Wednesday, 16 November 2011

Questions (239, 240)

Liam Twomey

Question:

238 Deputy Liam Twomey asked the Minister for Health the aspects of the Croke Park agreement, such as an 8 a.m. to 8 p.m. working day and a 5-7 workday week, that have been implemented; the areas of the health service in which this is happening; and if he will make a statement on the matter. [34965/11]

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Written answers (Question to Minister for Health)

The Public Service Agreement is an essential "enabler" for the health sector, to allow services to respond the healthcare needs of the population in an appropriate and sustainable manner, against a backdrop of very significant reductions in financial and staff resources. The Agreement also facilitates the implementation of major reforms aimed at improving access to services, as well as improving quality and safety, achieving better value for money and improving health outcomes at a population level.

The introduction of revised working patterns, such as an extended working day (8 a.m. to 8 p.m.) and new rostering arrangements, has potential significantly to improve the responsiveness and efficiency of health service delivery. Agreement was reached in February 2011 with the relevant staff unions (MLSA, IMPACT and SIPTU) on the introduction of an extended working day for medical laboratory staff. This affects some 3,000 staff, who now have a liability to be rostered between 8 a.m. and 8 p.m. from Monday to Friday. The HSE has projected annual savings of at least €5m arising from this agreement. Discussions are at present underway in relation to revision of work patterns for radiography staff and the HSE has also tabled proposals for more flexible rostering arrangements for nursing staff.

To date, the HSE has submitted two detailed progress reports on the implementation of the Health Sector Action Plan under the Public Service Agreement to the national-level Implementation Body. These refer to the periods March 2010-March 2011 and April 2011-September 2011 respectively. Sectoral progress reports are published on the Implementation Body's website www.implementationbody.gov.ie

Significant achievements reported to date include the transfer of the Community Welfare Service from the HSE to the Department of Social Protection, the centralisation of medical card processing (with estimated annual savings of €20m), implementation in late 2010 of a voluntary early retirement scheme and voluntary redundancy scheme for certain staff categories, under which 1,626 WTE staff left the public health service, and internal redeployment of a further 750 staff.

There must remain a clear focus on the part of all parties to the Agreement on achieving the changes and in particular the efficiencies which the PSA makes possible. The HSE will continue to pursue further initiatives with the staff side to ensure that all possible benefits from the Agreement are achieved.

Liam Twomey

Question:

239 Deputy Liam Twomey asked the Minister for Health how the Health Service Executive intends monitoring quicker discharge of patients, particularly at weekends by hospital consultants; the other changes to consultants’ work practices envisaged under the Croke Park agreement; and if he will make a statement on the matter. [34966/11]

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Immediately following my appointment I set about establishing the Special Delivery Unit to unblock access to acute services by improving the flow of patients through the system. The SDU was established in June and quickly began work with the HSE to put in place a systematic approach to eliminate excessive waiting in emergency departments.

The problems in our emergency departments are complex and they did not arise overnight. The particular issues vary from hospital to hospital and some of the solutions will depend on local factors. However it is clear that in many cases delayed discharge is a major factor. More rapid discharge depends on a number of factors but regular and timely ward rounds by consultants is critical, including at weekends. As part of the work the SDU is doing in supporting the HSE this issue is being closely monitored particularly on those sites which have a particular problem with trolley waits.

With regard to changes to consultants work practices, an immediate priority is to achieve more effective implementation of Consultant Contract 2008. I believe there is plenty of scope under the 2008 Contract, that provides for an extended working day, an increase in the length of the working week and structured weekend work, with consultants working as part of a team delivering the Clinical Directorate Service Plan, and the Croke Park agreement to achieve greater productivity from consultants. For example, increased consultant participation in patient discharges at weekends would more quickly free up beds for emergency admissions.

Question No. 240 answered with Question No. 236.