Written Answers Nos. 667 - 677
667. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the total number of non-consultant hospital doctors in tabular form by grade, gender and by Health Service Executive Region; and if he will make a statement on the matter. [3860/13]
View answerSubject to overall parameters set by Government, the Health Service Executive has the responsibility for determining the composition of its staffing complement. I have asked the Executive to compile the information requested by the Deputy and to reply to him directly.
668. Deputy Billy Kelleher asked the Minister for Health if he will confirm that no policy/guideline document exists to cover the administration of medicines by domiciliary care service employees; and if he will make a statement on the matter. [3870/13]
View answer676. Deputy Billy Kelleher asked the Minister for Health if he intends to introduce guidelines similar to the Guidelines for the Control and Administration of Medicines - Domiciliary Care Agencies as published by the Regulation and Quality Improvement Authority of Northern Ireland; and if he will make a statement on the matter. [3974/13]
View answer677. Deputy Billy Kelleher asked the Minister for Health if he will provide a copy of the Health Service Executive policy covering the role of care workers regarding medication; and if he will make a statement on the matter. [3979/13]
View answerI propose to take Questions Nos. 668, 676 and 677 together.
Government for National Recovery 2011 - 2016 commits to developing and implementing national standards for home support services, which will be subject to inspection by the Health and Information Quality Authority (HIQA).
1. Older People:
Primary legislation and resources will be required for the introduction of a statutory regulation system for home care services. The question of possible changes to legislation, including regulation and inspection for Home Care services for older people is under consideration. The Department is examining this matter at present, 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 Commission on Patient Safety and the Law Reform Commission. Various options are being considered at present, including the complex legal issues involved.
Currently the focus is for the Health Service Executive (HSE) to implement national guidelines on Home Care Packages while also developing additional guidelines in relation to the Home Help service and Quality Guidelines for Home Care Support Services. The latter two sets of guidelines are the subject of negotiations between the HSE and SIPTU, under the auspices of the Labour Court.
In addition, the HSE introduced in mid-2012, a Public Procurement Framework for Home Care services. These measures have been designed to enhance service provision overall, including quality and safety, for HSE home care recipients. Awarding of contracts is conditional upon vetting and other governance and quality assurance mechanisms.
2. Disability Services
The policies, guidelines, best practice standards, including legislation, are outlined in Part 2 of the Service Arrangements between the HSE and service providers. Currently, no national policy pertaining to the safe administration of medication within the disability sector, as applied to domestic settings, is included within Part 2 of the Service Arrangement.
Personal Assistants do not have responsibility or authority to administer medication directly to the service users. However, as PAs are directed by the service user, it is possible that under the service user's direction and in line with the service's "Safe Administration of Medication" policy, they may assist the service user in self-medication, i.e. opening a container / blister pack due to physical and sensory restrictions.
The remit of Care Workers that provide home support/home help type services is limited to supporting clients and the families in daily activities and is a "domestic" role. In these cases, the home support workers work alongside the family of the service user and do not have a role in the management of medication, which remains the responsibility of the family/primary carer.
The HSE has a clear expectation that all service providers have a "Safe Administration of Medication" policy in place. Some service providers have identified to the HSE that they are looking at developing broader medication management policies and "upskilling" their staff to allow for the safe administration of medication, as the service users currently need to be attended by a Nurse when direct administration of medication is required i.e. insulin injection or PRN medication.
Currently most service providers have policies in place when medication is self-administered with the support / observation of the staff i.e. opening a container/blister pack due to physical and sensory restrictions. With the de-congregation of services and the development of community based services that offer semi-independent living for clients with physical and sensory and/or intellectual disabilities, service providers are developing a range of staff supports that necessitate the development of "Safe Administration of Medication" policies for these staff grades. In this context, service providers will need to ensure that training is put in place for all staff grades alongside appropriate supervision and audit process.
There is significant learning to be gained from the safe administration of medication practice within community residential settings, alongside the best practice in place by service providers in domestic settings. These practices will be reviewed by the HSE, as the specification for Home Support and PA Services is developed for the disability sector in the coming months.
Insofar as regulation of residential services for people with disabilities are concerned, I can confirm that the Health and Information and Quality Authority will shortly be submitting standards for this sector to my Department for approval and it is anticipated that these will be launched in February. These standards will confirm that residential centres should have appropriate policies and procedures for medication management. However, these standards will only apply to residential services which are provided by the HSE or other service providers. They would not be applicable to people living in their own homes. Work is underway on the regulations required to bring the standards into law and discussions are taking place at the moment on the resources and staffing required by HIQA from 2013 onwards.
It is expected that the new regulatory system should be up and running by mid 2013.
673. Deputy Billy Kelleher asked the Minister for Health the reason Raphoe, County Donegal, did not make it to the top of the primary care centre list; and if he will make a statement on the matter. [3931/13]
View answerDelivery of health care infrastructure is a service issue. Therefore your question has been referred to the Health Service Executive for direct reply.
675. Deputy Nicky McFadden asked the Minister for Health if the services of a personal assistant will be provided for persons over the age of 65 years and who are generally most in need of this valuable service; and if he will make a statement on the matter. [3973/13]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive, for direct reply to the Deputy.
