Thursday, 27 June 2013
On behalf of the Minister of State, Deputy Kathleen Lynch, I thank the Senator for raising this issue as it gives us an opportunity to outline the current position.
Palliative care in Ireland is being developed on the basis of the following national strategic documents: Report of the National Advisory Committee on Palliative Care, published by the Department of Health and Children in 2001; Palliative Care Services - Medium Term Development Framework, published by the HSE in 2009; and Palliative Care For Children With Life-Limiting Conditions In Ireland - A National Policy, published by the Department of Health and Children in 2010.
The HSE acknowledges that the cost containments within the health sector over the last five years have meant that the implementation of the HSE medium-term framework has been substantially delayed.
Notwithstanding current budgetary difficulties, in 2012, approximately 35,738 people received specialist home care palliative services and 4,274 people received specialist inpatient care. There are currently 157 specialist inpatient palliative care beds in ten locations across the country. In 2012, there were 2,808 admissions to this service, a 4.4% improvement on 2011 figures.
That said, it is acknowledged that there is a wide regional and intra-regional variation in the availability of care and three geographic areas have no specialist inpatient units, namely, Wexford-Wicklow, the midlands and Cavan-Louth-Monaghan. All HSE areas have community specialist palliative home care teams in operation. Last year, 2,978 people accessed these services each month, which was a 4% improvement on 2011.
There are 38 acute hospital specialist palliative care teams. Again there is variability in service availability and composition of these multidisciplinary teams. Specialist palliative day care is provided in seven locations and an average of 330 patients used the service per month in 2012.
Some 817 new patients attended the service in 2012, which equates to an increase of 7.5% on 2011. There are over 170 palliative care support beds across approximately 80 locations. In 2012 the average number of patients per month in receipt of care was 150.
The 2013 HSE national service plan budget allocation for palliative care is €72 million, which does not include spending on palliative care provided in acute hospitals, approximately 170 palliative care support beds or home care packages. Furthermore, regional services continue to be developed. In HSE South, an additional 20 beds will be opened in 2013 in Marymount Hospice, to which the Senator referred. In Dublin-mid-Leinster, collaboration with primary care teams is being progressed to improve access to out-of-hours services and a plan for the provision of specialist inpatient beds for the midlands is being developed. The HSE has also met stakeholders to develop a specialist service in Wicklow. In HSE west, the HSE is engaging with Galway Hospice to discuss the expansion of capacity and is exploring the development of inpatient beds in counties Mayo and Roscommon. An additional consultant in palliative care medicine is also being appointed. In Dublin north-east, a business case and implementation plan are being developed for a 12 bed specialist inpatient unit at Our Lady of Lourdes Hospital in Drogheda. Meetings have also been held with St. Francis Hospice on the opening of beds in the unit at Blanchardstown.
While we are facing significant challenges overall in the health budget, the Minister is satisfied that every effort is being made to retain and improve palliative care services.