Vol. 645 No. 2
6 Deputy Pat Rabbitte asked the Minister for Health and Children the plans there are to increase the capacity of the National Rehabilitation Hospital or to provide such a service elsewhere; and if she will make a statement on the matter. [2713/08]
The National Rehabilitation Hospital in Dún Laoghaire is a 120-bed hospital which provides treatment and rehabilitation for patients with spinal cord injuries, head injuries, amputation, traumatic and non-traumatic brain injury, strokes, neurological disorders, children's disabilities and spina bifida. It also provides wheelchair and mobility aids assessment, pre-vocational and vocational training programmes involving a wide range of social, personal and work-related skills with a view to enhancing opportunities for each individual for further training, employment and educational options. There is also a 12-bed hostel to enable clients from outside the greater Dublin area to access day services in the hospital and the vocational training unit.
A new hospital is in the planning stages and once built will provide additional capacity at the hospital. This project would increase the bed capacity of the National Rehabilitation Hospital to 235 beds. I understand that a project team is working with an appointed design team to develop the brief for the new hospital and plan for the development.
The Health Service Executive has also informed the Department that a project team has just completed a needs assessment on the development of an acute medical rehabilitation unit of 25 beds which is recommended to be built at Beaumont Hospital. This unit would provide acute medical rehabilitation services and early rehabilitation for those suffering from brain injury who access the national neurosciences unit at Beaumont and who currently have to access services at the National Rehabilitation Hospital.
Plans had been prepared in some areas for regional rehabilitation facilities. The Department and the Health Service Executive are aware of the need to review the potential benefits of a regional network of rehabilitation facilities and services. The development of such a network should be considered in the context of a national strategy for rehabilitation services and the Department is currently considering this issue.
Does the Minister agree that it is hugely distressing for families to know that immediate rehabilitation care is crucial for those who suffer brain injury, stroke or any other condition that results in people attending the National Rehabilitation Hospital? Getting in quickly for treatment is crucial. I welcome the fact that a new unit is planned, which will increase the number of beds from 120 to 235. What is the timeframe for providing those extra beds? Are there any plans for Cork? There has been some confusion as to whether a unit is planned for Cork so perhaps the Minister will clarify the situation. Will he also clarify if an acute stroke unit or one of the acute regional units he mentioned is planned for Cork? There is serious concern in the south of the country that the beds currently available are all located in Dublin. It appears the new beds will also be in the Dublin area. What are the plans for the south of the country? Will the Minister also elaborate on the plans for regional units? I stress again how crucial it is for the projected recovery of these patients to get into hospital and receive treatment at an early stage. When will extra beds and facilities be provided?
The Department is currently considering the development of a formal policy on rehabilitation. A number of issues must be considered, including a needs assessment on a population health basis, the structure of the service provision, the location of the facilities and the nature of the facilities, that is, whether they are hospital, step-down or preparation for independent living. In other words, they would range from acute care to the stage just before going home. The need for the rehabilitation strategy has been brought to the fore for a number of reasons, including population growth and increased trauma survival, especially in cases of stroke and road traffic accidents. The national policy will inform the framework of rehabilitation services which the HSE, as the agency responsible for providing and contracting services, will have to develop.
What happened to the plans for a rehabilitation centre for Cork? Plans were drawn up. Why did it not go ahead? What is happening to the thousands of people in this country who suffer stroke or acquire a brain injury and end up in nursing homes? Does the Minister not agree that what is provided in Dún Laoghaire at present is inadequate from the point of view of capacity? Will the Minister state how Ireland compares to the rest of Europe, the United States and other countries in this area? It is true that Ireland is not at the races and that it is a disgrace compared to Europe?
I reject the last allegation. We are at the races——
You are in cloud cuckoo land.
——and the service provided by the National Rehabilitation Hospital is of the highest quality.
What about the capacity?
