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Dáil Debates & Questions
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March 31 2009
Parliamentary Questions
PARLIAMENTARY QUESTIONS Deputy Róisín Shortall (L): asked the Minister for Health and Children if she will protect the budgets for community care in order that elderly and disabled persons currently receiving a reasonable level of home help or home care will not be adversely affected; Minister of State at the Department of Health and Children (Deputy Máire Hoctor): Government policy in relation to older people is to support people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not an option, the health service supports access as appropriate to quality long term residential care. Additional funding of just over €200 million was provided to develop community services and supports for older people over the period 2006-8. The Home Help Sevice, delivered by or on behalf of the Health Service Executive (HSE), is a community initiative enabling people who otherwise might need to be cared for in longterm residential care to remain at home. The current level of investment by the Executive indicates:
Home Care Packages are a relatively new initiative developed over the past few years across the country. A package comprises a number of community-based services and supports, provided in a way to best meet the needs of an older person. The person will have significant medical, nursing and/or therapy requirements and may be recently discharged from hospital, or at-risk of admission to hospital, if such needs are not met in a planned way. Developments in Home Care Packages over 2006-8 include:
In addition to the wide range of other supports available to older people, such as Day/Respite services and Meals-on-Wheels, it is clear that the Government has made considerable improvements in recent years to enhance Home Care provision generally across the country. There is no doubt that demand can at times exceed resources. However, it is a matter for the HSE to deliver services both nationally and locally, in the context of Government priorities and its overall resources, while at the same time taking account of the need to maximise services to the most vulnerable in our society. Deputy Jan O’Sullivan (L): asked the Minister for Health and Children if she has established a mechanism to protect funding for new developments in the areas of mental health, disability, palliative care, Travellers’ health and other specific areas from being used for other proposes in 2009; Minister for Health and Children (Deputy Mary Harney): As the Deputy is aware, I have included additional funding in the 2009 Estimates for new developments which includes €15m for Cancer Services and €10m for Disabilities. To facilitate a more transparent level of accountability for this funding a new subhead, B 17, has been established in the Estimates for the Health Service Executive. The Deputy will be aware that proposals regarding the expenditure of development funding must be submitted as part of the National Service Plan, the approval of which I have the statutory responsibility. The implementation of the plan is the subject of ongoing monitoring by my Department throughout the year, including the use of development funding. In addition, the letter of sanction in respect of the Health Service Executive’s Vote issued each year by the Minister for Finance contains strict conditions regarding the use of these funds. I am satisfied that these mechanisms are more than adequate to ensure that development funding is used for the purpose for which it has been allocated. Deputy Ciarán Lynch (L): asked the Minister for Health and Children the number of new physiotherapy posts expected to be created in 2009; Minister for Health and Children (Deputy Mary Harney): There has been a growing demand for, and investment in, physiotherapy services over the last number of years. A particular priority for my Department and the Department of Education and Science in recent years has been the expansion of the supply of therapy graduates. The Government has also invested heavily in the education and training of such personnel in order to secure a good supply of graduates to provide for the healthcare needs of the population into the future. In this regard, since 1997, the number of training places for physiotherapists has been increased from 64 to 145 which represents an increase of 127%. The numbers employed in physiotherapy has also grown significantly, with 593 whole time equivalents employed in December 1997 compared to 1,449 whole time equivalents employed in December 2008, which represents an increase of 144%. The Government is committed to ensuring continued adequate recruitment of professional staff across a range of community settings to ensure the continued development of community services. Additional funding of €20 million has been provided in 2009 for health and education services for children with special educational needs. This funding will provide a total of 125 additional therapy posts in the HSE targeted at children of school-going age. 90 of these will be in the disability services, including speech and language therapists, occupational therapists, and physiotherapists. In addition, it is intended that certain key health and social care professional posts, including physiotherapists, are to be protected by setting employment floors for these grades within the Health Service Executive (HSE) in 2009. These posts are essential to the development of a number of services areas such as disability, child adolescent mental health services and child protection services. In order to protect these posts, it is envisaged that the HSE will establish minimum employment levels to be maintained within each of these occupations in the health sector in 2009. The recruitment and retention of these key front line professional posts is vital to ensure continued progress in the development of community settings. Subject to overall parameters set by Government, the Health Service Executive has the responsibility for determining the composition of its staffing complement. It is a matter for the Executive to manage and deploy its human resources to best meet the requirements of its Annual Service Plan for the delivery of health and personal social services to the public. With regard to the number of new physiotherapy posts expected to be created in 2009, as this is an operational matter it has been referred to the HSE for direct reply. Deputy Catherine Byrne (FG): asked the Minister for Health and Children the status of a review of the disability services sector which was announced in January 2009; the persons who sit on this committee; if