Ceisteanna Eile - Other Questions

Services for People with Disabilities

Pat Buckley

Question:

38. Deputy Pat Buckley asked the Minister for Health the respite care services available for parents and guardians of children with intellectual disabilities in CHO 4; and if he will make a statement on the matter. [50600/18]

My question is about the respite care services available for the parents and guardians of children with intellectual disabilities in CHO 4.

I thank the Deputy for raising this issue regarding the Government's ongoing priority to safeguard vulnerable persons in the care of the health service.

This Government’s ongoing priority is the safeguarding of vulnerable people in the care of the health service. We are committed to providing services and supports for people with disabilities which will empower them to live independent lives. As part of its ongoing service provision, this year the HSE will provide more than 182,500 overnight and 42,500 day respite sessions throughout the country.

I am informed by the HSE that, in the context of respite services in Cork and Kerry, it is recognised that the expansion of respite services for people with disabilities is essential to support families to continue to care for their family member with a disability, and in particular those with significant disabilities. In Cork, respite services are provided by COPE, the Brothers of Charity, CoAction, St. Joseph’s Foundation and Enable Ireland. This year community healthcare organisation, CHO, 4 has been able to develop a respite house in west Cork from within existing resources. This house will open on a phased basis from next week and will be open to referrals for respite across County Cork. A number of alternative respite services have been very successful in Cork, with more than 800 children and adults benefiting.

In Kerry, the HSE funds adult respite services for people with intellectual disabilities, which are provided by Kerry Parents and Friends Association and St. John of God services. Kerry Parents and Friends opened the Kilmorna house on a phased basis from the end of March 2018 and has been operating at full capacity since the beginning of July 2018, giving 1,460 bed nights per year. This year, HSE CHO 4 has provided in excess of 17,000 respite nights and 2,000 respite day services to people with a disability. More than 900 people with a disability have accessed respite services across CHO 4.

We are acutely aware that families need support to care for their loved ones at home and, therefore, the Government is committed to providing a range of accessible respite care supports for people with a disability and their families. We will give families more choices as we develop respite services.

A reply to a parliamentary question which we submitted states that, from 2017 to quarter 2 of 2018, service hours have gone down. I am interested to hear that the Department is fully committed and the reply we received stated that there were targeted actions to improve supply. However, there is no mention of Cork or of Kerry - it is Dublin, Dublin, Dublin. It seems to me to be an alternative plan. The reply states that the provision of residential respite services has come under increased pressure in recent years. It does not say weeks or days but years, so the Department has known about it for some time. We are getting the same answers over and over again but why is nothing being done? The services are being cut but the demand is increasing.

The funding for disability services has not been cut. Anybody who says that is misleading people.

I said the hours had been cut.

An extra €150 million is being put into disability services in 2019. Respite services are being developed and an additional €10 million has been provided in 2018 for services. I have visited the 12 new houses, the last of which will be completed in the next week or two. They are in each CHO area, with three in the greater Dublin area, and ten new respite centres have been opened to date.

There are issues over the need to develop more services and I will be working with organisations such as COPE in Cork, the Brothers of Charity, St. Joseph's Foundation and Enable Ireland. Additional funding allocated to Cork-Kerry community healthcare has been utilised to progress the development of a respite house in west Cork, which will be open on a phased basis from December 2018. It will be open to referrals for respite across County Cork. We have started investing in services but we are catching up, and I accept the point that there was underinvestment in these services. The reforms have begun and we have begun to put the focus on the person with the disability when we allocate funding.

The question relates to CHO 4 in Cork and Kerry, and I mentioned CHOs 7, 8 and 9, which are Dublin. The Minister of State mentioned money but I am talking about hours. The HSE's reply to the parliamentary question we submitted was that there are a number of factors which impact on the increased demand for respite, and an increasing number of children and adults who are seeking to access respite care. It states that this is a reflection of the general population increase but we have known about the increases in population for several years, yet there is still no forward planning to deal with it. It states that there has been an increase in the levels of complexity across the sector due to improved healthcare and an increase in the age of the population with a disability, resulting in the people presenting with challenging and changing needs. We have known this all along but there has been no forward planning to deal with this either. Finally, it states the HSE is fully committed to delivering much-needed new respite services and supports by the end of 2018. I do not think anything will be ready in the next five weeks to help these people.

