Written answers

Tuesday, 21 June 2005

Department of Health and Children

Hospital Staff

10:00 pm

Photo of Tommy BroughanTommy Broughan (Dublin North East, Labour)
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Question 58: To ask the Tánaiste and Minister for Health and Children if her attention has been drawn to the concern expressed at the recent INO conference in Killarney that the health and safety of patients and staff in hospitals and long-term units for the elderly was being put at risk due to a failure to address dangerously low staffing levels; the steps being taken to address this situation and to ensure that adequate staff numbers are provided; and if she will make a statement on the matter. [20818/05]

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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Clearly safe and effective delivery of services is of primary concern to me. I do not accept the Deputy's assertion that staffing levels in hospitals and long-term care units for the care of the elderly settings are at dangerously low levels. I am aware for example that the Irish ratio of nurses to the population is much higher than the ratio found in other developed countries. Work currently being carried out for my Department by FÁS suggests that we have 12.2 working nurses per 1,000 people, about 50% more than the EU average of 8.5. The Government has increased the number of nurses — whole-time equivalents — by 7,000 since 1999.

I fully support the principle that an appropriate level of service should be provided to patients across the country based on need. However, patients' needs vary considerably depending on the particular care being provided, the acuity of patients or their level of dependency. The Health Service Executive and the National Hospitals Office will need reliable evidence to establish best practice in the range of settings provided by the health services.

These matters must be dealt with through the correct deployment of staff, through appropriate skill mix and by making sure that the legislation is in place to provide proper regulation.

The deployment of staff is a matter for the Health Service Executive. However, this is a major policy issue in which my Department will also take a keen interest. The National Hospitals Office has already begun the process of reviewing all services at each hospital to ensure that they are staffed appropriately to deliver safe and good quality care. The Health and Safety Authority, HSA, has acknowledged that the hospitals are fully engaged in the process of addressing health and safety in their accident and emergency units. The HSA has also made clear its intention to carry out safety audits on other health care settings and I welcome this.

I accept that there are concerns about services for older people and I share these concerns. That is why I have made a commitment that the Social Services Inspectorate is to be established on a statutory basis and legislation to give effect to this will be published later this year. The inspectorate will be charged with the inspection of both public and private nursing homes and will be responsible for reporting on standards of care in such homes. It is planned to extend the brief of the Social Services Inspectorate to include residential services for older people and people with a disability.

The staff levels set for nursing homes are in accordance with the Nursing Homes Regulations 1993. However, having regard to the level of public concern currently about the registration and inspection of the nursing home sector, it is imperative that immediate action is taken to ensure that current systems and processes are as robust as they possibly can be within the context of the current regulations. Responsibility for the inspection and registration of the nursing home section has been assigned to a senior manager, within the national primary, community and continuing care directorate of the Health Service Executive from 15 June 2005. Steps are being taken to evaluate current procedures, and to agree and oversee the implementation of a national standardised inspection process and provide a progress report by 5 September 2005. A review has already commenced in the HSE-eastern region and this will be included in the national evaluation. Any recommendations arising from this in respect of the amendment of legislation or regulation will be addressed.

In addition, my Department is urgently reviewing the operation of the Health (Nursing Homes) Act 1990 and regulations made under the Act to strengthen the powers available to the Health Service Executive. This will be a wide-ranging review which will have the rights of the patient as the centre of its work. Again it is my intention to have this Bill published later on this year so that we can have an early debate will all stakeholders on a new framework for all patients in nursing homes.

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