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 Header Item Ceisteanna ó Cheannairí - Leaders' Questions (Continued)
 Header Item Gnó na Dála - Business of Dáil

Thursday, 22 November 2018

Dáil Éireann Debate
Vol. 975 No. 4

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(Speaker Continuing)

[Deputy Noel Grealish: Information on Noel Grealish Zoom on Noel Grealish] The knock-on effect of this is that people on the waiting list for operations and other procedures cannot get into hospitals because there are no beds available for them. In many cases, it has taken several weeks for applications for the fair deal scheme to be approved. There are people occupying hospital beds who have recovered sufficiently to be discharged but who cannot manage on their own at home. Pending approval of their application, they are expected to pay €900 or more per week to stay in a nursing home, money that they often simply do not have, so they must be kept in hospital until approval comes through. It is not where they want to be. It is widely accepted that people need to get out of hospital as early as possible to avoid the risk of infection. There are many others who could go home if they had sufficient support in the form of home care services but, unfortunately, there are long waiting lists for home help in many areas. The most recent figure concerning the number of people awaiting approval for home help is more than 6,200. My home county of Galway has the worst record in the country with more than 670 people waiting for home help.

Thankfully, our population is living longer but that also means that the demand for home help services and nursing home care will continue to grow. Unless sufficient resources are allocated to meeting this demand, the problem of hospital beds not being freed up will also continue to grow. This in turn will lead to growing numbers of people on waiting lists for treatment waiting for beds to become available and growing numbers spending nights on trolleys in our emergency departments because they also cannot be moved to a bed in the hospital.

I acknowledge that some progress has been made this year regarding the number of people on waiting lists for inpatient or day case treatment. However, more than 72,000 people were on waiting lists for inpatient and day care treatment at the beginning of this month, almost 12,000 of which had been waiting a year or more. Galway University Hospital has the highest number of any hospital at almost 9,400. The same limited progress is not evident in respect of outpatient waiting list, which currently stands at more than 516,000 people. The total went over the half million mark for the first time at the end of last year and has remained above that extraordinary level every month of this year. Again, Galway has the highest number of people awaiting outpatient treatment at just under 40,000.

What further measures does the Government propose to take to ensure that people are released from hospital more quickly into the proper care they need and to ease the worry, stress and even physical risk to vulnerable members of our society?

Deputy Charles Flanagan: Information on Charles Flanagan Zoom on Charles Flanagan I thank Deputy Grealish not just for his question but also his expressed acknowledgement that progress is being made on this matter. I assure the Deputy and the House that the Government will continue to make progress on what is a particular challenge. It is a challenge that faces us as we come into the winter season. I assure the House and Deputy Grealish that the primary focus of Government is on reducing delayed patient discharges. We can do this through the mobilisation of additional resources. As the Deputy acknowledged, the aim is to ensure that social care measures are effectively deployed, which will have the effect of enabling older people to leave hospital and return to a more appropriate care setting, including primarily their own home, as quickly as possible. If they are returning to their home, they will need adequate supports.

I assure the House that as part of its preparation for winter, the HSE has been requested by the Minister for Health to focus efforts on initiatives to enable hospital settings to de-escalate before the Christmas period, including supports of a social care nature. The HSE has commenced a range of measures to support older people's transition from acute care before Christmas into the new year. These measures were welcomed yesterday by the Minister for Health and the Minister of State with responsibility for older people, Deputy Jim Daly. This includes an allocation of 550 additional home care packages over the winter period. This is one of a number of initiatives that include additional transitional care beds and €4 million for aids and appliances that will assist older people to come home from hospital before Christmas and remain in their homes over the new year or for longer periods.

