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Health Services

Dáil Éireann Debate, Thursday - 13 January 2011

Thursday, 13 January 2011

Questions (40, 41, 42)

Michael Noonan

Question:

33 Deputy Michael Noonan asked the Minister for Health and Children the reason the Health Service Executive did not meet a funding shortfall of €750,000 for a foundation (details supplied) which will mean that a number of babies with severe developmental delay and brain damage may have to return to hospital at a much greater cost to the health service of €14 million; her views on same; and if she will make a statement on the matter. [1752/11]

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Written answers

The Health Service Executive (HSE) is working jointly with the Jack and Jill Foundation to identify and prioritise the needs of the children on a case-by-case basis. The HSE is prepared to work closely with Jack & Jill to ensure that no child is hospitalised for want of adequate home support, provided by Jack and Jill or the HSE. However, if a child needs hospital care, the HSE will provide this. The Health Service Executive will continue to fund Jack & Jill in 2011 on the same basis as in 2010, subject to any overall resources limitations that may arise for all providers in the disability sector generally, but it is not in a position to provide additional funding for the Foundation to compensate for the drop in its private fund-raising income.

Brian Hayes

Question:

34 Deputy Brian Hayes asked the Minister for Health and Children if standards for home care services have been completed; if these standards will be put on a statutory footing and inspected by the Health Information and Quality Authority; the timeframe for same; and if she will make a statement on the matter. [1727/11]

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Government policy is to support older people to live at home and in their communities for as long as possible and, where this is not an option for whatever reason, to support access to high quality long term residential care. The Government has in recent years provided significant investment to the Health Service Executive, to develop its range of community based services to older people.

The Department of Health and Children accepts the need for a more standardised approach to the regulation of home care generally, whether by statutory or non-statutory providers. The HSE, and the Department progressed during 2010, various improvements in home care provision overall, particularly relating to the governance of services. The position in relation to these is that:

The National Guidelines & Procedures for Standardised Implementation of the Home Care Packages Scheme was recently completed, and will be implemented across all Local Health Offices in 2011.

The HSE launched a Public Procurement Framework for Home Care Services on 22 October last. The Executive is at present progressing this, in line with the requirements and procurement timeframes contained in the Framework.

The Executive is also progressing, with a view to implementation in 2011, Quality Guidelines for Home Care Support Services for Older Peopleand National Guidelines for the Home Help Service.

The Procurement Framework, together with the Quality Guidelines, will enhance the standard of Home Care services provided by, or on behalf of, the HSE.

With reference to the possible regulation of home care services, the July 2008Report of the Commission on Patient Safety and Quality Assurance recommended, amongst other things, the extension of licensing systems to the primary health care area. The Law Reform Commission published, in July 2009, a consultation paper entitled Legal Aspects of Carers. This considers the legal issues surrounding home care and makes a number of provisional recommendations in the area of standards and regulations generally.

As previously indicated to the House, the question of possible changes to legislation, including regulation and inspection, for the area of Home Care for older people generally is under consideration. The Department is, at present, examining the regulation of this sector in the overall context of the licensing of Health Care providers. Legislation is currently being prepared in this regard, taking into account the recommendations of the Commission on Patient Safety, and the Law Reform Commission.

The Government is determined to do everything possible to protect all older people receiving Home Care. Our approach is to progress the various initiatives I have outlined, while examining the options and implications of introducing statutory regulation. It is not possible at this stage to provide a timeframe to indicate when any new statutory regime might be introduced. I wish to assure this House, however, that the Department of Health and Children will progress this work as quickly as possible, in conjunction with monitoring the other initiatives I have outlined above. This would include liaison, as appropriate, with relevant statutory and non-statutory organizations to ensure quality standards for all people receiving Home Care.

Martin Ferris

Question:

35 Deputy Martin Ferris asked the Minister for Health and Children if she will, without further delay and on a statutory basis, put in place regulations for the home care sector, to empower and resource the Health Information and Quality Authority to monitor compliance with these regulations, to establish proper qualifications, pay and conditions for home care workers and to change her policy from privatisation to one of direct provision of home care by the Health Service Executive. [1779/11]

View answer

Government policy is to support older people to live at home and in their communities for as long as possible and, where this is not an option for whatever reason, to support access to high quality long term residential care. The Government has, in recent years, provided significant investment to the Health Service Executive (HSE) to develop its range of community based services for older people. In some cases, where the service is approved and funded by the HSE, this may be undertaken by the Executive through a partnership arrangement with non-statutory providers to maximise service delivery.

In relation to the possible regulation of home care services, the Report of the Commission on Patient Safety and Quality Assuranceof July 2008 recommended,amongst other things, the extension of any licensing systems to the primary health care area. The Law Reform Commission published, in July 2009, a consultation paper entitled Legal Aspects of Carers. This considered various legal issues surrounding home care and made a number of provisional recommendations in the area of standards and regulations generally. The Department of Health and Children accepts the need for a more standardised approach to the regulation of home care, whether by statutory or non-statutory providers. The HSE, and the Department, progressed during 2010 various improvements to home care provision, particularly relating to the governance of services. The recently approved HSE Service Plan 2011 commits the Executive to developing its model of care this year to maximise community services to vulnerable older people. This provision includes:

National Guidelines & Procedures for Standardised Implementation of the Home Care Packages Scheme;

Quality Guidelines for Home Care Support Services for Older People;

National Guidelines for the Home Help Service.

In addition, the HSE launched a Public Procurement Framework for Home Care services on 22 October last. The Executive is progressing this Framework, in conjunction with the other measures outlined above, to enhance these services for HSE home care recipients.

As indicated to the House in recent times, the question of possible changes to legislation, including regulation and inspection, for Home Care services for older people is under consideration. The Department is, at present, examining this matter in the overall context of the licensing of Health Care providers. Legislation is currently being prepared in this regard, taking into account the recommendations of the Commission on Patient Safety, and the Law Reform Commission.

The Government will continue to do everything possible to protect vulnerable older people. This includes progressing the various initiatives I have outlined, while examining the options of introducing statutory regulation. This would have to take account, for example, of any resource or implementation implications. Not all of the issues raised by the Deputy, such as pay, would necessarily be covered by any new statutory regime. The Deputy can rest assured, however, that the Department of Health and Children will work closely with relevant statutory and non-statutory organizations to take all measures necessary to ensure quality standards for all people receiving Home Care.

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