Vol. 615 No. 6
6 Mr. McCormack asked the Tánaiste and Minister for Health and Children the reason the 2006 service plan for the Health Service Executive has still not been published; and if she will make a statement on the matter. [8348/06]
Under section 31 of the Health Act 2004, the Health Service Executive must submit a service plan to the Department of Health and Children within 21 days of the publication of the Estimates. The service plan was submitted in line with this legislation on 8 December 2005. There was a further period of 21 days from its submission to either approve the plan or issue a direction to have it amended. I approved the HSE plan on 22 December 2005.
Under section 31 of the Health Act 2004, it is my responsibility to "ensure that a copy of the approved service plan is laid before both Houses of the Oireachtas within 21 days after the plan is approved". I laid the service plan before the Houses of the Oireachtas on 9 January.
The HSE was established to bring reform to the health services — that is not to say it brought reform to the Government. Under the code of practice for State bodies, which the Tánaiste has outlined, the HSE has fulfilled its part. It gave the Tánaiste the service plan, which was laid before the Houses of the Oireachtas. When was the service plan placed on the website of the Department of Health and Children? It was extremely difficult to get copies of the plan for someone who was not a Member of the Houses or who did not know a Member of the Houses.
Why does the service plan contain no targets? We have no idea how many home-help hours or home care packages are expected to be delivered in 2006. We do not know what will happen in primary care. The service plan gives no figures and I would like to know what is happening in this regard. How does the board of the HSE monitor what is happening in its organisation if it is following a service plan without clear targets? An un-audited financial statement based on the service plan must also be published at some stage by the HSE board. I would like to know the figures from which it is working. I have serious concern with the transparency of what is happening in the HSE. The Tánaiste should speed up the process of placing these plans in the public domain and she should also review the plan. It is very poor on targets, facts and figures that people can use to see if the HSE is an addition to the health services or just a fob. We need greater accountability in what the HSE is doing.
The Deputy has made some valid points about the specifics in the plan. The HSE is a new organisation and has only been in existence for 14 months. Rather than the money being broken down along the lines of the old health board regions, I would like to see it broken down along more specific lines. I have communicated this to the HSE and in time that will happen. The plan is available on its website and has been available by e-mail since I approved it. It is one of the specified documents in the Act that is required to be made available to Members of the Oireachtas. I do not know whether that happened. If it did not happen I will ensure it will happen in future.
7 Mr. Perry asked the Tánaiste and Minister for Health and Children if the implementation of the European working time directive would be affected by her plans for public-only consultants; and if she will make a statement on the matter. [8340/06]
Implementation of the European working time directive will necessitate the following reductions in the working hours of all doctors: a maximum of 58 hours per week from 1 August 2004; a maximum of 56 hours per week from 1 August 2007; and a maximum of 48 hours per week from 1 August 2009.
The national task force on medical staffing was charged with examining how this directive could be implemented without adversely affecting service delivery. Against the background of the required decrease in non-consultant hospital doctor working hours, the task force recommended the introduction of a consultant-provided service and an increase in the number of consultants. These recommendations are being advanced within the context of the HSE-led negotiations on a new consultants' contract. The issue of public-only consultants is also being advanced in those talks. It is intended that as part of a consultant-provided service, such consultants will be remunerated exclusively on a salaried basis, that is, they will not receive additional remuneration for treatment delivered to private patients.
The new public-only consultant contract will help support the implementation of the directive and will improve patient access to care and ensure better delivery of health services.
I fully support what the Tánaiste is doing regarding public-only contracts, but the European working time directive must be teased out. We must fill people in. Neither the Tánaiste nor I can wait either the ten or the 25 years mentioned to get working health services. Do we need a new consultants' contract that includes the present consultants? Do we need a new work regime for junior doctors to be brought in more urgently? As the Tánaiste pointed out on "The Late Late Show", if the present batch of consultants does not join in a new contract, we will be stuck with the current system for 25 years. Will we find ourselves trying to piggyback two systems, the public-only consultants and the existing ones, along with work practices regarding junior doctors?