I recognise that funding for disability services has increased and nobody is denying it but there is a fundamental issue here. There is more money going in but fewer services being delivered. There are more people on waiting lists but fewer hours are being provided. Something is not working and we need to get to the bottom of it. The transition from child services into adult services is a disaster, and people who have day services and respite services lose them as soon as they reach 18 and are put back on a waiting list. We need care paths, and it is not just about the money. It is about good management and good strategies being put in place.

On the subject of respite care, the Minister of State mentioned St. Joseph's in Charleville. How many extra nights were made available for respite by that organisation in 2018 compared with 2017?

I wish to focus on the number of places available for overnight respite. In CHO 1, which includes my county of Donegal, there was a cut of one third in the number of overnight facilities for respite between quarter 2 of 2017 and quarter 2 of 2018, amounting to 400 nights being taken out of the system. The Minister of State can talk about increases in budget, something we do not dispute, but for parents on the ground the services are getting worse. The Minister of State can shake his head all he wants but the figures are there to prove it and they show that there was a reduction from 1,334 to 900 in that period. How can the Minister of State claim that represents improvement, or even stabilisation, is beyond me.

This year the HSE will provide 182,500 overnight and 42,500 day respite sessions throughout the country. CHO 4 has provided 17,000 respite nights and 2,000 respite day services to people with a disability, while in excess of 900 people with a disability have accessed respite services across the CHO. Deputy Jonathan O'Brien's point is very important. We are putting €1.8 billion into our social care for 2019 but there are issues with the funding. I often ask, in the course of my discussions with the HSE and the Department, why not enough of this filters down to people on the ground. I have set three objectives, which include investing in services and reforming services. I have spoken to parents in Kerry, Cork and Donegal and I will push those points because if there are gaps, they have to be dealt with. There has to be a change in mindset in this House, the HSE, the Department of Health and everybody else so that the focus is on the person with the disability. That is my job as Minister of State and it has been my focus for the past three years.

Respite Care Services

Thomas Pringle

Question:

39. Deputy Thomas Pringle asked the Minister for Health his views on the transfer of ownership of respite facilities from the HSE to a third party as in the case of a facility (details supplied); and if he will make a statement on the matter. [50835/18]

This questions relates to the Seaview respite care home in Donegal town, which has recently been handed over by the HSE to RehabCare for the provision of respite services for children and young people and for people with an intellectual disability. What are the views of the Department of Health about this? How does the Department see that this change will improve the services? The HSE could not recruit staff to run the health centre so I do not know how the private sector can do it.

I thank Deputy Pringle for raising this very important issue. Again, I stress that this Government's ongoing priority is the safeguarding of vulnerable people in the care of the health service. We are committed to providing services and supports for people with disabilities which will empower them to live independent lives. Earlier this year, the Government provided an extra €10 million to the HSE to allow it to open 12 additional respite houses across each community health organisation area. When fully operational, these houses will provide 19,000 extra overnight stays and 2,520 home sharing nights annually. Approximately €2 million of that extra money is being targeted at alternative respite services. These practical and important solutions which include extended day services, summer camps and Saturday clubs are making a difference to families across the country.

In response to Deputy Pringle's specific question, I am informed by the HSE that the executive owns Seaview House respite home in Mountcharles, County Donegal, and has no plans to transfer ownership of the facility to a third party. The HSE is engaging a third party provider to deliver respite services at Seaview House because of ongoing challenges in providing a consistent service. These challenges have resulted in a considerable reduction in the amount of respite care available to service users in south Donegal. This is relevant in the context of the issues raised by Deputy Pearse Doherty earlier.

The tender process is now complete and a provider has been identified to deliver this care. The HSE is confident that this new arrangement will be in place by the first quarter of 2019. There will be a planned transfer from the HSE to the new provider to minimise disruption to services and to ensure continuity of care. I assure the Deputy that I will keep a close eye on this matter.

With all due respect, that is a lovely outline of my question but not an answer. I specifically asked how these changes will improve the service. The HSE failed to provide an adequate service and put it out to tender. A third party will now provide the service and the only difference that this will make is that the HSE will be able to blame the third party. Is that all the Department of Health is interested in doing here? That seems to be the case, based on the response from the Minister of State. I am sorry to say that the response from the Department is very poor.