The importance of transitional care must not be understated. If it is appropriate, it is arranged through utilising the patient and family choice of provider. The use of transitional care has proven to very valuable in the hospital system. It has benefited and continues to benefit the transfer of large numbers of patients to more appropriate settings. Information of a preliminary nature, which I am happy to share with Deputy Grealish and others, will show that there have been more than 9,800 approvals for funding to date this year of which 830 were in Galway University Hospital. I assure the Deputy that the Department of Health expects the details of the winter plan to be finalised over the coming days. It will be published later this month and I am sure the Minister of State, Deputy Jim Daly, along with the Minister, will continue to keep the House and Deputy Grealish fully informed of developments in this challenge.

Deputy Noel Grealish: Information on Noel Grealish Zoom on Noel Grealish I am aware that there are many and often complex reasons for thousands of patients occupying hospital beds for longer than is ideal every year. I am familiar with many of these cases. The fact remains that the delays in approving fair deal applications for nursing home care and delays in funding for home care packages create some of these hold-ups. As I mentioned earlier, a hospital is the last place one would want older family members to be in if it is not necessary. International research has shown that every extra day in hospital increases the risk of acquiring an infection, having an adverse drug reaction or developing problems like bed sores. New Irish research published in the British Medical Journal found that older people were 72% more likely to be given prescriptions that were not appropriate for them.

I call on the Government to speed up the application process for the fair deal scheme. This would free up hospital beds and get people out of hospitals. There is a significant delay in approving home care packages. I welcome the announcement made by the Minister, but bringing a loved one home when there is no care at home for them is a significant worry for families. Will the Minister give a commitment that the Government will speed up home care packages and the application process for the fair deal scheme?

Deputy Charles Flanagan: Information on Charles Flanagan Zoom on Charles Flanagan The announcement yesterday of 550 extra home care packages is proof of the determination on the part of the Minister of State, Deputy Jim Daly, and the Minister to ensure this issue is adequately dealt with. I am assured that these initiatives will provide older people with the type of care they need, which is the type of care requested by Deputy Grealish. I am very keen to ensure it is delivered in the right place and within an appropriate period of time. Older people wish to be supported in their homes and in their communities. The additional investment in social and community care measures will support this objective in the winter ahead. The net budget for the nursing homes support is in excess of €960 million. The scheme supports approximately 23,300 people in respect of long-term residential care. The waiting time for funding approval is three to four weeks, but I assure Deputy Grealish that the Minister of State with responsibility for older people, Deputy Jim Daly, is focusing this winter on the issue of delayed discharges and social care measures, including the investment in home support, which will assist people in returning home to their communities as quickly as possible.

Gnó na Dála - Business of Dáil

An Ceann Comhairle: Information on Seán Ó Fearghaíl Zoom on Seán Ó Fearghaíl Before moving to Questions on Promised Legislation, the Government Chief Whip has a business proposal to make arising from the agreement of the Business Committee this morning.

Minister of State at the Department of the Taoiseach (Deputy Seán Kyne): Information on Seán Kyne Zoom on Seán Kyne It is proposed, notwithstanding anything in the Order of Business of 20 November 2018 or in Standing Orders, that the order of today’s business, following the sos, shall be as follows: Finance Bill 2018 - Report Stage (resumed) and Final Stage; Consumer Protection (Regulation of Credit Servicing Firms) Bill 2018 - Order for Report, Report and Final Stages; Social Housing Bill 2016 - Second Stage; and the Topical Issue debate. On Report Stage of the Finance Bill 2018, Members may make only one contribution on an amendment, or on a group of amendments, which shall not exceed three minutes, provided that the member who moved the amendment shall also have a right of reply which shall not exceed two minutes. The Social Housing Bill 2016 shall commence not later than 8 p.m. and shall be brought to a conclusion after one hour. In the event a division is in progress at 8 p.m., the Bill shall be taken on its conclusion. The House shall adjourn on the conclusion of the Topical Issue debate.

An Ceann Comhairle: Information on Seán Ó Fearghaíl Zoom on Seán Ó Fearghaíl Is that agreed? Agreed.

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