asked the Minister for Health if he is aware that the present structure of hospital administration does not permit dietitians and catering officers to make an adequate contribution to patient welfare; and if he will take the necessary steps to remedy the situation.
Ceisteanna—Questions. Oral Answers. - Hospital Dietetic and Catering Services.
30.
I am not so aware. I am satisfied that doctors are fully conscious of the importance of diet in patient welfare and take it fully into account when prescribing treatment.
The Minister is not unaware of the very responsible statement made recently to the opposite effect by somebody who is concerned in this area and who is not satisfied that sufficient attention is paid to general dietetic considerations in our hospitals?
Yes, I read a copy of the young lady's speech and heard her being interviewed on radio one morning while travelling to Dublin. I do not disagree with everything she said and neither do I necessarily agree with all that she said. Before I came in for Question Time a letter signed by the chairman of Sir Patrick Dun's Hospital and also chairman of the catering committee of that hospital was brought to my attention. It is a letter published in The Irish Times in which he refutes many of the suggestions, allegations or comments made by the lady in question. I think the Deputy would agree that prescribing treatment is primarily a matter for the doctor, who would do this in consultation with the dietitians and catering officers. I do not think they should have the exclusive right of determining a diet because the doctor is the person who treats a patient. He may decide on a low protein or a high protein content in the meals provided for patients and then, I assume, the catering officer or the dietitian would decide what type of food would be provided.
As the Minister is probably aware, my own personal experience indicates quite clearly that I should, and indeed I have every respect for the medical administration of our hospitals. But my question is directed to a particular aspect of hospital administrative structure. Perhaps the Minister would consider if the dietitians and catering officers have sufficient status and standing in the hospital administrative structure.
I think I shall be referring to that in some late questions. If not, would the Deputy, perhaps, put down a specific question?
31.
asked the Minister for Health the number of dietitians who are employed (a) full-time and (b) part-time in hospitals.
36.
asked the Minister for Health the number of hospitals which have no qualified dietitians on the staff.
With the permission of the Ceann Comhairle, I propose to take Questions Nos. 31 and 36 together.
In the grade of dietitian there are 21 wholetime and three part-time persons employed at present. These cover a total of 20 hospitals. So far as other hospitals are concerned, while there are no dietitians, as such, some of the persons employed as hospital catering officers may possess the diploma in dietetics but I cannot say how many there are.
I am sure the Minister realises that his answer to Questions Nos. 31 and 36 indicate that there are grounds for the complaint implicit in my Question No. 30, that is, if there are no dietitians in some other hospitals the administrative structure of those hospitals cannot be regarded as satisfactory from the dietitian's point of view?
I should say that health boards generally favour the appointment of catering officers and in many cases these office-holders have diplomas in dietetics. There are approximately 140 posts of catering officer in voluntary and health board hospitals throughout the country.
Is the Minister satisfied about the qualifications of the catering officers in these 140 cases? He indicated in his reply that some of them have dietitian qualifications. Could he give any indication of the standard of qualification of the others who are not qualified dietitians?
I cannot give the specific qualifications but most health boards—and I assume with medical advice—seem to prefer to employ catering officers.
32.
asked the Minister for Health the plans he has to ensure that the staffing of catering and dietitian services is brought into line with other areas of patient care in hospitals.
33.
asked the Minister for Health if he will arrange for an immediate review by his Department of the staffing requirements of the dietetic and catering services in all the hospitals and medical institutions for which he has responsibility.
With the permission of the Ceann Comhairle, I propose to take Questions Nos. 32 and 33 together.
Staffing requirements in the health services are under constant review and all reasonable requests for improvements are dealt with sympathetically by my Department.
At present, a survey is being carried out, under the aegis of my Department and in consultation with the staff concerned, of training needs in the catering area in hospitals. This should be completed shortly and will lead to a comprehensive review of staffing requirements in the catering and dietetic areas of hospitals.
I am sure the Minister accepts that there are two separate aspects of this matter: the nutritional aspect, immediately related to the medical aspect, and the simple matter of the quality of the food available as a matter of routine from day-to-day in our hospitals. Is he satisfied in regard to the latter aspect that the standard of food and meals generally in our hospitals——
I do not think Questions Nos. 32 and 33 refer to that at all.
I am talking about dietetic and catering services.
The question refers to services but the Deputy is talking about food.
By dietetic and catering services I mean the food, the end product of catering service in a hospital. I am asking the Minister if he is satisfied, in general, with the standard of meals served from day-to-day in our hospitals, or does he think there is room for improvement?
I have not had any what I might call official complaints but, as the Deputy is aware, there are people who complain from time to time and who object to the type of food. In the absence of any adverse reports I am satisfied, but if there is evidence to the contrary I will have an examination made in any particular hospital. Generally speaking I would say that the food is adequate.
34.
asked the Minister for Health if he is aware that there is deep dissatisfaction over the inadequate salary scales obtaining in hospital catering and dietetic services; and if he will take immediate action to rectify the situation.
35.
asked the Minister for Health if he will provide appropriate machinery for the negotiation of pay and conditions in the dietetic and catering services in hospitals and medical institutions.
With the permission of the Ceann Comhairle, I propose to take Questions Nos. 34 and 35 together.
I am not aware of deep dissatisfaction over the inadequate salary scales obtaining in the catering and dietetic services of hospitals. The officers concerned have access to the conciliation and arbitration scheme for local authority and health board officers in respect of such of their number as is employed in the hospital services of the health boards and those working in the voluntary hospital services have access to the Labour Court when direct negotiations fail to resolve any disputes that may arise in regard to their level of remuneration and other conditions of service. The full provisions of the national pay agreements have been applied to these and, of course, all other grades in the health services and their salary scales would not appear to have fallen out of line with comparable salaried staff.