The HSE is transferring responsibility for respite services at Seaview House to a third party. That is all that is happening here and I cannot see how that will improve the service. I ask the Minister of State to explain how that will improve matters. The only way the service can be improved is by improving working conditions for staff. I ask how the transfer of responsibility for service provision to a third party can help.

There was a lack of consistency in service provision but there are no plans to transfer the ownership of the facility to a third party.

I am not directly involved in the day-to-day issues here but there are obviously problems with regard to the delivery of services. The HSE has asked a third party to provide respite services and there are some very good service providers all over this State who provide such services on a regular basis. I am confident, as is the HSE, that the new service, with new efficiencies, will be in place in the first quarter of 2019.

As far as I am concerned, we cannot accept a reduction in the level of respite service provision in Donegal, as referred to by Deputies today. We must ensure that adequate respite services for adults with intellectual disabilities are provided. Their needs must come first. I make no apology for saying that the person with the disability comes first.

I will ask the question again. How will this improve the service? The service is being taken from the HSE and given to a third party. In that way, the HSE can blame the third party when the service does not work. That is the only change here. How does that benefit service users? The Minister of State has said that he does not get involved in day-to-day issues but surely the Department of Health has an interest in how the service is being provided and how the new arrangements will work. The only thing this will do is to provide cover for the HSE so that when things go wrong and are managed badly, it can blame the service provider. That is the only difference here. The Department of Health must take an interest in how the HSE provides services and there is no way that this represents an improvement for either the staff or the service users.

I have been raising this issue for many months and it is connected to my previous question. The Seaview House service provided 316 hours of service in some weeks while in other weeks, service levels were down to 36 hours. There were six weeks last year in which the service did not operate at all and the people who are being caught out here are those who need the service. I have been given assurances by senior managers in the HSE that this service will become a five-day rather than a three-day service in February when the service provider agreement is signed off. They have also assured me that there will be no issues in terms of ensuring that the service runs continuously. Can the Minister of State give the same assurances here on the floor of this House? I ask him to confirm that this service will move from a three-day to a five-day week basis and that the service provider will be able to operate it on that basis. What if it does not do so? What if the third party provider fails to provide an adequate service? What are the Department's plans in that event?

I assure both Deputies that the HSE, the Department and I, as Minister of State, will keep a very close eye on this situation. According to information provided to me, there were serious challenges in the delivery of services and the HSE came up with a plan to address those challenges. The plan is not about providing cover for the HSE. As I said earlier, we must ensure that high quality services for people with disabilities are delivered. We cannot have a situation where services are only provided three days per week. I totally accept that point. In response to Deputy Doherty's question about a five-day week service, I assure him I will push strongly for that. I am happy to give him a commitment that I will prioritise that issue in talks with the HSE on the service plan for 2019. I would like to see a five-day service in operation at Seaview House.

National Dementia Strategy

Mary Butler

Question:

40. Deputy Mary Butler asked the Minister for Health if the 2019 HSE service plan will provide for new and expanded services for persons living with dementia. [50724/18]

Will the 2019 service plan provide for new and expanded services for people living with dementia?

I thank the Deputy for her succinct question. The short answer is "Yes" but the slightly longer answer is that we must wait for the service plan for 2019 to be finalised. There is ongoing engagement between my Department and the HSE in that regard and, as would normally be the case, I expect to be in a position to approve the service plan this month and to publish it before Christmas.

I wish to acknowledge Deputy Butler's work and leadership in the cross-party group on dementia in this House. She will be very familiar with the national dementia strategy which aims to improve dementia care so that people with dementia can live well for as long as possible. Plans are progressing to further implement the strategy through the national dementia office, NDO. I had the pleasure of attending a really good meeting with that office about a month ago and heard about its work on the areas of diagnosis, post-diagnostic supports and the prescribing of anti-psychotic medications. The Deputy will also be aware that the HSE provides intensive home care packages to people with dementia to enable them to continue living with assistance at home but I accept that we will need to see the provision of more of these packages. The Department has also secured funding through the Dormant Accounts Fund for additional projects to improve care for people with dementia. One such project is the development of assistive technology memory resource rooms. I had the pleasure of visiting one such room in St. Colmcille's Hospital in Loughlinstown and another in Clonmel.