Perhaps the Deputy would give me an opportunity to reply. With regard to location, there are a number of places in addition to Cork that are considering providing some sort of rehabilitation, be it——
Some sort?
The Deputy should listen. It could be an acute, semi-acute or step-down service. There are various types of rehabilitation. On that basis, we are examining the development of a formal policy in the Department.
I thank the Minister for making arrangements before Christmas for some patients to be transferred from the National Rehabilitation Hospital in Dún Laoghaire, thus releasing badly needed beds. There is more capacity in new facilities. Does the Minister of State, Deputy Devins, not accept that the outcome for victims of stroke is far superior from dedicated stroke units than from some type of rehabilitation?
Does the Minister accept that part of the capacity problem arises as a result of HSE cutbacks? Many patients in the National Rehabilitation Hospital in Dún Laoghaire cannot be discharged because no home care packages are in place. Those patients, therefore, are occupying urgently needed beds. When will the cutbacks stop? When will these crucial hospital beds be released by putting in place care in the community?
I agree it is important that acute beds are released for acute cases. As Deputy Reilly mentioned, before Christmas provision was made to allow patients to be discharged from the National Rehabilitation Hospital. I agree that stroke units have a better outcome in the immediate situation. Obviously, rehabilitation is a different and complex area and, as such, the development of rehabilitative beds, be they acute, semi-acute or step-down, is a vital component of our infrastructure.
7 Deputy Lucinda Creighton asked the Minister for Health and Children the reason, in view of the implementation of her ten point plan for accident and emergency services, her description of the accident and emergency services as a national emergency in March 2006, the establishment of a task force on accident and emergency services and the subsequent publication of the emergency department task force report, the number of people waiting on trolleys in accident and emergency departments nationally is in the region of 300 to 400 per day; and if she will make a statement on the matter. [2655/08]
As I mentioned in an earlier reply, considerable improvements have been made in the delivery of services in emergency departments. Specific targeted actions are in train to deal with internal management in hospitals in order to improve patients' experiences. The HSE is also arranging for 200 additional beds to be contracted in private nursing homes with a particular focus on major Dublin hospitals. The HSE advises that 56 of these places have been filled since 18 January. In addition, the HSE advises that it will open an additional 100 long-stay beds from March onwards in a new community nursing unit at St. Mary's Hospital in the Phoenix Park. These will be used mainly for older people who have completed their acute phase of treatment. These developments follow on from the opening last December of 94 additional long stay beds at Cherry Orchard Hospital.
The HSE is proceeding with the implementation of an additional 360 home care packages in 2008 at a cost of €10 million. It is intended to prioritise these additional home care packages to support the Dublin area in particular, a number of the other large urban areas and some specific acute hospitals, such as Cork city, Waterford, Wexford, Limerick, Galway, Mayo. A total of 120 of these are scheduled for implementation in the first quarter. The combination of these measures and those outlined in my earlier reply will lead to continued improvement in emergency departments.
There were 400 people on trolleys two weeks ago. That is 20% more than in January 2007. A total of 57,000 bed days were lost last year between the Beaumont and Mater Hospitals, which is the equivalent of a 150-bed hospital being closed for a year.
The Deputy is giving information. The idea of Question Time is to elicit information from the Minister.
Will the Minister acknowledge that we have a capacity problem and that demand is outstripping supply? We can reduce demand by putting in place things such as prevention, national body tests, diagnostics in the community and one-stop-shops in the community where people can be seen and treated by their general practitioner without having to go to hospital. We can increase capacity by getting better use of beds that are currently inappropriately occupied and by building more beds in the short term. That will have to be done. There is no point having long-term plans for 2020 with 4,000 fewer beds in the system. Whether it is cystic fibrosis, psychiatry, mental health, care of the elderly, accident and emergency figures, neurology, urology or neurosurgery, the dreadful situation is an indictment of our health service. Beverley Seville-Doyle went into hospital at 11 a.m. and was found dead in a toilet the next day.
Has the Deputy a question?
