Annual Report 1997

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Authors Eastern Health Board (EHB)

Publisher Eastern Health Board (EHB)

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Annual Report 1997 Eastern Health Board Bord Slainte an Oirthir

"Working for the community, in partnership with the community'

Annual Report 1997

Headquarters: Dr. Steevens' Hospital, Dublin 8. Telephone: 01-679 0700 Fax: 01-679 0790 E-mail: ehbmis@iol,ie ANNUA I. I< [.• I' O |{ T I 9 y 7

Eastern I I 1. Dun Laoghaire F1 2. Dublin South East Health Board I I 3. Dublin South Central I I 4. Dublin South West I I 5. Dublin West Community SI 6. Dublin North West I I 7. Dublin North Central Care Areas I | 8. Dublin North | | 9. Co. Kildare | | 10. Co. Wicklow

The Eastern Health Board provides health and personal social services for 1.29m people in Dublin, Wicklow and Kildare.

Eastern Health Board A N N UAL R E P O R T 1 9 9 7

Contents

Chairperson's Message 4

Board Members 6

Programme Committees 9

Mission Statement 10

Demographic and Socio-Economic Profile 11

Management Team 15

Chief Executive Officer 16

Health Promotion 19

Community and Local Area Development 22

Customer Services Department 24

Children and Families 25

Appeals Services 29

People with Physical and Sensory Disabilities 30

Older Persons 34

The Homeless 38

Travellers 39

Women's Health 41

Services for Drug Misusers 43

Social Development 46

Asylum Seekers 47

Acute Hospitals 48

Community Services 52

Adult Mental Health 62

Community Alcohol Services 64

Personnel Department 65

Department of Public Health 68

Management Services 70

Technical Services 71

Estate Management Department 73

Subsidiary Companies 74

Communications 75

Finance 76

Bord S1 a i n t e an Oirthir Eastern Health Board in A N N U A 1. R E p O K T 19 9 7

When I was elected Chairperson of their families. The scale of the child the Eastern Health Board in July care challenge can be appreciated 1996 the major priorities I identified when we realise that there are for my term of office were the areas 365,132 children living in our of drug misuses, child care services, region. Almost 1,400 children are in services for the elderly and services our Board's direct care and just over Chairperson's for persons with learning 1,000 of these are in foster care, disabilities. while the remainder are looked after in small family-style residential Message Eighteen months later, I am pleased units and specialised units. During that very substantial progress has the year there were 3,480 child been made in these areas and that referrals to our 24 hour Crisis further exciting and innovative Intervention Service. The reasons developments are underway. these children cannot live at home are complex and varied. Our Drug Treatment objective is to care for and support In 1997 alone we vulnerable children and families so provided almost 1,000 that they may be reunited as soon as additional treatment possible. In 1997 we purchased places for drug three additional residential child misusers. By the end of care centres, opened an additional 1997 we had opened specialised unit for children with emotional and behavioural five Addiction Centres difficulties and dealt with over and 15 Satellite 2,000 cases of suspected child Treatment Clinics and abuse. Plans were advanced for the the number of beds in opening of a new 24 hour Reception our detoxification unit Centre for out of home children, at Cuan Dara had been two further residential centres for increased from 12 to 17. homeless children and two special There were 81 GPs care units. We also recruited a providing treatment for number of foster parents who will stable drug misusers in provide emergency care at short their own surgeries, 62 notice. Pharmacies were dispensing methadone The Board offers a wide range of on prescription - a child health services including Cllr. Roisin Shortall, T.D. doubling of the number developmental clinics, school Chairperson over the previous two years - medical examinations, immunisation planning was well advanced for a 20 programmes and support and advice bed downstream detoxification unit by the public health nursing service. and a 12 bed stabilisation unit and During 1997, in excess of 235,000 emergency services were in place at visits were made by Public Health all our Addiction Centres. A free Nurses to children in our Board's phone helpline had been set up for area. All of these services are aimed all those concerned with drug at promoting the health and well- misuses and six Education Officers being of children in our region. had been appointed to extend our all important prevention and education Also during 1997, services for programme. children with autism, based at the Beechpark complex, were developed Child Care - in particular, the parent support group meetings, A sibling We had developed a comprehensive educational and social programme range of health, protection, care and also took place and an information support services for children and pack for parents was prepared.

Eastern Health Board Bord Slainte an Olrthlr ANN IJ A 1., R E P O R T 1997

are the first Health Board to Older People being planned at Leopardstown Hospital in liaison with our Board. undertake such an initiative and the There are currently about 125,270 first student intake will be in A total of 2,586 persons receiving people aged 65 and over and 10,558 October 1998. care in private nursing homes are people aged 85 and over living in I would like to thank all the being subvented by our Board and our area and those numbers are set members of our Board for their between 1994-1997, the total number to increase considerably in future constructive approach to dealing of subventions paid by our Board years. Our objective is to provide with an onerous agenda, which grew from 2,307 to 2,586. Over the services which will allow older covered the health needs of a popu­ same period an additional £3.652m people to live in their own homes as lation of 1.3m people, and for their has been spent on nursing home long as possible and where this is no commitment and dedication. I would subvention to ensure the continued longer feasible to provide a network particularly like to thank our Vice implementation of the Heath of modern, high class, locally based Chairman, Cllr. Cyril Gallagher, who (Nursing Homes) Act 1990. community residential units. so ably assisted me during the year.

