Fergus O'Dowd (Louth, Fine Gael)
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577. To ask the Minister for Health to provide on update on the Programme for Government commitment to increase the number of specialist palliative care beds countrywide over the five years of government, ensuring that there will be a hospice serving every region in the country, since the establishment of the Government; and if he will make a statement on the matter. [2461/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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Since 2020, there have been new openings of specialist inpatient palliative care units in Wicklow (15 beds), Mayo (12 beds), and Waterford (20 beds). This means that CHO8 is now the only community healthcare organisation without at least one specialist palliative care inpatient unit.

In December 2021, I announced €10million in once-off funding to support a number of voluntary organisations including members of the voluntary hospice group and national organisations involved in end-of-life and bereavement care. €3million of this funding was allocated to progress plans for three new hospices in the Midlands, Drogheda and Cavan.

This provision of €1million for each of these three new hospice developments will be used for the development of architectural plans, the planning application processes and to commence early ground works as appropriate for the Cavan, Midlands and Drogheda developments. Funding has been released to the CHOs for drawdown as required.

With regard to Drogheda, the HSE continues to work with Newgrange Hospice Charity on the planning and development of the Drogheda Hospice. This work involves HSE Estates, CHO8 and the Newgrange Hospice Charity.

In September 2022, an Taoiseach Micheál Martin, announced €20million in capital funding for the development of a 20-bed specialist palliative care inpatient unit in Tullamore. The development will provide a hub for the provision of specialist palliative care services across the Midlands, including day care, outpatient, inpatient and community services. A tender competition took place in 2023 to secure the services of a design team for this project. A design team was appointed at the end of May 2023. The design process is ongoing.

In relation to the delivery of a specialist palliative care unit at St Christopher’s Hospice in Cavan, I have been informed by the HSE that the design of the hospice has been agreed by the Architects, Trustees and HSE Personnel (Estates, National Representatives and Service providers). Full planning permission has been granted by Cavan County Council for this build. Following the tendering process and selection of successful builders, it is anticipated that construction would commence in Q1 of 2024. Capital funding of 4 million euro has been successfully secured in the first instance to enable this project.

Once these planned hospices are open, there will be an inpatient unit in every region of the country, providing specialist palliative care inpatient services for people with complex needs, a hub for the existing specialist palliative community homecare teams and supporting the discharge of patients from acute hospitals.

At the beginning of 2021 the HSE announced an additional €10.68 million in recurring annual funding for the voluntary hospice sector from 2021 onwards. Funding was allocated to hospices that make up the Voluntary Hospice Group: Our Lady’s Hospice and Care Services, Harold’s Cross, Blackrock and Wicklow; St Francis Hospice, Raheny and Blanchardstown; Marymount Hospice, Cork; Milford Care Centre, Limerick; North West Hospice, Sligo; and Galway Hospice.

The redesignation of the four adult hospice organisations (Milford, Marymount, Galway and St. Francis) from Section 39 service level agreements with the Health Service Executive (HSE) to Section 38 agreements will take place this February 2024. The redesignation will provide a sustainable model of care for adult specialist palliative care services in Ireland and ensure the provision of these core services into the future. The government is providing a total of €18.6 million to achieve this.

Fergus O'Dowd (Louth, Fine Gael)
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578. To ask the Minister for Health to provide on update on the Programme for Government commitment to support community specialist palliative home care teams in all HSE areas, fund designated homecare packages, and resource specialist palliative care provided in hospices, since the establishment of the Government; and if he will make a statement on the matter. [2462/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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In Ireland, specialist palliative care services are delivered by the HSE in partnership with voluntary agencies to provide integrated, high quality and accessible palliative care to patients and their families. Specialist palliative care is provided by multidisciplinary teams in acute hospitals, specialist palliative care inpatient units (hospices) and in community settings by community palliative care teams (homecare teams). Consultants in palliative medicine have contracted hours across all three settings ensuring seamless transitions and integrated services for patients and their families.

A fully developed specialist palliative care unit (hospice) comprises in-patient beds, out-patient services and bereavement services. In 2023, there were 14 specialist palliative care inpatient units (hospices) providing a total of 276 beds across the country. This is an increase of 49 beds since 2020. Recent developments include the opening of new hospices in Wicklow (2020), Mayo (2019) and Waterford (2021). Plans are progressing for three further units in Drogheda, Tullamore and Cavan to ensure all regions have access to a specialist palliative care inpatient unit in line with national policy.

