Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Deputy Burke for the opportunity to address the issue of the provision of medical aids and appliances, including wheelchairs, by the Health Service Executive in the Cork-Kerry region. I heard the Deputy raise the issue with the Taoiseach the week before last.

The HSE provides a wide range of medical and surgical aids and appliances, including wheelchairs, free of charge to eligible persons such as medical card holders and people on the long-term illness scheme following assessment by a relevant health professional. These appliances and aids are provided by the HSE through community services known as community funded schemes. These products and services play a key role in assisting and supporting people to maintain everyday functioning and to remain living in their homes and their local communities. They also avoid the need for a hospital presentation or admission when facilitating early discharge from hospital back into the community.

Each community health organisation, CHO, operates processes for the allocation of funding for medical and surgical aids and appliances. Each application within a CHO is assessed for eligible persons by the local resource allocation group. A determination is made regarding approval based on priority and funding available within local budgets. At times, due to the demand for resources exceeding the available capacity, waiting lists may apply for some categories of items provided through the medical and surgical aids and appliances budget in a particular CHO. CHOs undertake a range of initiatives to ensure optimum use of resources, including, for example, through the efficient recycling of stock items such as wheelchairs and walking aids.

In CHO 4, the Cork-Kerry area, there is currently a waiting list in place for the purchase of some wheelchairs. While additional funding was recently allocated in CHO 4, to which the Deputy alluded, the effects of Brexit and the global issues with the supply chain have further impacted the sourcing of appropriate wheelchairs for some applicants. The HSE is currently trying to resolve these issues and to source the wheelchairs in as timely a manner as possible. It should also be noted more generally that the waiting times vary depending on the priority rating and that the rating is made by healthcare professionals based on clinical risk. Priority is given to individuals with the greatest level of clinical need.

At national level in the HSE, a national service improvement programme has been established with the aim of improving the quality and sustainability of the community funded schemes through the establishment of national standards. These standards will be based on evidence-based rationale and will include a list of approved items, national prescribing guidelines and clinical criteria for each.

This should improve equality of access, value for money and functional processes. Unfortunately, the Covid-19 pandemic has delayed progress on this programme but, as the situation improves, it will gather pace. It is important to note that section 6 of the Health Service Executive (Governance) Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or personal service to any individual or to confer eligibility on any individual.

See this speech in context