By the end of the year we had almost Learning Disability I would like to pay a special tribute completed a 10 year action plan for to the late Cllr. Tom Keenan who While we continued with our services for older peopleup to the died during the year and who made programme of upgrading year 2008. During 1997 six further a major contribution to the work of accommodation for persons with Community Ward Teams were our Board over many years. learning disabilities at St. Ita's established to provide professional Hospital, in Portrane, we also I would also like to thank members medical services to older people in finalised plans for the entire re­ who resigned or retired during the their own homes and to obviate the development of the non acute year - Dr. Margot Wrigley, Ms. Peggy need for them to go to hospital and services from a hospital to a Nealon, Cllr. Liam Creaven, Cllr. Reg to facilitate early discharge from community base and the provision Lalor, Dr. John Meehan, Cllr. Mary hospital. Nine Community Ward of modern acute and high support Whitty and Cllr. Dick Roche T.D. I teams have been established in the units in the St. Ita's complex. In would like to welcome the new last three years and the total number 1997 we provided 64 new residential members who joined our Board of teams has grown to 23. Since places, 50 emergency/respite beds during the year - Cllr. Catherine 1994, our Board has put in place an and 155 new day places for persons Quinn, Cllr. Patrick Vance, Cllr. additional 302 in-patient places and with learning disabilities. We Laurence Butler, Dr. Philip 40 day places for older people. opened three new community homes O'Connell, Dr. Marie Laffoy, Dr. These provide a full range of Kieran Harkin, Dr. Siobhan Barry catering for 21 clients at The Naul, services, including respite, and Ms. Maria Hoban. Malahide Road, Swords and one intermediate, convalescent, house on the campus, and a new 30 I would also like to thank the Chief residential and extended care. bed residential complex at the Executive Officer, Mr. P.J. Fitzpatrick, We have planned a network of 13 Hawthorns in Stillorgan for clients the Management Team, and all the strategically located residential formerly cared for in St. Ita's. members of staff for the hard work community units for older people. Upgrading of existing facilities at St. and long hours which they have Four of these have been built and Ita's Hospital continued with dedicated to the development of opened since 1995 - at Navan Road, £0.300m spent on renovations and services in our region. Peamount at Newcastle, Cherry purchase of equipment in 1997. I would like to thank the Minister Orchard and Sir. Patrick Duns' Planning permission was sought at for Health and Children, Mr. Brian Hospital. A further community unit Oldtown, Co. Dublin for the first of a Cowen, T.D., the Ministers of State at at South Circular Road is due to be number of village type complexes for the Department of Health, Mr. Frank completed in March 1998, together persons with learning disabilities Fahey, T.D. and Dr. Tom Moffat, T.D. with the commencement of a 40-bed now being cared for in St. Ita's. It is the former Minister for Health, Mr. in-patient facility at St. Monica's hoped to commence building this Michael Noonan, T.D. and the former Home, Belvedere Place. Further complex in 1998. During the year a Ministers of State at the Department community units are planned for the Consultant Psychiatrist was of Health, Mr. Brian O'Shea, T.D. and following sites: St. Clare's Home, appointed for the Kildare area to Mr. Austin Currie, T.D. for their due to be completed in April 1998, enhance services to persons with a support for the work of our Board Raheny, Dalkey, Lusk, Beaumont, mental handicap and autism. during 1997. Fairview, Maynooth, St. Clare's Approval also came during the year Cllr. Roisin Shortall, T.D. second unit, St. Brendan's and St. for an undergraduate R.N.M.H. Chairperson Loman's, where an additional unit is Programme at St. Ita's Hospital. We

Bord Slainte an Oirthir Eastern Health Board ANNUAL K E I' O R T 1997

Board Members 1998

Cllr. Roisin Shortall, T.D. Cllr. Cyril Gallagher, Chairperson, 12, Iveragh Road, Whitehall, Vice-Chairperson, 16 Glasmore Park, Dublin 9. Swords, Co Dublin Appointed by Dublin Corporation, Appointed by Fmgal County Council.

Cllr. Michael Barrett, Cllr. Ben Briscoe, T.D, Cllr. Eric Byrne, Cllr. Ivor Calleiy, T.D. 102, Glasnevin Avenue, Dublin 11. Dail Eireann, Dublin 2. 32, Ashdale Road, Terenure, Dublin 6W Dail Eireann, Dublin 2. Appointed by Dublin Corporation. Appointed by Dublin Corporation. Appointed by Dublin Corporation. Appointed by Dublin Corporation.

