Billy Kelleher (Cork North Central, Fianna Fail)
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342. To ask the Minister for Health if his attention has been drawn to a media report (details supplied) which suggests that 168,438 adult bed days per year equivalent to 460 beds per day could be saved through the targeted use of oral nutritional supplements in the management of disease related malnutrition in the community; the measures that have been put in place to free up these beds in the midst of the acute facility beds shortage; and if he will make a statement on the matter. [53070/17]

Billy Kelleher (Cork North Central, Fianna Fail)
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348. To ask the Minister for Health if his attention has been drawn to a 2016 HIQA report (details supplied); the actions that have been taken since the report’s publication to address these shortcomings in view of the fact that malnourished persons stay in acute beds for 30% to 70% longer than non malnourished persons; and if he will make a statement on the matter. [53076/17]

Catherine Byrne (Dublin South Central, Fine Gael)
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I propose to take Questions Nos. 342 and 348 together.

Minister Harris has made hospital food and malnutrition in hospitals a priority issue. In this context and with reference to the Deputy’s question on the relevant report, the Department of Health published Food and Nutritional Care in Hospitals – Guidelines for preventing Under-Nutrition in Acute Hospitalsin 2009. These Guidelines included a recommendation on using a nutritional screening tool, the Malnutrition Universal Screening Tool (MUST).

Currently the Department is working with the HSE on the development of the National Clinical Guideline for the Prevention and Treatment of under nutrition: Use of Nutrition Support in adults in the Acute Care Setting.This is to ensure use of the MUST tool in all Irish Hospitals and make it a mandatory requirement for all patients to be screened on admission to hospital.

The HSE is also addressing the issue by establishing a multidisciplinary hospital food and nutrition policy development group. This group includes representation from the chairs of the Nutrition and Hydration Steering Committee from a hospital within each Hospital Group. The HSE has employed a Project Dietitian with specific skills and experience in the area of hospital food/menus to lead on the development of a National Hospital Food and Nutrition Policy and Implementation Plan. This policy will be supported by the Acute Hospital Division and the Health and Wellbeing Division.

The Food and Nutrition Policy and Implementation Plan will include minimum nutrition standards and refer to other relevant policies, such as protected meal times policy, the use of oral nutritional supplements, nutrition screening and referral pathways. Oral Nutrition Supplements (ONS) are designed to prevent and treat under-nutrition. Evidence of their efficacy is underpinned by expert clinical guidelines including those of the National Institute for Clinical Excellence (NICE). There is increasing evidence of their cost effectiveness compared to standard care, arising largely from reductions in use of acute care resources.

I also understand that the Department is carrying out a health service Capacity Review which will have a wider scope than previous exercises which concentrated on just acute bed capacity. This Review will examine key elements of primary and community care infrastructure in addition to hospital facilities. It has involved a major data gathering exercise in relation to activity, un-met demand and capacity within the acute, primary and social care services sectors, analysis of that data, baseline forecasting of both demand and associated capacity requirements for each health sector and consideration and modelling of the potential impacts of policy change and productivity improvements. The Review will provide a basis for determining both the extent of capacity requirements over the next 15 years and the type of capacity needed. The findings will also inform the development of a new 10 year national capital plan. Work on this Review is at an advanced stage and a final report is expected early in the new year (2018).

Billy Kelleher (Cork North Central, Fianna Fail)
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343. To ask the Minister for Health the prevalence of disease related malnutrition across all health and social care settings in the past five years according to clinical treatment settings including inpatient, outpatient, nursing homes and general practitioner clinics by county, in tabular form; and if he will make a statement on the matter. [53071/17]

Billy Kelleher (Cork North Central, Fianna Fail)
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344. To ask the Minister for Health his plans to use nutritional screening and malnutrition rates as mandatory quality indicators across all clinical treatment settings; and if he will make a statement on the matter. [53072/17]

Billy Kelleher (Cork North Central, Fianna Fail)
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345. To ask the Minister for Health the initiatives his department is engaged in with regard to mitigating against the annual cost of disease related malnutrition in the community setting in which 93% of persons with malnutrition reside and which is estimated to be more than the annual cost of obesity at some €1.4 billion per annum; and if he will make a statement on the matter. [53073/17]

Billy Kelleher (Cork North Central, Fianna Fail)
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346. To ask the Minister for Health if his attention has been drawn to the example of best practice displayed by the Netherlands in tackling the issue of disease related malnutrition through the establishment of the Dutch malnutrition steering group (details supplied) which successfully reduced the prevalence of malnutrition across all healthcare settings over a 12-year period; his plans to bring forward a similar initiative here; and if he will make a statement on the matter. [53074/17]

Catherine Byrne (Dublin South Central, Fine Gael)
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I propose to take Questions Nos. 343 to 346, inclusive, together.

Hospital food and malnutrition in hospitals have been made a priority issue and in response the HSE has established a multi-disciplinary hospital food and nutrition policy development group, This group will include representation from the chairs of the Nutrition and Hydration Steering Committee from a hospital within each Hospital Group.

The HSE has employed a Project Dietitian with specific skills and experience in the area of hospital food/menus to lead on the development of a National Hospital Food and Nutrition Policy and implementation plan. This Policy will be supported by the Acute Hospital Division and the Health and Wellbeing Division.

The development of the policy will take cognisance of pre-existing policies and work in this area (Irish and international) including individual hospital nutrition policies, the HSE calorie posting, the healthier vending policies and screening policies already underway. The overarching food and nutrition policy will include minimum nutrition standards and refer to other relevant policies such as protected meal times policy, nutrition screening and referral pathways.

As the specific issues you have raised are service matters, they have been referred to the Health Service Executive for attention and direct reply to the Deputy. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up on the matter.

Billy Kelleher (Cork North Central, Fianna Fail)
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347. To ask the Minister for Health his plans regarding dietitians within CHOs and community settings; the sourcing allocation that is being made available to community dietitians to meet current and future demand levels; and if he will make a statement on the matter. [53075/17]

Catherine Byrne (Dublin South Central, Fine Gael)
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A national Obesity Policy and Action Plan was launched by the Minister of Health in September 2016. The national policy covers the period up to 2025 and aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy. The Policy acknowledged that every sector of our society has a role in reducing the burden of obesity, and emphasised the key role that the education sector will have in achieving the objectives, particularly in relation to child obesity.

The Obesity Policy prescribed 'Ten Steps Forward' that would be taken to prevent overweight and obesity. Under each step there are a number of actions, some of which have been identified for early implementation. Step 6 provides the mobilisation of the health services 'to better prevent and address overweight and obesity through effective community-based health promotion programmes, training and skills development and through enhanced systems for detection and referrals of overweight and obese patients at primary care level.'

The priority actions under this step are:

- Target high-risk groups through community development programmes that support healthy lifestyles, prevention and management of overweight and obesity in children and adults.

- Include obesity prevention and care as a requirement of GP contracts.

As the issue you have raised is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy. If you have not received a reply from the HSE within 15 working days, please contact my Private Office and they will will follow up the matter.