Máire Hoctor (Tipperary North, Fianna Fail)

The Government's motion is based on a recognition of the continued increase in funding for health services over each year of the last decade and the associated expansion of a wide range of frontline services and the high satisfaction levels with frontline health services shown in Insight 07, the most comprehensive, objective survey of public opinion on health services which was published last week. The Government motion also reaffirms the statutory requirement that the executive should manage its budget within the Vote approved by Dáil Éireann and acknowledges that the executive has taken measures to ensure that it meets this objective in 2007 by means of its break-even plan; and that it is the intention of the executive that these measures will not impact on planned frontline services, which will be maintained in line with the national service plan, and that provision is being made that where critical or essential vacancies arise, they may be filled by redeployment of existing staff.

As the Minister of State, Deputy Devins, noted in his contribution last evening, there are some very positive aspects of our current health service which are worth reiterating. Life expectancy in Ireland has increased steeply since 1999 and the 2005 figures show that life expectancy at birth is 79.59, an increase of 3.5 years. As a result our life expectancy is now considerably higher than the new EU27 average.

It is also important to acknowledge some of the key results of Insight 07, the recent customer service satisfaction survey undertaken by the HSE. Of particular note are the overall ratings with regard to quality of care, where 64% of inpatients, 58% of outpatients, 84% of GP patients and 76% of other community services rated their experience as excellent or very good.

My area of responsibility is services for older people and over the last two budgets, we provided the largest expansion ever in health services for older people, with €400 million additional current funding. Budget 2007 provided an additional €82 million for community services, 2,000 extra home care packages, benefiting 4,000 people at a cost of €55 million, 780,000 additional home help hours at a cost of €18 million, 1,100 more day places at a cost of €3.5 million, €5 million for expanded palliative care services and €500,000 for sheltered housing.

We have now increased the nursing home subvention from €190 maximum to €300 per week. We also provided €30 million for enhanced subvention. We are overhauling the way nursing home care is financed to remove the unfairness of the present system. No person in the care or his or her spouse will ever be forced to sell or mortgage their house to pay for care. Legislation to underpin the scheme is being prepared with a view to commencing the scheme in January 2008.

The Health Act 2007 established the Health Information and Quality Authority on a statutory basis. It also provides for the registration and inspection of all nursing homes, public, private and voluntary. Inspections will be carried out by the social services inspectorate, part of HIQA. New standards are being finalised and, for the first time, a care plan for each patient will be required.

The Health Service Executive has initiated an independent review of all acute hospital services in the mid-west region and how they can be developed in accordance with best practice. The consulting group Horwath Consulting Ireland, in association with Teamwork Management Services, is finalising the report on the review of acute services in the mid-west which is expected to be to be submitted to the HSE board by year end. Recommendations for the future configuration of clinical services, including accident and emergency, critical care, acute medicine and surgery, together with diagnostic services such as X-ray, for each of the hospitals in the mid-west area will also be set out in the report.

A cardiac clinical nurse specialist was redeployed in Ennis General Hospital on one day only to theatre recovery. It was imperative to the service and she has not been redeployed since and no other nurse has been redeployed. It is logical that staff would be redeployed to the areas of greatest need in the best interests of patient care and safety.

An internal staffing review was conducted in Ennis General Hospital. Unions were told in advance that any recommendations for staffing increases would have to be processed through the service planning process. This review recommended an increase of 26 staff, nurses and health care assistants. The matter is under consideration as part of the Estimates process for 2008.

The record shows that this year our health services and indeed in every year since 1997 have seen significant increases in funding, staffing and patient services. The HSE is managing services with the objective of avoiding any impact on frontline services and patient care and maintaining them in line with the national service plan for 2007.

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