Cllr. Joe Connolly, Senator Joe Doyle, Cllr. Betty Coffey, Rere 40 Northumberland Cllr. Jane Dillon Byrne, Silchester House, 39, Hughes Road South, Walkinstown, 14, SimmonscourtTce., Ave, Dun Laoghaire, Co. Dublin. Appointed Silchester Rd, Glenageary, Co. Dublin. Dublin 12. Donnybrook, Dublin 4. by Dun Laoghaire/ Appointed by Dun Laoghaire/ Appointed by Dublin Corporation. Appointed by Dublin Corporation. Rathdown County Council. Rathdown County Council

Cllr. Olivia Mitchell, T.D., 18, Ballawley Cllr. Ann Devitt, Cllr. Ken Farrell, Cllr. Stanley Laing. 86, Templeville Road, Court, Sandyford Road, Dublin 14. Lispopple, Swords, 4, The Drive, Orlynn Park, Terenure, Dublin 6, Appointed by Dun Laoghaire/ Co. Dublin. Lusk, Co. Dublin. Appointed by Rathdown County Council. Appointed by Fingal County Council. Appointed by Fingal County Council. South Dublin County Council.

Cllr. Charles O'Connor, Cllr. Dr. Pat Upton T.D., 1 College Drive, Cllr. Gerard Brady, Cllr. Michael McWey, P.O. Box 4122, Dublin 24. Templeogue, Dublin 6. 16, Clonwood Heights, Clane, Co. Kildare. Tower View Park, Kildare, Co. Kildare, Appointed by Appointed by Appointed by Appointed by South Dublin County Council. South Dublin County Council. Kildare County Council. Kildare County Council.

Eastern Health Board Bord Slainte an Olrthir ANNUAL REPORT 1997

Cllr. Kevin Ryan, Mr Gerry McGuire, Cllr. James Reilly, Cllr. Tommy Cullen, Deerpark, Baltinglass, Hilltop Nurseries, Camew, 1 The Strand, New Road, Donabate, Ballinakill, Carbury, Co. Wicklow, Co. Wicklow. Co. Dublin. Elected by Co. Kildare Appoimted by Appointed by Wicklow County Council registered psychiatric nurses Appointed by Kildare Co. Council. Wicklow County Council.

Dr. Jim Reilly, Dr. Charles Smith, Central Mental Hospital, Dr. John Fennell, St. Columcille's Hospital, Dr Ray Hawkins, Bray Medical Centre, Fingal House, Lusk, Co. Dublin. Dundrum, Dublin 14 Loughlinstown, Co. Dublin. Herbert Road, Bray, Co. Wicklow. Elected by registered medical practitioners. Elected by registered medical practitioners. Elected by registered medical practitioners. Elected by registered medical practitioners.

Dr. Philip O'Connell, Dr. Marie Laffoy, Dr. Siobhain Barry, Dr. Kieran Harkin, 57 Crayford Downs, 20 Avoca Park, Blackrock, Cluain Mhuire Clinic, 15 Grattan Crescent, Blackrock, Elected by Elected by Blackrock, Elected by Inchicore, Elected by registered medical practitioners registered medical practitioners registered medical practitioners registered medical practitioners

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Mr. Patrick Aspell, 61, College Park, Dr. Don I. Keane, Ms. Maria Hoban, Mrs. Bernadette Bonar, Newbridge, Co. Kildare 130, Merrion Village, 6 Ashgrove Crescent, 9, Leopardstown Park, Blackrock, Appointed by Co. Dublin. Elected by registered Dublin 4. Naas, Co. Kildare, Elected by registered general nurses. Minister lor Health & Children. pharmaceutical chemists. Elected by registered dentists.

Cllr. Laurence Butler, 3 Whitehall Mews, Cllr. Patrick Vance, Beachmount, Cllr. Catherine Quinn, 47 Beechwood Cllr. Dr. Bill O'Connell, Westminister Road, Foxrock, Putland Road, Bray, Co. Wicklow. Lawns, Rathcoole, Vale Road, Arklow, Co. Wicklow Appointed by Minister for Appointed by Minister for Appointed by Minister for Appointed by Minister tor Health & Children. Health S Children. Health i Children. Health & Children.

Bord Sliinte an Oirthir Eastern Health Board A N N I' A L K I: P O R T 19 9 7

G Visiting and inspecting health care facilities within the respective programmes and considering reports from the Programme Managers on the current levels and range of Meetmgs services being provided. The Programme Committees meet each month and their Progress Reports are considered by the Health Board at its monthly meeting.

