Sinn Féin in the Dáil May 27-30th 2008
Irish Politicians’ Blogs
Originally posted on ClondalkinSinnFein
To ask the Minister for Health and Children if her attention has been drawn to the fact that there has been a delay on the part of the Health Service Executive in allocating funding for disability services allocated for 2008, including funding for transitional services for children with autism completing school in 2008 and requiring assistance in their transition to day services in the autumn.
As part of the Multi-Annual Investment Programme 2006-2009 under the Disability Strategy, the Government provided the Health Service Executive with an additional €75m in both 2006 and 2007. This funding included monies to provide new and enhanced services for people with disabilities, to implement Part 2 of the Disability Act 2005, which came into effect on June 1st 2007 for the under 5’s and also for the continuation of the implementation of the transfer of persons with intellectual disability from psychiatric hospitals and other inappropriate placements. A further €50m investment was announced in the 2008 Budget.
The Deputy’s specific questions relate to the management and delivery of health and personal social services, which are the responsibility of the Health Service Executive under the Health Act 2004. Accordingly, my Department has requested the Parliamentary Affairs Division of the Executive to arrange to have this matter investigated and to have a reply issued directly to the Deputy.
To ask the Minister for Health and Children if she will establish a national working group comprising children with specific speech and language impairment and their parents and key agencies involved in service provision including her Department, the Department of Education and Science and the Health Service Executive, with a view to reviewing and establishing agreed terminology and diagnostic criteria for SSLI and addressing policy and service development.
The National Disability Strategy was launched in September 2004 following a number of positive legislative and policy measures in prior years, and contains a suite of elements, principally the Disability Act 2005, the Education for Persons with Special Educational Needs (EPSEN) Act 2004, Sectoral Plans prepared by six government Departments during 2006, the Citizens Information Act 2007 and a multi-annual investment programme totalling some €900m between 2006 and 2009.
Recognising the cross-cutting nature of this subject, the Government announced the establishment of the Office for Disability and Mental Health in January 2008, to support the Minister for Disability & Mental Health in exercising his responsibilities across four Government Departments: Health & Children, Education & Science, Enterprise, Trade & Employment and Justice, Equality & Law Reform.
The new Office brings together responsibility for a range of different policy areas and State services which directly impact on the lives of people with a disability and people with mental health issues. The Office will aim to bring about improvements in the manner in which services respond to the needs of people with disabilities and mental health issues, by working to develop person-centred services, focussing on the holistic needs of clients and service users and actively involving them in their own care. The Director of the Office is a member of the Senior Officials Group on Social Inclusion, which monitors progress on the Government’s commitments in relation to social policy, including the National Disability Strategy.
Very substantial progress has been made in recent years in the areas of disability and mental health, but much remains to be done. In particular, there is a need to improve co-ordination and communication across different Government Departments and agencies in their delivery of services to this client group. This will be the main focus for the new Office in the coming months.
A key priority for the Office for Disability and Mental Health is to support the implementation of the Health Sectoral Plan under the Disability Act 2005. The Office will focus in particular on facilitating the delivery of integrated health and education support services for children with special needs, by further developing existing mechanisms for co-operation and co-ordination between the health and education sectors, both at national and local level.
A Cross-Sectoral Team consisting of senior officials from the Office for Disability and Mental Health, the Department of Health and Children, the Department of Education and Science, the Health Service Executive and the National Council for Special Education was established in 2006 and meets on a regular basis. This group continues to address issues arising in relation to the implementation of both Acts. A sub-group of this team was set up in January 2008 in order to plan for the commencement of Part 2 of the Disability Act 2005 and the relevant sections of the Education for Persons with Special Educational Needs Act 2004 in respect of children aged between 5 and 18 and adults.
The focus of these groups is on the interaction required between the education and health sectors in order to advance and enhance services to people with disabilities. A wide range of matters are discussed in these fora and the matter raised by the Deputy will be considered by the Cross-Sectoral Team in this context.
Deputy Caoimhghín Ó Caoláin: Will the Government allow time to address the report by the health protection surveillance centre on the increased spread of Clostridium difficile? This is a major health emergency and it merits a debate in this House as the Minister and the HSE have not responded to this crisis properly.
An Ceann Comhairle: I am sure that is a matter for the Whips.
Deputy Caoimhghín Ó Caoláin: Will the Taoiseach accommodate such an opportunity?
