Phil Hogan (Carlow-Kilkenny, Fine Gael)
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I thank the Office of the Ceann Comhairle for allowing me to raise this important matter which concerns the provision of dialysis facilities in the south-eastern region.

The need for someone to receive renal dialysis places a difficult imposition and burden on their lives. It involves people attending a renal dialysis unit between two and three times a week and spending between three and four hours hooked up to a renal dialysis machine in order to stay alive. I understand the average age of people requiring renal dialysis is 69 and that more and more people are presenting each year requiring dialysis, primarily due to changes in lifestyle and habits.

Few of us in the House would relish the prospect of spending three hours up to three times a week immobile and linked to a dialysis machine for the purpose of giving us essential and urgent medical treatment. However, there is a crisis in the provision of dialysis facilities in the south east, where many people, particularly in the Kilkenny and Carlow areas, are being forced to travel for dialysis services to Dublin. Some of these dialysis patients have advised that this can involve a round trip of up to ten hours, three times a week. This is an incredible and unjust imposition on people and their families. I have heard that a large number of patients are being treated at the renal dialysis unit at Waterford Regional Hospital and that because of pressure on the hospital facilities there, the dialysis services have had to be provided through the night.

It is bad enough that any person should have to undertake dialysis two to three times a week, but it is even worse that he or she should be forced to travel long distances, or have the dialysis carried out during gravely anti-social hours. We are not just talking about the disruption on the person involved, we are also talking about the difficulties that are presented for their families and friends.

The reason I raise this issue is that I understand from local patients that a privately funded renal dialysis unit has been commissioned and is open in Kilkenny. It has the capacity to treat all necessary patients from Carlow and Kilkenny who are travelling long distances or undergoing anti-social treatment. I have visited the renal dialysis centre in Kilkenny, which operates as a Wellstone clinic, which is an impressive and commendable initiative. I understand it has also been visited by many HSE representatives, the consultant nephrologist and representatives of the Irish Kidney Association. However, there is the farcical situation where patients in need of dialysis must pass by the door of the clinic in Kilkenny, either on their way to dialysis facilities in Dublin or in the middle of the night on their way to dialysis in Waterford. According to local patients, while the clinic can take patients for dialysis facilities, the HSE is not prepared to pay for the treatment and claims that there is some outstanding procurement process under way.

I am not an expert in procurement law, but it strikes me that where there is a will there is a way. As a matter of policy, surely it must be open to the HSE and the Department of Health and Children to facilitate treatment of patients in circumstances where there is an urgent need in a manner that is most humane and accommodating to them, without raising unnecessary barriers.

I am convinced by many of the local representations I have received that giving people access to the Wellstone clinic would make a considerable improvement in the quality of their life. It would enable people to spend more time with their families rather than on unnecessary and uncomfortable travel to Dublin for treatment that is not optional. As a matter of policy, I urge the Department to ensure that the HSE, while fully adhering to appropriate procurement processes, does not apply those processes in a way that unnecessarily hinders people with urgent medical needs who can be accommodated locally.

I know the Tánaiste and Minister for Health and Children has put patients at the heart of her reforms to the health service and that she is anxious for the private sector to play a complementary role to the public health service. In Kilkenny we have a prime example of a privately developed and funded initiative that can make a substantial difference to the lives of patients throughout Carlow, Kilkenny and other parts of the south east. It must be a salutary lesson to any private sector investor contemplating involvement in the health sector to see that the Health Service Executive seems unwilling to be innovative and patient-focused in the application of public procurement rules in circumstances where, according to the Irish Kidney Association, such rules would not prevent the conclusion of an interim contract between the HSE and the operations of the clinic pending any formal procurement process.

I suspect the events we have witnessed in Kilkenny will be replicated in other areas throughout the State. As a matter of policy, the Department of Health and Children should encourage the commissioning of private sector companies to ensure, in conjunction with the public sector, that patients have the facilities they require as near as possible to their places of residence. I would be grateful to know when the Department will be able to ensure that the HSE sanction and commission the renal dialysis unit at the Wellstone Clinic in Kilkenny to allow the patients of Carlow and Kilkenny avail of this important service locally.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I am addressing this matter on behalf of the Tánaiste and Minister for Health and Children, Deputy Harney.

As the Deputy is aware, the management and delivery of health and personal social services are the responsibility of the Health Service Executive. This includes responsibility for the provision of haemodialysis services for people who live in County Kilkenny. As the Deputy pointed out, the clinic to which he referred is a private clinic offering a private haemodialysis service.

The Health Service Executive is undertaking a national review of haemodialysis. It is expected that the review will be completed later this year. The executive has informed the Department that, pending the completion of the national review, it is recognised that there is a need to source additional haemodialysis capacity for patients.

Given that Deputy Hogan belongs to a party that has made a strong case for value for money, I am sure he is a strong proponent of proper procurement procedures. Under procurement law, the executive must enter into a tendering process for haemodialysis services from the private sector. I understand the executive has begun a national procurement exercise to source additional haemodialysis services throughout the country. The executive has informed the Department that the procurement exercise should be completed within two months.

It is open to any private clinic providing haemodialysis to express an interest to the executive under this procurement process. The executive will seek to source additional haemodialysis services in locations that best meet the needs of patients with a view to minimising the requirement for patients to travel excessively to avail of haemodialysis treatments.

It is envisaged that the executive will form a list of suitable providers who will be invited to tender to provide haemodialysis services when and where an identified need exists. Quality of care, value for money, location and the timeframe for service delivery will be key considerations and detailed award criteria will be set out in the tender documentation.