Finance and Property Matt O'Connor, The Eastern Health Board meets on Committee the first Thursday of each month Secretary to the Board. (except August) at 6 p.m. and holds The Eastern Health Board has also special meetings from time to time established a committee to consider The membership is: to consider particular issues which financial and property matters and merit special consideration. In to report to the Board thereon. A key Board members: addition, the annual meeting of the role for the committee is the Cllr. Ivor Callely TD. Chairperson supervision of the implementing of Board, at which the Chairperson Mr. Gerry McGuire Vice-Chairperson and Vice-Chairperson are elected, the Board's service plan Dr. James Reilly is held on the first Thursday in July The membership of the Finance and each year. Property Committee is as follows:- Board Officers:

Cllr. Roisin Shortall T. D. Dr. Ailish Quinlan (Chairperson ) DCC & Medical Officer of Health Programme Committees Cllr. Cyril Gallagher Ms. Sheila O'Malley Section 8 of the Health Act, 1970, (Vice-Chairperson ) Supt. Public Health Nurse empowers a health board to establish Cllr. Michael Barrett Ms. Olga Garland such committees as it thinks fit and Cllr. Gerry Brady Head Social Worker to define the functions and Cllr. Ivor Callely, T.D. procedures of such committees. Cllr. Betty Coffey Other members: Cllr. Tom Cullen The Eastern Health Board has Ms. Pat Whelan Cllr. Ken Farrell established four Programme Ms. Marilyn Roantree Dr. Don Keane Committees Adoption &• Foster Care Services Cllr. Olivia Mitchell, TD. Ms. Mary O'Connell Cllr. Charles O'Connor O Health Promotion, Mental Health, Residential Care Addiction & Social Development Cllr. Laurence Butler Cllr. Kevin Ryan Ms. Peggy Walker Services for Pre-school Children © Services for Persons with Dr. Philip O'Connell Disabilities Mr. Brendan O Murchu Education Services O Acute Hospitals & Services for the Child Care Advisory Sr. Catherine Prendergast Elderly Committee: Services for Homeless Children The Child Care Advisory Committee © Community Services & Services Dr. Paul McCarthy has been established in accordance for Children & Families Child 8- Adolescent psychiatric with Section 7 of the Child Care Act services 1991, and its role is to assist in These Committees have the Ms. Margaret Dromey and following functions: ensuring that the provision of this Mr. Owen Keenan legislation are met. The committee is Support Services for O Considering and advising on such made up of representatives of Child Children &• Families business (mainly policy issues) as Care services, voluntary Mr. David 0'Donovan may be referred to them by the organisations and professionals Probation & Welfare Service Board, or which they may wish to working in this sector are Inspector Joseph Delaney refer to the Board. represented on it. Garda Siochana

Eastern Health Board Bord Slainte an Oirthir A N N V, A I. REPORT 1997

Chairs and Programme Committees

Cllr. Roisin Shortall, T.D., Cllr. Cyril Gallagher, Chairperson, EHB. Vice-Chairperson, EHB.

Cllr. Thomas Cullen, Chairman, Cllr. Charles O'Connor, Chairman, Mr. Gerry McGuire, Chairman, Cllr. Michael Barrett, Chairman, Community Services and Services Health Promotion, Mental Health, Acute Hospitals and Services tor Persons with for Children and Families Addiction and Social Development Services for the Elderly. Disabilities.

Community Services & Services Health Promotion, Mental Acute Hospitals and Services for Persons Health, Addiction and Services for the Elderly with Disabilities for Children and Families Social Development

Cllr. Charles O'Connor (Chair) Mr. Gerry McGuire (Chair) Cllr. Michael Barrett (Chair) Cllr. Thomas Cullen (Chair)

Dr. James Reilly (Vice-Chair) Cllr. Betty Coffey (Vice-Chair) Sen Joe Doyle (Vice-Chair) Cllr. Cyril Gallagher (Vice-Chair)

Dr. Siobhan Barry Cllr. Gerry Brady Mr. Paddy Aspell Cllr. Ivor Callely, T.D. Cllr. Anne Devitt Cllr. Eric Byrne Dr. Ray Hawkins Mrs. Bernadette Bonar

Cllr. Joseph Connolly Ms. Maria Hoban Cllr. Ben Briscoe, T.D. Cllr. Ken Farrell Cllr. Dr. Bill O'Connell Cllr. Jane Dillon Byrne Dr. Marie Laffoy Cllr. Larry Butler Cllr. Olivia Mitchell, T.D. Dr. Don Keane Cllr. Michael McWey Dr. John Fennell Dr. Philip O'Connell Cllr. Stanley Laing Cllr. Jim Reilly Cllr. Pat Upton, T.D.

Dr. Kieran Harkin Cllr. Roisin Shortall, T.D. Cllr. Pat Vance Cllr. Catherine Quinn

Dr. Charles Smith Cllr. Kevin Ryan

Eastern Health Board Bord Slilnte an Oirthir Mission Statement

Raiteas Misean

We exist to improve the health and social gain of the 1.3 million population in Dublin, Wicklow and Kildare

Taimid arm chun leas slainte agus soisialta daonra 1.3 milliun in Atha Cliath, Cill Dara agus Cill Mhantain a neartu.

