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 Header Item Services for People with Disabilities (Continued)
 Header Item Other Questions
 Header Item Hospital Waiting Lists

Thursday, 2 June 2016

Dáil Éireann Debate
Vol. 911 No. 3

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  4 o’clock

Deputy Margaret Murphy O'Mahony: Information on Margaret Murphy O'Mahony Zoom on Margaret Murphy O'Mahony I wish to congratulate the Minister of State, Deputy Finian McGrath, on his appointment. He has been a powerful advocate for people with disabilities during his time in public life. I know that will continue and I look forward to working closely with him.

The Minister has said a lot about plans, budgets and reviews, but with respect, the people who need these hours need them now. We need funding to be put in place now. It is quite disturbing that no extra funding has been put into personal assistant services since 2009. Currently there are people here who require but who have no personal assistant hours and also people who require extra hours. I would like the Minister of State to commit to working to ensure a significant increase in personal assistant hours is provided for in the next budget and HSE service plan and to setting a target for that.

Deputy Finian McGrath: Information on Finian McGrath Zoom on Finian McGrath I accept the Deputy's point that we have had some difficult years in regard to public finances following the international banking crisis and that there has been a reduction in resources over the past number of years. This has changed and it is now planned to invest in resources. As part of the programme for partnership Government, I have a new proposal coming on stream in regard to personalised budgets for people with disabilities.

The programme for partnership Government contains a commitment to establish a task force within three months for the implementation of personalised budgets for persons with disabilities. Personalised budgets provide an individual with more control in accessing services, giving the person greater independence, control and choice. The budget for the service is devolved to the person so that he or she can shop beyond traditional service providers to fit their needs. Other important policies in regard to transforming the lives of people with disabilities recommend the move towards a model of person-centred and individually chosen community based supports, underpinned by a more effective method of assessing need, allocating resources and monitoring resource use.

Deputy Margaret Murphy O'Mahony: Information on Margaret Murphy O'Mahony Zoom on Margaret Murphy O'Mahony As the Minister well knows, it is almost impossible to overstate how crucial personal assistance is in the lives of people with disabilities. Unfortunately, many of those who receive a service only get four hours per week. This is not good enough as they must squeeze an awful lot into those four hours. I urge the Minister of State to consider a further allocation for the people who receive only four hours assistance.

Clearly, this service needs to be expanded and I believe the Minister of State will look into that. It is deeply disappointing that there will be no additional services provided for in 2016. Also, relative to the outturn in 2015, there are serious concerns that the service may even be reduced this year. A €10 million increase in 2017 could deliver 400,000 plus hours. I call on the Minister of State to make this his priority.

Deputy Finian McGrath: Information on Finian McGrath Zoom on Finian McGrath I accept the Deputy's point in regard to the allocation of only four hours per week to a person with a disability. I plan to change that because it is unacceptable. It is important that the rights of people with disabilities are recognised. They are citizens of this State and have a right to a quality service. Our plan is to work with the task force to ensure people with disabilities get the maximum support. For that reason, I am bringing in a group of people to the task force to deal with personalised budgets. The idea is to ensure the adoption of a national, coherent application system to develop budgets before the end of 2017. The adoption of a single national coherent system will provide accountability for spending and will ensure the exploration of brokerage models where people are assisted to connect with and purchase the services that meet their needs.

I am also working on the Estimates for this year's budget and I make a commitment to the Deputy that I will do my best in regard to funding. We must try to catch up following the lack of resources over the past number of years.

Other Questions

Hospital Waiting Lists

 6. Deputy Seán Haughey Information on Seán Haughey Zoom on Seán Haughey asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when the upward trend in waiting list and waiting times will be reversed; and if he will make a statement on the matter. [13802/16]

Deputy Simon Harris: Information on Simon Harris Zoom on Simon Harris I look forward to working with Deputy Kelleher in his role as his party's spokesperson on health, a role he has carried out for a number of years.

