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Dáil Éireann díospóireacht -
Wednesday, 24 Apr 2002

Vol. 552 No. 4

Priority Questions. - Hospital Services.

Dan Neville

Ceist:

23 Mr. Neville asked the Minister for Health and Children the number of health board long care beds for the elderly in each of the past five years; and the projected increase in each of the next five years. [12620/02]

It is presumed that the Deputy is referring to the general mix of beds which are needed for the care of older people, for example, assessment and rehabilitation, respite, extended care, elderly mentally infirm and convalescent. The most up-to-date statistics in this regard were collated in July 2001 and the relevant figures are set out in the schedule circulated with this reply. Corresponding figures for 1997 are not readily available, but are being collated. It is not, therefore, possible to accurately state the overall bed numbers but we can say that since 1997 some 600 extra beds have been put in place. In the Eastern Regional Health Authority area alone, five new community nursing units in Meath, Dalkey, Lusk, north Dublin and south Dublin, have been opened since 1998, with a total of 261 beds. However, where increases occurred in other parts of the country, they would not have been as large. Not all new facilities produced an increase in bed capacity, as in some instances, new units were simply replacing old unsatisfactory accommodation which often dated back to the workhouse days. The recently published health strategy proposes the provision of 800 additional extended care and community nursing unit places per annum over the next seven years, including provision for people with dementia.

Public Beds for older people – information supplied by health boards, July 2001

Health Board

CNU

District/comm.hospital

Geriatrichome/hospital

Welfare home

Elderlymentally infirm

Acute hospitalinc. vol.hospital

Total

ERHA

406

258

1,095

202

31

841

2,833

MHB

169

123

433

72

62

46

905

NWHB

168

0

759

0

0

0

927

SHB

0

0

1,102

75

0

485

1,642

SEHB

34

151

904

293

114

26

1,522

WHB

451

93

697

0

13

151

1,405

Total

1,357

2,254

4,990

755

267

2,171

11,794

The Minister will understand my surprise that he does not have the information I requested. Would he agree that the elderly infirm are being treated disgracefully in this State; that the Government has no policy on this issue; that families are forced to live in misery and poverty to make up the balance between nursing home subvention and pension payments and the increasing cost of nursing homes in order to have a loved one cared for in a nursing home; that families are being put under extreme pressure and, as a consequence, stress is placed on the elderly themselves, who know what their families are going through and are aware that their condition is creating problems for them? Does he agree that the State is not making available services in general hospitals for elderly people who need continuing care which in many instances forces distantly related families to provide funding which is taken out of small incomes intended for day-to-day living? Does he agree that it is unfair that the elderly in nursing homes are forced to sell their homes? I know a person of 71 who is being forced to sell her cottage for £30,000 to pay the balance of what is required in the nursing home, meaning that she has no home to return to. Does the Minister agree that that is unfair and that the elderly are being treated disgracefully under the Government's stewardship?

I do not agree with the Deputy because more money has been put into the elderly services than ever before. The figure was £10 million in 1997 when we came into Government but it is now about €100 million. We have also increased subvention and funding for other sectors, such as pensions which have increased by over 30%.

In the general hospitals, the winter initiative helped in that area. As I stated, many new nursing homes are being built throughout the country—

I am asking about continuing care in the public service.

There are 11,000 public nursing home beds now and the private sector is providing over 12,000. Many more private sector beds are coming on stream and these are used by health boards in certain cases. Under the health strategy, more places will be provided in the coming years. Good progress has been made in this area in the past five years. Our main aim is to keep people at home and to strengthen community care whenever possible. Under the national development plan, we put in £2 billion, half of which will go into community care, something that has not happened before. We also want to establish good services on the ground, such as physiotherapy, occupational and speech therapy, home-help and carers. The allocation for carers alone has increased fivefold since the Government took up office. A great deal is being done in regard to care of the elderly both in the community and in nursing units.

Does the Minister of State agree it is unfair, despite promises made over a number of years by the Minister, that the scheme under which elderly people residing in nursing homes get incontinence pads free if they have medical cards still has not been introduced by certain health boards? Last March 12 months the Minister—

The Deputy should ask a brief question because I would like to give the Minster of State 30 seconds to reply.

