Thursday, 14 February 2019
Saincheisteanna Tráthúla - Topical Issue Debate
Medical Products Supply
It was with great concern I received telephone calls in regard to the provision of incontinence pads to older people by the HSE. I raised this issue in a parliamentary question and it was passed on to the HSE. We need to look at the human side of this issue. Caring for older people, loved ones, is a challenging task at the best of times. People caring for people with disabilities face the same challenge. These people should not have always to fight for basic things to be done right. Unfortunately, people do have to fight constantly to get basic services. I understand that the delivery and supply of these hygiene products was very good until procurement came into play. The centralised procurement process, from the children's hospital to incontinence pads, is leading us to innumerable difficulties. People can no longer depend on the right quantity of product being delivered or on timely delivery. Everyone will accept a one-off blip, even Homer can nod, but when there is a continuous problem the situation becomes serious. As I said, it should never have happened.
When I raised the issue with the HSE, it responded that following a national tender process Freightspeed was the successful bidder and awarded the contract for the delivery of incontinence wear and that while it has encountered some issues around supply it is working hard with Freightspeed to improve the situation. National procurement discounts local deliveries, local suppliers, the people we rely on and the people who care. When are we going to back to a system of procurement that is based not only on price but on service and reputation? I suggest that these contracts should be tendered for locally not nationally because regular, reliable local suppliers are being pushed out by the big people who do not have the same attention to the individuals as was there in the past.
Any of us facing the same situation involving faulty delivery as that facing people in the west of Ireland would ask that we put people ahead of the god of this procurement process that just seems to make a shambles of procurement from the highest level with the over-runs on the children's hospital right down to just delivering a few incontinence pads in time, on time and all the time.
I thank the Deputy for the opportunity to address this issue on behalf of my colleague, the Minister for Health. The community funded schemes are a collective name for the many products, supports, supplies and aids and appliances provided through the HSE community services for eligible persons. Their main purpose is to assist and support service users to live at home and also to facilitate hospital avoidance and assist with early discharge from hospital. The products are prescribed by consultants, GPs, public health nurses, continence advisers, physiotherapists, occupational therapists, speech and language therapists and dieticians. The products include incontinence wear that is delivered to healthcare settings such as long-stay residential services and to persons in their own homes.
The HSE has a national contract for the supply of incontinence products. Following a tendering process, the HSE selected a new product supplier and a new product distributor in 2018. I understand from the HSE that the new contracts have involved a lot of changes in the range of products and their distribution. There have been some issues relating to the timely delivery of products under the new contract. In 2018, the HSE put measures in place, including additional staff, an electronic management system and training of drivers to address initial difficulties. The HSE has informed the Minister for Health that it is continuing to work closely with the contracted delivery partners to ensure that the problems experienced by some service users in the CHO west region and other CHO areas are addressed as a matter of priority.
A governance structure has been put in place to oversee the national contract for the supply and delivery of incontinence products to ensure the timely delivery of these products to eligible persons in their homes across all CHOs. This involves each CHO putting in place additional controls and monitoring measures in respect of the ordering and distribution of these products. To support this process, additional administration staff have been put in place to carry out this work. The HSE is committed to ensuring that these service improvements will result in an enhanced and more efficient service for all. In the mean time, service users should let their local public health nursing service or health centre know if they are experiencing difficulties with supply of products.
I am not blaming the Minister of State. She gets these answers to read out. What we have just heard here blows my mind. The Government set up this national procurement system to save money. What result did we get? We got chaos, inefficiency, non-delivery and massive costs for the HSE in trying to undo the mess it created because the system was working perfectly until this tendering process was introduced. If the Government has made any savings by doing it on a national basis rather than continuing the old local tendering we used to have, the HSE has had to employ even more staff to monitor and try to get this right. As the saying goes, if it ain't broke, don't fix it. What we seem hell-bent on doing in this country is breaking everything and creating a central inefficient supply chain that does not work in the name of some savings that never materialise. In addition, we are taking jobs off smaller suppliers and thereby eliminating real competition - not just competition based on price. It is not just about competition on the visible price but competition on the real price of people getting what they need on time and in time.
As the final insult, and I accept the Minister of State was given her speech, her speech states that "in the mean time, service users should let their local public health nursing service or health centre know if they are experiencing difficulties with supply of products." We are talking about the families of service users, who are already hugely burdened with problems, having to put right what they should not have to put right. Another burden is being put on people. Is humanity gone from this country in the name of some god of procurement or are we going to put people first?
Again, I apologise to the Deputy if the answer was not adequate. We all want what is best for those who are ill in our communities, particularly those loved ones who spend a lot of time at home and people in nursing homes. I am not unfamiliar with the matter. When my mother was so ill at home, the local service made life easier for all of us when we were looking after her. It involves simple basic things like incontinence pads and other medical equipment that will help people stay at home and help their carers and families to give them the care they need at home. I did not decide that there would be a process for this. I believe that at some stage, we must look at local care and connect that through our primary care centres. Regarding why this problem has arisen, I can only relay to the Deputy the answer I have been given but I assure him that everything is being done through the HSE and the Minister to keep the services and the supply chain in place and to make sure it is done effectively and efficiently in each local area. That is what we all want. Nobody wants to see anybody, particularly people caring for those who are ill, being left without incontinence pads or other medical devices in their local communities. The Deputy may not agree with the procurement process. Probably some of us here do not agree with it either but it is in place. It is most important to make sure whoever gets this contract delivers effectively and on time to those people caring for their loved ones at home or in other health areas. I will take the Deputy's response back to the Minister and make sure he hears what the Deputy has had to say.