Lynn Ruane (Independent) | Oireachtas source

I have a few questions which I hope the Chairman will afford me the time to get through. My first set of questions are directed to the HSE. It was mentioned that one of the key aims of the HSE is to deliver health services in a way that is culturally appropriate. How is this implemented? What training do HSE staff receive and who delivers that training? Is the €10 million annual funding to Traveller health initiatives sufficient given the health needs of the community? Was an increase in funding sought under budget 2020 or in any of the last five budgets? If so, what was the response from the Department of Health? Ms McArdle described a Traveller health provision structure which is siloed from the rest of general service provision within the health service. What are the documented experiences of Travellers accessing general health services or in other words, services that are not Traveller-specific? Is there a long-term shift planned to mainstream Traveller healthcare within general services, perhaps as part of the Sláintecare reforms?

My next set of questions is to the ICGP. We heard previously in our sessions on Traveller mental health that many Traveller patients have had their medical cards revoked. If there is documented impact in this regard, what has been the impact thus far on Traveller patients? I made the suggestion at a previous committee hearing that regardless of a Traveller's circumstances, until such time as we exit the current health crisis every Traveller should be given access to a medical card. I would like to know if the witnesses agree with me in that regard. Are the HSE and the ICGP doing enough in the face of the Traveller health crisis? Is there prejudice when it comes to healthcare services and what is being done to root it out?

My final questions are to the representatives of the Traveller Visibility Group, Ms Breda O'Donoghue and Ms Liz McGrath. Ms O'Donoghue mentioned that the main cause of poor health outcomes is substandard living conditions. What type of engagement has the group had with local authorities in regard to raising the standards on that ground and has there been real dialogue between Traveller organisations and local authorities on how the issue can be addressed? It was also mentioned that the uptake in cervical screening is higher among Traveller women than in the general population and that this is due to the Traveller-led nature of the health intervention. Ms O'Donoghue also mentioned that the group is constantly consulted to give advice but that while there is consultation, when it shifts to Traveller-led services, it changes.

How can this model be developed for further inclusion and development within the HSE in respect of other forms of Traveller healthcare?