non-profit organisations in the sector can be represented on this committee; Minister of State at the Department of Health and Children (Deputy John Moloney): Following Budget 2009, I announced that a review will be conducted in 2009 of non-statutory agencies which provide services for persons with disabilities. The Review will consider a number of issues, including structure, overheads and coherence of and synergies within the sector with a view to assessing the scope for further efficiencies. This exercise will be undertaken with the focus at all times on the needs of people with disabilities. The Review has now been incorporated within a wider programme of VFM Reviews being conducted under the supervision of the Department of Finance and will include the statutory as well as the non-statutory sectors. Discussions are ongoing between the Department of Health and Children and the Department of Finance with regard to the terms of reference and scope of the Review. These discussions are expected to conclude shortly. The Steering Group for the Review will be selected on the basis of expertise rather than on a representative basis. Deputy Richard Bruton (FG): asked the Minister for Health and Children if she has sought or received any report on the deployment of occupational therapists who work for the Health Service Executive; if her attention has been drawn to the fact that the service is unable to provide a service for children with special needs who require a support for sensory perception; her views on whether too much of the time of occupational therapists is absorbed in building inspections for grant purposes which could be provided under supervision by suitability trained construction experts; Minister for Health and Children (Deputy Mary Harney): There has been a growing demand for, and investment in, occupational therapy services over the last number of years. A particular priority for my Department and the Department of Education and Science in recent years has been the expansion of the supply of therapy graduates. The Government has also invested heavily in the education and training of such personnel in order to secure a good supply of graduates to provide for the healthcare needs of the population into the future. In this regard, since 1997, the number of training places for occupational therapy has been increased from 29 to 110 which represents an increase of 279%. The numbers employed in occupational therapy has also grown significantly, with 291 whole time equivalents employed in December 1997 compared to 1,078 whole time equivalents employed in December 2008, which represents an increase of 270%. The Government is committed to ensuring continued adequate recruitment of professional staff across a range of community settings to ensure the continued development of community services. Additional funding of €20 million has been provided in 2009 for health and education services for children with special educational needs. This funding will provide a total of 125 additional therapy posts in the HSE targeted at children of school-going age. 90 of these will be in the disability services, including speech and language therapists, occupational therapists, and physiotherapists. 35 additional posts will be provided for child and adolescent mental health services, including clinical psychologists, occupational therapists, and speech and language therapists for new and existing multi-disciplinary teams. In addition, it is intended that certain key health and social care professional posts, including occupational therapists, are to be protected by setting employment floors for these grades within the Health Service Executive (HSE) in 2009. These posts are essential to the development of a number of services areas such as disability, child adolescent mental health services and child protection services. In order to protect these posts, it is envisaged that the HSE will establish minimum employment levels to be maintained within each of these occupations in the health sector in 2009. The recruitment and retention of these key front line professional posts is vital to ensure continued progress in the development of community settings. Subject to overall parameters set by Government, the Health Service Executive has the responsibility for determining the composition of its staffing complement. It is a matter for the Executive to manage and deploy its human resources to best meet the requirements of its Annual Service Plan for the delivery of health and personal social services to the public. With regard to the deployment and duties of occupational therapists, as this is a service matter it has been referred to the HSE for direct reply. Deputy Caoimhghín O’Caoláin (SF): asked the Minister for Health and Children the action she has taken to ensure that funding allocated to the Health Service Executive for spending on disability services is spent on those services and not diverted to other purposes; Minister of State at the Department of Health and Children (Deputy John Moloney): The National Service Plan, which sets out the quantum of services to be provided in any financial year by the Health Service Executive (HSE) out of the resources allocated to it, is the primary vehicle through which the Minister and the Department monitor and evaluate the performance of the Executive against the targets set out in the plan. The Plan is laid before both Houses of the Oireachtas. The Department has an agreed monitoring framework with the HSE and receives detailed comprehensive monthly reports from the HSE on all aspects of progression of the National Service Plan. Quarterly ‘high level’ meetings take place between the Secretary General of the Department and the Chief Executive Officer of the HSE to discuss issues arising in relation to implementation and progression of the National Service Plan. In addition, there is ongoing liaison and dialogue between various sections within the Department and their corresponding directorates in the HSE. There are also ‘triangular’ monthly meetings held between the Department of Finance, Department of Health and Children and the HSE. As the Deputy is aware, the Minister for Finance will be introducing a new budget on 7th April 2009 which will determine spending levels for public services including the health services the rest of the year. The Minister for Health and Children has given a commitment that she will come before the Oireachtas or the Joint Committee on Health and Children to address the situation that will arise in the health service following the introduction of the budget on the 7th April 2009. Deputy Bernard J. Durkan (FG): asked the Minister for Health and Children the level of research