Holly Cairns (Cork South West, Social Democrats)
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1198. To ask the Minister for Health the current status and proposed timeframe for the First 5 action plan to develop a dedicated child health workforce, adopting a population-based approach; and if he will make a statement on the matter. [12472/23]

Hildegarde Naughton (Galway West, Fine Gael)
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First 5 is Ireland’s first ever cross-departmental strategy to support babies, young children and their families. The ambitious ten-year plan will deliver a broader range of options for parents to balance working and caring and a new model of parenting support.

In line with the principles set out in Sláintecare, and the First 5 Whole of Government Strategy for Babies, Young Children and Their Families 2019- 2028, my Department is tasked with progressing Strategic Action 3A - to develop a dedicated child health workforce model with a population-based approach and focused on areas of high population density and disadvantage, recognising that this will require additional resources. This work was overtaken by other more immediate priorities with the onset of the pandemic.

The Department is now focusing on progressing this matter, including the development of a pilot model of practice for child health and wellbeing workforce. This requires the re-establishment of the relevant working group which will be tasked with, among other things, the scoping out of the most appropriate approach to developing a model, informed by international best practice and outcomes and the implications for the Irish context.

Separately, the Department is identifying an appropriate model for community nursing and midwifery in Ireland and aligning this model with the framework for Safe Nurse Staffing and Skill Mix in Community Care settings. This work will be helpful in developing a dedicated child health workforce model.

A detailed implementation report was published in 2019. Multiple divisions of the Department of Health, as well as partners including the HSE and Tusla, are involved in the implementation of the health-related elements of the plan.

Implementation of the 2019 actions of the First Five Years Strategy is underway across the following areas in the HSE that are responsible for implementing the actions from the First Five Years Strategy; 1) National Healthy Childhood Programme, 2) The Healthy Eating and Active Living Programme, 3) The Mental Health Division, 4) The National Women and Infants Programme, 5) National Immunisation Office, 6) Community Operations, 7) The Nurture Programme and 8) Strategic Planning and Transformation”. Some examples of the significant number of service delivery areas with a focus on children, either in whole or in part are outlined below.

The Children’s Health Ireland Hospital Group is perhaps the clearest example of an area of health service delivery that is entirely focussed on children. The New Children’s Hospital Project comprises the main hospital at St James’ campus in Dublin, and two new centres at Connolly and Tallaght hospitals.

The Paediatric Outpatient and Urgent Care Centre, Children’s Health Ireland (CHI) at Connolly, opened in July 2019. The Paediatric Outpatient and Emergency Care Centre, CHI at Tallaght, opened in November 2021. CHI at Tallaght and CHI at Connolly are successfully delivering a new model of ambulatory and urgent care for children and adolescents in the Greater Dublin Area, improving access to urgent and outpatient care for a significant number of children.

Despite unprecedented challenges and uncertainty arising out of Covid, Brexit and the invasion of Ukraine, which have affected the wider construction industry and the general economy, it is important to acknowledge the progress that has been made on the new Children's Hospital at St James’s.

The focus throughout 2022 and 2023 at the St James’s site is the internal fit-out. The most advanced areas have finished floors, walls, ceilings and joinery, such as nursing stations, installed. Equipment is also in place. The Emergency Department, Imaging, Critical Care and Therapy areas are progressing at pace. The first clinical rooms were completed in late 2022, ready for commissioning, and the rest will follow in a scheduled manner throughout 2023.

Building on the significant investment of €7.3m to continue implementation of the National Maternity Strategy (2016-2026) in 2021, funding of €8.7m was allocated under Budget 2022.

The funding provided in 2021 allowed for further development of community midwifery as well as specialist services. It has enabled the expansion of breastfeeding supports and strengthened training and education supports for staff.

The funding allocated in 2022 is providing for the recruitment of an additional 87.8 Whole Time Equivalent staff (WTE) into maternity services across the country, including consultants, midwives/nurses, Allied Health professionals, healthcare assistants and administrative staff. These posts are supporting the realisation of the Strategy’s vision of a new model of integrated, team-based care that provides increased choice to women, as well as improving outcomes and experiences for women and babies accessing maternity services.

Encouraging mothers to breastfeed is a priority for the Department of Health. National health policy, including the Healthy Ireland Framework, the National Maternity Strategy, the Obesity Policy and Action Plan, and the National Cancer Strategy, emphasises the importance of supporting mothers who breastfeed, as well as taking action to increase breastfeeding rates in Ireland.

The HSE Breastfeeding in a Healthy Ireland Action Plan is the framework for progressing supports for breastfeeding in Ireland.

In May 2021, Minister Donnelly announced additional annual funding to the HSE of €1.58 million to fund 24 additional lactation consultants thereby providing support to every maternity unit in the country.

By the end of 2022 there was a total of 45.6 WTE lactation consultants in post, comprised of 31.8 in maternity services and 13.8 WTEs in community services. In maternity services, 9.5 WTEs were allocated from the Ministerial announcement of 24 posts of which 8.5 WTEs were filled. In community services 14.5 WTEs were allocated from the Ministerial announcement of 24 posts. 7 WTEs were in post with a further 6 due to take up positions in early 2023.

The HSE is actively engaged in enhancing lactation supports through both these dedicated infant feeding positions and the implementation of training for all practitioners who provide advice and support in infant feeding as part of their wider service roles.

Healthy Ireland, which comprises both the Health and Wellbeing Programme in the Department of Health, and the Health and Wellbeing Division in the HSE, also provides significant supports for child health and wellbeing.

The HSE Education Team works with the Professional Development Service for Teachers in terms of supports and resources for schools and various wellbeing curricula.

The Sláintecare Healthy Communities Programme, which has been rolled out to 19 of the communities of most need around the country, includes many supports for families and children, including parenting supports and Healthy Food Made Easy courses.

The Department of Education’s Active School Flag programme, co-funded by Healthy Ireland, supports pupils in more schools to be more active, more often. Over 2,100 primary schools have engaged with the programme since inception and a pilot programme for post-primary schools is also in progress. Healthy Ireland also co-funds Sport Ireland’s Children’s Sport Participation and Physical Activity Study, and the Daily Mile in schools, which is managed by Athletics Ireland.

The Department of Children, Equality, Disability, Integration and Youth has responsibility for reporting on the wider implementation of the Strategy and recently met with Ms. Georgina Bassett, Deputy Chief Nursing Officer, Department of Helath on this matter.