Dáil Éireann díospóireacht -
Thursday, 2 Jul 1998

Vol. 493 No. 5

Adjournment Debate. - Health Services.

Mr. U. Burke

Thank you, a Leas-Cheann Comhairle, for selecting this item. I also thank the Minister for Defence, Deputy Smith, for taking the matter. I regret the fact that neither the

Minister for Health and Children, Deputy Cowen, nor his Minister of State is available.

The Western Health board has had to introduce severe and cruel cutbacks in nursing supplies in County Galway. This was done without consultation or agreement with the people charged with the responsibility of delivering that service to the community — the public health nurses and carers in their homes.

Not long ago, an Opposition spokesperson for health stood beside huge hoardings throughout the country declaring that health cuts hurt the old, the sick and the handicapped. Today he is the Minister for Health and Children, yet basic services, such as care for the elderly in their own homes or in nursing homes, are being denied to the very same people. Is it fair and will the Minister allow this situation to continue? For example, the carers of an 18 year old girl — handicapped since birth, epileptic, suffering from severe excema and totally incontinent — have been told that there is a 50 per cent cutback in incontinence wear, availability has been reduced to five pads per day.

Changes have taken place in the delivery of a modern caring health service to the community. High technology equipment, such as hoists and hi-lo beds, must be provided for people caring for their loved ones in their homes or in public health nursing homes. There is a 13 months waiting list for these basic items in the Western Health Board area. Basic medical supplies are not available in some district nursing care areas. Nurses are working in difficult, if not impossible, conditions to maintain proper standards. The chronically sick, the old and the handicapped are suffering as a result. Will our health services deny people bandages for their wounds or the incapacitated their wheelchairs? People in County Galway want their parents, the aged and the handicapped to live with dignity in their homes.

I call on the Minister to provide adequate funding to the Western Health Board to restore and develop basic public health services in County Galway. Must we neglect this section in our society at a time of economic boom? I ask the Minister to act now to alleviate the hardship of people in greatest need.

Mr. M. Smith

I apologise on behalf of the Minister for Health and Children, Deputy Cowen, who is unable to be here tonight. On his behalf, I thank the Deputy for raising this important issue.

The Minister is conscious of the valuable work done by the public health nurses in the Western Health Board area and appreciates this service. Public health nurses play a vital role at community level in the delivery of a wide range of services, including antenatal and postnatal services, child health services and services for older people, the travelling community and the sick and infirm. Many in this wide range of client groups are among the most vulnerable in our society.

In responding to the needs of its client group, the Western Health Board's public health nursing service has expanded considerably in recent years and this has been to the considerable benefit of patients. Recent expansions to the services being provided include a public health nurse liaison service between the hospital and the community in each of the three counties of the Western Health Board; the introduction of a specialist palliative care service which involves an increased input from public health nurses; considerable development in services designed to promote the breastfeeding of infants and the establishment of a regional public health nursing post to focus on travellers' health needs.

The introduction of other programmes has placed further demands on the public health nursing system. In particular, the introduction of a five day postnatal programme for all mothers following discharge from hospital, which I understand is the first of its kind in Ireland, has brought with it extra service requirements for public health nurses. The introduction of geriatric screening programmes has been a valuable development in the service provided to older people. These extra services are to the value of patients and clients in the community, but these improvements make further demands on public health nurses. It is an indication of their professionalism that public health nurses have extended their range of services, while continuing to provide high quality, committed care to persons in their own homes.

The limited resources available throughout the health service means that health boards may at times have to make choices as to what items they can fund. To contain expenditure within previously agreed levels, I understand the Western Health Board public health nursing service was obliged to prioritise requirements for June, which resulted in a reduction in the amount of nursing supplies ordered for that month. However, I am informed by the Western Health Board that cutbacks in nursing supplies were not near the level of 50 per cent as suggested by the Deputy.

I know the Western Health Board is conscious of the possible hardship that these cutbacks in nursing supplies may have caused some people. It is currently examining ways of meeting the demand in this area to see how best it can be achieved in an equitable and efficient manner. The board is committed to providing the best possible service for all its patients and clients and it will address the issue in this context.

I thank the Deputy for raising this matter and I assure him the Minister for Health and Children, Deputy Cowen, his Department and the Western Health Board will continue to work closely together to address the concerns he has raised.

Deputy Burke will be aware that the greatest increase ever was provided in both the Estimates and the budget this year for health services throughout the country. The comprehensive capital programme and the extension of services I have listed indicate the Government's commitment to ensuring we have the best possible health service we can afford. Problems arise from time to time and these must be addressed carefully, while ensuring that individuals are not neglected because priorities must be maintained. An exhaustive commitment to finding additional resources in the succeeding years will continue to be the Government's priority in this area.