Written Answers. - Health Services.
Bernard J. Durkan
Question:
89
Mr. Durkan
asked the
Minister for Health and Children
if he has examined in detail the delivery of health services with particular reference to the inability to meet requirements in respect of maternity needs, heart surgery, hip replacements, ear, nose and throat problems, orthodontics and general support services; if his attention has been drawn to the need to take dramatic action to address those issues of immediate and pressing concern to the general public.
[25685/01]
I am sure the Deputy is well aware that I am about to deliver a new health strategy shortly which will provide a framework for growth and development of our health services over the coming years. Therefore, it should be clear to the Deputy that the entire question of the improved delivery of health services has been the focus of my attention for some time.
I remind the Deputy that the overall budget for health services for 2001 is more than £5 billion, 6.35 billion. This represents a doubling by this Government of Exchequer input since 1997. The national development plan represents the greatest level of investment in health capital infrastructure, £2 billion, 2.54 billion, at 1999 prices, and is designed to bring benefits to all areas of the health services.
It is worth listing some of the benefits of this increased funding across the whole health system. The acute hospital system delivers a service that is ever growing in terms of its volume and complexity. A sum of £1 billion, 1.27 billion, has been provided under the national development plan for the development of hospital infrastructure. This will allow for the provision of major developments in the acute hospital sector in every region of the country. This Government has overseen significant increases in hospital activity levels. In particular there has been a 29% increase in day care activity in hospitals since this Government came into office. The hospital system has continued its high productivity performance in January to June 2001 by recording an overall rise of 5.1% activity increase, including almost 11% growth in day cases. This translates into an extra 22,000 cases treated over the same period last year.
There has been an increase of about 25% in the numbers employed in the health service since this Government came into office. We now have about 83,000 whole-time equivalent staff working in the health service. This includes an additional 250 consultants in our hospitals.
There is a comprehensive range of obstetric services available to women on a regional and tertiary basis. However, I am aware of recent difficulties relating to the recruitment and retention of midwives which are impacting on the capacity of maternity hospitals to cope with increasing demands for their services, particularly in the eastern region. I wish to set the record straight on the extent of the midwifery shortages in the Dublin area. Media reports of 110 midwifery posts vacant in the three Dublin maternity hospitals are incorrect. Information received by my Department indicates that while the three hospitals are short 84 midwives, the net vacancy situation is 54 posts, when account is taken of the number of registered general nurses that have been employed by the hospitals.
I have established a special forum to examine the current difficulties being experienced by the Dublin maternity hospitals in relation to the recruitment and retention of midwifes. This forum includes representatives of the three Dublin maternity hospitals, my Department, the Health Service Employers' Agency, the Eastern Regional Health Authority and the nursing unions. It held its first meeting on 19 October, and has been asked to report back to me as a matter of urgency. This forum will build on a number of initiatives already taken at national level to recruit and retain midwifes. I assure the Deputy that the provision of a comprehensive, safe and high quality, fully accessible obstetric service will continue to be of the utmost priority.
More than £60 million, 76.184 million, has been allocated under the National Cancer Strategy since 1997 and an additional 57 consultants together with support staff have been approved. We are now spending an additional £38 million, 48.250 million, on cardiovascular and cardiac surgery services.
At the invitation of my Department, a group representative of health board management and consultant orthodontists reviewed the orthodontic services. The objective of this review was to ensure equity in the provision of orthodontic treatment throughout the health boards. Following this review structural changes are being introduced in the orthodontic services. These changes include the creation of the grade of specialist in orthodontics, the development of specialist training programmes and the creation of a grade of auxiliary dental worker to work in the orthodontic area.
However, it will be some time before these structural changes impact significantly on service levels. Consequently, I asked health boards to develop proposals to make an immediate significant impact on their waiting lists. An additional investment of £5.3 million, 6.729 million, has been approved for orthodontic services this year, of which £3.7 million, 4.698 million, is to fund an initiative on orthodontic waiting lists. This will enable health boards to recruit additional staff and engage the services of private specialist orthodontic practitioners to treat patients.
Additional investment of £205 million, 260.35 million, has been made for the period mid 1997 to 2001 on services, both capital and non-capital, for the intellectually disabled and a further £107 million, 135.89 million, for the physically disabled. Additional development funding has increased from £3 million, 3.81 million, in 1997 to £33 million, 41.91 million, this year, excluding funding for nursing home subvention. Since the end of 1997 additional revenue of the order of £92.5 million, 117.475 million, has been allocated for the further strengthening and development of child welfare and protection services.
Some £34.5 million, 43.805 million, has been allocated to health agencies under the waiting list initiative for 2001 to enable hospitals to carry out waiting list procedures. Significant decreases have taken place in the number of patients waiting in the target specialties since June 2000; the number awaiting cardiac surgery is down by 52%, gynaecology is down by 35%, ENT is down by 30%, ophthalmology is down by 23% and orthopaedics is down by 14%. Considerable progress has also been made in reducing waiting times in target specialties. For example, between June 2000 and June 2001 the number of adults waiting for cardiac surgery for more than 12 months decreased by 68%, the number waiting for ophthalmology services for more than 12 months decreased by 38% and the number waiting for orthopaedic services for more than 12 months decreased by 16%. During the same period the number of children waiting for cardiac surgery for more than six months decreased by 85%, the number waiting for ophthalmology services for more than six months decreased by 31% and the number waiting for ENT services for more than six months decreased by 25%.
It is well recognised that the single most important limiting factor for admission to hospital is bed availability. A comprehensive review of bed capacity needs has been conducted by my Department in conjunction with the Department of Finance and in consultation with the social partners. The review has focused primarily on the emerging needs to increase bed capacity and to have a strategic framework in place in terms of the number of additional beds required in the short, medium and longer terms. The review of bed capacity will inform the new health strategy.
In addition to issues of capacity of services, the new health strategy to which I referred earlier will address issues relating to reform and modernisation of the health system. The strategy will outline the direction and scale of development planned in a number of service and professional areas for example acute hospital bed capacity, primary health care, medical manpower, nursing, etc. In addition, the strategy will include a plan covering the actions required for its implementation in the short, medium and long-term.
The Government is committed to the strategic planning and development of the health service. The increased level of capital and non-capital investment which I have outlined is strong evidence of the priority this Government attaches to improving the health services in this country.
Question No. 90 lapsed.
