Brendan Smith (Cavan-Monaghan, Fianna Fail)

I thank Deputy O'Connor for raising this important issue, to which I will reply on behalf of the Minister for Health and Children, Deputy Harney.

One of the key challenges facing the Health Service Executive is the need to ensure that services are planned and provided in line with the clinical need of patients. A number of experimental initiatives were put in place by the HSE with a view to providing, where appropriate, care in community-based settings instead of hospital settings. The hospital in the home service, with the introduction of primary care teams, community intervention teams, a rapid access service for the elderly and the GP out of hours service, is one of these initiatives.

The hospital in the home service was delivered by the service provider in question on the basis of a service level agreement with the Health Service Executive and for a period of one year. This agreement came to an end on 16 March. However, it was subsequently extended to 18 April.There are approximately 400,000 presentations to accident and emergency departments in Dublin annually. Some 100,000 of those who present are admitted. During the period of the agreement, the hospital in the home service treated in the region of 2,000 patients at an annual cost of €6.83 million. The hospitals benefiting from the service are Beaumont, Connolly, the Mater, St. James's, St. Vincent's and Tallaght hospitals.

A review of the service was carried out between January and March of this year under an independent chairman. The review made a number of recommendations. The main recommendation in the report, which has been adopted by the HSE, is that the concept of hospital in the home be retained and that it should be repatriated within existing HSE post-acute care and community services. The HSE is considering the manner in which it can best mainstream the service, previously offered by the service provider, into the executive. There is capacity within the community intervention teams in the greater Dublin area to absorb this service. Accordingly, the HSE is not in a position at this time to commit to a further 12-month contract. However, it is considering a number of points put to it by the service provider. The HSE has emphasised that no patient will be disadvantaged by this decision.

I assure Deputy O'Connor that the points he raised will be brought to the attention of senior management in the HSE tomorrow.

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