In 2022, there were 4,118 admissions to specialist palliative care inpatient units. This represents a 22.78% increase in comparison to 2020 (3,354). 97% of patients were admitted within 7 days of referral. Due to the ongoing Fórsa action, performance figures for 2023 are based on available data from January to August 2023. An anticipated increase in admissions to specialist palliative care inpatient units is expected to be 10% up on 2022 admissions.

There are 32 community specialist palliative care (home care) teams covering all 26 counties. The community specialist palliative care teams work in close partnership with GP’s and primary care teams and provide expert palliative care to both adults and children in all community settings including nursing homes.

In 2022, community palliative care teams provided care to an average of 3,592 patients each month in their own homes. This was an 8.3% increase from 2020 (3,316) and reflects the increased demand for palliative care services in the community. Due to the ongoing Fórsa action, performance figures for 2023 are based on available data from January to August 2023. An anticipated increase in care provided by community palliative care teams to patients in their own homes is expected to be 10% up on 2022 figures.

In partnership with the Irish Cancer Society and Irish Hospice Foundation, the HSE also delivers Night Nursing care to patients receiving specialist palliative care to enable people die at home and provide respite to carers during end-of-life care. In 2023, 2,835 patients received Night Nursing care in their own homes utilising an average of 3.47 nights of care per patient.

Funding provided for specialist palliative care in NSP 2022 (€2.4m) and NSP 2023 (€2.8m) provided for the enhancement of both adult and children’s palliative care services in the community including:

• Additional staffing for community specialist palliative care teams in line with workforce recommendations from 2001 Adult Palliative Care Policy.
• Enhanced provision of Night Nursing Services in partnership with Irish Cancer Society and Irish Hospice Foundation.
• Expansion of LauraLynn Hospice in the Home service.
• Additional Clinical Nurse Specialists to enhance availability of out–of-hours palliative care supports for patients in the community.

Fergus O'Dowd (Louth, Fine Gael)
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579. To ask the Minister for Health to provide on update on the Programme for Government commitment to increase resources for the children’s palliative care programme since the establishment of the Government; and if he will make a statement on the matter. [2463/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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A priority for 2024 is to continue implementing the recommendations from the HSE 2020 report 'Clinical Governance and Operational arrangements for supporting a model of care for children with life limiting conditions towards the end of life in the community in Ireland'. The new HSE Service Plan 2024 will underpin further improvements in children’s palliative care services. A multiagency approach is adopted to provide palliative care to children in their homes. This approach involves: collaboration between primary care, regional paediatricians, and adult community palliative care services - coordinated by the Clinical Nurse Coordinator (CNC) - and supported by paediatric palliative care team located in CHI Crumlin/Temple St. One of the cornerstones of children’s palliative care is to facilitate a fully integrated approach to care.

There have been significant increases in funding to enhance the provision of children’s palliative care services across Ireland in recent years. Across 2021 and 2022, funding was allocated for the recruitment of 12.5 additional whole-time equivalents to enhance the provision of children’s palliative care services across acute and community settings. These posts support the provision of specialist palliative care to children as close to home as possible.

In 2023, a Government allocation of €3.7million was provided for new measures in palliative care. These measures enhance the provision of adult and children’s specialist palliative care services across the country and include funding to support bereavement services for parents and families who have experienced the death of a child. The Palliative Care Budget increased to a total national service plan allocation in 2022 of €121.9 million from a national service plan allocation of €119m in 2021. In 2023, the budget was €130.1m.

Additional resourcing was provided in 2021/2022/2023 to support the Children's Palliative Care Programme. This included:

• €2.3 million in recurring funding to enhance and develop LauraLynn’s Children’s Hospice and outreach services. This funding has been used to increase LauraLynn’s Hospice in the Home Service across Leinster; and supported the opening of new LauraLynn Hubs in Munster and Connaught.
• 8.5 additional Clinical Nurse Coordinators (CNCs) were provided to take the total number of CNCs nationally to 18.5. This will ensure there are two CNCs in each Community Health Organisation.
• 2 Consultants in Paediatric Palliative Medicine, 1 Specialist Register, 3 Clinical Nurse Specialists and a Clerical Officer Grade IV for the Specialist team in Childrens Health Ireland Crumlin. These posts are partially recruited.
• The creation of 4 Regional Paediatricians with a Special Interest in Palliative Medicine for Waterford, Cork, Limerick and Galway to enhance regional leadership and support professionals delivering palliative care to children in their home. It’s expected these posts will be recruited in 2023.

Fergus O'Dowd (Louth, Fine Gael)
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580. To ask the Minister for Health the actions being taken by his Department to deliver transgender health services in Ireland; if his Department has considered the 'informed consent' model; and if he will make a statement on the matter. [2466/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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As this a service issue I have referred the matter to the HSE for direct reply to the deputy.