A recently completed mapping exercise provides a useful snapshot and baseline study into what, where and when dementia-specific community based services and supports are being offered. The study has also been used to inform a service finder hosted on the NDO’s website. This allows people to search for dementia-specific community services in their area. I acknowledge that there are gaps in access to services and a large variance in the services that are provided across the country. The NDO has met senior HSE officials in each community healthcare organisation, CHO, area to highlight the gaps that exist and to develop local action plans to improve service provision.

My Department is continuing to work with the HSE to prepare the 2019 national service plan. Pending a final agreement, I am unable to give specifics but it is my hope that we can improve services in this area in 2019.

Long-term planning is required for the approximately 55,000 people living with dementia and their carers. Population ageing is happening all over the world and Ireland is no exception in this regard. We are all living longer, which is good, but people want to live at home, safe and secure in the knowledge that if they need medical assistance, it will be provided to them. The number of people with dementia in Ireland is expected to increase.

It stands at 55,000, but that figure is expected to increase in the next three years to 68,000. My question is specifically about dementia care advisers, of whom there are eight in the country and who cover 11 counties. When a person is diagnosed with dementia, the support of a dementia care adviser cannot be underestimated. In order to provide a service for everyone with dementia, 32 dementia care advisers are required to cover the entire country. If we could see an increase of eight advisers year on year for the next three years, we would meet that target.

The Deputy is right to highlight the fact that more and more people are being and will continue to be diagnosed with dementia. Eleven of us will receive that diagnosis each and every day. It is estimated that there are over 55,000 people who have a form of dementia. There are about 4,000 new cases each year. After the age of 65 years, the prevalence of dementia nearly doubles every five years, but, of course, onset can occur at a much younger age. There are 4,000 people under the age of 65 years with early onset dementia. Based on population projections from the CSO, the number of people with dementia will double to 115,000 by 2036 and treble to 157,000 by 2046. Therefore, we have a lot of work to do to prepare our society to enable people with dementia to live and live well. I am very much aware of the work done by dementia care advisers and that the Alzheimer Society of Ireland provides a dementia care adviser service which is funded by the HSE at eight locations nationwide. I am aware that an evaluation was conducted by UCC to investigate how well it worked and provide recommendations on the future development of the service. The evaluation was published in September and recommended the continuation and expansion of the service. This is being considered as part of the national service plan process.

The mid-term review of the national dementia strategy which was launched in May acknowledged that people with dementia and their families were still dealing with inadequate services and supports. Unfortunately, the level of support varies according to one's address. I acknowledge that there is a lot of good work being done, of which there is no doubt. The Alzheimer Society of Ireland has been leading the way in providing help and support throughout the country. How we care for older people with dementia, in particular those with early onset dementia, will demonstrate the Government's determination to be inclusive and compassionate. I welcome the money allocated from the Dormant Accounts Fund. In my constituency of Waterford a memory clinic has been set up in St. Patrick's. It is the first in the area. I reiterate the importance of dementia care advisers and the need for people with dementia to have access to one, no matter where they live.

I have heard the Deputy advocate for dementia care advisers and appreciate and acknowledge the role they play at the eight locations. I also acknowledge that an independent evaluation has been conducted by UCC which very much sees the merit in and the need to expand the service. Obviously, we are having this conversation at a time when the HSE has received a budget of €17 billion. It needs to map the services it will provide in 2019. I expect that process to conclude shortly. One of my views which I am happy to share with the Deputy is that while she is right that a lot of good work has been done with moneys allocated from the Dormant Accounts Fund, as she has seen in Waterford and I have seen in my community and others, we need to look at how we can move beyond that funding to have a proper budget line for the National Dementia Office. I hope we can make some progress on that issue in 2019 and build on it further. Given the number of people being diagnosed with dementia on a daily basis, the direction of travel in terms of the services we need to put in place is clear for all to see. I hope we can make progress in that regard in the national service plan.