I extend my sympathies to her family. It is all plans for tomorrow and cutbacks today. Irish men, women and children are dying. Will the Minister use modular hospitals, as they do throughout Europe, to build 1,500 community beds, rather than 200 or 300 such beds, over the next six months? I thank the Minister for alluding to such hospitals earlier in response to a question I asked. The Minister for Education and Science plans to use schools in such a manner. We need to get those who do not need to be in our hospitals out of our hospitals. Will the Minister at least free up the beds that are currently there?
Although we may be political opponents, I have a great deal of respect for Deputy Reilly, as he knows. As someone who has a lot of knowledge of this area, he knows it is not all gloom and doom and bad news in this respect. Things have vastly improved. In 1980, life expectancy in this country was two years below the EU15 average — it is now 18 months above that average. Sweden is the only country in Europe where men live longer than they do in Ireland. Just one third of the number of people who used to die from circulatory illnesses 30 years ago now die from such illnesses.
While we face challenges and pressures, we should put things in context. I invite Deputy Reilly, as a member of as the Joint Committee on Health and Children, to visit Stockholm, which has twice the population of Dublin but just half the number of acute beds. They do things differently there — they have better discharge policies and they do not keep people in hospital unnecessarily. If one is in a hospital in Dublin on Friday, there is a 99% chance that one will still be there on Monday morning. I hope the new contract will deal with some work practice issues, such as the availability of consultants. I accept that we need more consultants.
I know of a hospital in Dublin that could free up 64 beds if it were to organise its acute beds system differently. Consultants went in there. Experts who have brought about change in other countries made recommendations about the hospital in September. I have seen a letter sent to the hospital by the HSE asking why certain recommendations have not been followed, given that there are people on trolleys. When I looked yesterday at data from another Dublin hospital, I learned that a patient who was fit to be discharged in 2006 is still in the hospital because the person is unwilling to go to a nursing home or a long-term care facility, or to go home on a home care package. Some existing issues in that regard will be dealt with under the fair deal. It is not appropriate for somebody to choose to stay in an acute hospital when alternatives have been put in place. As Deputy Reilly is aware, it is dangerous for a patient to remain in such a hospital if he or she does not need to be there. People should be in such hospitals only if they have to be.
Just under 5% of people in Ireland over the age of 65 are in long-term care, which is in line with the international average. The problem is that one third of those people would not need to be in long-term care if we had better home support systems. Not only are more facilities being put in place, but new home support packages are also being provided. They take a while to put in place because it is expensive to recruit the appropriate staff etc. We have been building them up each year over recent years and they are making an impact. It is a question of doing a number of different things.
During normal questions, a Member has one minute to ask a supplementary question and the Minister has one minute to respond. We will not get many questions covered if we do not stick to those rules. Deputies are entitled to have their questions answered, as long as we get to them. I will contradict what I have just said by allowing Deputies Morgan and Jan O'Sullivan to ask a brief supplementary question each.
While we might have a problem, a Leas Cheann-Comhairle, at least we are not facing a crisis, unlike the health service. How can the Minister credibly claim to be dealing with the accident and emergency crisis when she is continuing to cut back hospital services? Is she aware of a document that came into the public domain this week which advocates the closure of the accident and emergency department at Monaghan General Hospital? That would have a significant knock-on impact on Our Lady of Lourdes Hospital in Drogheda, which is already grossly overcrowded. How can the Minister claim to be dealing with the accident and emergency crisis when more and more services are being closed? When will she stop this approach? When will she take charge of this problem and sort it out? She is allowing HSE officials to tinker about with the health of people in this State as if they were dealing with cattle.
