Written Answers Nos. 225-232
225. Deputy Róisín Shortall asked the Minister for Children and Youth Affairs the reason for the delay in the full implementation of the recommendation of the report of the independent child death review group to establish an independent child death review mechanism; and the timescale she is working to in relation to this recommendation. [15950/13]
Amharc ar fhreagraI indicated when I published the report of the Independent Child Death Review Group that I welcome the findings and recommendations of this report, and that I accept fully the need for action in the areas identified.
In relation to the recommendations to establish an independent Child Death Review mechanism, the lack of transparency into what was happening to children and young people known to the State has been corrected by the creation in 2010 of the National Review Panel for Deaths and Serious Incidents, chaired by Dr. Helen Buckley. It allows for timely reviews and quick feedback to the system on changes required as well as identifying individual or systemic risks which need immediate action. The National Review Panel was established by the HSE on foot of guidance from the Health Information and Quality Authority (HIQA). The Review Panel is independently chaired by Dr. Helen Buckley, and is mandated to review all serious incidents involving children in care, to include deaths in care. While the group was established by the HSE it has an independent role and receives independent legal advice. The Panel produces and publishes reports that are entirely objective and independent of the HSE.
My Department is currently in the process of reviewing the operation of the Child Death Review mechanism to ensure that it continues to operate effectively and independently, particularly in the context of the establishment of the Child and Family Support Agency and the other existing institutional arrangements for client safety.
226. Deputy Róisín Shortall asked the Minister for Children and Youth Affairs the progress made to date in respect of each of the recommendations of the report of the independent child death review group; and if she will make a statement on the matter. [15951/13]
Amharc ar fhreagraI indicated when I published the report of the Independent Child Death Review Group (ICDRG) that I welcome the findings and recommendations of this report, and that I accept fully the need for action in the areas identified. The necessary actions are being implemented as part of the Government’s reform programme for children’s services, the most radical reform of child welfare and protection services ever undertaken in the State. The integrated delivery of these reforms will ensure that responses to many of the ICDRG recommendations will be mainstreamed into the work programme of the new Child and Family Support Agency.
Detailed work is underway to implement the ICDRG recommendations as follows:
- Legislative Reform – in order to support the rights of children generally, and particularly those who require the intervention of child welfare and protection services, the Constitutional referendum on children was held in November 2012. Issues related to the in camera rule and child care court proceedings have also been subject to legislation. The Child Care Act 1991 (Section 29(7) Regulations were made in November 2012 facilitating the public reporting of child care court proceedings by researchers. These regulations have facilitated an independent project under Dr Carol Coulter which is carrying out research, for publication, on child care hearings in the courts. The Government has recently published the Court Bill 2013 to directly address issues related to the in camera rule. The draft Heads of the Children First Bill were considered by the Oireachtas Committee on Health & Children and the report of the Committee is being considered by my Department in the development of these legislative proposals. Consideration is also being given to strengthening legislation regarding the provision of aftercare. I recently met with experts and representatives of organisations working with young people in care to discuss the approach.
- Organisational Reform – preparations are advanced for the establishment of the Child and Family Support Agency. The Agency will be an essential vehicle for ensuring the ethos of quality and accountability called for by the ICDRG is strongly reflected in children’s services. The Heads of the Child and Family Support Agency Bill have been approved by Government and drafting of this legislation is advanced. Significant operational and industrial relations preparations have taken place including notification of almost 4,000 individuals of their planned transfer to new Agency.