That essentially makes it quite clear that the European working time directive will be at least a decade behind before we gain any control over this. The public service cannot wait for that. It has nothing to do with the Hanly report but with getting a health service to patients in their communities. In some respects, the Tánaiste has made the mistake as witnessed in many statements made in this regard. She is selling the concept of what one does with the consultants as a progressive move. I am very concerned at what will happen with the European working time directive. If the hours are cut for any reason, for example, because someone takes a court case, might we not run into massive problems in the health service? Does the Tánaiste have any contingency plans for that case?
I have asked the Tánaiste before whether we have some mechanism to get consultants on public-only contracts into the system quickly. All that I see happening is that we are in a situation, and I would like to know what contingency plans the Tánaiste has if the European working time directive fails. Will we go back to the EU or do we have an emergency plan? If we do not, patient safety and care and the delivery of health services to them will collapse very quickly.
Regarding negotiations under the auspices of the Labour Relations Commission, LRC, with non-consultant hospital doctors, I understand that good progress has been made. On the wider contract issue, we clearly wish to shrink the number of non-consultant hospital doctors and increase the number of consultants. I have received a very favourable reaction from many consultants to the concept of a public-only contract. I have met an amazing number of people who have said that they thought it a very good idea. Quite a number of category one consultants in particular may well opt for that contract.
Unfortunately, consultants are unhappy because of two issues, one being to do with pricing the new contract through the review group on higher pay on the same basis as other public service jobs. They want it priced through the talks process and negotiation. The other issue on which there is dispute is the decision of the HSE board to stop appointing category two consultants who can work on several different hospital sites, something not very satisfactory from a patient or hospital perspective.
We urgently need the new contract in place. I intend for it to have a five-year review clause or something of that kind. Our having a current contract or contracts with no review clauses puts the State and health service in a very vulnerable position. As I said, that contract is clearly for their working lives, but either side could break it. However, there would be financial consequences in doing so. It would be better if we could negotiate a new contract. I certainly hope that we can introduce new consultants to the Irish health care system on a public-only contract very soon.
I was recently in Canada regarding cancer services and met quite a few excellent Irish doctors heading services there. There is a great deal of Irish expertise overseas that I would love to attract back to our health care system. Many of them would return if we could provide an appropriate contract of employment and substantially increase the numbers of people in different areas.
I wanted to come in on that last point. Under the European working time directive, there is a clear need to ensure more consultants in the system. In line with what Deputy Twomey has already put to the Tánaiste, can she outline to us what steps she is now taking and what further measures she is considering to ensure greater throughput, not only regarding indigenously trained staff from whatever community, but also regarding ensuring that they remain in the system? Every citizen is paying for the process. We are not paying for them to go off and take their skills elsewhere. There is massive investment on the part of every taxpayer in this State.
We are losing people at an inordinate rate. What steps will the Tánaiste take to ensure that people remain in the system here? We must gear matters towards that. It must be attractive, and that is not only a matter of money but a raft of different things that affect the conditions of employment. We must make it attractive for people to stay.
I agree with the Tánaiste that the Canadian system is very interesting since it is open to all on the basis of need and free at the point of delivery, excepting only a very small number of services not provided through the national health system. Along with other experiences, it is well worth considering in formulating a new health care system in our own jurisdiction. I would like to know the Tánaiste's response and what she is now doing to attract back some of those whom we have already lost.
Recently, Connolly Hospital in Blanchardstown won approval for seven new consultants to implement what we are attempting through the contract discussions, including team working. Almost all of them are Irish people who have returned from positions in the US, which is very encouraging. I very much agree with the Deputy that it is not all about the salary. It is also about working conditions. It is not just the facilities but such matters as protected time for education, training and research, clinical governance issues and back-up facilities. Many consultants have said to me that they returned, got a job and found themselves virtually on their own without any secretarial or information technology back-up.