I would like to ask the Minister about home care packages. Many Deputies attended a presentation made by the Irish Senior Citizens Parliament yesterday. When one meets senior citizens, one is told that their preferred option is to stay at home, with support. The Minister said that home care packages are expensive. They are primarily privately procured. We are privatising the care of elderly people in their own homes. Why can we not build up the home help service so it is like it used to be? The Minister talks about home help as if it were some kind of newfangled way of looking after people. Is she abandoning the development of the public home care system, involving public health nurses and home helps etc.? While I welcome the provision of an additional 360 home care packages this year, they do not represent much more than a drop in the ocean in terms of the number of elderly people in this country.
Rather than providing for such cutbacks in the HSE, would it not be more cost-effective to develop the public provision of care for people at home? It would mean that elderly people would not have to stay in acute hospitals and we would not have to pay the private sector its top-up profit, not to mention the cost of recruiting professionals and paying their salaries?
We are developing the home care sector. It is not something that has always been done, however. It used to be all or nothing — one went into a public long-term care facility, where 90% of the cost of one's care was subsidised, or one went into a private nursing home, perhaps with the help of a subvention, and had to pay at least 60% of the cost of one's care. It was totally inequitable. There was virtually nothing else at home. The home help service has been developed rapidly since it was initiated some years ago. I am in favour of whatever works for older people, regardless of who provides the care. I meet many families and hear their stories. I saw a letter yesterday or the day before in which a family in Dublin was full of praise for a private company that is supplying the care. There has to be some flexibility.
It is more expensive.
It is not actually. It costs a great deal of money to recruit people and meet their pension requirements, etc. I am familiar with the position in the north east, which is represented by Deputy Morgan. The document to which he referred is a draft — no final decision has been taken on it.
It is an intention.
It demonstrates a serious intent.
Can I outline the intention in the north east, which has a higher level of admission into the acute system than any other region? Half of the surgical patients in the region come to Dublin hospitals. One third of medical patients in the region come to Dublin hospitals. They have longer stays.
It is proposed to bring an end to elective surgery at Louth County Hospital as well.
There will be less inpatient activity in the north east. That is what is needed in the region and that is what will happen. It is forecast that inpatient numbers there will decrease by approximately 1,800. There will be more day case activity there. That is the way it should be——
That cannot happen because we are grossly short of general practitioners.
——and that is the way it is in every good health care system in the world. One should not have to staff hospitals on Saturdays and Sundays if surgical procedures can be done on a day basis from Monday to Friday. That is a fact all over the world.
That was happening.
It is happening here. We are not closing anything.
You are.
We are trying to make things better.
Closures are being advocated.
According to the HSE, 800 community supports will be provided in the north east next year.
8 Deputy Terence Flanagan asked the Minister for Health and Children if she plans to increase the number of ambulances available to the Dublin Fire Brigade Ambulance Service; and if she will make a statement on the matter. [2672/08]
A review of ambulance service provision in Dublin city and county, which was commissioned and jointly chaired by Dublin City Council and the Health Service Executive, was completed in February 2007. The review was not formally progressed during 2007 because we were awaiting the receipt of the judgment of the European Court of Justice in a case against Ireland relating to the arrangements for the supply of emergency ambulance services in the Dublin area by Dublin Fire Brigade. The judgment in that case was published on 18 December last. The HSE and Dublin City Council are in a position to formally consider the recommendations arising from the review.
The HSE gives Dublin Fire Brigade funding to provide an emergency ambulance service for Dublin city and county. The HSE has provided over €9 million for this purpose in 2008. Dublin Fire Brigade operates 12 ambulances for emergency services only, from a number of bases in the city and county. The service operates on a 24-hour, 365-day basis. The HSE operates its own fleet from four Dublin city bases — St. James's Hospital, Loughlinstown, Tallaght and Swords. The service may be supplemented by ambulances from the wider Dublin and mid-Leinster area as required.
I have noted what the Minister has said. As I am a magnanimous sort of person, like the Minister herself, I like to impart information occasionally. I remind the Minister that housing, education and public facilities affect longevity, but we do not have community facilities like those in Sweden.
I do not doubt that the Deputy will one day be on the Government side of the House and therefore in a position to impart such information.