The Taoiseach: It is a matter for the Whips. I am not in a position to say whether a debate can be held.
Deputy Caoimhghín Ó Caoláin: Yesterday, a 70 year old man had to wait for eight hours in the outpatients department of Our Lady of Lourdes Hospital in Drogheda for an X-ray that took but a few minutes.
An Ceann Comhairle: The Deputy must get to the legislation.
Deputy Caoimhghín Ó Caoláin: He had to sit in the discomfort and the indignity of his own wet because he could not access the toilet facilities in that department.
An Ceann Comhairle: To what legislation is the Deputy referring?
Deputy Caoimhghín Ó Caoláin: These are the realities and stories coming to Deputies from all over the jurisdiction. I am asking in the context of the eligibility for health and personal social services Bill, what the Taoiseach can do to bring forward legislation and to make some concerted effort with the Minister and the Department to have these disgraceful situations stopped once and for all.
An Ceann Comhairle: When is that legislation due?
The Taoiseach: It is due next year.
To ask the Minister for Health and Children the immediate action she will take to implement in full the recommendations of the Health Protection Surveillance Centre on the alarming spread of C-dificile and other hospital based infections.
I would like to assure the Deputy that tackling Healtcare Associated Infections (HCAIs), including Clostridium difficile (C. difficile), continues to be a priority for the Government and for the Health Service Executive (HSE).
I assume the recommendations that the Deputy is referring to are the Guidelines for the Surveillance, Management and Control of C. difficile-associated disease which were published on 22nd May by the Health Protection Surveillance Centre in the HSE. They give national guidance and deal with the isolation of C. difficile ribotype 027 for the first time in Irish hospitals. They will be a valuable resource in assisting in the prevention, management and control of this infectious disease. The HSE is considering the Report at present to decide on its implementation.
As the Deputy will be aware, the HSE launched a National Infection Control Action Plan in March 2007. An Infection Control Steering Group, chaired by Dr. Pat Doorley, National Director (Population Health) is responsible for overseeing the implementation of the plan. Over the next five years, the HSE aims to reduce HCAIs by 20%, MRSA infections by 30% and antibiotic consumption by 20%. Achievement of these targets will benefit all patients who are at risk. These targets will be achieved through the development of national and local level action plans to reduce the potential for spread of infections between persons in healthcare settings, and, in addition, will focus on reducing antibiotic use in Ireland. The Steering Group is supported by eight Local Implementation Teams which will ensure that all local facilities are focused on achieving the national targets.
C. difficile was not, up to now, a notifiable disease and, as a result, it was difficult to quantify the extent of infection in the health care system. However, it was examined in the Third Prevalence Survey of Health Care Associated Infections (HCAIs) in acute hospitals in 2006. The survey found that thirty-six patients had C. difficile representing 0.5% of patients studied. In March 2008, the Chief Medical Officer of my Department instructed the HSE to make C. difficile a notifiable disease and since May 4th all cases are required to be notified to the relevant Department of Public Health. The number of cases reported to date is within the range identified in the 2006 Survey.
While accepting that not all HCAIs are preventable, I am satisfied that significant steps are being taken to reduce the rates of HCAIs generally and to treat them promptly when they occur.
Cuts and privatisation preventing progress on mental health – Ó Caoláin
Published: 29 May, 2008
Commenting on the Report of the Mental Health Commission, Sinn Féin Health spokesperson Caoimhghín Ó Caoláin said it highlights the very serious situation where cuts imposed by the HSE are affecting mental health services. He said privatisation was also preventing progress in the neglected area of mental health.
Deputy Ó Caoláin said, “This is the first major report from a statutory body to state clearly that since they were imposed last autumn the HSE cuts are affecting patient care. It is alarming that the recruitment embargo has led to an acute shortage of key mental health staff, including occupational therapists and social workers. It must be remembered that these cuts are being imposed on mental health services that are already sub-standard, having been one of the most neglected areas of our health services.
“In my own constituency the Commission has raised concerns about St. Davnet’s, Monaghan. St. Ita’s in Portrane is also one of the six hospitals that the Commission finds of special concern.
“It should be noted that since Beaumont Hospital was built in Dublin in 1987 a new psychiatric unit there, to replace St. Ita’s, has been promised. This was finally on stream until Health Minister Harney brought in her notorious public-private hospital co-location scheme. The private hospital for Beaumont is to be built on the site allocated for the psychiatric unit which has been put on the long finger yet again.