It is a range of factors and in Canada, one thing I found very attractive was that after six years one can have a six-month sabbatical to conduct research or attend training. Many consultants there find that very tempting. Others may feel that after the age of 55 they do not want to do night or weekend work. We need a flexible contract of employment that attracts and keeps the best. In particular, we must double the numbers we have. That will make the system very appealing. However, we could not possibly begin to do that on the current contract, which is very unsatisfactory from the perspective of the patient and the health system.
8 Mr. Deenihan asked the Tánaiste and Minister for Health and Children the status of the European working time directive; and if she will make a statement on the matter. [8338/06]
62 Mr. Perry asked the Tánaiste and Minister for Health and Children the way in which the European working time directive is affecting the delivery of health services; and if she will make a statement on the matter. [8339/06]
108 Mr. Noonan asked the Tánaiste and Minister for Health and Children if the slow progress of the European working time directive will affect the delivery of health services and lead to the downgrading of services to a number of hospitals here; and if she will make a statement on the matter. [8341/06]
I propose to take Questions Nos. 8, 62 and 108 together.
The provisions of the European working time directive as it relates to the working hours of doctors in training came into force on 1 August 2004. The relevant provisions were transposed into Irish law by way of the European Communities (Organisation of Working Time) (Activities of Doctors in Training) Regulations 2004. That will ultimately reduce non-consultant hospital doctors' working hours to an average of 48 hours per week. The introduction of new rosters in many sites would facilitate significant progress towards compliance with the directive while maintaining safe patient care and existing levels of service provision.
Employers and the Irish Medical Organisation have been engaged in discussions for some time under the auspices of the Labour Relations Commission to advance proposals to effect a reduction in the working hours of non-consultant hospital doctors. The LRC however, has requested that both parties refrain from engaging in any form of unilateral action for the duration of the negotiation process. Consequently, health employers are at present awaiting agreement between management and the IMO at national level before proceeding with the introduction of these rosters. On 7 February 2005, both sides accepted a proposal made by the LRC to establish a national implementation group. This group co-ordinates the work of local implementation groups in nine pilot sites, issues agreed guidance on matters related to the implementation of the European working time directive and assists in the development of local implementation plans.
Each local implementation group includes consultants, non-consultant hospital doctors, nurses and management. These groups have drawn up pilot projects to try to find viable solutions to the difficult issue of reducing hospital doctors' hours. Suggested projects have been brought before the national implementation group for consideration. It is expected that many of the suggested projects will be up and running in the near future, with the full backing of all of the stakeholders.
Additional information not given on the floor of the House.
The data gathered from this exercise will help to determine how we begin to reorganise services over a 24-hour day to maintain high quality patient care while achieving compliance with the directive.
Service in our hospitals has not been adversely affected by the implementation of the working time directive. I am confident the implementation of this directive, and the introduction of new non-consultant hospital doctors and consultant contracts, will greatly improve service provision generally and hospital care in particular.
Twelve years after this directive was first mooted, we will now get nine pilot schemes which will not even reduce the non-consultant hospital doctors' hours to the level expected by 2004. Hence, in order to reduce Members' concerns about the impact on the health service in the coming years, what is planned? The Tánaiste mentioned Canada. If we want to establish a consultant-led service, how many Irish graduates are available to return? Does she have any plans to instigate measures similar to those used for decentralisation, that is, to go worldwide in an attempt to gauge how many people might be available? This could even include junior doctors, who are engaged at present in the discussions regarding the European working time directive. How many people might wish to return to Ireland as consultants? It would be useful to know what specialties are available, so we could gauge whether it will be possible to move to a consultant-led service within the next two to three years.
I do not have an answer to Deputy Twomey's question, unless one takes into account the experience in respect of the seven recent consultant appointments in Blanchardstown. I understand all the appointees came from overseas, mainly from the United States. There are many Irish doctors in the United States, Canada and other countries and many of them might be attracted home. However, much would depend on the new contract of employment as well as the consultants' possible locations. Clearly, the reduction in working hours for the non-consultant hospital doctors will only be successful when they are replaced by consultant-led services. We will then have an appropriate system of health care delivery. One cannot have one without the other, and the sooner we can begin to recruit such consultants, the better.
