Áine Brady (Kildare North, Fianna Fail)

I thank the Senator for raising this matter and providing me with an opportunity to clarify the position.

The provision of non-emergency patient transport is an area where there is considerable expenditure annually in the health services and where, in the interest of safeguarding the provision of front-line services, improved management and control is a necessity. The special group on public service numbers and expenditure programmes report - the McCarthy report - recommended that a review of the continued provision of non-emergency patient transport by the HSE be carried out with a view to securing efficiencies of at least 20%. In addition, the renewed programme for Government agreed in October 2009 commits to exploring the provision of a full-scale transport system in rural areas using the network expertise of Bus Éireann, the physical infrastructure and personal resources of the school transport system and the financial resources currently being spent on transport by the HSE and the Department of Education and Science.

In this context, the Department of Health and Children has set out the principles which should underpin the HSE's operational practice for non-emergency patient transport. These principles emphasise that it would be expected that, as a rule, patients should be in a position to make their own transport arrangements unless there are clear clinical factors involved. The provision or arrangement by the HSE of other forms of transport should be confined to circumstances where the HSE is satisfied that while the person does not require clinical support on the journey, his or her medical condition warrants the making of arrangements for transport, either directly provided by the HSE or in limited circumstances by other providers. In such cases the HSE would also need to be satisfied that the person was not in a position to make or fund his or her own transport arrangements.

In order to realise the maximum efficiencies in 2010, the Department has requested that based on the principles set out, the HSE develop a new set of rules for the provision of patient transport. Savings at a minimum of €10 million in 2010 and a further €5 million in 2011 should be achievable under the new arrangements.

The specific issue raised by the Senator concerns the arrangements made between the HSE in Donegal and Seirbhís lompair Tuaithe Teoranta, SITT, a rural transport service for the provision of transport for patients to HSE day centres, day hospitals and other centres. As public transport services are available, the HSE had provided free transport services to day centres, day hospitals and other centres in Donegal. With the establishment of the rural transport schemes, it was envisaged that an alternative viable transport system would be established and the HSE would focus its resources on service delivery. This has not happened to date and the HSE is now required to deliver savings for 2010 in line with its service plan.

In order to sustain transport services and provide continued access to HSE services in Donegal, it was agreed with the local transport provider that a charge would apply to daily return journeys to HSE services from February 2010. The HSE will resource the provider for the provision of the transport service to HSE centres, less the income generated from the charges. It was also agreed that transport routes would be streamlined to avoid duplication by different services.

I understand the HSE has acknowledged that the notice and quality of the communication regarding the introduction of the transport charges was inadequate in this instance. This is now being addressed by the HSE in conjunction with the transport provider and the HSE has apologised for the limited notice to service users. While I appreciate there is an additional financial cost for users with the introduction of these charges, I am informed they were kept to a minimum. I am sure the Senator will agree that in these challenging times, the absolute priority must be to maintain the front-line services within the resources available. I will take on board the points made by the Senator and discuss them with the Department and the HSE.