Ms Siobhán McArdle:

I thank the committee for the invitation to the HSE to attend the committee meeting. I am the assistant national director with responsibility for primary care services. I am joined by my colleagues, Ms Concepta de Brun, the HSE regional social inclusion specialist and Ms Deirdre O'Reilly, the Traveller health co-ordinator for the Cork and Kerry community healthcare area.

The All Ireland Traveller Health Study in 2010 provided evidence of a widening gap in health status between the Traveller community and the general population. It found that people from the Traveller community experience lower levels of life expectancy than the general population and higher levels of morbidity associated with chronic disease conditions and other causes.

The goals of the HSE are to promote health and well-being as part of everything we do in order that people will be healthier; to provide fair, equitable and timely access to safe quality health services that people need; and to foster a culture that is honest, compassionate, transparent and accountable. The HSE is committed to ensuring that health services for people from the Traveller community are provided in accordance with these values and objectives. The national Traveller health advisory forum, which was established in 2008, supports models of good practice in the delivery of health initiatives to the Traveller community at local, regional and national level. It operates under the governance of the HSE social inclusion service, which is part of primary care and supports the delivery of actions in Government policies to improve access to health services and address health inequalities within the Traveller community.

Each year, in the HSE approximately €10 million is allocated through social inclusion services for Traveller health initiatives. This funding supports staff working in Traveller primary healthcare projects and Traveller health units. Additional funding is also provided through dormant accounts and mental health services. The majority of HSE funding for Traveller health is used to support Traveller primary healthcare projects. There are 27 such projects nationally, which are staffed by members of the Traveller community. They adopt a peer-led approach, supporting members of the Traveller community to support others in achieving health outcomes. The projects promote population health initiatives by providing information to families on vaccination and health screening programmes. This approach has played a key role, as Ms O'Donoghue has pointed out, in improving vaccination rates in the Traveller community. Traveller primary healthcare projects play an important health promotion role. For example, they provide education on antenatal care, child development checks, smoking cessation, diabetes care and asthma medication management. The positive impact of the work of the projects was highlighted in the All Ireland Traveller Health Study.

All Traveller primary healthcare projects fall under the remit of eight Traveller health units.

They are located in the nine community healthcare organisations and serve a Traveller population of approximately 36,000. The Traveller health units are key bodies in delivering appropriate targeted services to members of the Traveller community, overseen by co-ordinators such as Ms O'Reilly. Every Traveller health unit has an annual action plan relating to the local health needs of the Traveller community in that given area. These plans contain actions relating to primary care, mental health, public health and health and well-being. Traveller health units have established regional networks to share learning, ensure consistent practice, and optimise efficiency and value for money. Arising from these networks, regional initiatives have made a positive impact on the healthcare needs of the Traveller community.

We have provided a great deal of information in our written submissions on the range of actions being undertaken in general by the HSE, specifically in the Cork-Kerry area, in partnership with the Traveller community and other organisations to support Traveller health. The key aims of the work are to improve access, opportunities, participation rates and outcomes in the healthcare system, to reduce health inequalities experienced by Travellers, to deliver health services in a way that is culturally appropriate, to support positive mental health initiatives and to reduce the rate of suicide and mental health problems.

I thank committee members for their attention and for their interest in the actions being undertaken to improve Traveller health outcomes. I acknowledge and commend the commitment and motivation of staff working in the Traveller primary healthcare projects, the Traveller health units, primary care services and the wider health service. Through them, we are committed to providing fair and equitable access to health services and to supporting improvements in health outcomes for the Traveller community.

Ms De Brun, Ms O'Reilly and I are free to take members' questions, if they have any.