Pat Breen (Clare, Fine Gael)

I welcome the opportunity to contribute on the Health Service Executive's national service plan 2012. I support Deputy O'Donnell's call for the need for a fair share of funding for HSE mid west, particularly when one considers the savings the agency made in the region over the past 12 months.

This is a challenging time for everyone working in the HSE, health service users, patients and their families. This plan has been laid out against the background of up to 3,500 impending retirements from the health services when it is anticipated 7,700 public servants will avail of the overall retirement scheme. However, it is important to remember between 5,000 and 6,000 health services staff retire in a normal year and that the majority of those leaving by the end of this month are within 12 to 18 months of their normal retirement.

Listening to Fianna Fáil Members, one would believe the introduction of the incentivised retirement and this scheme came as a surprise to them. It was during their watch in government that the moratorium on recruitment was introduced in the first place. It was the former Minister for Health and Children, Mary Harney, who introduced the voluntary redundancy and retirement scheme in the HSE which, at the same time, was aimed at reducing the number employed in the public sector from 2011 onwards.

No Member will dispute the review of pension arrangements for serving public service staff poses challenges for the HSE. It does, however, provide an opportunity for real public sector reform. While it is difficult to confirm the final figures given that each employee has up to the last day of February to change his or her mind, the HSE has a clearer picture of where to plug the gaps in services through either personnel redeployment, savings efficiencies in other areas and limited targeted recruitment.

Despite a reduction of €750 million, funding is still significant even in these difficult and challenging times with the health budget this year standing at €13.3 billion. As the Minister for Health rightly said earlier, reform is no longer just an option, it is an essential requirement for all involved in health service provision. The Minister is a reforming one. Being a medical practitioner he knows the health system inside out. Already, in his short time in office, he has achieved much with the introduction of the special delivery unit. The statistics prove this. The number of people on emergency department trolleys at 8 a.m. for the first 16 days of January 2012 stood at 5,046 when it was 6,893 during the same time in 2011, a reduction of 27%. The Government is driving health service reform.

Finding new innovative ways of delivering our health services is essential in minimising the impact on reduction in resources for the patient. The HSE is capable of adapting to the changed economic environment. Today, I was pleased to be informed that following the review of the long-stay nursing homes in the mid-west region, no nursing homes will close in County Clare. There was much scaremongering by some Opposition Members on this matter. I am happy to reassure the patients, their families and the staff of Regina House, Kilrush, St. Joseph's Hospital, Ennis as well as Raheen Community Hospital in Tuamgraney and Ennistymon Community Hospital that their doors will not be closing. I pay tribute to the management and staff in the non-acute section of the HSE for making this possible even with a reduced budget. It was confirmed to me this evening by the HSE and the Minister's office that there would also be no bed closures. We must, however, remember no further bed closures will depend on staff leaving the health service and changes to sick leave arrangements as well as other work arrangements.

I thank the Minister for Health, Deputy Reilly, for his support on this matter. I had lobbied both him and the Minister of State, Deputy Kathleen Lynch, on this on many occasions. I know their preference is to see as many old people to live in their own communities. That is, however, not always possible.

I welcome the additional provision of €35 million for mental health services in this year's plan. This is important as it is estimated that over 300,000 people suffer from depression, a startling figure. The development of specialist day-care centres can play a pivotal role in reducing the need for long-stay beds in acute psychiatric services.

More than 4,000 people are identified with dementia every year and it is reckoned by 2040 it will affect up to 147,000 people. Many of these patients are cared for by their families and friends at home but also they can avail of day-care services. As well as the outstanding social interaction value the centres provide, it is a source of comfort for families to know their loved ones are looked after in a safe environment for several hours during the day. I hope more of these facilities will be built in our communities because they have a valuable role in the development of care for the elderly allowing them to live in their own homes for longer, which is what most people want to be in a position to do.

Last Monday I spoke at the launch of the new Sikorsky S-92 helicopter at Shannon Airport. The helicopter's primary role will be in search and rescue operations along the west coast and it will be a great asset to the Coast Guard's helicopter rescue crews. It is capable of operating in all weather conditions and its auxiliary fuel tanks allow it to travel extended distances. However, it is also ideal for providing the HSE with air ambulance services. The crew members, most of whom are trained paramedics, told me they will be able to travel from Shannon Airport to parts of west County Clare, such as Kilbaha and Carrigaholt, in 20 minutes. That will help people in disadvantaged areas. I understand negotiations are ongoing between the HSE and the Coast Guard and I hope the air ambulance service will be up and running by July, which is welcome news for people who live in rural, isolated parts of my constituency and tourists who visit the county during the summer. The air ambulance service will be assisted by advanced paramedics on the ground, about whom I hear positive reports. I acknowledge the work they do in covering the county on a 24/7 basis.

I have insufficient time to speak about the testing for type two diabetes which the HSE is rolling out. We are living in unprecedented times and we face major challenges with our reduced health budgets. Ministers have to cut their cloth by their measure. A significant number of experienced staff will retire next month but the staff remaining in the HSE are well trained professionals and while the departure of their colleagues will pose a challenge, they can reduce the impact on front line services by working together.

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