Eastern Health Board Bord Slainte an Oirthir ANNUAL REPORT 1997

There are now 1.3 million people 5,394 in 1996. Births to single living in our Board's area, mothers as a percentage of the total accounting for 36% of the births increased to 28.6% in 1996 population of the country. from 7% in 1980. The region has had an overall 11% population increase since 1981. Health Status Demographic In our Board's region, the average An Ageing Population yearly death rate per 100,000 population is slightly higher and Socio- The population of our area is ageing, overall for men (1108.5 per like that of Western Europe 100,000) and slightly lower for generally. Between 1980 and 1996, women (690.6 per 100,000), than Economic the number of live births to mothers the national averages (men- 1102.4 living in the region decreased by & women 694.2 per 100,000). Profile almost 30%, from 26,202 in 1980 to 18,879 in 1996. The crude birth rate Statistics show that proportionally has increased in the last year to 14.6 fewer men die of cardiovascular per 1000 population. disease in Dublin, Wicklow and

The total number of children under Kildare than nationally, but significantly more than average die 17 years living in our area is of cancer. The death rate for 365,132, (28.2% of the total women from cardiovascular disease population). There are 805,536 here is lower than the national people aged between 18-64 years, average but there is a higher than (62.1% of the total), and the number average death rate from cancer. aged over 65 is 126,271, which is Both the sexes have a lower rate of 9.7% of the total. Those aged 85 deaths from accidents, injury and years and over (10,558) account poisoning than nationally. for 0.8% of the population in the region. The dependency ratio* in the Life Expectancy Eastern Health Board is 49% which Life expectancy at birth in Ireland is is significantly lower than the approximately 73.2years for men and national average of 58%. 78.7 for women. This is below the The number of births to single average for the E.U. at 74 for men mothers in our Board's region has and 80.5 for women (Eurostat increased from 1,856 in 1980 to Demographic Statistics 1996) and

'(Number of persons aged 0-14 years and sixty five years and over as a percentage of those aged 15 - 64 years)

1981 1991 est. 2011

Projected growth in the Elderly population in EHB region 1981-2011.

Bord Slainte an Oirthir Eastern Health Board A N N (I A 1. R E P O K T 1997

may be partly explained by very high death rates from heart disease and certain cancers, e.g. colorectal Other and breast cancers.

Causes of Death Injury 1 ! Infant & Neonatal Death Rates Cancer Infant Eastern Republic

Death Rate Health of Ireland Respiratory Board per 1,000 Circulation live births:* 6.5 6.3

20.0 25.0 30.0 35.0 45.0 Neonatal Eastern Republic Percentage of all deaths Death Rate Health of Ireland Board Main causes of death in EHB region (percentage). per 1,000 live births:** 4.6 4.6 Disease Specific Death The single biggest preventable cause 1 (*: An infant death is the death of a child Rates of cancer is smoking but other under the age of one years. ** : A lifestyle factors such as diet and neonatal death refers to the death of a The three most important causes of alcohol are also very important. live born infant during the first month) premature death in Ireland are Much of the progress which will be cancer, cardiovascular disease and The Eastern Health Board rates are made in reducing cancer deaths in injury. similar to the national rate. These the future will come therefore from rates are as much an indication of Our region has a lower death rate improvements in lifestyle. good socio-economic conditions as from cardiovascular disease and Three Regional Directors of Cancer they are of good health care. from injuries than the national average. However, both men and Services have been appointed in our Board's region. They have produced Death Rates women in our region have a higher death rate from cancer. Heart disease a 'Cancer plan' for our area, in co­ Populations with a greater rates have fallen in Ireland in the operation with our Board. proportion of older people will last two decades. It is believed that Our Board has contributed to the naturally have higher death rates. 60% of the decline is due to changes extension of the Eccles Street Standardised rates are death rates in lifestyle, and the remainder to Breast Screening Programme to the which have been adjusted to allow medical care. At national level the Eastern, Midland and the North for differences in the age structure of standardised death rates for both Eastern Health Board areas. It is populations where death rates are to men and women are more than twice hoped that screening women in be compared. the E.U. average. the 50 - 65 year age group will begin in our area in 1998. Direct Standardised death rates The important risk factors relating to death from cardiovascular disease 1991-1995 per 100,000 population include smoking, (accounting for Injury (deaths from all causes) approximately 25% of ischemic Because of the relatively young heart disease), high blood cholesterol EHB Irish age of many accident victims, (linked to fat content of the diet), area. Republic accidents are the single greatest overall lack of physical exercise and cause of lost years of potential life untreated high blood pressure. Male deaths 1108.5 1102.4 before the age of 65. The National Health Promotion Strategy sets a Female deaths 690.6 694.2 Cancer target of reducing deaths from overall deaths 857.6 874.3 Death rates from cancer are still accidents by 10% over 10 years above the E.U. average. The main and significantly reducing (source: Public Health Information Systems) cancer deaths are due to lung, breast morbidity particularly among The standardised overall death rates and colorectal cancer. Cancer death children. Inter-agency are a little lower than the national rates accounted for 26% of all deaths collaboration is required to reduce average. in our area in 1996, compared to the deaths from accidents, mainly national figure of 23%. through prevention.

