I thank the Minister for attending to address my concerns about the Institute of Community Health Nursing. One thing of which we can be sure is that all of us wish to be healthy, live long and have a family with few medical concerns, but at one stage or another everyone here will use the health service, in some cases in an emergency and in others for longer term care. Therefore, we must develop, protect and care for health services, something at which we are failing miserably. Despite the economies that have been forced on us, we can be proud of the nurses and doctors who serve us so well. Their loyalty to us and their care should be mirrored by ours for them. The foundations of effective and economic care lie outside the walls of the high-tech hospitals and in the communities. Countless international studies by bodies such as the World Health Organization show that the highest quality and most equitable systems are based on the primary health care model, that is, the care we receive where we live.
My bias is not based on my profession as a GP in rural Ireland but on fact. Family doctors and public health and community nurses have a pivotal role to play. Every day they serve young mothers and their babies and care for the elderly who cannot be as independent as they once were. They are a resource, of which we can be proud and which we should nurture because they are our eyes in communities. For years they have been involved in the early detection of vulnerability and identifying problems such as neglect, child and elder abuse, post-natal depression and the risk of suicide. Community health nurses are generalists. The community is their client and their caseloads include people of every age group across the health-illness spectrum, including mothers and babies, schoolchildren and older people, as well as those with intellectual, mental and physical disabilities. They also provide care for and support those in need of palliative care, as well as their families. They work from local health centres or primary care centres and provide a range of services free of charge, including child health and school visits, visits to care for older people and provide care on discharge from hospital. They provide home and clinical care for adults who have a nursing need and hold a medical card. They co-ordinate respite care support services for carers and assess the need for special equipment. They knock on 10,000 doors every day, delivering services discreetly and effectively in a timely fashion.
Community nurses are supported by the Institute of Community Health Nursing, a small yet vibrant body, the funding of which is far from adequate. In fact, it is abysmal. The organisation seeks the development of the profession in order to research what is done in order that it may be done better and to be an advocate for those who often cannot make their own voices heard. The ICHN is severely struggling to keep services running with the limited number of public health nurses available.
We are all aware that the population is ageing and the Government and the HSE are using this as a justification and reasoning when explaining the crippled emergency department crisis. The chronic ailments afflicting people can and should be addressed by public health nurses in the comfort of their own homes which afford them security and dignity. The waiting lists for older people to receive day care services and families to receive a respite care service when they need a break are a continual frustration and bottleneck in the system.
The key word and a solution is integration in the health system, with social services, hospitals, general practitioners and public health and community nurses working together, preferably through partnership arrangements, for the betterment of the health of the country. The problems we see in secondary care services will never be rectified until primary and community care services are adequately resourced.
