Seanad debates

Thursday, 27 October 2011

Health Services: Statements, Questions and Answers

 

12:00 pm

Photo of Mary Ann O'BrienMary Ann O'Brien (Independent)

There are widespread concerns about the adequacy of the home care services offered by the HSE to geriatric, adult, mental and pediatric sectors of society. I am sure the Minister will agree that the standard of service on a small island with a small population is unsatisfactory in the 21st century. There is grave concern about the lack of governance over the standards applied to services once they are put in place. It appears that joined-up thinking and communication are lacking between the Department of Health in Hawkins House and the HSE. This is causing breakdowns in the operation of health services and the implementation of the Minister's objectives.

In my area of pediatric disability, I am only too aware that parents have to fight sections of the HSE every step of the way to obtain the care to which their sick children are entitled from the State. I ask the Minister to imagine what it is like to be a sleep deprived parent who cares for an adored and seriously ill child. The child may be tube fed, which requires 22 hours of attention per day. He or she may need postural drainage every hour or else will be vulnerable to chest infection, reflux or more serious implications. A parent in this situation must fight to arrange meetings with the HSE.

I am not the only person to argue that if the HSE contracted to private care agencies the provision of first rate services the State would make considerable savings and all the stakeholders would benefit greatly.

Will the Minister consider extending to the families of children with serious chronic illness an automatic entitlement to a medical card? Persons over 70 years of age are able to renew their medical cards by signing an affidavit that their circumstances have not changed in the previous year. Ireland's position on medical cards flies in the face of the last two reviews by the United Nations of the provision of child care in Ireland. Both UN reports recommended that any child with a certified illness or disability should be provided with an automatic medical card. In Ireland, however, the child's parents or guardians are means tested and if they fail the test they must either cover medical bills that can cost thousands of euro per annum or call on the support of charities. The parent of a sick child must still pay the ESB bill and television licence. This is a disgraceful state of affairs given that the well-off receive children's allowance without means tests. The moment these children turn 16 they will be granted medical cards in their own right as citizens. Surely a sick child should be regarded in his our her own right.

The only conclusion I can draw is that the Government will protect people over 70 years through legislation but are prepared to let chronically ill children suffer. I might be bolder by suggesting it has something to do with the fact that children do not have a vote. This reform would create a great deal of good will for the Government at no great cost to the Exchequer.

Why does the HSE not have a similar national home care budget for sick children as it has for the elderly? Why are there glaring inconsistencies in the home care packages offered by various HSE areas to the parents of severely ill children? Such services include nursing hours, carers' support, home help and out-of-home respite services.

I could speak about a myriad of cases, such as J. J Ryan from Tipperary or Matthew McGrath from Gorey, County Wexford, whose mummy wrote to me the other day. To give Senators a feel for her struggle with the HSE, I will quote from parts of her letter. Matthew McGrath, who is now eight years old, was born a beautiful little boy but was infected with meningitis when he was two and ended up with severe brain damage to the point that he cannot see or hear, has to be tube fed and suffers epileptic fits. His mother writes:

In a long battle, I have battled with the health service to secure funding for the last few years to take our son home. It is my constant dismay that parents have to fight for this when firstly, the health board have no alternative arrangements for our children .... absolutely nothing and secondly, when 90% of families want desperately to have their chronically ill children at home, within the family unit, as their basic human right. I am astounded, 6 years on, to still read stories in the media of families fighting to get support to bring their children home. Why does the wheel have to be reinvented each time and at what expense? The meetings held in the hospital with our local community health professionals were a fiasco. Each meeting saw 4 or 5 professionals travelling up to Dublin (at, I suspect, an above average mileage rate) arriving with no suggestions, or proposals and basically saying 'no' to everything the hospital or family proposed (not that we, the family, were ever included in the meeting process). They show no regard or respect for parents or families of chronically ill children. At the end of the day it was a matter of standing firm and them realising that we were not going to go away so they had to come to some sort of package deal. At this stage of the game these packages should be fairly straightforward and should be offered up to parents .... The list of waste, negligence and sheer apathy goes on and on. Our fight to keep our son at home with the level of support we need to function as a family goes on and on.

I could continue to read from the letter, but I conclude by asking the Minister a final question. According to an internal document reported on in the national media on 14 October last, the HSE is considering radical cuts — cutting home help hours by 600,000 and personal assistant hours by 400,000, providing no further appliances or aids for patients and freezing the issue of new medical cards between now and the end of the year. The same internal document states that these radical measures "will require discussion with the Department of Health before implementation". I ask the Minister to set out the Department's position on these dramatic proposals. According to the HSE assessment, these cuts will increase the demand on the acute sector and the demand for long-stay care in fair deal beds and the number of delayed discharges, will lead to longer waiting lists and accident and emergency waiting times, and will reduce the ability of older people to remain at home.

Comments

No comments

Log in or join to post a public comment.