Improving access for patients is a key objective for our public health service. The 2016 HSE service plan undertakes to maintain 2015 levels of service in respect of scheduled care and to continue to address waiting times as part of the regular performance and accountability process. The HSE seeks to ensure that those whose clinical needs are most urgent are prioritised accordingly, while managing the needs of those who have been waiting longest for routine treatment in chronological order. Currently, 94% of patients wait less than the maximum waiting time of 15 months for inpatient, day case or outpatient procedures, with over 60% of patients waiting less than six months for their required care.

A scheduled care governance group has been established within the HSE to co-ordinate key initiatives to reduce waiting times and the number of patients awaiting treatment. Actions overseen by this group include driving greater adherence to chronological scheduling, relocation of low complexity surgical procedures to smaller hospitals and administrative and clinical validation procedures to ensure that patients are available for treatment. All too often, I have heard stories of people who have passed away remaining on a waiting list and the difficulty this has caused for their family and for the accuracy of the list.

Each hospital group has been mandated to designate a key person to lead and support waiting list management improvements so as to advance towards compliance with maximum waiting times. The National Treatment Purchase Fund supports the management of inpatient, day case and outpatient waiting lists, by working with the HSE to assist hospitals in developing local demand and capacity planning and providing technical guidance materials to ensure the highest standard of data quality and practice.

My Department is currently engaging with the NTPF and the HSE on a focused plan for endoscopy waiting lists in 2016. The programme for Government and the supply and confidence arrangement with Fianna Fáil contain a commitment to reactivate the NTPF and to provide €15 million in 2017 to address waiting lists. My Department will engage with the NTPF and the HSE in this regard.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher It is a sad indictment of the situation that over the past number of years we have seen an escalation in the number of people waiting for inpatient day case treatments, with 74,000 plus now awaiting treatment. The waiting list for outpatient appointments has risen to 407,000 people. Over the past number of years there has been a due diligence process in place for assessing waiting numbers, so the lists are reasonably accurate. The previous Minister for Health set a target of 15 months, a less ambitious one than the Minister prior to him. Therefore, it is backwards we are going in terms of the adjudication of our success or failure in terms of our ambition. This issue must be addressed.

I understand the Minister has had a meeting in regard to the winter readiness programme and I acknowledge that at least the Department is preparing in time. One of the solutions to winter readiness is the cancellation of elective surgeries and scheduled treatments, but I do not believe this can be seen as a long-term sustainable solution to overcrowding in our emergency departments. The NTPF is in place and I hope it is used wisely and efficiently. However, the issue of the 407,000 people on the waiting list is a sad indictment on everybody, because these people are unsure of what is wrong with them until they get a proper diagnosis.

Deputy Simon Harris: Information on Simon Harris Zoom on Simon Harris The Deputy has made a fair point in regard to the 15 month target. As I said earlier, some 94% of patients are being seen within that 15 month target and 60% of patients are being seen within the six month period. However, we must continue to try to do better.

What we see here is a direct result of a period of difficult economic decisions, through the time Fine Gael was in government and during the time Fianna Fáil was in government before that. We are now in a different place, where we can now begin to reinvest in the health service, increase health budgets and increase the resources being made available to tackle the issues outlined. I am not afraid to admit it if I hear a good idea from somewhere else and I accept the NTPF was a model championed by the Deputy's party. I believe it has a role to play here and that it needs to be reactivated. We should all strive for investment in the public health service, but there is also a role for the NTPF in the effort to reduce waiting lists. I want to start a programme for endoscopy with the NTPF this year, to put at least €15 million into the NTPF for 2017 and to have discussion in this House about how best to target that in terms of the most difficult and acute types of treatment needed.

In regard to the winter initiative, the Deputy is correct that we must be very careful that the consequence of preparing for the emergency department situation does not distract from the waiting list situation. The best way to ensure that is to increase resources for the health service and increase recruitment and retention of front line staff.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher As an aside, access to diagnostics is an important issue, particularly the issue of direct referrals by GPs into diagnostics. The reason we have such a build-up of people on waiting lists currently is due to the inability to access diagnostics. We do not seem to be sweating the assets of public diagnostic services, which work on a five day week.


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