Health Services Staff Remuneration

Pearse Doherty

Question:

41. Deputy Pearse Doherty asked the Minister for Health when pay will be restored for section 39 workers; and the full cost of this measure [49020/18]

Joan Burton

Question:

63. Deputy Joan Burton asked the Minister for Health if he has been in consultation with the Department of Public Expenditure and Reform on the outcome of the audit of pay restoration for section 39 workers; and if he will make a statement on the matter. [43835/18]

Thomas P. Broughan

Question:

85. Deputy Thomas P. Broughan asked the Minister for Health the status of the restoration of pay for section 39 organisations; if the necessary funds have been allocated to his Department; if not, the timeframe for payments to be restored; and if he will make a statement on the matter. [48839/18]

Cathain a bheidh pá oibrithe in eagraíochtaí section 39 curtha ar ais mar a bhí sé? When will pay be restored for section 39 workers and what will be the full cost of this measure? This issue has been discussed at length by my party colleague, Deputy Louise O'Reilly, my party leader, Deputy McDonald, and others. It is an issue of equality, in particular, for workers who had their pay cut at the same time as public servants but who did not have it restored at the same pace, if at all. It is also an issue about the delivery of services which, in some cases, are becoming unsustainable owing to the lack of funding.

I propose to take Questions Nos. 41, 63 and 85 together.

I thank the Deputy for his question and acknowledge the fact that he has raised this matter on a number of occasions. He will be aware that in February an agreement was reached at the Workplace Relations Commission, WRC, between my Department, the HSE and health sector trade unions on a process aimed at resolving the pay restoration issue for staff employed by section 39 bodies in 50 pilot organisations. The 50 organisations included were agreed to at the WRC by all parties, including the unions.

I asked the HSE to engage with the section 39 organisations to establish the facts which varied from organisation to organisation in regard to what cuts had been applied and how and when they had been implemented. The HSE has completed the first phase of its work on the agencies identified as part of the WRC process. This exercise has shown that, of the agencies which returned data, a majority applied pay reductions of some form. It also shows that some agencies made provision for some form of pay restoration between 2016 and 2018.

Following constructive engagement, with the assistance of the WRC which I thank for its work, an agreement was reached on 2 October between all parties. Pay restoration will commence, with an annual pay increase of up to €1,000, in April 2019 for those employed by the 50 organisations involved in the pilot programme. Any outstanding balance will be paid in two equal amounts in 2020 and 2021. The cost of this phase of pay restoration will be €7.7 million.

The HSE is undertaking a validation exercise in respect of those 50 pilot organisations and their funding requirements to ensure pay restoration. Further information was requested from them in November and the returns are either being assessed by the HSE or, in some cases, still being worked on by the organisations. I urge those organisations to provide the necessary information as a matter of urgency.

In respect of the organisations which did not form part of this phase, it is recognised that some of them will also have pay restoration issues and a process of engagement to address the issue will commence in 2019. We have agreed a way forward between all parties. Phase one of restoration will proceed in 2019. We will then move on to the other organisations.

The Minister gave dates and some indication of the cost. He referred to a figure of €1,000 in the context of pay restoration in April 2019 and an overall figure of €7.7 million. When will pay for employees who had their pay cut in line with public sector employees be completely restored and when is the end point for all section 39 workers, given the need to provide clarity for them? The Minister might outline the incremental steps to be taken to achieving this. It is clear that the instruction given at the time was that section 39 agencies should look at their cost base and follow public pay policy. This was confirmed by the former head of the HSE to Deputy Louise O'Reilly and also made clear by Mr. Jim Breslin, Secretary General of the Department, when he was before the committee. Therefore, it is only right that there be full restoration in line with what has happened in the public sector.

There is a second issue related to how the costs will be absorbed. Will the Minister inform the House that the cost of pay restoration will be met for the section 39 agencies to ensure they will not reduce services in dealing with the issue?

The answer to the Deputy's last question is "Yes". They will be provided with funding to meet the cost of pay restoration to ensure it will not impact on the delivery of services. I accept that many section 39 organisations applied pay cuts. I also accept, as I think the Deputy does, that section 39 employees are not State employees. Therefore, it is different and the position varies from organisation to organisation. In the WRC process it was found that there were different levels and that cuts had been applied in different ways and that there had been restoration for some but not for others. It was important to analyse the issue correctly and I thank the unions for working with us in that regard.