This is particularly true if we want to provide facilities at a regional level. For example, some regions have no plastic surgeon, possibly only one dermatologist, as well as significant gaps in rheumatology. Until we secure a better contract of employment which is more cost-effective from the health system's perspective, we will be unable to substantially increase the numbers of consultants. The two go hand in hand and I hope the negotiations can be concluded quickly.
9 Mr. Cuffe asked the Tánaiste and Minister for Health and Children the cost to the State of introducing a free flu vaccine; and if she will make a statement on the matter. [8608/06]
Information provided by the Health Service Executive indicates that the total cost to the State of introducing free influenza vaccinations for the entire population would be more than €160 million a year, based on certain assumptions about the cost of the vaccine and GP fees.
However, vaccination for the entire population against seasonal influenza is not currently recommended and there would be serious questions about the cost effectiveness of such an approach.
Currently, the seasonal influenza vaccine is available free of charge from general practitioners to medical card holders and holders of GP visit cards who are deemed to be at risk of serious illness as a result of contracting the disease. While persons in the at-risk group who do not have a medical card or a GP visit card can obtain the vaccine free of charge, the fee for administering the vaccine in such cases is a matter between the general practitioner and the patient. The at-risk groups include persons aged 65 years or older, those with specific chronic illness such as chronic heart, lung or kidney disease, and those with a suppressed immune system.
Additional information not given on the floor of the House.
The question of extending the immunisation categories is kept under review by the national immunisation advisory committee.
I thank the Tánaiste for her reply. What is the uptake among the at-risk group to which she referred? As for the vaccination of those with medical cards, can the Tánaiste provide an estimated cost to the State at this time? What company supplies the vaccine to Ireland? Has the Tánaiste any data in respect of adverse effects among those who have availed of it?
I understand the WHO recommends there should be an uptake of 75% among the at-risk groups. It recommends that this target should be achieved by 2010. I am sorry not to have uptake figures and I will try to acquire them for the Deputy. I also lack data pertaining to adverse effects. While I am told the vaccine is effective in up to 90% of cases, I do not know what the adverse effects might be.
They are minor.
I am not aware of any significant adverse effects. Those who are between 66 and 70 years' old and who are above the medical card threshold find that it is the luck of the draw as to whether their doctor charges them. Some are deterred from getting the flu vaccine because their doctors sometimes charge them the full amount. Surely the Minister accepts that it would actually be cost-effective to ensure that the group in question can have the flu vaccine free? I mean both the vaccine and the doctor's visit. Does she not appreciate that in terms of protecting accident and emergency units from overuse, it would be helpful to permit those who are 66 years old and older people to avail of the flu vaccine without being obliged to incur any cost?
I want to find out exactly how much that would cost. That might be interesting.
My question concerns the free flu vaccine which has already been offered to those in the poultry sector. This was an initiative launched by the Tánaiste before Christmas. What level of proactivity was employed by the Department in promoting its uptake by those who are involved in the poultry sector and their families, as well as by those numerous categories of people who were listed in response to a question I raised on the Adjournment in this regard? If I remember correctly, the question was taken by the Minister for Arts, Sports and Tourism, Deputy O'Donoghue. Can the Tánaiste advise on the uptake by those involved in the poultry sector? Was a particular effort employed in those areas of the State in which poultry farming constitutes a significant part of the local agricultural practice? These are extremely important points because, as Members are aware, if avian flu presents, it is critically important to prevent it mixing with traditional flu, thus creating a new pandemic. This is a possibility and the risk is even greater than when I first asked these questions. Can the Tánaiste provide the House with an update in this respect?
