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 Header Item Medical Products Supply (Continued)
 Header Item Human Rights

Thursday, 14 February 2019

Dáil Éireann Debate
Vol. 979 No. 4

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(Speaker Continuing)

[Deputy Éamon Ó Cuív: Information on Éamon Ó Cuív Zoom on Éamon Ó Cuív] Any of us facing the same situation involving faulty delivery as that facing people in the west of Ireland would ask that we put people ahead of the god of this procurement process that just seems to make a shambles of procurement from the highest level with the overruns on the children's hospital right down to just delivering a few incontinence pads in time, on time and all the time.

Minister of State at the Department of Health (Deputy Catherine Byrne): Information on Catherine Byrne Zoom on Catherine Byrne I thank the Deputy for the opportunity to address this issue on behalf of my colleague, the Minister for Health. The community funded schemes are a collective name for the many products, supports, supplies and aids and appliances provided through the HSE community services for eligible persons. Their main purpose is to assist and support service users to live at home and also to facilitate hospital avoidance and assist with early discharge from hospital. The products are prescribed by consultants, GPs, public health nurses, continence advisers, physiotherapists, occupational therapists, speech and language therapists and dieticians. The products include incontinence wear that is delivered to healthcare settings such as long-stay residential services and to persons in their own homes.

The HSE has a national contract for the supply of incontinence products. Following a tendering process, the HSE selected a new product supplier and a new product distributor in 2018. I understand from the HSE that the new contracts have involved a lot of changes in the range of products and their distribution. There have been some issues relating to the timely delivery of products under the new contract. In 2018, the HSE put measures in place, including additional staff, an electronic management system and training of drivers to address initial difficulties. The HSE has informed the Minister for Health that it is continuing to work closely with the contracted delivery partners to ensure that the problems experienced by some service users in the CHO west region and other CHO areas are addressed as a matter of priority.

A governance structure has been put in place to oversee the national contract for the supply and delivery of incontinence products to ensure the timely delivery of these products to eligible persons in their homes across all CHOs. This involves each CHO putting in place additional controls and monitoring measures in respect of the ordering and distribution of these products. To support this process, additional administration staff have been put in place to carry out this work. The HSE is committed to ensuring that these service improvements will result in an enhanced and more efficient service for all. In the meantime, service users should let their local public health nursing service or health centre know if they are experiencing difficulties with supply of products.

Deputy Éamon Ó Cuív: Information on Éamon Ó Cuív Zoom on Éamon Ó Cuív I am not blaming the Minister of State. She gets these answers to read out. What we have just heard here blows my mind. The Government set up this national procurement system to save money. What result did we get? We got chaos, inefficiency, non-delivery and massive costs for the HSE in trying to undo the mess it created because the system was working perfectly until this tendering process was introduced. If the Government has made any savings by doing it on a national basis rather than continuing the old local tendering we used to have, the HSE has had to employ even more staff to monitor and try to get this right. As the saying goes, if it ain't broke, don't fix it. What we seem hell-bent on doing in this country is breaking everything and creating a central inefficient supply chain that does not work in the name of some savings that never materialise. In addition, we are taking jobs off smaller suppliers and thereby eliminating real competition - not just competition based on price. It is not just about competition on the visible price but competition on the real price of people getting what they need on time and in time.

As the final insult, and I accept that she was given her speech, the Minister of State indicated, "In the meantime, service users should let their local public health nursing service or health centre know if they are experiencing difficulties with supply of products." We are talking about the families of service users, who are already hugely burdened with problems, having to put right what they should not have to put right. Another burden is being put on people. Is humanity gone from this country in the name of some god of procurement or are we going to put people first?

Deputy Catherine Byrne: Information on Catherine Byrne Zoom on Catherine Byrne Again, I apologise to the Deputy if the answer was not adequate. We all want what is best for those who are ill in our communities, particularly those loved ones who spend a lot of time at home and people in nursing homes. I am not unfamiliar with the matter. When my mother was so ill at home, the local service made life easier for all of us when we were looking after her. It involves simple basic things like incontinence pads and other medical equipment that will help people stay at home and help their carers and families to give them the care they need at home. I did not decide that there would be a process for this. I believe that at some stage, we must look at local care and connect that through our primary care centres. Regarding why this problem has arisen, I can only relay to the Deputy the answer I have been given but I assure him that everything is being done through the HSE and the Minister to keep the services and the supply chain in place and to make sure it is done effectively and efficiently in each local area. That is what we all want. Nobody wants to see anybody, particularly people caring for those who are ill, being left without incontinence pads or other medical devices in their local communities. The Deputy may not agree with the procurement process. Probably some of us here do not agree with it either but it is in place. It is most important to make sure whoever gets this contract delivers effectively and on time to those people caring for their loved ones at home or in other health areas. I will take the Deputy's response back to the Minister and make sure he hears what the Deputy has had to say.

Human Rights

Deputy Maureen O'Sullivan: Information on Maureen O'Sullivan Zoom on Maureen O'Sullivan I am glad to have the opportunity to raise this issue. It has come about from engagement some of us have had with people from Bahrain and human rights organisations. It is also topical today because 14 February is the eighth anniversary of the pro-democracy movement that took place in Bahrain along with many other countries in the Middle East. In the eight years since then, we have seen the repression of the movement. What is the fear around democracy and democratic movements? When we look at the world, we can see that it is those countries with free democratic elections and the peaceful transfer of power after elections that have stability, growth, health and education.

Bahrain has seen the horrific repression of a democratic movement. It involves the repression of the protesters, be they lawyers, doctors, students, teachers, human rights defenders and members of civil society. The repression continues today with torture, police and military brutality and forced disappearance. I want to look in particular at the treatment of prisoners. There are inhumane conditions in Juw Prison and Isa Town Female Detention Center. Both prisons violate the UN standard minimum rules for the treatment of prisoners. As well as the inhumane physical conditions, there are concerns over access to medication for prisoners, family visits, degrading searches and above all, the lack of accountability. I want to mention three women prisoners in particular: Hajer Mansoor, Medina Ali and Najah Ahmed Yusuf, all of whom are in need of medical care. Their cases have been raised by the Tánaiste and Minister for Foreign Affairs and Trade and the UN.

There are questions around the relationship our Royal College of Surgeons of Ireland, RCSI, has with King Hamad University Hospital. I must ask whether the RCSI is living up to its ethical and moral standards. I have had correspondence from the Tánaiste and Minister for Foreign Affairs and Trade on this. I think there is a need to go further.

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