involved in equitable distribution of funding, via the health boards in each area, to each of the hospices?
(Limerick East): No, obviously I do not have any objection to equity. However, the direction in which the health service is moving means that the health boards will have far more discretion over the allocation of resources paid to them by way of block grant. The manner in which we grant aid to health boards will be equitable but, within their area of responsibility, the health boards will have to make the decisions on funding.