I am not in a position to give Deputy Ó Caoláin an update. As for the cost of extending free vaccinations to the group referred to by Deputy McManus, as we have seen in respect of the over-70s medical card, if one announces that something will be made available to a class of citizen by virtue of the class rather than on the basis of economic circumstances, one ends up paying substantially more for it. However, if it were to be paid for on the basis of the current free scheme, it would probably cost approximately €20 million. The vaccine costs €4.45 per dose and there would be a medical fee of €34.43.
That is good value and is worth doing.
We might give consideration to the measure, especially if we could deliver it at a cost of €19 million. However, I suspect that were we to take such an approach, it would cost much more to include the group in question. Clearly, our aim is to have a 70% uptake among the at-risk group by 2010, which has great benefits. Members are all aware, from their experiences with elderly people, that those who receive the flu vaccine are less likely to encounter winter complications. It is highly successful.
Has the Tánaiste anything at all to say regarding the scheme she introduced before Christmas for the poultry sector?
If it is in order, I will return to the Deputy on this matter.
10 Ms Enright asked the Tánaiste and Minister for Health and Children the procedures which are in place to protect patients and visitors to hospitals under the health and safety regulations; if her Department has had discussions with the health and safety authority regarding the possible exposure to litigation by patients or visitors under the Safety, Health and Welfare at Work Act 2005 if they feel they have been exposed to hazards by the action of Health Service Executive employees; and if she will make a statement on the matter. [8370/06]
All employers, including the Health Service Executive and hospitals, are obliged to adhere to the requirements set out in health and safety legislation and to ensure the safety, health and welfare of their staff. Hospitals must also ensure that patients and visitors are not exposed to risks to their safety, health and welfare.
Under existing legislation any hazards must be risk assessed and appropriate control measures put in place to eliminate the hazard or, where this is not possible, reduce it as far as reasonably practicable. It is also open to the Health and Safety Authority to make the necessary inquiries or carry out such inspections as it deems necessary to verify the compliance of any employer with existing legislation.
In 2005 the HSA wrote to the chief executives of all hospitals with A&E departments. This letter required the hospital chief executives to ensure that a comprehensive written risk assessment was prepared, in accordance with the Safety, Health and Welfare at Work Act. The Health and Safety Authority has urged all those working in hospitals to have due regard for their own safety and that of others and to liaise with their safety representative and management to ensure all risks have been addressed. The national hospitals office of the Health Service Executive has in place a standard operating procedure for risk assessment in A&E units. This procedure deals with any hazard that could cause harm to staff, patients, clients or visitors occurring at any time and in any location within A&E units.
The Health Service Executive is responsible for implementing procedures to protect employees, patients and visitors to hospitals under all the health and safety legislation. I understand that in 2006 the Health and Safety Authority is continuing its work relating to the potential risks to safety, health and welfare of hospital workers and has written to the Health Service Executive recently in this regard. There are obvious synergies between employee health and safety and patient safety. The issues involved cut across a number of agencies including the Health Service Executive, Health and Safety Authority and possibly the health and information and quality authority, HIQA, when it is established. My Department will have a role in ensuring a coherent approach has been taken at a national level by the various public agencies involved.
This refers to a recent parliamentary question which stated the Health and Safety Authority is focusing on the existence and implementation of a comprehensive infection control policy. I seek a bit of background on this. What we are focusing on here is the significant increase in cases of MRSA, the increase in cases of tuberculosis — a recent report stated there were 300 cases in Dublin alone — and the increase in cases of hepatitis B. While we have identified there is a problem to some to degree, has the HSE any plans to help hospitals, nursing homes and other care settings to draw up these site-specific risk assessments for their institutions and to identify and correct the problems because the road the HSA is going will either close these institutions or expose them to massive amounts of litigation?
We know the biological agents within the health service that have gone out of control. We are not talking only about the baseline hospital acquired infections but about how they have gone out of control. Apart from the hygiene audit, has the Tánaiste and Minister for Health and Children any plans in place to assist facilities within the health service to draw up these risk assessments and to give the resources to correct the difficulties identified? For example, a decade ago hospitals stopped swabbing hospital workers to see if they had MRSA and therefore workers and patients have been probably more exposed to MRSA. I want to know what progress she has made in moving this matter of hygiene on a little.