For those employed by the 50 organisations, the following will apply. Pay restoration will commence, with an annual pay increase of up to €1,000, in April 2019; 50% of the outstanding sum due will be paid on 1 October 2020, with the remaining 50% to be paid on 1 October 2021. That is the agreement. Based on the information available to me, it appears that almost 90% of those staff who suffered a pay cut will, on average, have 75% restored in 2019. The payments are being made on the basis of the following criteria. First, it is pay restoration, not pay progression; second, the intention is to restore pay reductions made and no more; and, third, only staff in the 50 organisations are eligible. We will have to do a further body of work in 2019 on the additional organisations.

I want to tease out the issue of the additional organisations and the number involved to see why we are in a situation where we have to wait until next year to quantify the number of additional employees not covered by the arrangement agreed to at the WRC. Will the Minister outline the organisations not included in the 50 organisations and indicate when we can expect pay restoration to commence for employees in these agencies?

I ran out of time during my last reply.

On the issue of information and returning information for those 50 organisations, there was a deadline date of 23 November. As of 29 November, of the 50 organisations, just over half had returned their applications. A further group have asked for an extension and this has been granted until this Friday, 7 December.

The Deputy logically asked what will happen with the other organisations. The plan is to begin a process of engagement similar to what we did this year for the 50 organisations. Truthfully, I do not have a specific date for when this will happen in 2019 but I will make enquiries and revert directly to the Deputy. Phase 1 of the plan is to begin the restoration of those 50 organisations, starting in April 2018 and then use 2019 to carry out a similar exercise with the other section 39 organisations.

Hospital Staff Data

Michael Moynihan

Question:

42. Deputy Michael Moynihan asked the Minister for Health the number of medical, nursing and care posts vacant in Mallow General Hospital; and if he will make a statement on the matter. [50785/18]

I want to introduce a question on medical nursing and care posts in Mallow General Hospital. Is the hospital working to full capacity in light of the crises in the city hospitals in particular and will the Minister make a statement on the matter?

I thank the Deputy for the question. As the Deputy knows, Mallow General Hospital is part of the South/South West hospital group. It is a model 2 hospital providing acute general hospital services to the people of north Cork. The hospital has 54 acute beds, in excess of 220 staff and a budget of approximately €17.5 million in 2018.

There are approximately 20 staff vacancies at present in Mallow General Hospital across medical, nursing and health and social care. The HSE has advised me that the overwhelming majority of these posts have been sanctioned for funding and we are awaiting the advertisement through the national recruitment services division. I will ask for that to happen urgently.

Retaining and increasing the number of nursing, medical and health and social care staff in the public health service is a key priority. The total number of consultants, non-consultant hospital doctors and nurses has increased despite these challenges.

I have no doubt that we need to continue to do more, not just in Mallow General Hospital but in all of our model 2 hospitals. I had the pleasure of visiting Bantry General Hospital and Clonakilty Community Hospital this week as well. There is definitely capacity in some of our smaller hospitals and I want to see us do more there. I am told that there are very few medical post vacancies in Mallow General Hospital and the majority of vacancies are nursing posts. I would be very happy to visit Mallow General Hospital in due course to meet the management there and to look at what the opportunities are to expand services there.

One of the areas that I am particularly interested in is whether we can take pressure off the larger hospitals where there is bed capacity in some smaller hospitals and whether we can use the National Treatment Purchase Fund, NTPF, to insource into some of our smaller hospitals as well as outsourcing. There is more that we can do in these hospitals and Mallow General Hospital certainly has an important role to play.

I thank the Minister for the reply. Mallow General Hospital has had large investment in its theatres and so forth in recent times. Right through various crises this year, especially in the earlier part of the year from January to March, the theatres were closed for a long time. Up to and including 1 April, there were four weeks when no work was going on there because of issues, and at that time there was massive pressure on Cork University Hospital, CUH, and on the city hospitals.

There are approximately 20 vacancies, as the Minister said. When will they be advertised and filled? We have to be serious about making sure that all services are utilised to the fullest extent that is humanly possible to make sure that Mallow General Hospital can continue to provide fantastic work and services. I have personally experienced it throughout the years and I cannot praise the people who are working there enough. Top of the range surgeons are working there but it is underutilised, particularly when there are massive challenges in the city hospitals. It is high time that we looked at Mallow General Hospital and other hospitals to make sure they are working to full capacity.