Eastern Health Board Bord Slainte an Oirthir ANNUAL REPORT 1997

reported cases of this disease in our Communicable INFECTION NUMBERS Board's area and nationally. Much if Diseases Gastro-enteritis<2 years 1267 not all of the increase in 1997 may Communicable diseases are no be explained by the introduction of longer a major cause of death as Salmonella 253 better laboratory diagnostic they were at the turn of the techniques. The incidence may Food Poisoning century in Ireland. Since the increase for a period of years and introduction of measles vaccine, (other than salmonella) 316 then decrease without apparent just over a decade ago, there has reason. 25 been a major drop in the Bacillary dysentery The table below shows the number incidence of this disease and its of cases reported to the Health Board complications and, following the Gastro enteritis in childhood is in 1996 and 1997. introduction of a vaccination, in very common and is usually viral the past five years, there has been in nature. With the increase in the CONFIRMED CASES OF a dramatic decrease in deaths number of people eating outside MENINGITIS from Haemophilus B Influenza the home and the volume of 1997 meningitis (Hib). Nonetheless mass-produced food, the number 1996 there is a need for continuous of cases of salmonella and other Meningococcal efforts to promote and maintain a food borne infections has risen. Disease 127 173 high level of childhood Proper cooking and storage of vaccination and to ensure full food is very important in Other Bacterial implementation of protocols for preventing infections. As person Cases 37 27 the control of hospital and to person spread is also involved, Total Bacterial community outbreaks of good personal hygiene must be Cases 164 200 communicable diseases. maintained at all times.

There were nine deaths in 1997 and six deaths in 1996 as a result of meningococcal disease. 18

16 Tuberculosis:

14 The number of deaths and the

12 number of new cases have dropped dramatically over the last few 10 decades. There were 129 cases of 8 tuberculosis notified in 1997 and

6 113 notified in 1996. All children in the Eastern Health Board area are 4 offered BCG at birth, and a 2 standardised data collection system 0 is being used to monitor trends of cr> o> CT> o> Tuberculosis.

YEAR Methicillin Resistant Staphylococcus Aureus Trends in percentage of births to mothers aged under 20 and those 35 and over 1980-1995 in Eastern Health Board region. (M.R.S.A.) M.R.S.A. is an organism which is resistant to the antibiotic Methicillin Gastro Intestinal Meningitis: and which has become prevalent in Infections Meningococcal disease, either in the hospitals internationally due to increasing use of antibiotics. More Gastro intestinal infections were form of meningitis or septicaemia recently times, it has become the most frequently reported (blood poisoning), accounts for the prevalent in nursing homes and disease in our area in 1997. majority of cases of meningitis. Over other community facilities. M.R.S.A. The following infections were recent years, there has been a does not cause problems for the vast reported. substantial increase in the number of

Eastern Health Board Bord Slainte an Oirthir A N N [ i A 1. !< !• I' i I R T 19 9 7

, majority of people infected but it can cause serious disease and even death HIV Testing Figures: J in more debilitated people. The total number of confirmed positive tests from the anonymous unlinked In 1996 laboratories in our region screening programme scheme are included below for the Eastern Health reported 729 cases of MRSA isolates Board area as well as nationally , to the surveillance system. M.R.S.A. Total positive HIV tests from the anonymous unlinked is a cause for concern but hospitals screening programme in the area are operating a comprehensive infection control . policy. Year Eastern Health Board National number rate number rate HIV End of 1996 24 (31.6/100,000) 37 (16.6/100,000) The first cases of HIV appeared in Ireland in 1981. The rate of End of 1997 37 (37.0/100,000) 64 (22.6/100,000) j occurrence of new cases has now j begun to drop but the disease will be present in the community well into The anonymous unlinked screening data is the best indicator of the HIV i the twenty first century. prevalence in the community.

New AIDS cases resident in the EHB area. Direct Standardised Death Rates 1994 1995 1996 1991-1995 per 100,000 population 46 36 34 Eastern Health Board Republic of Ireland New AIDS Cases Ireland Male Female Overall Male Female Overall 1994 1995 1996 Causes 1108.5 690.6 857.6 1102.4 694.2 874.3 67 55 79 Cardio vascular | (Source: Department of Health j Disease 480.1 284.0 366.0 497.5 298.9 389.0

I In 1994 and 1995; almost exactly Cancer 303.3 196.9 236.7 266.5 181.7 217.0 I two thirds of AIDS cases notified in Injury and j the country had a resident address in Poisoning 44.2 19.0 31.0 57.4 21.4 39.3 our area. In 1996 less than half of all Source: DOH PHIS cases notified were from our area.

