Tuesday, 2 March 2004

Questions (222, 223, 224, 225)

Liz McManus

Question:

302 Ms McManus asked the Minister for Health and Children the reason for his failure to provide adequate funds for the development of the neurophysiology service in Dublin, in view of the fact that there has been no permanent consultant attached to either the national centres of neuroscience or spinal trauma in Dublin for two years, and that the Eastern Regional Health Authority has indicated a willingness to approve a post based at the national neuroscience centre at Beaumont, pending the provision of adequate funding by his Department for essential infrastructural development; and if he will make a statement on the matter. [6652/04]

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Written answers (Question to Minister for Health and Children)

The Eastern Regional Health Authority is charged with responsibility for commissioning health and personal social services on behalf of the population of the region and also on behalf of those outside the region who are referred for specialist treatment. My Department has, therefore, asked the regional chief executive of the authority to examine the issues raised by the Deputy and to reply to her directly.

In addition, the Deputy will be aware that I requested Comhairle na nOspidéal to examine existing arrangements for the provision of consultant-level neurology and neurophysiology services nationally and to make recommendations on the future organisation and development of those services. Comhairle has recently published its report and, having considered it, I am happy to endorse its recommendations for a significant enhancement of neurology and neurophysiology services, including increases in consultant manpower.

The report also recognises that there are aspects of a number of other specialties and services, such as rehabilitation medicine, geriatric medicine and old age psychiatry, which are related to and overlap with neurology services. Comhairle has recommended that a national multidisciplinary review of rehabilitation services be undertaken to inform the policy framework further in regard to the development of neurology services.

Consistent with this recommendation and in line with commitments in the national health strategy, a national action plan for rehabilitation services is currently being prepared by my Department. The action plan will set out a programme to meet existing shortfalls in services and to integrate specialised facilities with locally based follow-up services. The rehabilitation action plan, together with the Comhairle report and the work undertaken by the Neurological Alliance of Ireland through its own publications will, in my view, offer a comprehensive policy framework for the future development of neurology and neurophysiology services in this country.

My Department will continue to work closely with the alliance and with the Irish Consultant Neurologists' Association in regard to the future development of services. The implementation of the Comhairle recommendations will be progressed having regard to the evolving policy framework in this area, competing funding priorities and the report of the national task force on medical staffing.

Richard Bruton

Question:

303 Mr. R. Bruton asked the Minister for Health and Children the systems which he has in place for monitoring and evaluating the standards of health care in hospitals; if the systems are based on self-evaluation by the hospital concerned or external evaluation; the frequency with which defects in standards of care have been uncovered; and the systems which are in place for rectifying such lapses. [6656/04]

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Conor Lenihan

Question:

326 Mr. C. Lenihan asked the Minister for Health and Children the comparative results for the Dublin hospitals and the way in which they fared in the accreditation report conducted on their performance and services in 2003; and if he will rank the different hospitals in the order in which they performed under the different criteria applied to them. [6963/04]

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Conor Lenihan

Question:

327 Mr. C. Lenihan asked the Minister for Health and Children the way in which Tallaght Hospital performed in the accreditation report conducted on the hospital in 2003; and his views on this report on the hospital in view of the fact that it is in relative terms a new facility. [6964/04]

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I propose to take Questions Nos. 303, 326 and 327 together.

The health strategy emphasises the need to ensure the provision of high quality and safe care at the heart of a modernised health service. Consistent with this policy, I established the Irish health services accreditation board, IHSAB, on 1 May 2002.

The IHSAB operates an accreditation programme in the acute hospital sector with the aim of assuring safety for patients, staff and the public, within a framework of continuously improving quality of care. The accreditation process operates through a combination of self-assessment and peer review, using the skills of trained independent Irish and international surveyors in order to assess the safety and quality of care being provided. The standards applied by the IHSAB have been internationally accredited by the International Society for Quality in Healthcare.

The accreditation process first requires each participating hospital to carry out a thorough self-assessment, and to submit its findings to the IHSAB. Subsequently, a team of surveyors will visit the hospital to carry out the accreditation survey, following which a detailed report is issued to the hospital. The process is designed to bring to the attention of the hospital all significant issues which have been identified during the survey.

To ensure that these issues are acted upon, each hospital is required to submit progress reports in relation to issues of specific concern, with a more comprehensive report required from the hospital 12 months after the survey. In addition, surveyors carry out review visits where significant areas of concern have been identified. There is also a requirement that a further complete survey is conducted 18 months following the initial IHSAB survey.

I am satisfied that the accreditation process is already serving to assist participating hospitals in identifying and acting upon opportunities for quality improvement, and I look forward to the continuing roll-out of the scheme by the IHSAB across the hospital sector.

The questions raised relating to the accreditation surveys conducted at Dublin hospitals are appropriate to the IHSAB and, accordingly, have been referred for direct reply to the Deputy.