“Cuts and privatisation are thwarting the progress promised when the Mental Health Act was enacted in 2001. This report is an indictment of Minister Harney and her government colleagues.” ENDS
To ask the Minister for Health and Children the number of persons with an intellectual disability and those with autism accommodated in psychiatric hospitals; the number of same accommodated in de-designated units which were formerly designated as psychiatric services; the numbers of same moved from psychiatric hospitals prior to 2002 to alternative accommodation which is now unsuitable for their needs; the names and locations of the hospital, units and other accommodation in each case; and if she will make a statement on the matter.
To ask the Minister for Health and Children the status of her Department’s programme to transfer persons with an intellectual disability or autism from psychiatric hospitals and other inappropriate placements; the progress made in implementing this programme since 2002; the number of persons moved from inappropriate placements to appropriate accommodation in each year since 2002; and if she will make a statement on the matter.
The National Intellectual Disability Database, (NIDD), report for 2007 identified 329 individuals with intellectual disability, all aged 20 years or over, as being accommodated in psychiatric hospitals. It should be noted that registration on the NIDD is voluntary.
An integral part of the National Disability Strategy is the Multi-Annual Investment Programme, (MAIP), announced in the 2005 Budget, which provides €900m for the period 2006 to 2009. MAIP contains specific commitments in relation to the provision of specific high priority disability services over the period 2006 to 2009. MAIP commitments include the development of new residential, respite and day places for persons with intellectual disability and autism in each of the years covered by the programme as well as the transfer of persons with intellectual disability/autism from psychiatric hospitals and other inappropriate placements.
The Deputy’s specific questions, in relation to the progress and details of the programme to move those individuals to more appropriate accommodation, relate to the management and delivery of health and personal social services, which are the responsibility of the Health Service Executive under the Health Act 2004. Accordingly, my Department has requested the Parliamentary Affairs Division of the Executive to arrange to have these matters investigated and to have a reply issued directly to the Deputy.
To ask the Minister for Health and Children when the 2007 report of the Alcohol Marketing Communications Monitoring Body will be published; and if she will make a statement on the matter.
To ask the Minister for Health and Children when the revised voluntary code to limit the exposure of young people to alcoholic drink advertising will be published; and if she will make a statement on the matter.
To ask the Minister for Health and Children the research and analysis she has undertaken in advance of revising the codes to limit the exposure of young people to alcoholic drink advertising and to determine the effectiveness of the current voluntary code; and if she will make a statement on the matter.
To ask the Minister for Health and Children when she will implement the recommendations of the working group on tackling alcohol misuse in Sustaining Progress to include representatives of the social partners on the Alcohol Marketing Communications Monitoring Body.
The 2006 Annual Report of the Alcohol Marketing Communications Monitoring Body (AMCMB), established to monitor compliance with the voluntary codes, was submitted to my Department in July 2007. The Monitoring Body concluded that although there had been a number of breaches of the code throughout 2006, there has been overall compliance with Voluntary Codes. The Monitoring Body were generally satisfied that where breaches were identified immediate remedial action was taken to rectify the situation and prevent recurrence. I expect to receive the 2007 Annual Report of the AMCMB in the coming weeks and I intend to have it published very shortly thereafter.
Following consideration of the 2006 Annual Report, officials from my Department commenced discussions with representatives of the Irish alcohol industry and representatives of the Irish advertising industry with a view to strengthening and expanding the codes on alcohol marketing and communications in order to provide significantly greater protection for children and young people. These discussions resulted in a revised set of Codes on adverting and sponsorship being drafted. Final drafting changes are currently being made to the revised Codes which are expected to be published before the end of June 2008.
The aim of the Codes on Advertising and Sponsorship is limit the exposure of young people to alcohol advertising and marketing. My Department is satisfied that the Codes have been successful in controlling the content of alcohol advertising as well as controlling the timing and placing of alcohol advertisements. However, research is needed to establish how effective the Codes have been in limiting the exposure of young people to alcohol advertising and marketing. My Department intends commissioning appropriate research within the next 12 months to test the effectiveness of the Codes in achieving this aim.
In monitoring the implementation of the revised Codes it is my Department’s intention to facilitate further representation and involvement from the social partners in the process of monitoring compliance with the Codes through the AMCMB.
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