Joe Carey (Clare, Fine Gael)
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Question 51: To ask the Minister for Health and Children her plans to develop a national strategy on the diagnosis, treatment and care of people with dementia; the date that this strategy will be completed; and if she will make a statement on the matter. [25774/10]

Ciarán Lynch (Cork South Central, Labour)
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Question 64: To ask the Minister for Health and Children the progress that has been made in developing a national strategy for the care and support of Alzheimer's patients and their families; and if she will make a statement on the matter. [25903/10]

Áine Brady (Kildare North, Fianna Fail)
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I propose to take Questions Nos. 51 and 64 together.

As the Deputy is aware, dementia is a most distressing condition both for those suffering from it and their families, and presents a significant and growing challenge to health and social services. Alzheimer's disease represents about 70% of the cases of dementia. People are living longer and as a consequence are more likely to develop some form of dementia. While dementia is not solely related to age, the prevalence is higher in older people and increases with age. It is estimated that about 5% of people over 65 years of age have some form of dementia with this figure rising to 20% for people over 80 years of age. The demographic make–up of Irish society is changing. The population is growing older and the number of people aged over 65 is estimated to almost triple over the next 30 years.

As I have indicated previously, my Department has started the process of developing a policy on dementia that will support the delivery of long-term care services having regard to future demographic trends and the consequential increase in demand for long-term care. This policy will be developed on the basis of the best evidence available from national and international sources. Officials in my Department have engaged with relevant stakeholder groups on the first stage of the process which is to assemble the research and evidence upon which the policy will be developed. I expect this will be received in 2011, at which stage work on the policy will commence formally.

However, in the interim I would also like to advise the Deputy that the Health Service Executive (HSE) is currently exploring the potential for changes in care pathways for people with dementia, and will make recommendations for the future provision of dementia care across all health and social services. An audit is underway within the HSE of the current specialist dementia care services available both in residential/hospital and community services. This audit will inform future planning and development of services for people with dementia. The educational needs of staff will also be identified to inform any future staff requirements for working in the area of dementia care. This work will also feed into the overall dementia policy formulation.

Ciarán Lynch (Cork South Central, Labour)
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Question 53: To ask the Minister for Health and Children if caring organisations that are funded through the Health Service Executive to deliver services are being compensated in situations when they are forced to replace front-line staff that are not exempted under the public service moratorium; if her attention has been drawn to the fact that many such organisations have, in effect, suffered major funding cuts because of the moratorium; and if she will make a statement on the matter. [25904/10]

Mary Harney (Dublin Mid West, Independent)
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The Government has made it clear that a critical part of its strategy to restore the public finances is to achieve sustainability in the cost of delivering public services relative to State revenues. To help achieve this goal, it will be necessary to restructure and reorganise the public service and to reduce public service numbers over the coming years.

The Employment Control Framework for the health sector provides for a net reduction in employment of 6,000 in wholetime equivalent (WTE) terms from March 2009 to the end 2012 and consequential pay roll savings. Based on numbers reductions already achieved in 2009, the net target reduction to end 2012 is 4,560 WTE. Therefore, the net target reduction in numbers in 2010, and in each of the following two years, is 1,520 wholetime equivalents. The Government decision has been modulated to ensure that key services are maintained insofar as possible in the health services, particularly in respect of children at risk, older people, persons with a disability, mental health services, and cancer services. The Framework, accordingly, provides for a number of grades and posts that are exempt from the moratorium on recruitment and promotion.

In addition, the HSE also has some degree of flexibility under the Framework to sanction the filling of certain other posts (both within its own organisation and in voluntary service providers funded it by it) on an exceptional basis provided it achieves the overall target reductions in both staffing levels and pay costs. The requirement is that a post or posts of equivalent value must be suppressed in order to meet the cost of the post being filled.

Against the background of reduced budgets and staffing levels in the health sector, a reorganisation and restructuring of work is required not only to maintain the level, quality and safety of services but also to expand the range and accessibility of community services in order to avoid the necessity for hospital attendances. The new Public Service Agreement, which was ratified last week by the Public Services Committee of ICTU, clears the way for the implementation of a major transformation programme for the health sector to commence on a collaborative basis involving unions and employers. The programme is designed to achieve significant cost efficiencies while protecting the quality and effectiveness of services to the public.

The foregoing arrangements apply across the publicly funded health services and there can be no question of exempting voluntary service providers or providing them with additional funding. This would undermine the strategic objectives of Government policy which are to reduce staffing levels and achieve payroll savings in order to bring the public voluntary finances into sustainable balance. Voluntary providers, in common with the HSE, need to identify, and implement under the Public Service Agreement, whatever changes in staffing levels, skill mix and work practices are necessary to protect services within the reduced level of funding now available.