Maria Corrigan (Fianna Fail)

I join my colleagues in welcoming the Minister to the Chamber. Like other Senators, I am always in admiration of her ability to speak so comprehensively on the health service without a note in hand. I welcome the progress she has outlined. I am very conscious that the HSE is a relatively new body for the provision of services. It is very clear from the Minister's contribution this morning that there are many areas of health delivery and health provision in which the HSE has excelled. There are areas where much work remains to be done.

We will always be talking about the work that needs to be done. It would never be acceptable for us to wake up some day and say everything is perfect. We should always try to be a bit better and strive for even greater developments.

The Minister spoke a lot about good practice. An essential component of this for any organisation is constant review and reflection. Given the relative newness of the HSE, and bearing in mind that we are nearing the end of the term of its first CEO, Professor Brendan Drumm, are there plans to take stock of and reflect on the executive's experience to date and consider how this might inform future practice?

I welcome the progress the Minister outlined, particularly the emphasis on education, upskilling, training and public awareness. These are essential to the HSE's effectiveness and patient safety.

The Minister spoke very eloquently and effectively on the emphasis we are now placing on early intervention and prevention. Sometimes the work we do on prevention can be very hard to measure and quantify. I have no doubt that any investment in prevention will be one for the future of our health service and for our citizens, the people we represent. Although we may never be able to quantify the impact of the investment, I am very honoured to be involved with Dr. Ken McDonald and the work he does with the Heartbeat Trust. I can see very clearly the progress being made on early intervention, assessments associated with prevention and education. These are having an impact on cardiac care. Cardiac disease is one of the main killers in Ireland.

There are a few issues I would like to refer to in the presence of the Minister, the first of which concerns vaccinations. I welcome the roll-out of the cervical cancer vaccine but I am concerned about the uptake under the childhood vaccination programme. I ask the Minister to consider launching a public-awareness campaign. Over recent years, there was much confusion caused in the public domain over the safety implications of vaccines, particularly in respect of the MMR vaccine and its alleged links to autism. It is really important that we send out a message today that there is no credible scientific evidence to link the MMR vaccine to autism and that there is very clear scientific evidence linking diseases such as measles, rubella and mumps to early and unnecessary death and the needless acquisition of disabilities. In the future, Ireland will have people with acquired intellectual disabilities that could have been prevented had they not contracted one of the diseases.

One of the issues we face as a consequence of there not being sufficient uptake of the vaccine is that we no longer have herd immunity in Ireland. This has implications for every infant under 18 months. It is not possible to administer the vaccine to those under 18 months. If we maintain herd immunity, it will mean children under 18 months will not come into contact with those diseases. If we do not have immunity among children over 18 months, they could unintentionally carry disease back home to an infant under 18 months.

From my professional background and having kept up to date with developments, particularly studies carried out in England, I am aware all the research linking MMR to the onset of autism has now been withdrawn and is no longer credible. However, I am not too sure the public is aware of this. I ask the Minister to consider an awareness campaign in this regard.

Concerns were raised recently in the news over developmental checks for younger children. This is a really important part of our work in the fields of early intervention and prevention. Developmental checks are often the first occasions on which it is noticed that things are not quite going according to plan for younger children. The checks comprise an essential component of prevention and intervention.

I very much welcome the fair deal. It has given peace of mind and reassurance to people and gives equitable access to older people who seek nursing home care. However, an issue has arisen for people who suffer the onset of Alzheimer's disease or an age-related disorder. The person's needs increase and they require a higher level of care. Often, they must be moved to a higher support corridor or wing, but they are no longer covered by the fair deal from the moment of the transition. That occurs in nursing homes where high support has been put in place for age-related disorders and part of the nursing home has become registered under the mental health institutions. In one week the person is covered by the fair deal but when they are moved the following week to a different part of the nursing home they are under the mental health section and are no longer covered. Families will then often face bills of between €1,300 and €1,800 per week.

I did not have a chance to speak about the protection of children, which is really important with regard to the HSE. I would welcome another opportunity to discuss that, if possible. I have previously sought the establishment of an Oireachtas joint committee on the protection of children and vulnerable adults. The Minister said it is really important to have inspections carried out without fear or favour, and that this is taking place at present in the mental health and elderly sectors. It is imperative those inspections take place in residential services for children with disabilities and children who are unaccompanied minors. We should also consider inspections in residential services for adults with intellectual disability, who are also quite vulnerable and whose residential settings might not be up to the standard we would desire.