Jillian van Turnhout (Independent) | Oireachtas source

I welcome our guests. I also welcome the long awaited appointment of Mr. Stephen Mulvany in the area of mental health. I hope we will now see great developments.

I add my voice to those of Deputies Ó Caoláin and Healy on the issue of cochlear implants. I was also part of the all-party group which met the representatives in question. The Minister of State, Deputy Kathleen Lynch, referred to the business plan and the budgetary process. Does this mean that 2014 will be the earliest date for the consideration of funding? I am very conscious of comments on the likelihood of second implants working only before children reach a certain age. There are children who are borderline in this regard. Time does not stand still when the Government makes policy decisions. I am very concerned by the fact that a decision will not be made on this matter for six or seven months. As an all-party grouping, I have no doubt we will follow up on this matter.

In the context of the questions I posed and in addition to Deputy Denis Naughten's query on stroke services, I welcome what is stated about outpatient services in the reply to question No. 23. I am very concerned about this issue which is very close to my heart. One out of every five people in Ireland will suffer a stroke at some point. In that context, the Irish Heart Foundation is holding its awareness week events from 10 to 14 June next.

I wish to raise the matter of the response given to question No. 32. As a Senator I do not get to ask parliamentary questions. I get to ask three questions at the quarterly meetings here. I go through the material and try to make sure that I have a question. When I get a stock reply similar to that which has been given to parliamentary questions on several occasions, I must note my disappointment. That is exactly what we got to question No. 32. We got a cut-and-paste reply. The last person who got such a response was Deputy Seán Kyne on 25 April. The reply states that an implementation plan beyond the overall operational planned commitments would not be beneficial. That contradicts the foreword by the Minster of State, Deputy Lynch, in the National Policy and Strategy for the Provision of Neuro-Rehabilitation Services in Ireland 2011- 2015, which states: "I look forward to receiving, at a very early stage, a comprehensive implementation plan from the HSE." The policy is unequivocal about the need for a three-year implementation plan to address those key actions that can be initiated and implemented within a short timeframe and on a cost-neutral basis while working towards the achievement of a longer-term vision. The reply I got goes on to state that the rehabilitation medicine programme has been working in collaboration with the national disability unit as part of the expert working group planning for the implementation of the report. My understanding is that this is not entirely accurate. I have been advised by the Neurological Alliance of Ireland, which is a member of the existing working group in this area under the rehabilitation medicine programme, that the initial clinical lead, Dr. Áine Carroll, clearly defined the working group's role as being limited to medical rehabilitation and, therefore, it is not concerned with overall implementation. It is of great concern to me that halfway through this implementation period it has been suddenly decided that we no longer need an implementation plan and only a partial implementation plan could be achieved. I am really concerned about this issue. Promises were made and now there is the question of whether we actually need the plan.

On question No. 34 on the children's palliative care programme, I am pleased to hear that the candidates for outreach nurses have been chosen, but when will they be in their posts? I have asked this question at previous quarterly meetings. Where will the palliative care fit in the reform of the health services? There have been many initiatives and developments, including staff training in palliative and end-of-life care, many of which are currently funded by the Irish Hospice Foundation. Can the Minister and the HSE outline the plans they have to fund these projects in order that they will continue? The Irish Hospice Foundation contributed €5.7 million this year.

In the area of palliative care for children, doctors are sometimes loth to say to parents and to write down that their child has a terminal illness. This is a big issue the Irish Hospice Foundation faces in regard to medical cards for children with terminal illnesses. The parents only get a medical card for their child when the child is at the end of life. Can the issue of medical cards for terminally ill children be addressed?