Written Answers Nos. 181-200
181. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will quantify the full-year savings from sourcing the 20 most expensive and 20 most common on-patent pharmaceuticals from another member state parallel import, that state being where the cost of the drug is the lowest in Europe. [30465/14]
View answerMost drugs and medicines which are paid for by the HSE are supplied to patients through over 1,800 community pharmacies who, in turn, purchase them from wholesalers or, to a lesser extent, directly from drug manufacturers. The current pharmacy based model results in over 70 million items being dispensed annually through local pharmacies across the State, including low population centres in rural areas. It enables pharmacies to receive deliveries each day from multiple wholesalers ensuring that all patients have continued access to essential medicines without delay. Under this model, as the drugs are purchased by individual pharmacies with no direct input by the HSE, there is no scope for the type of central procurement arrangement envisaged by the Deputy.
182. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide in tabular form the total amount of moneys collected in 2011, 2012, 2013 and to date in 2014 from private patients using public hospital services as a percentage of total income and as a percentage of actual cost of services used; and if he will make a statement on the matter. [30466/14]
View answerThe information sought by the Deputy is not readily available. However, I have asked the Health Service Executive to supply this information to me and I will forward it to the Deputy as soon as possible.
184. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the extent to which the diagnostic-related groupings system is employed in the health service here; if there is scope to extend this system; the expected efficiencies and savings which could be expected from same; and if he will make a statement on the matter. [30468/14]
View answerDiagnosis Related Group (DRG) systems classify patients into distinct groupings which are clinically similar and consume similar health resources. Irish hospitals use the AR-DRG grouping system which groups each hospital's inpatient and daycase workload into 698 DRGs. Until the end of 2013, the main use of the DRG system was to adjust the budget allocations of acute public hospitals by up to 3% in line with the complexity of their casemix and their relative performance under the Casemix System. DRGs have also been used as a tool to assist with planning as well as monitoring and assessing performance within the acute hospital sector.
Since January, 2014 the DRG grouping system has been used to facilitate the introduction of a new prospective, case-based funding model for public hospital care called Money Follows the Patient. The new model involves moving away from inefficient block grant budgets to a new system where hospitals are paid for the actual level of activity undertaken. As such, hospitals will be funded based on the quantity and quality of the services they deliver to patients. They will be liberated, subject to overall budgetary ceilings, to pursue the most cost-effective means of achieving this standard of performance. Budgetary discipline will be delivered through the use of fixed budgets for MFTP activity.
The new model is being rolled-out on a phased basis and full implementation will take a number of years. The MFTP approach is initially being applied to inpatient and daycase activity in public hospitals. However, it is intended that the payment system will extend over time to cover other hospital activity and eventually evolve so that money can follow the patient out of the hospital setting to primary care. The work of the National Clinical Programmes will be central to the future development of the payment model so that care can be financed as a bundle/package across a variety of settings.
Encouraging hospitals to use the resources at their disposal more efficiently is one of the central objectives of the MFTP system. A recent pilot project, which implemented a MFTP model in the orthopaedic speciality, showed the positive impact that MFTP can have through productivity gains. Introduction of MFTP resulted in significantly reduced average lengths of stay, increased numbers of day of surgery admissions, and an increase in the number of discharges at the weekend. Crucially, these improvements were delivered while not raising any quality concerns.
185. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his views on whether the introduction of a prospective case-based payment system for hospital services using the existing diagnostic-related grouping system would result in savings arising from increased efficiency and productivity of 5%; if he will provide details of the pilot projects carried out to date; if he will provide detail of efficiencies and savings realised, including the money saved, total value and as a percentage of local budgets; and if he will make a statement on the matter. [30469/14]
View answerThe Money Follows the Patient Policy Paper, which I published in February 2013, outlines the Government's plans for the introduction of a prospective case based payment system for hospital services using Diagnosis Related Groups (DRGs). Implementation of this new funding model commenced in January of this year with the approach initially being applied to inpatient and daycase activity in public hospitals. Full implementation will take a number of years and a phased approach to roll-out is being employed. The new model involves moving away from inefficient block grant budgets to a new system where hospitals are paid for the actual level of activity undertaken. As such, hospitals will be funded based on the quantity and quality of the services they deliver to patients. They will be liberated, subject to overall budgetary ceilings, to pursue the most cost-effective means of achieving this standard of performance. Budgetary discipline will be delivered through the use of fixed budgets for Money Follows the Patient (MFTP) activity. It should be noted that, as stated in the MFTP Policy Paper, the new funding mechanism does not aim to reduce budgets but, rather to drive efficiency in the provision of high quality hospital services.
