Catherine Byrne (Dublin South Central, Fine Gael)
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I propose to take Questions Nos. 141 and 142 together.

Health and wellbeing are not evenly distributed across society. There are socially excluded groups who experience extreme health inequalities. Such groups include Travellers homeless people, refugees and asylum seekers and people with addiction issues. Inequalities in health are reflected in the mortality and morbidity rates of the population.  Rates of chronic diseases are another indicator of health inequalities.

The National Traveller and Roma Inclusion Strategy (NTRIS) has over 30 actions to address the health needs of Travellers and Roma. It includes an action for the HSE to develop and implement a detailed action plan, based on the findings of the All Ireland Traveller Health Study, 2010, to continue to address the specific health needs of Travellers, using a social determinants approach.    

I understand the health action plan will be finalised by the HSE by the end of the year.  I and the Minister for Health are engaged with and supportive of the health action plan. We are committed to providing leadership to support the implementation of the action plan. The Department will review the arrangements for engagement with Traveller organisations to support the action plan and is willing to participate in any new HSE structure to oversee the implementation of the plan.

Catherine Byrne (Dublin South Central, Fine Gael)
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I propose to take Questions Nos. 143 and 145 together.

The Department provides funding in the region of €10m per annum to the HSE for targeted measures to improve the health status of the Travelling community. These include:

- primary healthcare projects, counselling services, family support programmes and men's health projects; dedicated public health nurses and related staff;

- mental health promotion and suicide prevention services in a culturally sensitive manner, to reduce the stigma associated with mental health.

The Department will allocate €17 billion to the HSE for the delivery of health services in 2020. The details of these services will be set out in the HSE National Service Plan for 2020. The plan will include specific measures to improve Traveller health, including a Traveller health action plan.

Both I and the Minister for Health are engaged and supportive of the Traveller health action plan and we are committed to providing the leadership to support the implementation of the plan.

Catherine Byrne (Dublin South Central, Fine Gael)
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The HSE grant-aids a range of service providers under section 39 of the Health Act 2004.The employees of agencies that receive grant-aid from the HSE under Section 39 are not public servants and are not specifically subject to the pay-scales approved for public servants. These employees have a private sector employment relationship with their employer.

Primary Health Care for Travellers Projects are supported by HSE Social Inclusion in each Community Health Organisation area via Section 39 funding.  Each project employs Travellers as Community Health Workers to provide primary health care to the Traveller Community.

Any individuals employed by section 39 organisations are not HSE employees, therefore neither the HSE nor I have a role in determining the salaries or other terms and conditions applying to these staff.  It is a matter for Section 39 organisations to negotiate salaries with their staff as part of their employment relationship and within the overall funding available for the delivery of agreed services.

Catherine Byrne (Dublin South Central, Fine Gael)
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Sláintecare is a high-level delivery programme, tasked with delivering a health and social care service that meets the needs of all our population.

As part of Sláintecare, a resource allocation model is to be implemented on a regional basis. The model will be based on the population profile of the regions, which, it is intended, will capture the differing health needs of the region. As committed to in the Sláintecare Action Plan 2019, work is ongoing under the Population-Based Planning Programme to establish population quantum and profile by region, which includes factors such as age, deprivation and ability.

The Department of Health is developing an inclusion health framework to enhance the delivery of health and social care services to meet the complex health needs of socially excluded groups.

The HSE Intercultural Health Strategy provides an integrated approach to addressing the many unique health and support needs experienced by service users of diverse ethnic, cultural and religious backgrounds who live in Ireland.

The HSE is developing a Traveller health action plan, based on the findings of the All Ireland Traveller Health Study, to address the specific health needs of Travellers, using a social determinants approach.

I understand the health action plan will be finalised by the HSE by the end of the year.  I and the Minister for Health are engaged with and supportive of the health action plan. We are committed to providing leadership to support the implementation of the action plan.