Dáil debates

Thursday, 8 March 2018

Topical Issue Debate

Medical Products

3:25 pm

Photo of Seán SherlockSeán Sherlock (Cork East, Labour)
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I am speaking on behalf of a three year old boy from Killeagh in County Cork, Adam King. He has been waiting for a wheelchair since last July. I have been asking the Minister for Health about this for several months when Adam can expect to receive his wheelchair. It is a shame that when there is an increased allocation of resources, particularly to the Health Service Executive, HSE, that facility cannot be afforded to a three year old boy. His parents, Fiona and David, say that his dignity and safety are compromised daily.

Without a wheelchair, he is forced to spend much of his time on the ground on all fours. He has a walking frame but his mother, Fiona, says that it is too heavy to manoeuvre comfortably and he tires quickly. He can walk extremely slowly for a few metres before needing a break and, as I said, he is on a waiting list for a replacement walking frame since July 2017. He is due to start preschool in August and will need to be trained in the use of the wheelchair in advance to do everyday tasks. For example, he will need to learn how to hoist himself from it onto the toilet. I find it a little undignified to have to make the case in this House for a three year old child at a time when we have increased resources.

The manner in which the waiting list is operated is a cause of major frustration for Adam's parents. Last December, Adam was top of the Enable Ireland list but since then he has fallen back to fourth on the list. At the rate at which wheelchairs are allocated his mother, Fiona, estimates it could be May or June before his application is approved. There are no complaints by the family against Enable Ireland. Adam's parents say that his therapists from a physiotherapy and occupational therapy point of view are wonderful. Their critique is of the HSE resource allocation group which meets fortnightly, or monthly. At those meetings all the disability organisations, including the COPE Foundation and Enable Ireland, present their waiting lists, indexed in order of clinical need and applications for aids and appliances are also received from community health care organisations and acute hospitals on behalf of patients that are being discharged. While Fiona and David recognise that Adam is de factocompeting with adults who are in the acute hospital system, they would in no way wish for anybody else to be deprived of their services if they have a more urgent need but they, and I, fail to understand, as I am sure would anybody in this House, why at a time when we have increased resources owing to increased tax intake, economic growth and so on, the methodology used to allocate resources cannot be looked at afresh so that we do not have competing with adults for what is a basic human right.

Yesterday, the Dáil debated a motion on the ratification of the United Nations Convention on the Rights of Persons with Disabilities. It is ironic that Adam is not having his rights or entitlements enforced.

3:35 pm

Photo of Richard BrutonRichard Bruton (Dublin Bay North, Fine Gael)
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I thank Deputy Sherlock for raising this issue. I extend my sympathies to Adam and his family for the difficulties he is experiencing. I understand that his case was considered at today's fortnightly meeting, but I do not have information on the outcome of it. As I understand it and as the Deputy described, new priorities can disrupt a ranking on a waiting list and I can understand how that can create frustration for families. Overall, I am told that in the Cork and Kerry area, where there are applications from young people under the age of 18 for appliances of this nature, 80% are dealt with within six months. Deputy Sherlock's point in regard to the methodology that is being deployed in this regard is an important one. I understand from the Department that it has identified a need for an improvement programme in these type of schemes and work in this regard, which is being led by the HSE primary care team, is at an advanced stage. The aim is to improve the quality of service and the sustainability of the approach, to establish national standards and to ensure equity of access, value for money and good processes and management systems. There is a recognition that the system does not offer the type of certainty, standards, equity of access and clarity for the families involved.

I will ask the Minister for Health, Deputy Harris, to specifically request that the HSE, in undertaking this improvement programme, take account of the comments made by Deputy Sherlock in regard to the experience of this particular family. I understand that Adam is top of the list as of 27 February. However, I take the point the Deputy makes that the possibility of other applicants being deemed to be more urgent creates a difficulty that I can well understand. I will bring the Deputy's concerns to the Minister's attention. As I said, there is at least an acknowledgement that change is needed in this area in terms of the approach that is being taken.

Photo of Seán SherlockSeán Sherlock (Cork East, Labour)
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I welcome the Minister's reply. To be fair to him, he has empathised with the case. I welcome his comments in regard to the Department having identified the need for an improvement programme in areas in which there is an allocation of sources. The bottom line is that this three year old child's social development is being affected because his immobility is being limited and he cannot join in and play with other children. We need a speedy resolution of this case. I believe there is money available to do this and that the methodology by which money is allocated can always be changed. I hope that Adam can receive his wheelchair in a timely fashion. I hope that it will not be 2019 before he receives what is effectively a human right. Article 7.2 of the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD, states that in all actions concerning a child with disabilities the best interests of the child shall be a primary concern. According to Adam's father, as waiting lists and practices are not common across jurisdictions how can we as a nation genuinely believe that Article 7.2 of the UNCRPD can be enacted in what appears to an unequal system?

I welcome the Minister's comments. I hope that in raising this case in the Dáil cognisance will be taken of the fact there is a three year old boy in our midst who needs a wheelchair now.

Photo of Richard BrutonRichard Bruton (Dublin Bay North, Fine Gael)
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I can sympathise with the Deputy saying that waiting lists are inappropriate. In many ways, they are. Every day in this House a new procedure or application is highlighted that could be funded and there is a debate about the allocating of resources to it. We all feel the need to prioritise those cases. Waiting lists appear to be an inevitable part of health services across the globe. I do not envy the Minister for Health, even with the extra money he is getting, being able to resolve these issues. It is encouraging that the HSE has recognised that this is an area where it can do better and improve the consistency, quality, sustainability and fairness of the system. I hope that the improvement programme I referenced earlier will not only benefit Adam as his case is dealt with but will move us to a position where cases like Adam's can in the future be dealt with in a better fashion.