Micheál Martin (Cork South Central, Fianna Fail)
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1122. To ask the Minister for Health if it is his policy to have an occupational therapist in every hospice; the number of hospices that employ a full time occupational therapist and or a part time occupational therapist; the number of hospices that do not employ an occupational therapist; his plans to provide for an occupational therapist in every hospice; and if he will make a statement on the matter. [26954/17]

Helen McEntee (Meath East, Fine Gael)
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The Department of Health policy on the development and provision of specialist palliative care services is contained in the 2001 Report of the National Advisory Committee on Palliative Care (DoH). This document sets out the staffing ratios required for specialist inpatient units (hospices) and specialist palliative care services in the community (homecare). In hospices the ratios are determined by the number of beds and in the community by population.

Occupational Therapy is one of the disciplines that work as part of specialist palliative care multi-disciplinary teams (MDTs). With regard to specialist inpatient units, the Report recommends a ratio of one occupational therapist (OT) for every 10 beds. The HSE considers this to be a high level of staffing of one discipline in consideration of the overall needs of an MDT. However, the OT skill mix is being fully maintained for the planned new hospices currently in development.

There are eight hospices providing specialist inpatient beds in Ireland. The HSE’s Palliative Care Services Three Year Development Framework (2017-2019),due to be published this summer, indicates that of the six voluntary hospices, four have either full- or part-time OTs and two do not. Of the two HSE run services one has an Occupational Therapist and the second does not.

The Palliative Care Development Framework undertook an examination of staffing levels in all existing services and whereas it found gaps in some health care disciplines it also found higher levels of staffing in some areas. One of the recommendations in the Framework is to review these and to work with services to reconfigure where possible and/or to identify the need through the budget process for additional staff to strengthen multi-disciplinary skill mix configuration. This will include the provision of occupational therapy.

The Department of Health has welcomed the Framework as a good basis for the development of palliative care services, though the implementation of the framework will be subject to the overall budgetary process and the configuration and availability of resources.