Prior to the commencement of MFTP, the HSE operated a prospective funding pilot programme for Primary Hip and Knee Replacements (four DRGs) between 2011 and 2013. The pilot related to elective work only. Seven hospitals initially participated, with a further five joining from January 2012. The pilot involved the participating hospitals' current budgets being reduced by an amount of money related to the four DRGs. This portion of the budget was then “earned” back, based on the work carried out in the hospital. There was no other change to any other portion of the hospital budget.
No specific savings figures have been calculated for the pilot programme. However, reviews of the pilot highlighted a number of efficiency related benefits including significantly reduced average lengths of stay, increased numbers of day of surgery admissions, and an increase in the number of discharges at the weekend. While the level of improvement varied across the different hospitals and the different DRGs, all showed significant improvements in these key determinants of hospital efficiency and productivity.
This pilot was the first example of Money Follows the Patient in operation in Irish hospitals and was a useful exercise in highlighting the benefits that can accrue as a result of these types of funding arrangements. It also provided useful lessons in terms of systems and process requirements as well as the need for stakeholder buy-in ahead of roll-out to the wider hospital system.
A shadow funding exercise was also carried out in Q4 2013 using eight representative hospitals. This exercise: (i) compared, on a systematic basis, actual hospital activity against baseline activity targets; and (ii) informed hospitals of what the financial implications of any variance from the targets would be in a “live” system without impacting on budgets. Although this was not strictly speaking a "pilot" it did provide key lessons which are being applied in the 2014 MFTP roll-out.
While it is not possible to specify a percentage increase in efficiency that will result when MFTP is rolled out across all public hospitals, I am confident that its introduction will drive efficiencies in similar areas to those evident in the orthopaedic project. This will help to deliver a more efficient and productive hospital system.
186. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the total State spend on suicide prevention and awareness projects, including funding for the National Office of Suicide Prevention, for the years 2011, 2012, 2013 and to date in 2014; if he will provide a breakdown of same by year and by scheme and-or project; and if he will make a statement on the matter. [30470/14]
View answerFunding for suicide prevention is provided to the National Office for Suicide Prevention (NOSP) by the HSE from its overall budget for mental health. Funding provided in the years 2011 to 2014 is set out in the following table.
|
Year |
Funding €m |
|
2011 |
4.1 |
|
2012 |
7.1 |
|
2013 |
8.1 |
|
2014 |
8.8 |
Responsibility for the allocation of this funding rests with the NOSP. I have therefore, referred the question regarding the breakdown of the spend by scheme/project to that Office for attention and direct reply to the Deputy.
187. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the total State spend on Health Service Executive disability services for the years 2011, 2012, 2013 and to date in 2014; if he will provide a breakdown of same by year and by scheme and-or project; and if he will make a statement on the matter. [30471/14]
View answerThe Government is fully committed to ensuring the on-going delivery of vital services and supports to people with disabilities within available resources. The Health Service Executive (HSE) was provided with funding for Disability Services since 2011 as follows; €1,576 million in 2011, €1,554 million in 2012, €1,535 million in 2013. The HSE has been provided with funding in the order of €1.4 billion this year to fund the 2014 disability services programme for children and adults with disabilities. The majority of this funding is distributed through non-statutory agencies who deliver over 80% of all disability services. There are in the region of 300 such agencies at present across the country that provide a significant and broad range of services for children and adults with disabilities in partnership with and on behalf of the HSE.
The manner in which funding is allocated/distributed allows for a distinction between broad categories of funding such as services for older people, primary care and disabilities in general. Disability services are provided based on the needs of an individual rather than by the actual type of disability. The HSE has informed the Department of Health that it does not separate out the spend on Physical & Sensory, Intellectual or Autism Disabilities as some of the Disability Service providers offer services to both Intellectual and Physical & Sensory service users.
In relation to the specific queries raised by the Deputy, as these are service issues, they have been referred to the Health Service Executive for direct reply to the Deputy.
