Tuesday, 23 November 2021
Saincheisteanna Tráthúla - Topical Issue Debate
Medical Aids and Appliances
I thank the Minister of State, Deputy Butler, for dealing with this matter. I was advised over six weeks ago that there were 28 children on a waiting list for vital medical devices such as wheelchairs and, in one particular case, a device required to assist a young person in regard to speech development. My understanding was that there were a total of 28 children on that waiting list as of the start of October 2021. In October, I tabled a parliamentary question to the Minister for Health. As a result, funding was made available, as I understand it, for devices to be provided for ten children.
In the parliamentary question I asked specifically about CHO 4 and CHO 5. CHO 4 is the Cork-Kerry region and CHO 5 is the Carlow-Kilkenny region. The reply I received from the HSE was to the effect that there is no waiting list in CHO 5, but in regard to CHO 4, the Cork-Kerry area, the reply states that the HSE sincerely regrets that there can be a waiting time for important equipment such as wheelchairs, in some cases, but that this is due to circumstances beyond its control, such as long lead times when ordering from manufacturers and that in other cases, the funding available to it does not meet the demand. Why is there discrimination between children who are living in, say, Mitchelstown and children living in, say, Cork city? If one is living in Mitchelstown one could be waiting for up to 12 months for equipment whereas if one is living in Cahir there is no waiting list. That is total discrimination. I have raised this here with the Taoiseach as well in the past two weeks. He advised that there is adequate funding within the HSE. I understand that there is an underspend in some departments and that €60,000 would resolve the problem for the medical devices that are required for the remaining 18 children. I ask the Minister of State to clarify that this funding will be provided prior to 31 December.
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.
I thank the Minister of State for her reply. I am aware that equipment has been ordered for ten children, leaving 18 for whom equipment has not been ordered. My understanding, from the Taoiseach's reply to my question, is that there is adequate funding for this provision within the HSE. I am concerned that if the funding is not directed to the Cork-Kerry region before 31 December, we will move into the 2022 budget and the money will have to go back to the Department of Finance. The money is there and there are 18 children for whom equipment has not been ordered. They have been assessed and it has been decided they require the equipment.
These children are located throughout all of counties Cork and Kerry, not in any one place. This is why it is very difficult for parents. I spoke to one last week who saw the article on this issue in the Irish Examiner. Her child was number three on the waiting list but no one from the HSE had called to tell her the equipment for her child was ordered. I advised her to contact the HSE. When she did so the following morning, she was advised that the equipment was ordered. This was the first she heard of it, even though she had been waiting since last March. To reiterate, there is equipment ordered for ten children and another 18 for whom it is not ordered. If it is not done by 31 December, we are going into next year's budget and the children will be back on the waiting list. There is a serious discrepancy between what is happening in CHO 4 and CHO 5. That is why I put down the question to the Minister in October about the comparison between the two areas. I am asking that the issue be resolved.
I could read out the script I have been given but it more or less reiterates what I have already said. I heard the Deputy raising this issue with the Taoiseach two weeks ago and what the latter said in reply. There are 28 children who are in need and, as far as the Deputy is aware, appliances will be provided for ten of them, leaving 18 without. I will take this issue back to the Department of Health and the Minister to see whether we can make some progress on it.