Fergus O'Dowd (Louth, Fine Gael) | Oireachtas source

I thank Senator Daly for bringing this matter before the Seanad. I would assure him that I will bring it to the attention of the Minister of State at the Department of Health, Deputy Kathleen Lynch.

In answer to the Senators specific questions in relation to the number of paediatric tracheotomies and nursing care, I will put the following on the record of the Seanad.

Information available from the hospital inpatient inquiry database would indicate that the number of children between zero and 16 years who have had this procedure and have been discharged from hospital is relatively small. Of the 74 such discharges between 2010 and 2012, the majority have been from Crumlin children's hospital, 41 discharges, and the Children's University Hospital, Temple Street, 21 discharges. However, it is not possible to say how many of those children were discharged with the tracheostomies still in place.

The active register of the Nursing and Midwifery Board of Ireland has a total of 4,274 individuals holding a children's paediatric qualification. This does not mean that all of these are actively practising in this discipline. Individuals may hold more than one qualification and as such may be practising in another division of the register. It is also possible that individuals may not be practising at all, but still pay annual retention fees to maintain their names on the register. Under new requirements set out in the Nurses and Midwives Act 2011, future registration will capture more defined information on current employment. This will allow for more accurate analysis of the active register, including numbers of practising paediatric nurses.

The HSE established a working group to examine the discharge of infants or children with complex health care needs from the acute paediatric hospitals in Dublin mid-Leinster in July 2012. The group comprised representatives from the paediatric hospitals, HSE primary care, nursing agencies, Jack & Jill Foundation, LauraLynn House and University College Dublin.

The group is finalising its report and will submit it to the national director for quality and patient safety. Findings indicate the following needs: establish a clinical governance model for children discharged into the community; ensure that all staff providing care to children with complex needs are fully trained; and develop a support package for parents.

It is proposed that these recommendations will apply throughout the HSE. A key recommendation concerns the need for a detailed paediatric home care package to be agreed prior to the child's discharge from hospital, with a detailed specification outlining the care requirement for each child and family. A paediatric home care package needs to include a key worker to advise everyone within the family on all aspects of the child's care and trained nursing-care staff.

The provision of safe home care for children who are well enough to leave hospital, such as these children, is a priority for the Minister for Health. He has highlighted care at home for children who have had to undergo tracheotomies as a priority service area for the HSE in planning its services in 2014. The Minister is meeting the advocacy group tomorrow. The HSE has informed the Minister that, following publication of the national service plan for 2014, officials will meet in early December to discuss future steps to deliver on the working group's recommendations in 2014.