First, by way of clarification, there is no outbreak of tuberculosis. The report mentioned in newspapers today is three years old and the figures mentioned are for a five-year period.
I recently communicated with Professor Drumm on MRSA in hospitals and on informing patients and putting strategies in place. It is the intention of the HSE — it is currently doing this in some cases — to work with hospitals one by one on the issues that arose in hygiene. Of course hygiene has a part to play and hand-washing has a part to play, and so too has appropriate prescribing of antibiotics and isolation facilities. A host of issues arise. The intention is that the HSE will work with the hospitals on these issues.
This morning Deputy Ó Caoláin asked me about visiting hours. It is not a matter for me to decide hospital visiting hours and we certainly will not introduce legislation in that regard, but the best hospitals in the world restrict visiting, except in the case of terminally or seriously ill patients where clearly one would want their families to have access. Many hospital employees, and indeed patients I know from my circle of friends and acquaintances, have told me that if one is sharing a room with others in hospital and there are visitors constantly in the ward, it is difficult to get the required rest. The more we can control visiting times in hospitals, the better. In addition to the issues for staff and patients, there are also significant issues from a hygiene perspective.
I welcome the reference by the Tánaiste and Minister for Health and Children, Deputy Harney, to the earlier question I put to her. While that may be the experience in the circle of acquaintances to whom she has spoken, would she recognise that others may have a very different experience and that the visiting opportunities of people is an integral part of the curative process of those who are ill and hospitalised? Real concerns are being expressed, particularly, in the cases I have noted, by family of older long-stay patients. This is causing great concern.
There is every argument for particular straightening of visiting opportunities but restrictive curtailment on the back of the MRSA issue — the two are linked — suggests that visitors were the cause or the most significant contributing factor to the presence of MRSA in hospitals. That is not the case, and it is dumping on visitors. Visitors are an integral part of the address of any illness that a hospital patient may present with. It is simply not acceptable to look to that as the panacea for MRSA or to distract from the other major contributory causes such as the standards of cleanliness, upkeep and maintenance. I appeal to the Tánaiste and Minister for Health and Children to look again at this. It is the wrong course to take.
The Tánaiste and Minister for Health and Children mentioned the necessity for isolation units. Would she agree with the assessment of Dr. Sam McConkey, an infectious disease consultant at Beaumont Hospital, that the facilities are just not adequate? Can she comment on the fact that two of Dublin's biggest hospitals, St. James's Hospital and Beaumont Hospital, have no isolation units at all?
I am not familiar with Dr.McConkey's observations. First, to refer to Deputy Ó Caoláin's comments, of course I am not suggesting there would not be any visiting but it is unreasonable to have virtually open door visiting from maybe 10 a.m., and sometimes earlier, until 10 p.m. That is difficult for staff but particularly for patients. Certainly in places where patients are sharing rooms, it is extraordinarily difficult.
Policy on patients differs. I remember as a child being in hospital and my parents were told not to come and see me until the end of the treatment, and apparently they looked in the window. Nowadays parents are encouraged to come and stay with the children. In the period since I was born the position has changed.
Deputy Harney has got over it.
I have got over it. I have forgiven them.
I had a similar experience.
Policies change. The new paediatric facilities must provide for parents to stay with the children. Policies change in this area all the time.
Certainly I am told by many people at hospital level, and I know from patients, that there can be difficulties if there is open access. Confining visiting times to particular hours, if that is possible, is in everybody's interests.
Clearly we must do more about isolation facilities. They say the hospital of the future will have single rooms. One can imagine the cost, both in terms of the provision of hospitals of that kind and of the staff implications of such hospitals. I understand that will be the global norm a number of years from now for issues to do with infection and appropriate patient treatment. We are providing increased isolation facilities in new facilities being built and that must be the norm in new facilities.