I tabled this question because I am concerned that on 18 January 2007, Dublin Fire Brigade had four ambulances tied up at the Mater Hospital for between two and three hours and three further ambulances tied up at Beaumont Hospital. The seven ambulances in question, which represent over 60% of Dublin Fire Brigade's ambulance service, could not be used because the service could not get its trolleys back.
When I asked the Minister a question about the matter, it was referred to the HSE, which issued a facetious response to me. I asked why Beaumont Hospital and the Mater Hospital do not provide portakabins where spare trolleys can be kept, thereby allowing ambulance personnel to deliver patients into the care of accident and emergency departments, to collect a spare trolley from the portakabin and to get back on the road to save someone else's life on the M50 or wherever. The facetious response I was given was that patients cannot be moved off trolleys, which has nothing to do with what I asked.
The reality, as the Minister said, is that Dublin Fire Brigade has had just 12 ambulances for the last 20 years, even though the population of the greater Dublin area has exploded by 600,000 or 700,000 in that time. Ambulances have to stay outside accident and emergency departments in a manner that seems designed to keep patients out of hospital, although for all the wrong reasons. I would like the Minister to ensure I get a proper response to my question. I ask her to give the House a commitment that she will instruct the HSE to ensure that spare trolleys are kept in portakabins in the manner I propose. Given that ambulances are such scarce resources, and more of them are needed, I ask that those we have at least be used appropriately.
I agree with the Deputy that prosperity influences longevity. Professor Brendan Walsh, by the way, stated in a well-argued paper last week that it was half prosperity and half improved treatments.
I have heard one ambulance driver talk about a particular experience but I am not aware that it is the huge issue the Deputy is making it out to be.
It is.
If it is, I will make sure that whoever is responsible in the HSE speaks with the Deputy about this issue.
I have not seen the review referred to by the Deputy as it has not been published because of the litigation in the European Union, but I understand that the 15 recommendations therein are currently being considered by the HSE.
I would be grateful if the Minister could organise that, bearing in mind the 75,000 incidents — 205 incidents a day — which must be dealt with by the Dublin Fire Brigade.
9 Deputy Ciarán Lynch asked the Minister for Health and Children the consultation she and her Department have undertaken with groups and bodies which represent the interests of older people regarding the fair deal legislation; the bodies that were consulted; the account that has been taken of their views in drafting the legislation; and if she will make a statement on the matter. [2738/08]
Since the announcement of the new nursing home support scheme, A Fair Deal, the Department has met with the National Federation of Pensioners Associations, the Irish Farmers Association, the Irish Senior Citizens Parliament and the social partners. The Department also attended the AGM of the Irish Senior Citizens Parliament at its request and participated in a workshop on the new scheme.
In addition, the Department has dealt with queries and representations from interest groups, public representatives and members of the public. All of the issues raised during formal consultation and otherwise were given careful consideration in drafting the Bill. The Bill providing for the scheme is at an advanced stage and is currently being finalised by the Office of the Attorney General. The Minister hopes to publish the Bill as soon as possible following Government approval.
I do not want to quibble with the Minister of State, but we met representatives of the Senior Citizens Parliament yesterday and they said they had not had any meaningful consultation, as have a number of other organisations. They wish to discuss with the Government their real concerns about the legislation and, in particular, their concerns about its effect on the family home. They are also concerned about the possibility of pressure being put on elderly people to sign over resources to other family members. This is a real worry to people at that stage of their lives, when security, their possessions and their family homes are important to them. There is concern about the effect of this legislation from this point of view. What is the nature of the consultation the Minister has had with these organisations? Was there an opportunity for them to engage directly, express their concerns and discuss how they might be addressed in the wording of the Bill?