I will ask the HSE to revert directly to the Deputy in terms of when the advertisements for those vacant posts will be placed, but my understanding is that it is pretty imminent and that they have been sanctioned for funding so it is a matter of placing the advertisements. I had an opportunity to meet the CEO of the South/South West hospital group with my colleague, the Minister of State, Deputy Jim Daly, in Bantry on Monday where we had a discussion about better utilising the model 2 hospitals within the South/South West hospital group. The Minister of State will follow up on that for me but we agreed with the South/South West hospital group that when new consultant posts are being sanctioned anywhere in the group, part of the requirement in the contract will be that the consultant goes out to the model 2 hospitals and carries out more of their clinics and theatre practice there. Through that we can drive more patients and citizens through the model 2 hospitals and keep them out of the larger hospitals, which are very busy, as the Deputy rightly said.

I will come back to the Deputy directly through the HSE on when those posts will be advertised. I have made it very clear to the South/South West hospital group that I want to see plans to better utilise our model 2 hospitals, and I am happy to engage with the Deputy further on that.

How long have these positions been vacant in Mallow General Hospital? When was it decided that these 20 vacancies would be filled? When was that decision taken by the South/South West hospital group? The Minister has used fine words about utilising Mallow General Hospital as much as possible to make sure that it takes pressure off other hospitals. That is a fine aspiration, but how long have these vacancies been there? My information is that they have been there for quite some time. When will they be filled so that we will have Mallow General Hospital working to its full capacity?

From my experience within the hospitals, I am being told that when theatres are closed and there is a large cancellation of planned surgeries in the city hospitals, at the same time Mallow General Hospital's theatres are lying idle. How long have these positions been vacant? When were they identified? Have they been advertised as of now and, if they have not, when will they be advertised and when will they be filled?

I want to be associated with Deputy Michael Moynihan's comments and I congratulate the staff at Mallow General Hospital. I had a parliamentary question on this on 29 November asking about Mallow General Hospital, Midleton Community Hospital, St. Finbarr's Hospital, Youghal Community Hospital and so forth and I have not received an answer yet. The Minister gave an answer that there are 20 staff vacancies today in Mallow, but we are still having problems getting answers from the HSE. These community hospitals are the heartbeat of the country and we need to have them fully staffed.

I urge the Minister to keep an eye on the parliamentary questions that we are putting to the HSE because we are not getting the answers at all.

I will follow up the matter that Deputy Buckley raised. That is not acceptable and the HSE is meant to answer those questions within a specific timeframe, so I will follow that up directly with it.

I answered Deputy Michael Moynihan's second question by saying that I would get the HSE to revert to him directly on when those advertisements will be placed. It is important to point out that some vacancies have arisen very recently. I believe the two staff nurse posts have arisen only in the past month. Another one of the vacant posts for a clinical nurse specialist in cardiac rehabilitation has become vacant because one of the candidates has been promoted to a candidate advanced nurse practitioner which will ultimately be good for the hospital. Some of the vacancies are looking ahead towards three maternity leave posts which will arise in 2019.

It is not aspirational. We will do more in our model 2 hospitals. In fact we are already doing so and the evidence is there throughout the country. I had these discussions with the chief executive of the South/South West hospital group on Monday and there is capacity to do more in Mallow General Hospital. I am determined that we will do so and I am happy to keep in touch with the Deputies on that.

Questions Nos. 43 to 47, inclusive, replied to with Written Answers.

Home Care Packages Provision

Michael Moynihan

Question:

48. Deputy Michael Moynihan asked the Minister for Health if extra home care packages will be provided in north-west County Cork this winter; and if he will make a statement on the matter. [50784/18]

I refer to the 550 home care packages that were promised and which were discussed in the House last week. How many of them will be in north Cork? When will they be rolled out or are they also aspirational? I would love to come back on the second or third week of January and see how many of those 550 home care packages have been put in place because, as we head into the second week of December, it is very difficult to get home care packages or to even get answers from HSE staff on how they will be allocated or who will get them.

There will be 300 this side of Christmas and 250 the other side of Christmas. That is the commitment that we have been given from the HSE to deliver those 550 home care packages.