188. Deputy Ciarán Lynch asked the Minister for Health the reason a financial statement regarding a medical card has not issued to a person (details supplied) in County Cork some eight weeks after the decision, thus preventing an appeal; and if he will make a statement on the matter. [30474/14]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has issued to Oireachtas members.
189. Deputy Bernard J. Durkan asked the Minister for Health the progress made to date in respect of an appeal for medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [30480/14]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has issued to Oireachtas members.
190. Deputy Thomas Pringle asked the Minister for Health further to Parliamentary Question No. 585 of 24 June 2014, if he will provide a breakdown in tabular form of the number of persons on the long-term illness scheme who were also medical card holders for the period October 2010 to end of November 2013. [30481/14]
View answerThe HSE is responsible for the administration of the community drug schemes, therefore, this matter has been referred to the HSE for attention and direct reply to the Deputy.
191. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 166 of 2 July 2014, the reason those medical card holders who had a serious illness or disability and who lost discretionary medical cards as a result of a decision by the centralised office prior to 1 July 2011 are not being treated in the same manner as medical card holders in the same circumstances who lost them after 1 July 2011. [30487/14]
View answerAs the Deputy is aware, prior to mid 2011, the medical card scheme was operated locally in approximately 100 administrative centres throughout the country which, until 2005, were managed by 10 different autonomous health boards. This model gave rise to the application of a non-standard approach when the element of discretion was used in the decision to grant a medical card. The different treatment of cases depending on their geographical location, is fundamentally discriminatory, an undesirable administrative practice and contrary to fair or sound administration.
The centralisation of medical card processing was completed on 1 July 2011. This meant that all new medical card applications and reviews made from 1 July 2011 were processed centrally by the PCRS Office in Finglas, Dublin. Centralisation delivered a consistent and equitable application of eligibility and service provision and has provided clearer governance and accountability, as well as improved management information. It is in the context of the finalisation of the centralisation project - 1 July 2011 - that the Government decided that the HSE would issue cards to persons, with a serious illness, whose discretionary card was refused renewal in the period from 1 July 2011 to 31 May 2014.
It should be noted that the provisions of the Health Act, 1970 (as amended) have not changed and that all applications for a medical card continue to be assessed against the HSE's National Assessment Guidelines. The HSE is continuing to assess and issue medical cards where discretion has been exercised to people to avoid undue financial hardship. In the event of a change in circumstances for those who had the renewal of their eligibility refused, they can submit a new application to PCRS.
192. Deputy Finian McGrath asked the Minister for Health when the drug eculizumab will be sanctioned for a person (details supplied) in County Laois. [30491/14]
View answer193. Deputy Finian McGrath asked the Minister for Health the reason the drug eculizumab is not being sanctioned for a small number of persons with a life-limiting disease; and if he will make a statement on the matter. [30492/14]
View answerI propose to take Questions Nos. 192 and 193 together.
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. The HSE received an application for the inclusion of Eculizumab (Brand: Soliris) in the community drugs schemes. The application was considered in line with the procedures and timescales agreed in 2012 by my Department and the HSE with the Irish Pharmaceutical Healthcare Association (IPHA).
In accordance with these procedures, the National Centre for Pharmacoeconomics (NCPE) conducted a pharmacoeconomic evaluation of Eculizumab and concluded that, at a total cost per patient per year of €437,247 and a cumulative gross budget impact over 5 years estimated at €33 million, the therapy did not represent value for money for the treatment of patients in the Irish healthcare setting. In addition, the manufacturer did not include an economic model as part of their submission and failed to demonstrate the cost-effectiveness of this therapy. Consequently, the NCPE was unable to recommend reimbursement of the product under the community drug schemes. The report is available on the NCPE's website www.ncpe.ie.
The NCPE report is an important input to assist the HSE in its decision making process and informs further discussions between the HSE and the manufacturer of the drug. The HSE assessment process is intended to arrive at a decision on the funding of high cost new medicines that is clinically appropriate, fair, consistent and sustainable. The HSE is now carefully considering all the issues which arise in relation to the proposed benefits and costs of this medicine and expects to reach a decision in the near future.
