Finian McGrath (Dublin North Central, Independent)
Link to this: Individually | In context

Question 109: To ask the Tánaiste and Minister for Health and Children if she will enhance the out of hours general practitioner services, rapid access clinics, community intervention teams, primary care teams and home care packages in order to develop the health service here; and if assistance will be given in resolving the crisis at accident and emergency departments here. [20094/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

People need to be able to obtain, in an integrated manner, the services most appropriate to their particular health and personal social service needs. In the vast majority of cases, it is appropriate that these services be provided within the primary care or community setting and that people have recourse to the acute hospital system only where their condition requires it.

General practitioner co-operatives provide the means for patients, both medical card and private, to access appropriate qualified medical care out of hours, including domiciliary visits where deemed appropriate, by dialling a lo-call number. Out-of-hours co-operatives are now in place in all HSE areas, providing coverage in all or in part of all counties. It is estimated that over two million people are currently covered by out-of-hours co-operatives and that additional funding provided in 2006 should allow for up to 350,000 additional persons to be covered.

I am committed to the further development of GP co-ops so that, ultimately, such services will be available to all of the population. The putting in place of appropriate arrangements for large urban areas, including Dublin, is a particular priority in this regard.

The main objective of Community Intervention Teams is the prevention of avoidable hospital admission and the facilitation of early discharge from hospitals. These services are additional to existing mainstream community services and will enable the fast-tracking of non-medical care or supports for an interim period, while mainstream services are being arranged for the patient. This service is focused on the adult population and 85%+ of the anticipated cohort of patients to be supported will be in the population over 65 years old. The phased implementation of this model is being introduced first in Cork City and will then be introduced into Dublin South, Dublin North & Limerick.

The 2006 Estimate for the HSE includes an additional €10 million in revenue funding to enable the establishment of up to 100 new primary care teams. This will enable the provision of some 300 additional frontline personnel to work alongside GPs in order to provide integrated and accessible services in the community. Work by the HSE to establish these teams is underway. In planning for the establishment of these teams, the Executive intends to concentrate where possible on areas of disadvantage and with significant health inequalities.

I am encouraged to learn that in excess of 1,000 general practitioners have responded positively to an invitation from the HSE seeking expressions of interest in becoming involved in the further development of primary care services. In carrying out this development of services, the HSE will be focusing on the reorganisation of the resources already available to the health service and on developing new ways of working in line with the interdisciplinary service model described in the Primary Care Strategy.

The Government has provided additional funding for services for older people amounting to €150 million in 2006, with almost three-quarters of this being committed to community care supports. The funding provides for a number of community and home-based initiatives including Home Care Packages, the Home Help service, Day and Respite Centres, Meals-on-Wheels and Sheltered Housing, among others.

Home Care packages have been piloted successfully in several regions in recent years, with just over 1100 provided to people at the end of 2005. In Budget 2006 a further €55m was committed to this area, of which €30m has been provided in 2006 and a further €25m will be provided in 2007. This will allow for the phased introduction of a further 2,000 packages by the end of this year. The HSE has advised that 249 new Home Care packages were commenced in the first quarter of this year.

Home Care packages are delivered through the HSE, by a range of providers including the Health Service Executive itself, voluntary groups and the private sector. The scheme is intended to be as flexible as possible and highly responsive to the real needs of the individual. These packages are multidisciplinary and may include services such as nurses, home care attendants, home helps and the various therapists including physiotherapists and occupational therapists.

Tackling the current difficulties with A & E is the Government's top priority in health. The service being provided to some patients in A & E is unacceptable and must be improved.

Our objectives are to reduce the numbers waiting for admission, the time spent waiting for admission, and the turnaround time for those who can be treated in A & E and do not require admission.

The HSE is continuing to implement the 10-Point Action Plan. In addition, it has been agreed with the HSE that a number of additional measures will be implemented by the Executive. These include in particular the setting of performance targets for individual hospitals. In terms of implementation, the HSE is taking the following approach:

∙Tackling the issue on a hospital-by-hospital basis

∙Developing hospital-specific time-based targets in relation to A & E and delayed discharges

∙Development of financial incentives linked to performance in these areas

∙Development of additional targeted initiatives aimed at delivering an immediate and sustained impact.

In the immediate term, the HSE is introducing a series of measures to improve facilities for patients and staff in A & E departments. Long-term care beds are being secured from within the private sector to facilitate the discharge of patients who have completed the acute phase of their care. The acute beds that become available as a result of this initiative will be ring fenced for those patients awaiting admission in A & E departments. Funding is being made available within the capital programme to develop admissions lounges to ensure that patient privacy, dignity and comfort are preserved while awaiting admission to an acute bed.

The HSE has established a dedicated Task Force to oversee the implementation of the framework for improving the efficiency and effectiveness of services in A & E departments. The Task Force will support individual hospitals in identifying specific problems and addressing them. It will work with hospitals to introduce a system of "whole hospital" performance measures to improve the patient's journey not alone through the A & E department but through the hospital system from admission to discharge.

I am confident that by improving hospital processes and procedures, by providing additional step-down beds for those patients who do not require acute hospital care, and by expanding and enhancing primary and community care services we can achieve a sustained improved in our A & E services.

Finian McGrath (Dublin North Central, Independent)
Link to this: Individually | In context

Question 110: To ask the Tánaiste and Minister for Health and Children if a place will be provided for a person (details supplied); and if she will ensure that they get 24-hour day residential services as a matter of priority. [20095/06]

Tim O'Malley (Limerick East, Progressive Democrats)
Link to this: Individually | In context

The Deputy's question relates to the management and delivery of health and personal social services, which are the responsibility of the Health Service Executive under the Health Act 2004. Accordingly, my Department has requested the Parliamentary Affairs Division of the Executive to arrange to have this matter investigated and to have a reply issued directly to the Deputy.