James Reilly (Dublin North, Fine Gael) | Oireachtas source

I welcome the opportunity to speak about the very valuable work that is under way in audiology services and the national cochlear implant programme. I am aware that since the cochlear implant programme commenced at Beaumont Hospital, more than 700 patients have received cochlear implants. I also know that the programme does much more than provide surgical services. It also provides an assessment service to potential candidates and a rehabilitative service to those who are actually implanted.

While the programme has provided single implants to date, it is now considered best practice worldwide that children should have bilateral cochlear implants, and I do not believe there is any disagreement about that. I was very pleased to meet with the group Happy New Ear in July of this year and again today, and to hear from them at first hand about this issue. I know that Happy New Ear also met with the national clinical care programme in audiology on two occasions this year, as well as with my colleague the, Minister of State, Deputy Kathleen Lynch, who spoke earlier.

As the Minister of State has already outlined, the HSE, with Beaumont Hospital, has developed a proposal to introduce a bilateral cochlear implant programme in Ireland. I welcome the fact that, in developing this proposal, the HSE had input from Happy New Ear and other stakeholders. It is also very important to note that the proposal drew on the input of two UK experts who were engaged to advise on how to make progress on this complex development. A bilateral cochlear implant programme will involve the assessment, fitting and post-operative follow-up of simultaneous cochlear implants. The proposal also outlines a number of options for a sequential programme - that is, the provision of second implants to children who have already received one implant and who are assessed as being suitable for a second.

The introduction of a bilateral cochlear implant programme - both simultaneous and sequential - will obviously be dependent on the availability of additional funding. As people will be aware, yesterday's budget saw the announcement of the Health Estimates. Once again, 2014 will be a very challenging year for the health service. I am pleased to have been able to prioritise children's health care with the commencement of free GP care for children aged five years and younger. I believe this measure will ensure better medical outcomes for children and more treatment taking place in the community rather than in hospitals. I also want to note that my colleague, the Minister for Public Expenditure and Reform, Deputy Howlin, reconfirmed the Government's commitment to make up to €200 million available from the sale of the national lottery licence for the new children's hospital. This capital project is an absolute priority for me and for the Government. The new building is one side of the equation; the services for children, and the people who deliver them, make up the other. That is why I have established a children's hospital group, the board of which includes members from both within and outside paediatric health care, which brings new and different perspectives and insights from outside the world of health care to join with the expertise and experience of those from within that world. I very much welcome the fact that the three paediatric hospitals themselves are committed to coming together and that work is under way on integrating services across the three hospitals.

As I conclude, I must reiterate there is no question but that the 2014 budget for the health sector represents the greatest challenge the health sector has ever faced. Full details will be worked out, worked through and set out in the HSE's national service plan, which must be submitted to me in early November.

Knowing the challenges ahead, it is important to be clear that the resources needed for the introduction of a bilateral cochlear implant programme, and indeed any service development, must be considered in the context of the service plan and in the context of my over-riding priorities of quality and, in particular, patient safety.

In conclusion, much as the Deputies opposite might wish to stand in my shoes today, the choices we have had to make in this budget have not been easy. Some of them have been very hard and some of them have resulted in things such as the prescription charge, which is not the direction in which I believe our health service should be going. However, our country is in the hands of others as regards our finances, so we are anxious to exit this bailout and get our financial sovereignty back. I must make choices about this very sensitive issue, which is a priority for me, and other matters such as screening for diabetic retinopathy, which can cause irreversible blindness if not detected early. There are no easy choices, but this issue will be one of my top priorities. I look forward to the opportunity of having that priority expressed in the national service plan.

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