Thursday, 10 April 2008
Defence Forces Medical Service.
Question 6: To ask the Minister for Defence if each member of the permanent Defence Forces have been made aware by their employers of the content of the Defence Forces Medical Services Patients Charter; and if he will make a statement on the matter. [13516/08]
Question 15: To ask the Minister for Defence if, consistent with the terms of the agreed patients charter for the Defence Forces, each member of the permanent Defence Forces has been informed of the names and contact details of the medical officer and dental officer responsible for the management of their medical and dental care; and if he will make a statement on the matter. [13514/08]
Question 31: To ask the Minister for Defence if, consistent with the terms of the agreed patients charter for the Defence Forces, the name of the doctor, dentist and pharmacists are prominently displayed in each Defence Forces surgery and pharmacy; and if he will make a statement on the matter. [13515/08]
Question 47: To ask the Minister for Defence if, consistent with the terms of the agreed patients charter for the Defence Forces, members of the permanent Defence Forces who require ongoing treatment from Defence Forces medical and dental officers or routine examinations or treatment are given appointments for specific dates and times and are usually seen within 30 minutes of the stated time; and if he will make a statement on the matter. [13517/08]
I propose to take Questions Nos. 6, 15, 31 and 47 together.
Military medical services and their facilities exist to maintain the health of the Defence Forces and to support them in operational and overseas activities. The focus of the military medical service is on primary care, occupational medicine, acute trauma management, preventative medical programmes and field medical training.
The challenges in the medical arena have been recognised for some time and a review of the provision of medical services is ongoing as part of the modernisation agenda for the Defence Forces. The representative associations are involved with us in this review. The scope of the review includes the level of service to be provided to members of the Defence Forces and the resources required for the delivery of that service.
The review has already produced a patients charter with the agreement of all parties, which I welcome. The agreement on the patients' charter identifies the rights of members of the Defence Forces as patients and their obligations as users of the Defence Forces medical services. It also identifies the obligations on the providers of the services.
The implementation of the patients charter is under way. The military authorities have assured me that issues such as publicising the charter, displaying names of medical personnel and the awareness of personnel about the medical or dental officer with responsibility for the management of their medical care will be implemented in the coming weeks.
However, the full implementation of the charter is clearly dependent on the resolution of the structural, resource and other challenges facing the medical corps. The challenges we face with medical services in the Defence Forces and therefore the scope of the medical review go beyond the patients charter. It is one item on the medical review agenda. The Minister looks forward to the active engagement of the representative associations with the overall process.
In view of the complexity of the challenge and the need for concrete steps, the Minister has decided to engage consultants to make recommendations on the best means of meeting the medical requirements of the Defence Forces. Tenders for the engagement of consultants have been issued with a tender closing date of 18 April. The consultancy will deal with all relevant issues affecting the sustainable provision of the relevant medical expertise and services to the Defence Forces.
The development of the capacity of the medical corps forms part of An Agreed Programme for Government. The Minister is committed to providing a sustainable medical service to meet the needs of the Defence Forces both at home and abroad. I can assure the House that Defence Forces personnel requiring medical treatment are getting the care they need.
Another consultants' report will not solve the problem of getting personnel for the Army. They are probably looking at alternatives but I cannot see a consultants' report finding the solution. The patients charter was signed off last September, nine months ago, but nobody has seen it, including Army personnel. It has not been put on display anywhere. That is not good enough. The health of the Defence Forces is very important because they have to stay healthy in order to carry out their duties. There are difficulties such as basic appointments. I understand everyone arrives at the military hospital on Infirmary Road at 8.30 a.m. Some people could have to wait there all day to see a doctor or to get medical advice. There is also the issue of a different doctor on duty every time they return. Patients like to see and meet the same doctor as much as possible as they build up a communication and a trust with them. I have asked this question repeatedly about the medical backup service for the Defence Forces. I am not happy with what I hear and see in regard to the medical backup at present. Will the Minister of State give a timescale for implementation of the patients charter? Can a designated officer of high rank be appointed to ensure the patients charter and all the recommendations agreed last September will be put in place?
Much of this issue will hinge on the work of the consultants. There are issues to be addressed. At the end of the summer the consultants will be appointed and later in the year we will have the report. The Deputy is correct in saying that full information concerning the patients charter should become available. I have asked for a copy of the charter. The Deputy asked that the charter be made readily available; that is an obvious point that must be dealt with and I will certainly pursue it.
Difficulties in regard to the recruitment of medical officers have endured for some time despite the concerted efforts of my Department and the Defence Forces. The numbers attracted to work in the Defence Forces have served only to address natural wastage. The pay and allowances of doctors and dentists were recently increased substantially in consultation with the Minister for Finance. In addition the Defence Forces have recently undertaken an intensive recruitment campaign, the result of both these initiatives has been disappointing. It is important to get this right. The consultants will be asked to review the career prospects being offered to young doctors, opportunities for career development and membership of specialist registers. They will also examine the range of services required by the Defence Forces at home and overseas and for options on sustainable future positions. In summary, I will certainly follow up on the request in regard to the patients' charter and keep the Deputies informed on the progress of the consultants' work. It is important to get on with this work and to get it right.
I take on board all the points the Minister of State has made. When the medical corps is at about half strength there is a serious problem. For example, given that only one Irish-born doctor was recruited in the past five years there is a serious issue here. I suggested financing the studies of doctors on the basis that they would enter a contractual arrangement to give a number of years service to the Defence Forces. The more I think of it, the more I think it must be done on a formalised basis. A similar scheme operates in the US armed forces.
We can receive consultants' reports for ever but the simple issue is inducements to attract people. I accept that efforts have been made by increasing pay levels but it has not worked. People are more amenable to serving in the Defence Forces for a limited length of time if they are given assistance with studies at a time in their careers when resources can be a serious problem.
I will convey Deputy O'Shea's view on the scholarship-type system to my officials and will ask them to convey it to the consultants examining the options available. There are problems with personnel because there are 21 doctors in the medical corps. We need more and, in the absence of a sufficient number of military and medical officers, civilian doctors and dentists are employed on a sessional basis, inside and outside barracks, to maintain the service required for the Defence Forces.
Defence Forces personnel requiring treatment are receiving the care they need. The setting of targets for service provision is worthwhile but everyone must realise that meeting these targets is dependent on resolving these bigger issues. Fundamental issues must be addressed. The Minister and I are determined to do so and I will convey Deputy O'Shea's suggestion to my officials.
Regarding inducements to enter the military medical personnel corps, the availability of a crÃ¨che is a major issue for young married females. I tabled a question today on the availability of a crÃ¨che at the Curragh, the biggest centre, but nothing is happening. Ancillary facilities such as a crÃ¨che can provide an inducement for people to join the medical corps.
I am aware of those who do not receive appointments and do not know when the next appointment is scheduled for or who will care for them. This is true of dental as well as medical care and is not acceptable.
I will convey Deputy Deenihan's point to my officials. The medical corps is not immune to the wider challenges in the medical field. In addition to the pay and allowance factors, career opportunities for a young doctor in the Defence Forces and other ways to attract a medical officer are being examined. The Minister will be in a position to report on progress in due course.