Kathleen Lynch (Cork North Central, Labour)

I thank the Senator for raising this issue as it provides me with an opportunity to reaffirm the Government's commitment to developing palliative care services. Government policy for palliative care is based on the report of the national advisory committee on palliative care from 2001. Palliative care is primarily concerned with quality of life.

The Government's objective of the continued development of palliative care services is reflected in the funding of these services in recent times. In 2009 in the region of €79 million was made available, with approximately €66.5 million of this being provided to the main voluntary organisations. It is accepted that these organisations do an extraordinary job. The overall budget provision in 2010 was €76 million and €74 million was provided in 2011. The HSE reports that specialist palliative care is provided to 3,600 people each month, and it is understood that the admission rates - waiting times - to palliative care beds over all regions is 90% to 100% within seven days of active referral.

A palliative care services medium-term development frameworkwas published by the HSE.This sets national priorities, which have been agreed by all stakeholders. In line with recommendations of the framework, the HSE established in July 2010 the national steering group on palliative care services to monitor progress on the implementation of the framework at national and regional level. As the Senator is aware, the Health Act 2004 provides the Health Service Executive with responsibility for the management and delivery of health and personal social services. As a statutory body the provision of these services, including progressing palliative care services at local level, is therefore an operational matter for the executive.

There are a number of developments ongoing in the south east with regard to palliative care services. In the south east, including Waterford, specialist palliative care is delivered through hospital and community-based consultant-led multidisciplinary teams. These teams consist of consultants, non-consultant hospital doctors, senior occupational therapists and a principal social worker. Acute and primary care services in the south east have access to specialist palliative care teams 24 hours a day, seven days a week.

The Irish Hospice Foundation established a national programme to mainstream hospice principles in hospital practice. It focuses on four key themes generated from a pilot project: integrated care; communication; dignity and design; and patient autonomy. Waterford Regional Hospital is participating in this programme.

The management team at St. Luke's General Hospital in Kilkenny continues to work with the Susie Long Hospice voluntary group on the plans to develop outreach inpatient palliative care beds for Kilkenny. In liaison with the Susie Long Hospice Group it is planned, during 2011, to upgrade ward areas to provide improved accommodation for patients currently in receipt of palliative care and other related services.

The integrated oncology unit and 20-bed palliative care unit at Waterford Regional Hospital to which the Deputy refers, like all potential capital projects, must be submitted through the HSE's capital steering committees for approval to be included in the HSE multiannual capital programme. I must inform the Senator that this project has not been included in the draft HSE capital plan 2011-2015, so it will not be considered for progress in the current plan. I understand the HSE has just appointed a project team to design a business case for the development.

The estimated total cost of all potential projects is always greater than the capital funding available. Health care is a labour intensive activity and hospices are one of the most labour intensive services. Therefore, sufficient revenue and current funding to staff and operate new facilities is one of a number of critical factors considered in such a project's appraisal. Given the level of contractual commitments already in place, there is limited funding available for new contracts before 2014. The executive is required to prioritise capital infrastructure projects within its overall capital funding allocation and within the multiannual commitment thresholds notified by the Department of Public Expenditure and Reform.

I reiterate the strong and real commitment of the Government to progressing the highest possible standards of palliative care nationally. However, all future developments, including capital projects, must be considered within overall budgetary and economic constraints. I know Cork has a very good and accessible palliative care programme so I understand fully where the Senator is coming from and why it would be a significant addition to the region. There is no dispute in that manner and it is an incredible service to be available to everyone. Unfortunately, I am sure the Senator understands the country's Government does not have the money to progress the project. If he continues with pressure, it will eventually come about.