Imelda Henry (Fine Gael) | Oireachtas source

I move amendment No. 1:

To delete all words after ??Seanad Éireann?? and substitute the following:
??acknowledges the valuable work being done by many organisations, including the Jack and Jill Children's Foundation and the Irish Hospice Foundation as part of wider Health Service Executive funded delivery of services to people with disabilities;
welcomes progress so far under Palliative Care for Children with Life Limiting Conditions in Ireland ? A National Policy (2009);
commends developments beyond palliative care needs by both statutory and non-statutory agencies to progress services generally for such children;
notes the complex and multi-disciplinary nature of such services, which has placed emphasis on developing home-based supports, and respite care, on a more uniform basis nationally for such children and their families;
notes ongoing discussions between the Health Service Executive and relevant non-statutory organisations to further promote where possible services for children with life-limiting conditions;
notes that the Health Service Executive has consistently funded the Jack and Jill Children's Foundation, subject only to the general estimates reductions applied evenly to all agencies in the disability and palliative care sectors in recent years;
notes that the recommendations contained in the value for money and policy review of disability services relate to the full range of residential, day, respite and other support services delivered by and on behalf of the Health Service Executive;
recognises that the preference for keeping the child-client at home must take account of the availability of resources across all types of service delivery funded under the disability and palliative care programmes;
acknowledges the difference in the cost of hospital versus home-based services, but points out that the costs relating to a 24-hour acute medical service will always show an unfavourable cost when compared to a home-based support service, which is entirely different to the type of service provided to families for a specified number of hours;
notes that the Minister for Health and the Minister for Children and Youth Affairs are satisfied that the broad principles as outlined in the United Nations Convention on the rights of the child in terms of the provision of appropriate health services to children are reflected in current policies being pursued by the Health Service Executive;
acknowledges the Minister for Health on the various services in place for children with life-limiting conditions, ranging from acute hospital-based to home-care supports, the progress that has been made or is planned in line with the programme for Government and under health reforms, for such care needs, and the need to maximise service delivery in this area in line with resource availability;
acknowledges, however, that recent economic circumstances will regrettably have a bearing in terms of the availability of wider resources to ensure the expansion of that provision and best possible outcomes for children, and notes that within this context, the Health Service Executive is working to ensure that the best possible level of service for children and young people are maintained; and
notes that the Government is embarking on a major reform programme for the health system, the aim of which is to deliver a single-tier health system, supported by universal health insurance, and guided by the principle of money follows the patient and care for all persons, including children with life-limiting conditions, as close to the home as possible, within available resources.??.

I welcome the Minister and also take the opportunity to welcome Jonathan Irwin from the Jack and Jill Children's Foundation. I commend the work the foundation does in caring for children with life-limiting conditions. Without the support of this organisation life would be very difficult for the children and families concerned.

I have no problem supporting the ethos of this motion. It is a pity that during the good times, when we had money, previous Governments did not address this issue. Many children availing of services provided by the Jack and Jill Children's Foundation also avail of other specialist health supports and disability services, both hospital based and community based. The aim of the HSE is to ensure that all children with life-limiting conditions would receive services on an equitable basis and through a standardised approach. A paediatric palliative care consultant was appointed in May 2011 and is based in Our Lady's Children's Hospital, Crumlin, with additional sessions in the Coombe hospital. Four nursing posts have been filled in Temple Street Children's University Hospital, Our Lady of Lourdes Hospital, Drogheda, Waterford Regional Hospital and Limerick Regional Hospital. Pending approval from the HSE control group on recruitment, additional nurses will be placed in Galway, Cork, Crumlin and Mullingar.

A needs assessment report, Respite Services for Children with Life-limiting Conditions and their Families, was undertaken in Dublin, mid-Leinster and Dublin North East in 2012. It is hoped to have the needs assessment for HSE South and West completed before the end of 2012. Funding for paediatric palliative care is incorporated in the overall palliative care provision in the agreed HSE service plan. A total of ¤78 million was allocated this year for palliative care. As we are now in a situation where we must make cuts of ¤3.5 billion everywhere, it will be difficult to expand the health budget.

Palliative care for children is delivered differently from the palliative care services for adults. Many children requiring palliative care have life-limiting conditions, as opposed to advanced terminal conditions, and children may survive for many years with these life-limiting conditions. Where children need palliative care it is usually provided at home. In the home, the family is supported by their family doctor, public health nurse and the specialist palliative care team, where it is available. The medical and nursing care of children in hospital is the responsibility of paediatric trained medical and nursing staff, with support from the specialist palliative care service.

A national policy was launched in March 2010. Ultimately, this policy aims to ensure that all children with life-limiting conditions will have the choice and opportunity to be cared for at home. In line with the key findings of the palliative care needs assessment for children, this policy prioritises community-based care for children who need palliative care. I commend the Minister for the various services in place for children with life-limiting conditions, ranging from acute hospital based to home care supports. Progress has been made or is planned for such care needs, in line with the programme for Government and under health reforms.

The Government has embarked on a major reform programme for the health system, the aim of which is to deliver a single tier health system supported by universal health insurance and guided by the principle that money follows the patient and providing care for all persons, including children with life-limiting conditions, as close to the home as possible, within available resources. The HSE remains committed to working with all voluntary disability service providers, including the Jack and Jill Children's Foundation, to ensure that all of the resources available for specialist disability services are used in the most efficient and effective manner possible. The Minister for Health was in the Chamber today and after hearing his lengthy speech I have the utmost trust and faith in him in the very difficult job he must undertake in the next few years.

We are committed to children's issues. We have set a date for the children's rights referendum, we are going to build a new children's hospital and we are committed to supporting agencies that deal with children. Children's rights are at the forefront in this House. We are lucky to have Senators Mary Ann O'Brien and Jillian van Turnout, who have an in-depth knowledge of and deep commitment to children's issues. I hope we will be in a position to revisit this issue again very soon.