I welcome the Minister of State, Deputy Shane McEntee, congratulate him and wish him well in his portfolio in the Department of Agriculture, Fisheries and Food.
Health Service Staff
The Minister of State is welcome and I thank him for taking this Adjournment matter, I presume on behalf of the Minister for Health and Children. My request to the Minister of State is to ask the Minister for Health and Children whether the HSE will address, as a matter of urgency, the serious lack of community health doctors in County Galway, which now is putting the health of children at risk, particularly in two respects: the BCG vaccine and developmental checks for children. I thank the Minister of State for taking the time out of his schedule to attend the House and I am grateful to the departmental officials for considering and researching this issue.
My request for this Adjournment matter arises from the alarming situation in Galway whereby the recruitment embargo is having a severe impact on the delivery of patient services and is compromising the public health objectives of the health care system, especially in respect of child health services. In the past five years five doctors have departed the University Hospital Galway community medical department. Through retirement, maternity leave or other reasons, they have left a gaping hole in the Department's front-line team. In the past six months two further medical staff have been lost to the department, with one departing in October 2010 and the other in April 2011. None of these front-line professionals has been replaced. In addition, owing to the incentive for HSE staff to take redundancy, further gaps have arisen in respect of the administration and support staff. This directly affects the accountability and transparency of the hospital's performance.
The impact of these human resource constraints is showing up in many different cases and obviously on staff morale. The two issues that require the Minister's most urgent attention, however, are the administering of the BCG vaccine and the monitoring and roll-out of child developmental checks. As for the importance of BCG vaccination, the current waiting list for at-risk non-national toddlers is 800 and growing. These children, who were born in Ireland, have one or more parents from a country where there is a high prevalence of tuberculosis. Furthermore, 50% of schoolchildren do not receive the vaccination. Consequently, unless this matter is addressed, the Galway region is on the doorstep of an epidemic. One key point being raised by this Adjournment matter is that 800 at-risk children are not getting the BCG vaccine and this could spread contagion among the general population. The response and solution that appears to be emanating from hospital management is that staff can be redeployed. That has yet to materialise, however, and will no doubt have an impact on other areas in the hospital. Redeployment is too easy a response to every problem because while one can state one will move staff from here to there, unless that is properly co-ordinated, it will not work.
In respect of the developmental checks, as a matter of public interest and in the interest of complying with international obligations, all children are meant to be checked by the health system. The objective is early detection and intervention and this is an important check and a human right. At present in Galway, the startling position is that 50% of toddlers in the county have had no screening, 1,850 toddlers under the age of ten months are on the waiting list at present and 450 toddlers between seven and nine months have not had a developmental check. An assessment I received from a health care professional who has direct experience of the current crisis states:
We are now operating at a nonfunctional, unsafe and ineffective level as a Community Medical Department because of the failure to appoint a designated number of community health doctors. [...] There has been a failure to understand the seriousness and implications of the current situation they have failed to respond to the requests and concerns of the principal medical officer and more recently to the concern of the Director of Public Health.
As the HSE locally is ignoring the problems associated with the BCG vaccine and developmental checks, I now bring them to the attention of the Minister for Health and Children. While I acknowledge he has an enormous task on his hands, one cannot allow to be left unattended children in an at-risk group who urgently need the BCG vaccine and who pose a risk to the entire population or children who could have problems with their sight, hearing or limbs identified at an early stage. It will be important for the Minister to liaise with the director of public health, who is based in Merlin Park, and with John Hennessy, the HSE west director of operations, to sanction the appointment of these doctors. While I may be talking out of turn a little, I believe even sanctioning the appointment of two doctors would make a difference to this team. I have met some of the staff there and they are at their wits' end. They emphasise repeatedly the urgency of this case and what I do not wish to see is the making of a "Prime Time" programme on this subject. I look forward to the Minister of State's response which I hope will cover the BCG vaccine and developmental health check issues.
I thank the Cathaoirleach for his welcome and wish all Members well on my first visit to this beautiful Chamber. In my capacity as Minister of State in the Department of Agriculture, Fisheries and Food with responsibility for horticulture, forestry, food safety and the greyhound industry, I have sent a letter to all Members, either physically or via e-mail, containing my contact telephone number. As far as I am concerned, I am there on behalf of everyone and it is not my office but theirs. They should not be afraid to make use of it as I have staff there who will help them out. This was done for me when I was in Opposition and it was of great help. Consequently, I urge Members to avail of the forthcoming telephone number.
I can see that Senator Fidelma Healy Eames is passionate about this issue and I have listened to what she has had to say. I will read out the reply on behalf of the Minister and will bring any supplementary questions to his attention, as I would be foolish to take on the task of attempting to answer them.
I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy James Reilly. I thank the Senator for raising this matter as it provides me with an opportunity to outline to this House the importance attached by the Minister to the issue raised. Community health doctors are an integral part of the overall health services provided by the HSE. The main services provided include child protection services, which include involvement in child protection teams, co-ordination of the medical needs of children in long-term care and medical assessment of children where child abuse has been alleged. Child and adolescent health services include developmental examination for seven to nine month old infants, child health clinics, school health services and medical audiology clinics. Community health immunisation services include neonatal BCG vaccination programmes and school vaccination programmes to children in primary schools. Services for older people include co-ordination of medical services for the elderly and involvement in cases of elder abuse. Services for persons with disability include medical assessment for disability allowances and involvement in the assessment of need process for children aged up to five, all under the Disability Act 2004. Social inclusion services include targeted community health medical services for socially marginalised groups.
The recruitment of staff in the health services is subject to the Employment Control Framework 2011-2014. That framework is required to maintain tight control on the cost of providing public services while protecting front-line services as far as possible. There are 184 community medical officers employed by the HSE. This equates to an average of 4.2 per local health office area. The latest data available from the HSE indicate there are nine community medical officers in the Galway local health office, which is the third highest number in the country. I am satisfied, therefore, that there are sufficient resources to ensure essential child health needs are addressed. The HSE is reviewing its community medical services. This review is nearing completion and is expected to be positive about the future direction of the service with regard to children.
The Senator may ask a supplementary question.
I acknowledge that this matter does not come within the remit of the Minister of State, but I thank him for his very generous remarks to us. This response is very worrying because it does not tie in with the facts as I have outlined them. Will the Minister of State acquaint the Minister for Health and Children with the facts about the shortage of doctors because they do not tie in with what he has stated? The principal medical officer and the director of public health in Galway is very worried about this.
I will. The Senator will also have an opportunity to put her case. She has all the information and she is passionate in her concern. There is nothing like lobbying.