Eastern Health Board Bord Slainte an Oirthir ANN U A I. REPORT 1997

The Management Team * 1997

P. J. Fitzpatrick, Chief Executive Officer.

Michael Walsh, Pat McLoughlin, Deputy CEO and Seamus O'Brien, Maureen Windle, Programme Manager, Services for Programme Manger, Programme Manager, Programme Manager, Acute Community Services. Health Promotion, Mental Health, Hospital Services & the Elderly. Persons with Disabilities. Addiction and Social Development.

Philip Doyle, Brid Clarke, Programme Manager, Martin Gallagher, Mary Kelly, Estate Management Officer. Children and Families Finance Officer. Personnel Officer

Mary Crowe, Dr. Brian O'Herlihy, Maureen Browne, Jim Curran, Management Services Officer. Director, Public Health. Communications Director. Technical Services Officer.

Eastern Health Board Bord Sliinte an Olrthi A N N A 1. RE P 0 R I' 19 9 7

J 1997 was yet another year of This money will then be re-invested growing demand upon our services. in the development of the hospital's Significant service expansion was services for the benefit of the undertaken to meet the challenges rapidly expanding population in the posed by our region's growing catchment area of the hospital. At population which is also the beginning of the year, a new Chief experiencing rapid social and Intensive Care Unit was opened demographic change. with special isolation facilities. • Approval was received during the Executive Additional funding was received year for the purchase of a C.T. from the Department of Health and scanner at a cost of £0.350m. Children in 1997 as follows: Officer's Recruitment of the necessary staff and building of the required Drugs/AIDS services £4.720m. Report accommodation was also approved, Child Care £4.253m. bringing the full development costs to £0.650m. Approval was also Acute Hospitals £0.247m. received to further expand radiology and orthopaedic, day surgery and Services for the Elderly £4.530m. occupational therapy services at the Services for the Mentally hospital. The total cost of new Handicapped £1.654m. developments, including the development of a new education Services for Physical and centre and 200-seat lecture theatre Sensory Disabled £0.537m. in conjunction with the Royal College of Surgeons, was £3.5m. Mental Health £0.449m. Approval was also received from Cancer Services £0.700m. the Department of Health and Immunisation Programme£0.980m. Children to significantly expand the scale of the planned redevelopment Total £18.07m of Naas General Hospital. This will allow for the virtual replacement of Our Board very much welcomed the current hospital during the next this additional funding which, development phase; the total cost of along with contributions from our the project will be £30m. Services at Board's own resources, allowed for Naas General Hospital were the development of new services for enhanced during 1997 by the patients and clients in our Board's appointment of two additional region. Consultants. These appointments will help to reduce outpatient Developments in our Board's waiting lists and will provide more hospital services were a key feature adequate cover in both General of 1997. Significant progress was Medical and Surgical Departments. made in planning a modern hospital The level of anaesthetic cover at the at James Connolly Memorial hospital was also enhanced during Hospital, Blanchardstown which the year. This hospital's catchment will cost approximately £50m. Our area population has increased Board's application for re-zoning of rapidly in recent years; to meet surplus lands at the hospital was increased demands on the Accident approved by Fingal County Council. and Emergency Service an It has been agreed by the Minister Observation Unit was opened for Health and Children that monies during the year. Maximising our received from the sale of the land Board's resources is a major priority will be matched pound for pound and a bed utilisation study was by an allocation from the undertaken at the hospital by our Department of Health and Children. Board's Department of Public

Eastern Health Board Bord Slainte an Oirthir ANNUAL REPORT 1997

Health. A Bed Manager was older persons, including appointed to ensure the most public health nursing, effective use of the hospital's bed day care, carer support resource. and respite services.