I understand what the Deputy is saying. Only two weeks ago I met with members of the Senior Citizens Parliament and a number of other bodies, allowing an earlier opportunity for consultation. As we speak the Bill has not yet come before us as it is still with the Office of the Attorney General. We are not in a position to discuss the Bill until it is published, which we expect to take place within the next couple of weeks. On its publication we will be able to engage further with the stakeholders and the social partners.
Having met with the Senior Citizens Parliament representatives, I am surprised to hear they felt they did not have sufficient consultation. I understand that the Minister, Deputy Harney, has been in discussion with that group and with others. An afternoon at Farmleigh was dedicated to the consultation process with a number of groups. This opportunity will be there again once the Bill is published.
I confirm what Deputy O'Sullivan has said. Representatives of Age Action Ireland have said they feel they were not properly consulted. Perhaps the legal difficulties being experienced by the Attorney General with regard to this Bill are a consequence of this lack of consultation.
The Minister has given many good examples of how the new scheme, A Fair Deal, is expected to work. In principle, I do not have an issue with this. However, she omitted the difficult examples. With regard to running down the other assets before the family home is affected, what about the shopkeeper who owns a shop and lives with Mammy? What about the publican or the small farmer? This must be clarified. However, the most important issue is the standard of care and protection of patients. A plan must be devised, implemented, monitored and enforced. When I met with representatives of HIQA, they did not indicate they were in a position to do this within a reasonable time. They have not even devised the standards yet, let alone obtained the resources for monitoring, enforcement and inspection of homes. Unless there is someone to enforce standards, there is no point in having them. We must have standards to protect our elderly people. Will HIQA be given the funding to do this within the next six months? My understanding is that it will not.
I hope the Minister will publish the heads of the Bill early to allow ample time for discussion, with no guillotines. This is a major issue for our society for the reasons already outlined.
The HIQA report is due on the desk of the Minister shortly and we will not be found wanting in putting together the regulations that will underpin the guidelines when they are finally presented.
The Deputy gave an example of a shopkeeper. The immediate contribution by the applicant towards the cost of his or her care will be based on 80% of his or her assessable income. In the case of a shopkeeper, this refers to his or her earnings, or for an older person, his or her pension. Depending on the amount of assessable income there will also be a deferred contribution of up to 5% of the applicant's assets, such as his or her home.
What does the Minister mean by running down other assets before the family home?
I did not make any reference to running down anything.
It is in the document.
The Deputy is not too bad at running down things himself.
The contribution is deferred because it will not have to be paid during the applicant's lifetime, if that is the option he or she takes.
The Minister of State should make sure she crosses at a zebra crossing.
Before Christmas, the Taoiseach said the legislation would not, as promised, be published at that time because extra time was needed for consultation. I understand the Minister is now saying that the consultation will happen after the legislation is published. If this is the case, why was the extra time needed? Why did the Minister not simply publish the legislation and then allow a considerable period for consultation? I do not get the impression there has been any consultation since the Taoiseach deferred the Bill's publication.
The Taoiseach did not defer the Bill. We are working in conjunction with the Office of the Attorney General. This is a complex Bill and we must make sure it is right before it can be published. When we have the proposed legislation before us, the opportunity will then be given for further engagement with the stakeholders.
So the Bill was not put off because of the need for consultation but because it was not ready.
Absolutely, yes.
We got a different impression.
10 Deputy Joe Carey asked the Minister for Health and Children the date cervical screening will become available nationally; the reason this was not made available by the end of 2007 as she promised; and if she will make a statement on the matter. [2642/08]
I have already answered a similar question. There is no point in reading out the same answer. I refer the Deputy to my reply to Question No. 4.
I will have a look at that.
Does Deputy Reilly want to ask a supplementary question?
I would not mind if the Leas-Cheann Comhairle would not mind. The failure of the Minister to give us a proper date that she will commit to is disturbing. I hope she will find herself able to deliver on this within the next number of weeks. Despite her extensive answer earlier, she did give a commitment that the programme would be launched in January.