- Operational Reform - A central feature of the new Agency will be a new Service Delivery Framework which will prioritise serious child protection referrals while providing for development of new ‘Local Area Pathways’ which will involve a greater use of community-based services to address child and family welfare concerns in a timely & effective manner. Significant work has taken place in relation to this service redesign. A group has been established in the HSE to work with the Irish Youth Justice Service on the needs of the most vulnerable youths, in line with the needs highlighted in the Child Deaths Report. Work is progressing on development of a National Child Care Information System to comprehensively address issues of record keeping and data management. The procurement process is now at contract stage. The ICDRG highlighted concerns in relation to social worker assignment and care planning. As of Quarter 4 2012, data indicates that 92% of the total children in care population had an allocated social worker. There has been a significant improvement in recent years noting that as recently as 2009, for example, some 17% of children in care did not have a social worker. In the case of children in special care and high support facilities, 100% had allocated social workers. 87.6% of the total children in care population had a written care plan as defined by the Child Care Regulations, 1995. In the case of children in special care and high support facilities, 100% had written care plans. Two out-of-hours pilot projects in Donegal and Cork were commenced and independently evaluated. The HSE has reviewed the Evaluation Report and prepared a business case for a National Out of Hours Social Work Service. The HSE is in discussion with relevant staff representative associations.
- Workforce Development - this Government completed the recruitment of 260 additional social workers proposed in the Ryan Report Implementation Plan. Over 1,400 social workers are employed in Children and Family Support Services and the introduction of 260 additional social workers represents a significant strengthening of the workforce. Arrangements for the induction, training and supervision of these staff have been put in place. Support for all staff includes the introduction of national guidance, such as Child Protection and Welfare Practice Handbook, and supervision of the implementation of this guidance.
- Oversight - Last July, I launched the first-ever HIQA ‘National Standards on Protection and Welfare of Children’. HIQA recently announced the commencement of inspections of child protection services, in line with new standards. Meanwhile 10 cases identified in the ICDRG report have been referred for independent review under Dr. Helen Buckley. One of these reviews has already been completed. Specific work is proceeding in relation to the Review Group’s recommendations regarding mechanisms for the independent review of child deaths. It is necessary to ensure that any such arrangements are developed in a manner that is fully consistent with the major organisational reforms currently in train including the transfer of child protection services from the HSE to the CFSA and the recent expansion of HIQA’s inspection regime to cover all child protection services. My Department has also consulted with colleagues in the North in order to share learning from the respective approaches to child death review.
I trust these details illustrate the seriousness with which the ICDRG report is being advanced. Finally, my Department has also used the detailed research undertaken in the report to highlight more general policy issues across Government, including for example discussions on the preparation of a National Substance Misuse Strategy, which is expected to be considered by Government shortly.
227. Deputy Brendan Griffin asked the Minister for Health if a person (details supplied) in County Kerry, who wishes to continue in employment will be permitted to work beyond their 65th birthday; and if he will make a statement on the matter. [15826/13]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for direct reply.
228. Deputy Michael Healy-Rae asked the Minister for Health the position regarding funding for a project (details supplied) in County Kerry; and if he will make a statement on the matter. [15850/13]
Amharc ar fhreagraI understand the Deputy is referring to respite services for children with life-limiting conditions. My Department administers a National Lottery Discretionary Fund from which small once-off grants are paid to community and voluntary organisations, providing a range of health related services. If an organisation wishes to make an application for National Lottery Funding they should send in a formal application. Detailed procedures, along with the application form are set out on the Department's website - www.doh.ie. The HSE receives an annual capital allocation for the building, equipping and furnishing of health facilities. There are always more construction projects than can be funded from the Exchequer's capital health care allocation. The HSE is required to prioritise infrastructure projects within its overall capital envelope taking into account the existing capital commitments and costs of completion over the period. The method and timescale for the delivery of health care infrastructure is dependent on a number of factors; it is a dynamic process constantly evolving to take account of changing circumstances, including the feasibility of implementation.
The Deputy may wish to note that in 2010 the Department of Health published Palliative Care for Children with Life-limiting Conditions in Ireland – a National Policy (DoH 2010) which provides the foundation and sets out clear direction for the development of an integrated palliative care service for children and their families, across all care settings.Following on from the publication of the policy, the National Development Committee for Children’s Palliative Care (NDC) was established by the HSE. The NDC is co-chaired by the HSE and the Irish Hospice Foundation. It includes a representative from my Department. The Committee has overall responsibility for overseeing the implementation of the national policy recommendations. The committee’s emphasis on partnership is reflected in its membership comprising statutory, voluntary, professional, and parent involvement.