—stated he would ensure this would happen. It is not being introduced. There are elderly, incontinent people in nursing homes who are not receiving incontinence pads.

The Deputy is making a statement.

A directive has been issued by the Minister.

The Mid-Western Health Board has told me it is still considering the directive.

If the Deputy gives me the names of the nursing homes, we will take up this issue.

In view of the very exceptional circumstances as we come to the end of a five year term, we will take Question No. 22 in the name of Deputy Ring.

Thank you, a Leas-Cheann Comhairle.

Michael Ring

Ceist:

22 Mr. Ring asked the Minister for Health and Children when a lung transplant unit will be established here. [12454/02]

The Deputy will be aware that the programme for Government, An Action Programme for the Millennium, contains a specific commitment to support the establishment of a heart and lung transplant facility in Ireland and to ensure that the programme, when introduced, will be in a position to match the highest international standards in lung transplantation.

The Mater Hospital, Dublin, has been designated as the surgical site for the programme. The provision of a lung transplant unit at the hospital forms part of a major capital development approved for the hospital. To progress this project an expert consultative group, chaired by the Eastern Regional Health Authority, was established to advise my Department on various issues associated with the development of the programme. The report of the consultative group has been received and is being progressed as a priority by my Department in conjunction with the ERHA and the Mater Hospital. The report was the subject of a recent and very positive discussion with the ERHA and the Mater Hospital.

Considerable preparatory work has been completed by the hospital in relation to the commencement of this project. Key issues addressed include governance, management and quality assurance criteria, including external peer review of the proposal. The hospital is finalising an assessment of the financial requirement associ ated with the introduction of the programme. On receipt of this information and subject to approval by my Department, I am advised that the hospital proposes to commence lung transplantation towards the end of the current year.

In terms of progressing the establishment of the programme, the Deputy will be pleased that a number of key clinical appointments have been made at the Mater Hospital, including the appointment of a consultant surgeon and a consultant physician.

Pending the establishment of the programme in Ireland, an agreement is in place with the Freeman Hospital in the UK for the treatment of Irish patients requiring lung or heart and lung transplant. To date, 19 patients from this country have received transplants at the Freeman Hospital under the agreement. This contract will continue while the necessary arrangements are being progressed in terms of establishing the programme in Ireland.

It is important to note that lungs donated in Ireland have been retrieved by the medical team at Newcastle and have helped to facilitate this additional transplant work at Newcastle for the benefit of Irish patients. I assure the Deputy that the establishment of the Irish programme will continue to be progressed as a priority by me and my Department in conjunction with the ERHA and the Mater Hospital.

In reverence to you, a Leas-Cheann Comhairle, I will be lenient on the Minister. Many people are waiting to be called for heart and lung transplants outside the State. Does the Minister expect that transplants will be performed in Ireland by the end of this year? How many people are waiting for such operations?

I do not have the figures. Approximately 124 people were referred for assessment but approximately 20 are still waiting. I will forward the figures to the Deputy. I had them with me last weekend when I met the Cystic Fibrosis Association. We are awaiting specific details from the Mater Hospital. There will be a state-of-the-art heart and lung transplant unit in the new Mater Hospital which is under construction. It is included in the specification but we cannot wait until that is completed. We are looking for an interim solution using the existing facilities at the hospital and its administrators will come back to us with their requirements. Subject to that, I am advised we could begin the process by the end of this year.

The key aim is to ensure everything is done in accordance with international best practice and we get off to a good start in terms of the success of the programme. I am acutely aware that many people are on a waiting list and time is against them. The agreement with the Freeman Hospital at Newcastle has been very good for Ireland because it has provided stability and continuity in the programme of transplantation. Until then it was done on a clinician to clinician basis. We are prioritising this service and I am hopeful the programme will be commenced by the end of the year.

I hope the Minister will keep the pressure on because a commitment was given on this by his party in its programme for Government. We are five years down the road but I will be the first to welcome the transplantation programme if it commences by the end of the year. Many young and middle-aged people are waiting for such operations and I agree we are lucky there is an agreement with the Freeman Hospital. However, I would like this surgery to be undertaken in Ireland.

I agree with the Deputy.

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