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Health Services.

Dáil Éireann Debate, Tuesday - 21 June 2005

Tuesday, 21 June 2005

Questions (30)

Liam Twomey


51 Dr. Twomey asked the Tánaiste and Minister for Health and Children the number of services (details supplied) for the elderly, that were promised in the national health strategy 2001, which have been delivered since 2001; and if she will make a statement on the matter. [21184/05]

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Oral answers (8 contributions) (Question to Minister for Health)

The national health strategy, Quality and Fairness: A Health System for You, was launched in 2001 by the former Minister for Health and Children, Deputy Martin. The strategy is centred on a whole system approach to tackling health in Ireland and goes beyond the traditional concept of health services. It is about developing a system in which best health and social wellbeing are valued and supported. The strategy sets out a blueprint to guide policy makers and service providers in the planning and delivery of health services over a seven to ten-year period. It sets national goals for better health for everyone, fair access, responsive and appropriate care delivery and high performance.

There have been many reforms to our health services since the publication of the strategy, most notably the enactment of the Health Act 2004 which transferred responsibility for the management and delivery of health and personal social services to the Health Service Executive. The strategy outlined a number of action points regarding services for older people which the executive continues to implement. The Department has requested the parliamentary affairs division of the executive to arrange to have this matter investigated and to have details of the specific services for older people being delivered now to be collated and to reply directly to the Deputy.

I would like to highlight a number of developments since the publication of the strategy. Additional revenue funding of approximately €121 million was allocated for services for older people between 2002 and 2004. Some €15.228 million in additional funding has been allocated for services for older people this year. That money is being spent on a variety of services, such as nursing home subventions, home care grants, elder abuse and the home help service. Following the publication of the O'Shea report on the nursing home subvention scheme, a working group of all stakeholders was established by the Department to review the scheme's operation and administration. The review was launched in 2003, at the same time as the report of the Department of Social and Family Affairs on the financing of long-term care.

An interdepartmental group comprising senior officials from the Departments of Finance, Health and Children and Social and Family Affairs and chaired by the Department of the Taoiseach was established in January 2005 to identify the policy options for a financially sustainable system of long-term care. The group is due to report to the Tánaiste and the Minister for Social and Family Affairs this summer. Home care grant schemes have been piloted in a number of areas as an alternative to long-term residential care, to assist older people living at home in the community. Older people being discharged from the acute hospital system and those living in the community are being targeted under the schemes. Funding of €2 million has been allocated to the Health Service Executive for the scheme this year.

The ten-point action plan aimed at improving the delivery of accident and emergency services, which was announced by the Tánaiste, is being implemented at present. Additional revenue funding of €70 million has been made available to the Health Service Executive in 2005 for the initiatives, which include measures to facilitate the discharge of patients from acute hospital beds to a more appropriate setting.

Additional information not given on the floor of the House.

There are three specific proposals relating to services for older people in the plan. An additional 500 older people will receive intermediate care for up to six weeks in the private sector. Some 100 high-dependency patients will be transferred from acute hospitals to private nursing home care. The home care package scheme will be expanded to support 500 additional older people who have been discharged from the acute hospital sector to their own homes.

I will remind the Minister of State of the kind of details I was seeking when I tabled this question. I wanted to know how many of the promised 600 additional day hospital beds were provided. It was planned to provide such beds in facilities offering specialist services to those affected by falls, osteoporosis, fractures, Parkinson's disease, strokes, heart failure and incontinence. Have the promised 1,370 additional assessment and rehabilitation beds been put in place? How many of the planned 7,000 day care places for the elderly have been provided? What has happened to the Government's intention, as outlined in the strategy, to establish 800 places each year in additional extended care and community nursing units? It is not unreasonable, almost four years after the publication of the strategy, to want to know how many of the places in question have been put in place in the health care system.

What is happening in respect of long-term beds? I tabled a question six months ago looking for information about the number of long-stay beds in public nursing homes under the control of each of the six HSE subdivisions. I learned that the number of such beds is decreasing in each of the subdivisions which bothered to reply. I did not receive a response from some of the subdivisions to my parliamentary question.

Do I understand correctly from the Minister of State's reply that the Government did not initiate a review of its policy for the care of the elderly until recently, even though such a review was promised in the health strategy? Is it the case that no policy will be in place until the review has been completed? Can the Minister of State explain why just 5% of people in this jurisdiction who suffer strokes have access to rehabilitation beds, according to the Irish Heart Foundation, when 70% of people in Northern Ireland enjoy such access in such circumstances? I would like the Minister of State to tell me why many of the statistics relating to care beds are terrible. We have heard many announcements of what is planned.

We are running out of time for this question.

I would like to get answers to the questions I have asked. We all hear about spin, but——

I suggest that the Deputy submit a question.

I am looking for an answer to the clear question I originally submitted. The former Minister for Health and Children, Deputy Martin, and the Minister of State, Deputy Callely, spent two years discussing the planned provision of 850 community beds. Now it has gone into a puff of wind.

As I have said, the 2001 health strategy outlined a number of measures which could be taken to improve services for older people. The Government has implemented a number of the strategies. The HSE will continue to implement the strategies and to make the improvements which have been commenced. I have given details of the finances which have been made available to support the measures in question. The Department has contacted the parliamentary affairs division of the HSE to get the specific figures sought by Deputy Twomey.

When the Minister of State writes to the HSE, he should ask it to reply promptly to the questions asked by Deputies. I refer to questions which have been submitted.