11 Ms B. Moynihan-Cronin asked the Tánaiste and Minister for Health and Children, in view of the warning from St. Columcille’s Hospital, Ireland’s only obesity clinic, that 500 people are on waiting lists and that it is estimated 30 people will die while on the waiting lists, the steps she will take to aid St. Columcille’s Hospital; the measures which will be taken to combat obesity here; and if she will make a statement on the matter. [8548/06]
The report of the national task force on obesity, Obesity — the Policy Challenges, was presented to the Taoiseach in May 2005. The report contains 93 recommendations aimed at tackling overweight and obesity. These relate to actions across six broad sectors: high level government; education; social and community; health; food, commodities, production and supply; and the physical environment. Additional funding of €3 million has been made available to the Health Service Executive to support the implementation of the report's recommendations. The strategic planning and reform implementation of the HSE have approved the following projects to take place this year: expanding the healthy food made easy programme, recruiting four physical activity officers to target obesity in all settings, providing four specialist community dietician posts for obesity and weight management to support all initiatives, the procurement of equipment for growth monitoring and further progress work with the food service sector on healthy food provision. The HSE has confirmed that additional resources will be allocated to obesity services in St. Columcille's Hospital during 2006. In 2006, the executive will spend approximately €25 million on health promotion, of which approximately €5 million per annum will be spent on measures to prevent obesity. In addition, much of the work of hospital and community dieticians is concerned with the treatment of obesity.
I thank the Minister of State for his reply but he did not address my concerns about the obesity clinic in St. Columcille's Hospital. I presume he has read the statement on his Department's website that 2,500 deaths per year are caused by obesity while a total of 30 people on waiting lists to access treatment die annually. The most recent figure for the waiting list for the obesity clinic in St. Columcille's Hospital is 500. The Minister of State glided over information I sought. Food campaigns are all very well but I asked about a specific obesity clinic and he has replied that the HSE will provide resources. How much? When? In what form?
In recognising the seriousness of the obesity problem, we established a task force——
I asked about St. Columcille's Hospital. I do not want a lecture about the obesity task force.
The Deputy is the expert on lecturing in the House. She has asked a question and, if she will allow me, I will answer. In recognising the seriousness of the problem, we put in place a task force. It reported last May and, at the end of the year, I announced that, apart from the normal expenditure on obesity programmes, I would provide an additional €3 million to tackle the obesity problem. St. Columcille's Hospital will get some of this money. I cannot give the Deputy a breakdown of how the money will be spent but I will make inquiries and come back to her.
The task force report contained 93 recommendations, of which 24 relate to the health service. Many other areas——
How many have been implemented?
We are implementing a number of them. A number of initiatives were in place and we are expanding them. We will also implement other initiatives during the year. The provision of an additional €3 million demonstrates how serious we are about tackling the problem.
The Minister of State promised he would answer the questions I asked and he has not done so. He stated in his original reply that resources would be invested in St. Columcille's Hospital. How much and for what purpose?
I do not normally like repeating myself but if it is necessary, I will do so. The Department has provided an additional €3 million to support the implementation of the recommendations in the task force report.
What about treatment?
Some of the money will be used in St. Columcille's Hospital. I do not have the breakdown of how that money will be used but, as soon as I have the information, I will forward it to the Deputy.
I thank the Minister of State.
I would love to move on the next question, which addresses the €40 million spent on the development plan for the Mater Misericordiae Hospital before it was terminated but I must refer to this issue. There was a significant row earlier about the poor quality of replies to parliamentary questions referred to the HSE. It is a cause of huge concern for Opposition Members. This question is clear. What steps will be taken to aid St. Columcille's Hospital? I am surprised the Minister of State would come into the House and tell Deputy McManus that he will reply to her question at a later date. This is Question No. 11, not No. 44, and it is not as if for some reason we have failed to reach it. I expect an answer regarding how much the hospital will receive or whether it will be given an extra dietician or consultant or more junior doctors. That information should have been provided.
Written Answers follow Adjournment Debate.
