Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank Senator Burke for raising this important issue and for allowing me to address the matter. I am answering on behalf of the Minister of State, Deputy Kathleen Lynch, who is responsible for social care.

The HSE is responsible for the delivery of health and personal care services. The current health reform programme involves a major change process which will see a

greater integration and a streamlining of service access and provision for the public. The staff appointed to dietician posts will be required to work as part of multi-disciplinary teams delivering a co-ordinated approach to client care. Currently dieticians practice across health promotion, acute hospital services and primary care and interact on a daily basis with service users. There are 129 community facilities through which the HSE provides residential care for older persons and all of these facilities have access to dietetic services. This service recognises the fact that making healthy and nourishing food choices easily accessible to older people in residential care can help reduce the incidence of poor nutrition - both under-nutrition and over-nutrition.

The nursing homes support scheme, the fair deal, provides financial support towards the cost of long-term residential care in nursing homes. The scheme covers the cost of standard components of residential care. While access to dieticians is not covered by this scheme, older people in residential settings are entitled to be referred and assessed for HSE ancillary services and therapies. These include physiotherapy, occupational therapy, OT, and access to dieticians - access is provided in the same way as to those who are resident in the community.

In conjunction with the development of primary care teams, specific development funding has been provided to develop services for older people in the community. Referral protocols, direct access to diagnostics, individual care plans, discharge planning, integrated care pathways and shared care arrangements will allow for a more fully integrated primary care service.

As the HSE implements the reform programme, it continues to review the job descriptions for all posts with a focus on maximising the contribution of all professionals to the overall well-being of the public and all service users.