currently in hand or proposed in respect of incidence of autism and Asperger’s syndrome; how this compares with other European countries; if genetic or other comparisons have been made; if the levels here are as high or higher than in other EU or non-EU countries; the initiatives she will take to address conclusions accruing from such comparisons; her views on the level of support, diagnostic or treatment support services available to parents of children with autism or Asperger’s syndrome; her plans to address this issue; the level of diagnostic treatment or support services available to the parents of autistic children; Minister of State at the Department of Health and Children (Deputy John Moloney): The Department of Health and Children does not collect information on children identified with Autism and Asperger’s on a national or international basis. Information pertaining to diagnosis is specifically excluded from the National Intellectual Disability Database as the database is not designed as a medical epidemiological tool. Accordingly the database does not record the incidence of Autism or any other disability. In 2004, the Department of Health and Children, through the Health Research Board, approved expenditure of €5 million on autism research to help improve international understanding of the genetic causes of autism. This €5 million is the Irish contribution to a new major international research initiative called the Autism Genome Project which will receive a total investment of €12 million from a variety of international organisations over the next three years. The other co-funders in the international consortium include Autism Speaks (US), the British Medical Research Council (CIHR), Southwest Autism Research and Resource Centre (SARRC), and the Hilibrand Foundation. This unique combination of international, public and private partners funding a consortium of clinicians and scientists is a new and welcome departure in the field of autism research. The Health Research Board has informed my Department that this funding was awarded as follows:— €2.8 million: Professor Michael Gill, Department of Psychiatry, Trinity College, Dublin— €2.2 million: Professor Andrew Green, Director National Centre for Medical Genetics, Our Lady’s Hospital for Sick Children, Crumlin (affiliated to UCD).This figure represents the largest tranche of funding to be awarded by any of the four funders within the international consortium. The Irish researchers are at the forefront in unraveling the genetic determinants of autism and related disorders. They are using novel state of the art genetic sequencing technology to analyse DNA samples taken from autistic patients to identify candidate genetic markers for autism. They will collaborate with their international colleagues to then link these genetic markers with clinical outcomes. This unique international research effort will greatly improve not only our understanding of the causes of autism, but its diagnosis and treatment. With regard to the remaining matters raised by the Deputy, these relate to the management and delivery of health and personal 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. Deputy Andrew Doyle (FG): asked the Minister for Education and Science if alternative options for budget cuts were discussed before cutting special needs education in view of the fact that the estimated saving from this budget measure is €7 million. Minister for Education and Science (Deputy Batt O’Keeffe): The Deputy will be aware of my commitment to ensuring that all pupils, including those with special educational needs, can have access to an education appropriate to their needs preferably in school settings through the primary and post-primary school network. The Deputy will also be aware that there has been unprecedented investment in providing supports for pupils with special needs in recent years. There are now about 19,000 adults in our schools working solely with pupils with special needs. This includes over 10,000 SNAs — compared with just 300 in 1997. There are over 8,000 resource and learning support teachers in our schools compared with just 2,000 in 1998. Over 1,000 other teachers support pupils in our special schools. As well as this significant increase in the numbers of additional teachers and SNAs directly providing appropriate education and care supports for children with special educational needs, much investment has taken place in the provision of transport, specialist school accommodation, home tuition, assistive technology and equipment. I would like to reassure the Deputy that there will be no pupil with a special educational need who will be without access to a special needs teacher as a result of the decision to apply the normal rules which govern the appointment and retention of teachers of special classes for pupils with a mild general learning disability (MGLD). Teacher allocations to schools typically increase or decrease depending on pupil enrolment. In the case of classes for MGLD the normal pupil teacher ratio that applies is 11:1. My Department however permits schools to retain a teaching post where it has a minimum of 9 pupils in the class. In the case of the school referred to by the Deputy, the school confirmed that they have 8 pupils in the MGLD class, therefore the school no longer qualifies to retain the class. These special classes which are to close pre-date the 2005 General Allocation Model of allocating additional teacher support to schools to enable them to meet the needs of pupils with MGLD as well as a number of other high incidence disabilities. All primary schools were allocated additional teaching resources under the General Allocation Model to enable them support pupils with high incidence special educational needs including MGLD. In the case of the school referred to by the Deputy, the school has shared access to a learning support/resource teacher. When the General Allocation Model was introduced, schools with additional teachers in classes for MGLD were allowed to retain the teachers for these classes. All of the other primary schools in the country who do not have classes for children with MGLD cater for these pupils from within the General Allocation Model. Pupils with a MGLD have, and will continue to have access to additional teaching resources to support their education. I would like to take the opportunity to emphasise that priority will continue to be given to making provision for pupils with special educational needs within available resources.
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Inclusion
Ireland, Unit C2, The Steelworks, Foley Street, Dublin 1, Ireland.
Tel: 01 8559891 Fax: 01 8559904 Email: info@inclusionireland.ie |