194. Deputy Róisín Shortall asked the Minister for Health the target month for the finalisation of a costed implementation plan for the national clinical programme for asthma; and the steps he is taking to ensure this implementation plan will be finalised in time for inclusion in the 2015 Health Service Executive service plan. [30493/14]
View answerThe HSE, through its Clinical Strategy and Programmes Division, established the National Clinic Programme for Asthma (NCPA), which is one of a number of chronic disease programmes aimed at bringing a systematic approach to changes in how services for patients are delivered. The overarching aim of the Programme is to reduce the morbidity and mortality associated with asthma in Ireland and to improve clinical outcomes and the quality of life of all patients with asthma. A key component is the improved management of people with asthma in primary care, thereby avoiding emergency attendance at General Practitioner (GP) out-of-hours services, emergency departments and in-patient services.
The initial focus has been on the development of national asthma guidelines based on international best practice, early asthma diagnosis, active asthma treatment, guided self-management and patient education. This work is complete. A number of other elements of the Programme have also been implemented, including an asthma education programme and patient education materials. The Programme has also developed a National Model of Care for Asthma, which details how physicians, nurses and other health professionals will work with engaged patients to make the clinical decisions most appropriate to their circumstances; and to collaborate with specialist colleagues in providing a safe, seamless patient experience within the health system in Ireland.
The National Model of Care for Asthma in general practice has been agreed by the HSE's Clinical Programmes, the Asthma Society and the ICGP. Implementation of this model in general practice involves consultation on the GP contract with representative bodies. A Framework Agreement with the Irish Medical Organisation (IMO) has recently been signed, which allows progress on these issues, initially in the context of the provision of GP care free at the point of access for children under 6 years.
The following revised reply was received on 23 October 2014.
The HSE, through its Clinical Strategy and Programmes Division, established the National Clinic Programme for Asthma (NCPA), which is one of a number of chronic disease programmes aimed at bringing a systematic approach to changes in how services for patients are delivered.
The overarching aim of the Programme is to reduce the morbidity and mortality associated with asthma in Ireland and to improve clinical outcomes and the quality of life of all patients with asthma. A key component is the improved management of people with asthma in primary care, thereby avoiding emergency attendance at General Practitioner (GP) out-of-hours services, emergency departments and in-patient services.
The initial focus has been on the development of national asthma guidelines based on international best practice, early asthma diagnosis, active asthma treatment, guided self-management and patient education. This work is complete.
A number of other elements of the Programme have also been implemented, including an asthma education programme and patient education materials.
The Programme has also developed a National Model of Care for Asthma, which details how physicians, nurses and other health professionals will work with engaged patients to make the clinical decisions most appropriate to their circumstances; and to collaborate with specialist colleagues in providing a safe, seamless patient experience within the health system in Ireland.
The National Clinical Programme for Asthma Model of Care has been approved by the HSE and the Asthma Society and planning is underway for implementation. Implementation of this model in general practice will require consultation with the Irish Medical Organisation (IMO).
A Framework Agreement with the IMO has recently been signed, which allows progress on these issues, initially in the context of the provision of GP care free at the point of access for children under 6 years.
195. Deputy Colm Keaveney asked the Minister for Health in reference to a recent health and safety audit report dated June 2014 conducted in the department of psychiatry at University Hospital Galway which noted that some staff working in the unit had not received training and education in relation to physical restraint, which is a requirement in the 2009 code of practice of the Mental Health Commission on the use of physical restraint in approved centres, the number of staff currently assigned to that department; the number who have not received the training referred to earlier; the action taken to address the management failure in not ensuring all staff had received this training; if any disciplinary action has been taken in relation to this matter; and if he will make a statement on the matter. [30504/14]
View answerAs this is a service matter this question has been referred to the HSE for direct reply.
196. Deputy Colm Keaveney asked the Minister for Health in view of the requirement in the 2009 code of practice by the Mental Health Commission on the use of physical restraint in approved centres that all staff working in such units receive training and education in relation to physical restraint of psychiatric patients, and in view of the fact that psychiatric patients sometimes present in accident and emergency units, if he will confirm that all staff working in such units, including any private security guards, have received this training; if he will provide details of the last audit carried out into this; the number of staff who have yet to receive the appropriate training and education; and if he will make a statement on the matter. [30505/14]
View answerAs this is a service matter this question has been referred to the HSE for direct reply.