The National Cancer Screening Service Board, which has responsibility for this issue, will be subsumed under Professor Tom Keane as soon as possible because it makes sense to have both screening and treatment under the control of one person. The board was not in a position to go to tender for laboratory services or to sign contracts with general practitioners to provide screening until it found out what resources it would have. We did not know what resources it would have until the budget. A total of €15 million was allocated to the board on top of the €5 million allocated last year. On this basis it is now proceeding, as Deputy Reilly will have heard from his colleagues, with discussions on a proposed 12-month contract. It has also sought expressions of interest from suppliers of laboratory facilities. I am always terrified of giving dates, although I am happy to say——
That is not a word I would ever associate with the Minister.
I do not give dates unless I really believe that is what will happen and I have been given specific information.
Deputy Reilly was referring to the word "terrified".
All I can say is that it will be the middle of the year, which means May to July, so some time around June. I will be extraordinarily surprised and disappointed if that timeframe is not met, if that is helpful to the Deputy. I am sure he will be quick to remind me if it is not met.
I will do my best.
We have been told by Mr. Tony O'Brien that accredited laboratories will carry out the testing. Is the Minister satisfied that adequate laboratory facilities will be available and will they be in Ireland or outside the country?
Based on my last discussions with Mr. O'Brien, I understand that it will be 50:50 because the accredited facilities in Ireland do not have the capacity to provide a ten working day turnaround.
Then it will be done in accredited laboratories.
11 Deputy David Stanton asked the Minister for Health and Children her plans to establish an office for disability and mental health under the Minister of State; the timescale for the establishment of same; and if she will make a statement on the matter. [2555/08]
The establishment of the office for disability and mental health was announced by the Taoiseach on Wednesday, 30 January 2008. The office will support me as the Minister of State for disability and mental health at the Department of Health and Children in exercising my responsibilities in four Government Departments, namely, the Departments of Health and Children, Justice, Equality and Law Reform, Education and Science and Enterprise, Trade and Employment.
The office will focus on supporting the implementation of the health sectoral plan under the Disability Act and will facilitate the delivery of integrated health and education support services for children with special needs. The office will also support the development of training and employment support services for people with a disability. On mental health, the new office will have responsibility for driving implementation of the recommendations of A Vision for Change and the recommendations of Reach Out: National Strategy for Action on Suicide Prevention. It will also develop closer co-operation between the health and justice sectors on cross-cutting issues relating, for example, to the provisions of the Criminal Law (Insanity) Act and the Central Mental Hospital.
I welcome the establishment of this office and the office for older people. We suggested it in our manifesto before the election so I am delighted that the Minister for Health and Children has taken it on board. She had also suggested it. Could the Minister of State outline the staffing and structure of this new office? If he does not have it now, he might send it to us later. What role will the office have in co-ordinating the important and valuable work done by the various voluntary bodies around the country with people with disabilities? For example, will it have a role in co-ordinating and tracking expenditure and ensuring services are delivered? What kind of reporting mechanism will the office have? Will it have a chief executive and what kind of staff will be in there? Is the office operational or is there a timescale for setting it up?
The office will be built around the existing Department of Health and Children staff who deal with disability and mental health. An existing director at the Department of Health and Children, Ms Bairbre nic Aonghusa, has been appointed to head up the new office and she has already taken her place so the office is operational. I intend to visit, and have visited, various voluntary bodies, both service users and providers, around the country. I have found it enormously informative and the office will track the money allocated to the HSE as it disburses it around the areas of disability and mental health.
Has the office a budget and what role will it have in the spend of the health budget on mental health, disability and elder care?
How will the office interact with the National Disability Authority, NDA?
As the Deputy knows, the NDA is within the remit of the Department of Justice, Equality and Law Reform. Those functions have been delegated to the new office of disability and mental health. The office's budget will be the budget for disability and mental health given by the Department of Health and Children to the HSE and we will closely track how that money is disbursed to the various organisations.
Written Answers follow Adjournment Debate.