On 4 March 2013, the Irish Hospice Foundation and LauraLynn, Ireland’s Children’s Hospice, in partnership with the HSE published a report titled "Respite Services for Children with Life-limiting Conditions and their Families in Ireland – A Needs Assessment". The report provides a national overview of service provision and future respite requirements as part of a palliative care service for children in Ireland. The report identifies some of the challenges involved in planning for respite care such as difficulties with definitions and terminology; determining the numbers of children who require respite care and the numbers currently availing of services; the extent and location of current service provision; the perhaps at times unnecessary distinction between disability services and palliative care.
The report provides an indication of what is currently available and what is required at a national level to provide for the respite needs of children and families. The report acknowledges that a significant level of respite support is already being provided but access is inconsistent around the country and can be dependent on diagnosis and/or geographic location.
The report will assist the Department of Health and the National Development Committee for Children’s Palliative Care in planning for the respite needs of children with life-limiting conditions, and is a useful contribution to filling in the gaps in the understanding and knowledge of the way respite services for children are organised. A number of the recommendations in the report are already under consideration by the National Development Committee and the Committee has undertaken to examine all of the recommendations through its on-going programme of work.
229. Deputy Sean Fleming asked the Minister for Health when an appointment for the urology clinic in Portlaoise Hospital, County Laois, will be approved in respect of a person (details supplied) in County Laois; and if he will make a statement on the matter. [15766/13]
Amharc ar fhreagraIn relation to waiting list management in general, the National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has recently been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists. In relation to this particular query raised by the Deputy, I have asked the Health Service Executive to investigate the situation and respond directly to the Deputy in this matter.
230. Deputy Sandra McLellan asked the Minister for Health if he will approve and expedite a medical card in respect of a person (details supplied) in County Cork; and if he will make a statement on the matter. [15783/13]
Amharc ar fhreagraThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
231. Deputy Sandra McLellan asked the Minister for Health if he will review a decision to refuse a medical card in respect of a person (details supplied) in County Cork; and if he will make a statement on the matter. [15789/13]
Amharc ar fhreagraThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
232. Deputy Robert Troy asked the Minister for Health if he will clarify the eligibility criteria for medical cards for those persons who have worked both in this State and another EU member state and who are in receipt of a non-social welfare pension, these persons do not currently qualify for a medical card, however, if a person enters this State and has not worked in another EU member state or made contributions, they do qualify for a medical card. [15794/13]
Amharc ar fhreagraUnder the provisions of the Health Act 1970, eligibility for health services in Ireland is based primarily on residency and means. Any person who is ordinarily resident in Ireland is entitled to either full eligibility (medical card holder) or limited eligibility (all others) for health services. Determination of eligibility for a medical card is the responsibility of the HSE. Medical cards are provided to persons who are, in the opinion of the HSE, unable to provide practitioner, medical and surgical services to themselves and their dependents without undue hardship. Under the provisions of EU Regulations, a person may also be granted a Medical Card under the Regulations if:
- the applicant is living in Ireland and receiving a social security payment from another European ion /European Economic Area (EU/EEA) country or Switzerland and is not getting an Irish social welfare payment (apart from Child Benefit or Early Childcare Supplement). The applicant must not be liable to contribute to the Irish Social Welfare System, (i.e. PRSI)
- the applicant is living in Ireland and working in another EU/EEA country or Switzerland and is liable to pay Social Insurance Contributions in that country
- the applicant is living in Ireland and is the dependent spouse or child of someone employed in another EU/EEA country and Switzerland. The applicant must not be getting an Irish Social Welfare Payment apart from Child Benefit or Early Childcare Supplement and must not be liable to contribute to the Irish social welfare system.