197. Deputy Colm Keaveney asked the Minister for Health his views on whether it is appropriate that private security guards may be deployed to assist in restraining psychiatric patients in accident and emergency departments; if there have been any incidents of same in 2012 or 2013; and if he will make a statement on the matter. [30506/14]
View answerThe question of employing private security guards is a matter for hospital management in the first instance, in accordance with appropriate legal and other standards. I have been advised by the HSE that security arrangements in terms of deployment differ from hospital to hospital and policies are devised and implemented at a local level.
As this is a service matter I have referred the question to the HSE for attention and direct reply to the Deputy.
198. Deputy Colm Keaveney asked the Minister for Health if he will provide in tabular form the numbers of patients, broken down by status as either voluntary or involuntary patients, who have been subjected to electroconvulsive therapy without their express consent in each inpatient acute psychiatric unit, for each year from 2011 to 2013, inclusive, and to date in 2014; and if he will make a statement on the matter. [30507/14]
View answerThe Mental Health Act, 2001 includes a range of safeguards to ensure that the rights of people who are admitted involuntarily for psychiatric care and treatment are protected. In relation to the administration of ECT, section 59 of the Act requires that a patient must consent in writing to the treatment unless he or she is unable or unwilling to give consent, the treatment may then be administered if it has been approved by the consultant psychiatrist responsible for the care and treatment of the patient, and also authorised by another consultant psychiatrist. ECT remains a recognised treatment for severe mental illness. The Mental Health Commission has published rules regarding the administration of ECT and adherence to these rules is monitored on an annual basis by the Inspector of Mental Health Services.
Information on the numbers treated with ECT is collected by the Mental Health Commission. The following table shows the number of patients who have had ECT for the years 2011 - end June 2014. The second table lists the approved centres in which ECT was performed, for each of those years. The Commission does not provide specific details of the number of ECT treatments for each centre as this information may potentially enable patients to be identified.
Treatment without Consent Electroconvulsive Therapy (Adult) from 1 January 2011 to 30 June 2014
|
- |
- |
- |
- |
Legal Status of Patient |
- |
- |
Reason for Lack of Consent |
|
Year |
No. Approved Centres Administrated ECT |
No of Individual Patients |
Involuntary |
Voluntary |
Unable |
Unwilling |
Other* |
|
2014 (1 Jan – 30 June) |
6 |
15 |
16 |
0 |
14 |
2 |
0 |
|
2013 |
12 |
34 |
36 |
0 |
32 |
1 |
3 |
|
2012 |
14 |
27 |
28 |
0 |
24 |
1 |
3 |
|
2011 |
13 |
22 |
25 |
0 |
18 |
3 |
4 |
|
- |
- |
- |
- |
- |
2014 and 2013 Data undergoing validation with services and may be subject to minor amendments |
- |
- |
* Treating CP indicated unable/Another CP indicated unwilling
Treating CP indicated unwilling/Another CP indicated unable
Treating CP indicated unwilling & unable/Another CP indicated unable
Treatment without consent Electroconvulsive Therapy (Adult) from 1 January 2011 to 30 June 2014
|
Year |
Names of Approved Centres |
|
2014 |
Avonmore & Glencree Units, Newcastle Hospital |
|
- |
Department of Psychiatry, Letterkenny General Hospital |
|
- |
Department of Psychiatry, St Luke's Hospital, Kilkenny |
|
- |
Department of Psychiatry, University Hospital Galway |
|
- |
Elm Mount Unit, St Vincent's University Hospital |
|
- |
St Patrick's University Hospital |
|
2013 |
Acute Psychiatric Unit 5B, University Hospital Limerick |
|
- |
Acute Psychiatric Unit, AMNCH (Tallaght) Hospital |
|
- |
Admission Unit & St Edna's Ward, St Loman's Hospital, Mullingar |
|
- |
Adult Mental Health Unit, Mayo General Hospital |
|
- |
Department of Psychiatry, Letterkenny General Hospital |
|
- |
Department of Psychiatry, Midland Regional Hospital, Portlaoise |
|
- |
Department of Psychiatry, St Luke's Hospital, Kilkenny |
|
- |
Elm Mount Unit, St Vincent's University Hospital |
|
- |
Jonathan Swift Clinic |
|
- |
St Edmundsbury Hospital |
|
- |
St Patrick's University Hospital |
|
- |
St Vincent's Hospital – St Louise's, St Mary's, St Teresa's, & Psychiatry of Old Age Wards |
|
2012 |
Acute Psychiatric Unit, AMNCH (Tallaght) Hospital |
|
- |
Admission Unit & St Edna's Ward, St Loman's Hospital, Mullingar |
