Jillian van Turnhout (Independent) | Oireachtas source

I ask the Minister to encourage those concerned to ensure that the legislation would be taken in the Dáil. In respect of GP care for those under six years, I want to be clear that I support the Bill but the amendment yesterday was about a gagging clause and I do not want any perception that there could in any way be a gagging clause. I do not see the reason that the amendment that was agreed in the Seanad yesterday could or should delay the passage of the Bill. I believe there has been a misinterpretation of how votes have gone. I fully support that Bill.

I tabled a question on palliative care, Question No. 13, and when I looked at the reply my initial response to it was that it was excellent.

Unfortunately, however, when one drills down into the figures in tables 1 and 2 of the reply, one finds that while the services have exceeded all targets set for community and inpatient units, the figures provided are consolidated and do not show regional disparities. For instance, the Dublin and mid-Leinster region includes south Dublin, which is very well served by large inpatient units and hospices, whereas the midlands region does not have any inpatient beds. The same types of disparity arise between Dublin and the north east region. While the Dublin area is well served by hospices, there are no inpatient units in the north east counties. Given that it is proposed to introduce a new framework for development and configuration, is it not time the HSE presented figures in a more focused manner, one which shows the distribution and performance of teams in different areas? Some areas have inpatient beds while others do not. Are target figures available for each county? May we have detailed figures on staffing levels for all palliative care teams in each county and region? I also seek greater detail on who will be involved in drawing up the high-level framework. Who will be the members of the group and who will oversee it?

I am particularly concerned about children's palliative care outreach nurses. One of the first questions I asked when I was made a Senator three years ago was on the funding for posts that are currently funded by the Irish Hospice Foundation. Is the HSE preparing to take over incrementally the funding arrangements for children's palliative care, as agreed? Will it guarantee that there will be no loss of services as the funding changeover takes place? I am very concerned that we are unable to obtain clarity on this issue.

Question No. 14 relates to assessment of needs under the Disability Act 2005 and speech and language therapists. Unfortunately, the figures provided are also misleading. I asked specifically for figures on the number of speech and language therapists working with children. The figure of 838 cited in the reply refers to the number of speech and language therapists in the Health Service Executive - in other words, in primary care, acute hospitals and services for older people - and is not confined to speech and language therapists working with children. Informed sources have indicated to me that the approximate number of speech and language therapists working with children is between 260 and 270. This is, however, an estimate. I ask for an accurate figure for the number of speech and language therapists for children.

As with the figures provided in the previous answer, the figures on speech and language therapists do not show the geographical disparities. Furthermore, as we know with figures in the health system, the figures do not show that generally, approximately 10% of staff are on leave of absence, maternity leave or other type of leave. I have been informed that 80 posts under the progressive disability service for children have not even been advertised. This raises questions if it is true and I ask the witnesses to clarify the matter.

On the waiting list for therapy services and assessment of needs, the reply notes that services can begin before an assessment of needs has been done. The figures I have seen suggest otherwise. Some 3,000 people have been waiting for more than 12 months for speech and language therapy services and 2,000 have been waiting 12 months or more for occupational services.

On the reply to my question about the national disability strategy, none of the three legislative pillars has been fully commenced. The issue here is that while one hears that the legislative pillars are in place, it transpires that they have not been commenced.

Perhaps I will pursue Question No. 15 with the Minister of State, Deputy Kathleen Lynch, as it relates to nursing homes. The issue is one of planning ahead. The Central Statistics Office forecasts that the number of persons aged 85 years and over will increase by 46% by 2021, which is only seven years from now. This is the age cohort that is most dependent on continuous care services in the community and in nursing home and community nursing home settings. We must plan ahead if we are not to face a situation ten years from now in which members of this committee are asking why the issue was not addressed, given what was known about the ageing of the population and the need to provide care to meet demand.