Seanad debates

Wednesday, 12 June 2019

Nithe i dtosach suíonna - Commencement Matters

Medical Aids and Appliances

10:30 am

Photo of Denis O'DonovanDenis O'Donovan (Fianna Fail)
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Tá fáilte romhat, a Aire-Stáit as iarthar Chorcaí.

Photo of Maria ByrneMaria Byrne (Fine Gael)
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I, too, welcome the Minister of State and thank him for coming to discuss this very important issue.

I raise an issue in CHO 3 - the mid-west - of the HSE. Recently I have encountered three cases - I am sure there are many more - in which people have received not very nice letters. They were told that as there was no funding available, they would not be given power chairs. The three cases which are very significant involve two children and one adult. The adult suffers from a rare form of dwarfism that renders him unable to walk very far. As a consequence, he needs a power chair. One of the two children suffers from a rare condition, Moyamoya, while the other suffers from rare conditions and has had to use a chair since they were a very small child. The biggest issue for the three is they have outgrown the chairs they use. All three have received a similar letter citing a lack of funding and indicating that the HSE does not know when funding will become available. I am concerned because the lack of funding is holding them back. Their families are also concerned. The parents of the two children take them out as often as they can, but because they no longer fit in their chairs it has become very difficult for them to leave their homes. In fact, one of the children now falls out of their chair because it is too small. When will funding be released? How can the lives of the two children and one adult concerned and their families return to normal? It is very important that this issue be resolved as quickly as possible.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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Gabhaim buíochas leis an gCathaoirleach as ucht na fáilte, mar is gnách, agus gabhaim buíochas leis an Seanadóir freisin for raising this important issue.

The HSE provides a wide range of medical and surgical aids and appliances such as wheelchairs and walking aids free of charge for medical card holders and those participating in the long-term illness scheme. Assessment by a relevant health professional is required. The community funded schemes is the collective name for the many products, supports, supplies, appliances and aids provided through community services. There is a variety of products and services provided under the schemes. The products and services play a key role in assisting and supporting service users to maintain everyday functioning and remain in their homes and local community. Their provision also avoids the need for a hospital presentation or admission, while facilitating early discharge from hospital back into the community.

Each community healthcare organisation, CHO, operates standard processes for the allocation of funding for medical and surgical aids and appliances. At times, because the demand for resources exceeds available capacity, there may be waiting lists for some categories of items provided from the medical and surgical aids and appliances budget in a particular CHO.CHOs undertake a range of initiatives to ensure optimum use of resources. I refer, for example, to the efficient recycling of stock items such as walking aids.

In the CHO 3 area in the mid-west, there is a waiting list in place for the purchase of 25 powered chairs. It should be noted that waiting time varies depending on the priority rating, a rating which is made by healthcare professionals based on clinical risk. Priority is given to clients with the greatest level of clinical need. In addition, work is progressing in CHO 3 on the establishment of a stock database to maximise recycling of stock items across the mid west. Under the aids and appliances project, data will be transferred onto an online system allowing clinicians to review all stock online, validate waiting lists and use recycled stock more efficiently.

At national level within the HSE, a service improvement programme has been established to improve the standard and quality of the many products and services provided as part of community funded schemes and to implement standardised national contracts for the supply and pricing of these products to ensure best value for money across all CHOs. These measures will help to ensure that there is equitable access to products and services irrespective of where the service user lives.

Photo of Maria ByrneMaria Byrne (Fine Gael)
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I thank the Minister of State. While I accept that everything is being assessed and that there is a waiting list, the lives of these three people have been impacted. The Minister of State has just said there are 25 people on the waiting list. I am not sure how many other people are affected but I have been contacted by three individuals and I am really concerned that they have no quality of life. They cannot do what they have been used to doing every day. It is my understanding that in other CHO areas people get their wheelchairs more or less straight away. It very much depends on the number of people on the list. Is there any hope that some of the funding that is not being used in other areas could be diverted on a temporary basis? It is not fair that 25 people are waiting in the CHO 3 area while there are few if any waiting in others. I know that is hearsay but the people with whom I am in contact have spoken to patients in other areas who got chairs immediately. There is a problem here and the funding must be found. That is what I am asking for today.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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I thank the Senator. She makes a very fair point. I will speak to the Minister following this discussion and I will try to get a handle on the national picture. The answer I have given the Senator is very much focused on CHO 3 but the Senator makes a very valid argument that if there were better alignment between all nine CHOs and a streamlining of the available funding, that might improve the situation. Ultimately, we want to ensure that the three people to whom the Senator refers and the other people on the waiting list of 25 in the CHO 3 area are dealt with as quickly as possible. I will have a conversation with the Minister in terms of the HSE looking at this issue from a national perspective in order to try to get better alignment between the CHOs to better utilise the system. Each CHO working on its own is not going to solve the problem and better collaboration may be required. I will speak to the Minister on behalf of the Senator.