|
- |
Adult Mental Health Unit, Mayo General Hospital |
|
- |
Clonfert Ward & St Luke's Ward, St Brigid's Hospital, Ballinalsoe |
|
- |
Department of Psychiatry, Letterkenny General Hospital |
|
- |
Department of Psychiatry, Midland Regional Hospital, Portlaoise |
|
- |
Department of Psychiatry, St Luke's Hospital, Kilkenny |
|
- |
Department of Psychiatry, Waterford Regional Hospital |
|
- |
Elm Mount Unit, St Vincent's University Hospital |
|
- |
Highfield Hospital |
|
- |
Jonathan Swift Clinic |
|
- |
St Aloysius Ward, Mater Misericordiae University Hospital |
|
- |
St John of God Hospital Limited |
|
- |
St Patrick's University Hospital |
|
2011 |
Elm Mount Unit, St Vincent's University Hospital |
|
- |
Jonathan Swift Clinic, St James's Hospital |
|
- |
Acute Psychiatric Unit, AMNCH, Tallaght |
|
- |
Department of Psychiatry, Midland Regional Hospital, Portlaoise |
|
- |
St Aloysius Ward, Mater Misericordiae University Hospital |
|
- |
Department of Psychiatry, Connolly Hospital |
|
- |
South Lee Mental Health Unit, Cork University Hospital |
|
- |
Department of Psychiatry, St Luke's Hospital, Kilkenny |
|
- |
Acute Psychiatric Unit, Midwestern Regional Hospital, Ennis |
|
- |
St Brigid's Hospital, Ballinasloe |
|
- |
Department of Psychiatry, University College Hospital Galway |
|
- |
St John of God Hospital |
|
- |
St Patrick's Hospital |
199. Deputy Colm Keaveney asked the Minister for Health the number of cognitive behavioural theorists currently employed within each Health Service Executive operational area; the number of whole-time equivalent posts there are; if he will increase that number; and if he will make a statement on the matter. [30509/14]
View answerAs this is a service matter this question has been referred to the HSE for direct reply.
200. Deputy Colm Keaveney asked the Minister for Health the policy initiatives his Department has taken since 2011 aimed at disrupting the power relations within inpatient psychiatric units in terms of service users and those delivering the service; the number of service users appointed to the area management teams within the Health Service Executive; if none, when he plans to implement this policy; and if he will make a statement on the matter. [30510/14]
View answerA Vision for Change, our mental health policy, recommends that service users and carers should participate at all levels of the mental health system. It is acknowledged that service users have a unique insight into the experience of mental illness and are central to how we progress and further develop our mental health services.
In line with this policy, the HSE in September 2013, commenced a consultation process with a range of stakeholders representing services users, family members and carers to seek to determine how their independent voices will continue to be heard. This consultation led to the appointment of an interim Head of Service User, Family Member and Carer Engagement in January 2014 as a member of the HSE National Mental Health Management Team and a commitment to establish of a Reference Group to provide service user, family member and carer input into new organisational structures.
A Vision for Change recommends that a recovery orientation should inform every aspect of service delivery and service users should be partners in their own care. The Recovery approach that we want to see places a unique emphasis on the value of each person and their understanding of their illness and should be seen as natural process which service users believe can put greater choice and control back in their hands.
The 'Advancing Recovery in Ireland' (ARI) initiative which is a partnership project between the HSE and other bodies is a welcome development. The initiative focuses on service level structures, systems and practices that can maximise personal recovery opportunities and outcomes for service users. It aims to achieve this by facilitating the individual to manage their personal recovery and by the development of recovery focused mental health practice in the service. It recognises the service provider, service user and family as equal stakeholders. Some of the innovations being developed through ARI are Recovery Colleges, Peer Support Working and the Recovery Context inventory Tool. The ARI is an 18 month initiative which is being rolled out on a phased basis to allow maximum benefit, the initial phase of which commenced in May 2013.
In relation to the number of service users that have been appointed to the area management teams, as this is a service issue I have asked the HSE to provide this information directly to the Deputy.
