Wednesday, 10 March 2010
Thalidomide Compensation Scheme
Rural Transport Services.
I raise an issue that has emerged in my constituency of Donegal South West with regard to the use of the rural transport service in transporting people to day centres within the area. The service is currently operated by Seirbhís Iompair Tuaithe Teoranta, or SITT, as it is commonly known. SITT and the HSE have been working together on a pilot project for an integrated transport service to HSE-run day centres in towns within Donegal South West. The pilot project ended on 31 December 2009 and has been shown to be beneficial. It is in the process of being rolled out throughout the county. The people who avail of the service to various day centres, including Carrick Day Centre, the Woodhill Resource Centre, Killybegs Day Hospital, Donegal Day Hospital, the Cleary Centre, Rowanfield House and St. Agnes's Centre, are receiving an excellent service. However, in February they were asked to contribute €3 per day for the service. We may imagine a person attending one of these day centres five days a week, for whom €3 may seem a small amount but it equates to €15 per week, which adds up.
In early February the SITT rural transport company wrote to each passenger advising him or her of the €3 charge. The letter stated:
To date, transport for passengers accessing HSE Centres and Services was fully funded by the HSE. Regrettably, there is a shortfall in the amount of funding available at present and therefore it has been necessary to introduce a small charge of €3 per person per day.
This is payable to SITT and should be given to the driver working on behalf of SITT on your day of travel.
This is a cause of concern. A meeting was held on 22 February by some of those involved in the process. I subsequently raised the issue with the HSE locally and the response I received from the local health manager in Donegal was as follows:
Due to the limited public transport services in the county, the HSE provided free transport services to day centres; day hospitals and other centres. With the establishment of the rural transport schemes, it was envisaged that an alternative viable transport system would be established and the HSE would focus its resources on service delivery. To date this has not happened. In order to sustain transport services and provide access to HSE services the following was agreed with SITT [not with the passengers but with the transport provider]:
1. Transport services to HSE centres would be provided by SITT.
2. A €3.00 charge would apply to daily return journeys from February 2010.
4. Transport routes will be streamlined to avoid duplication by different services.
5. HSE services will co-ordinate holiday periods.
That was the response of the HSE, but it does not address the problem, which is why I am raising the issue in the light of the concerns expressed in my area. I have received a large volume of representations on the issue which affects elderly individuals and vulnerable groups within our society. The people concerned have free travel passes. I am requesting that the free travel pass cover this service. I do not expect an immediate response to the issue and I do not expect the Minister of State to have had all the information before my presentation tonight. I ask that the issue be reviewed given the anxiety and stress the issue is causing these patients travelling to the day centres.
I appreciate this is a financial burden to the HSE, whose budget is under financial pressures like every other budget in the State. Nonetheless, this was a pilot project in operation in south Donegal and will be rolled out to the rest of the country. It is a small charge relative to the overall HSE budget but it is detrimental to the budgets of the passengers in question. As they are social welfare recipients, the €15 would alternatively be spent on groceries or heating bills. I ask that the matter be reviewed if possible.
Áine Brady (Minister of State with special responsibility for Older People and Health Promotion, Department of Health and Children; Minister of State, Department of Environment, Heritage and Local Government; Minister of State, Department of Social and Family Affairs; Kildare North, Fianna Fail)
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I thank the Senator for raising this matter and providing me with an opportunity to clarify the position.
The provision of non-emergency patient transport is an area where there is considerable expenditure annually in the health services and where, in the interest of safeguarding the provision of front-line services, improved management and control is a necessity. The special group on public service numbers and expenditure programmes report - the McCarthy report - recommended that a review of the continued provision of non-emergency patient transport by the HSE be carried out with a view to securing efficiencies of at least 20%. In addition, the renewed programme for Government agreed in October 2009 commits to exploring the provision of a full-scale transport system in rural areas using the network expertise of Bus Éireann, the physical infrastructure and personal resources of the school transport system and the financial resources currently being spent on transport by the HSE and the Department of Education and Science.
In this context, the Department of Health and Children has set out the principles which should underpin the HSE's operational practice for non-emergency patient transport. These principles emphasise that it would be expected that, as a rule, patients should be in a position to make their own transport arrangements unless there are clear clinical factors involved. The provision or arrangement by the HSE of other forms of transport should be confined to circumstances where the HSE is satisfied that while the person does not require clinical support on the journey, his or her medical condition warrants the making of arrangements for transport, either directly provided by the HSE or in limited circumstances by other providers. In such cases the HSE would also need to be satisfied that the person was not in a position to make or fund his or her own transport arrangements.
In order to realise the maximum efficiencies in 2010, the Department has requested that based on the principles set out, the HSE develop a new set of rules for the provision of patient transport. Savings at a minimum of €10 million in 2010 and a further €5 million in 2011 should be achievable under the new arrangements.
The specific issue raised by the Senator concerns the arrangements made between the HSE in Donegal and Seirbhís lompair Tuaithe Teoranta, SITT, a rural transport service for the provision of transport for patients to HSE day centres, day hospitals and other centres. As public transport services are available, the HSE had provided free transport services to day centres, day hospitals and other centres in Donegal. With the establishment of the rural transport schemes, it was envisaged that an alternative viable transport system would be established and the HSE would focus its resources on service delivery. This has not happened to date and the HSE is now required to deliver savings for 2010 in line with its service plan.
In order to sustain transport services and provide continued access to HSE services in Donegal, it was agreed with the local transport provider that a charge would apply to daily return journeys to HSE services from February 2010. The HSE will resource the provider for the provision of the transport service to HSE centres, less the income generated from the charges. It was also agreed that transport routes would be streamlined to avoid duplication by different services.
I understand the HSE has acknowledged that the notice and quality of the communication regarding the introduction of the transport charges was inadequate in this instance. This is now being addressed by the HSE in conjunction with the transport provider and the HSE has apologised for the limited notice to service users. While I appreciate there is an additional financial cost for users with the introduction of these charges, I am informed they were kept to a minimum. I am sure the Senator will agree that in these challenging times, the absolute priority must be to maintain the front-line services within the resources available. I will take on board the points made by the Senator and discuss them with the Department and the HSE.