A development brief was drawn up I extend our thanks to for St Columcille's Hospital, the Boards and Loughlinstown during the year, an managements of the allocation from the Department of voluntary hospitals in Health and Children allowed for the the region for their development of surgical services at ongoing understanding the hospital including the and co-operative appointment of an additional participation in the Consultant Surgeon and the Accident and Emergency purchase of new anaesthetic and Steering Group during endoscopy equipment. 1997. During the year, our Board's Ambulance Significant service developments for Service was involved in the elderly also took place in 1997. final planning for V The Community Residential Unit at creating the long-awaited Sir Patrick Dun's Hospital became new Ambulance fully operational, as did the 25-bed Command and Control unit for the elderly at Peamount Centre at Townsend Hospital. Additional long stay Street which will p . Fitzpatrick, Chief Executive Officer. places were provided at provide a fully integrated Leopardstown Park Hospital and St Ambulance service for Dublin. Having eliminated the Category One Monica's Home, Belvedere Place. waiting list for orthodontic Continuing our process of shifting Construction of the new 50-bed assessment, the waiting list for our mental health services away residential units at St Clare's, Category Two was reduced from Griffith Avenue, and South Circular from large, outmoded institutions, a 10,676 in September 1996 to 5,517 Road, were almost completed by the further 50 beds were closed in St in December 1997. year's end. A new Day Unit at St Brendan's Hospital, thus enabling There was improved co-ordination Brigid's Home, Crooksling, and a patients to be transferred to more and delivery of services for the day service for Alzheimer's/ appropriate accommodation. The homeless during the year as a result Dementia patients at Crinken Lane, development plans which were of increased co-operation between Shankill, for patients in South East approved by the Department of the statutory and voluntary agencies Dublin were provided. Psychiatry of Health during the year provide for through the Homeless Initiative. old age services were enhanced by the re-location of services from St Loman's Hospital to the new the opening of a community-based During the year, the growing service at St Vincent's Hospital, Elm hospital at Tallaght. Similarly, numbers of asylum seekers posed Park and plans were further arrangements were advanced for new challenges for our income advanced for a Day Care Centre at new acute psychiatric units at St maintenance and health and welfare Maynooth. Six additional Vincent's, Elm Park, Beaumont and services. Approximately 300 new Community Ward Teams were put at James Connolly Memorial arrivals presented to the service in place during the year in Hospitals. These developments are each month and it is estimated that Community Care Areas 1, 3, 4, 8, 9 in accordance with our Board's 2,400 asylum seekers/ refugees and 10, bringing the total number of policy of providing acute resided in our region in 1997. In such Teams in the region to 23. This psychiatric care in psychiatric units order to respond to their needs, our development facilitates the early in general hospitals. Board established a Refugee Centre to provide Community Welfare planned discharge of elderly The development of mental handi­ Services and medical facilities. Six persons from acute general hospitals cap services has taken place in general practitioners, an Area by the provision of rehabilitation partnership between our Board and Medical Officer and nursing staff and care in the person's own home. the many major voluntary service were engaged to provide immediate It also prevents or delays providers in the region through the access to emergency medical care admissions to long-stay care and Central Planning Committee. enhances other support services to

Eastern Health Board Bord Sliinte an Oirthir ANNO A 1, R E l> O K T 19 9 7

and screening for asylum seekers on National Social Services Board, Drugs Task Forces in the parts of arrival in tie country. Irish National Organisation for the our region experiencing most Unemployed, Irish Association for difficulties from drugs misuse; local Significant internal re-structuring Spina Bifida and Hydrocephalus, authorities in the provision of and other service developments Irish Patients Association, Irish services for homeless persons and a were effected by our Board in 1997 Travellers Movement, National wide range of agencies involved in and are detailed in this Annual Council on Ageing and Older the care of children, older persons, Report. Primary among these was People, Free Legal Aid Centres, people with physical and sensory the re-structuring of our Board's Combat Poverty, in establishing disabilities and learning disabilities. senior management so that we will procedures so that the system we I am grateful to all the management be better equipped to meet current establish will be objective, easily and staff of these agencies for their and future challenges involved in accessible and equitable. continued co-operation and support delivering a very wide range of during 1997. health and personal social services As emphasised in the Health to 1.3 million people. Strategy, many of the Strategy's Any organisation is only as effective targets depend crucially upon a co­ and efficient as its staff and I would The Programmes were re-organised ordinated and integrated approach like to take this opportunity to say around the major care groups as to Health Promotion. In order to how much I appreciate the loyal follows: accomplish such an approach, our and dedicated service which our © Acute Hospitals and Services for Board established a Health staff provide. I am grateful for the the Elderly Promotion Steering Committee and openness to change which our arranged for the appointment of a Board's staff have demonstrated © Children and Families Health Promotion Officer and the during the year. In this regard also I Q Services for Persons with establishment of a Health Promotion wish to thank the many staff Disabilities Resource Unit. associations and trade unions for their assistance. Best wishes for a ® Health Promotion, Mental Recognising that information happy retirement are extended to Health, Addiction & Social technology is central to the staff who retired during 1997 and Development development of modem best wishes for a long and happy organisations, our Board developed career with the Board are extended © Community Services an information systems strategy to staff who joined us throughout This re-structuring will allow our during 1997 to provide a framework the year. Board continue the process of re­ for the implementation of modern orienting our services so that a information technology throughout I am very appreciative of the help, seamless service can be offered to the region. A comprehensive review support and courtesy which was clients and service delivery will be of our existing systems and extended to our Board by the more efficient and effective. infrastructure was completed Secretary of the Department of Alongside this development, together with a plan for Year 2000 Health and Children and all his arrangements were made to appoint compliance. officials in 1997. Directors of Care Groups to support The Report of the Task Force on I wish to express thanks to the the Programme Managers in service restructuring the Eastern Health Chairperson, Councillor Roisi'n planning and development. Board was published. This Report Shortall T.D., Vice-Chairperson, Cllr. Arrangements were also made to set out the details of the new Cyril Gallagher, the Chairpersons of appoint General Managers in all Eastern Regional Health Authority our Programme Committees and all local Community Care Areas who which will have responsibility for the members of our Board for their will be.responsible for all funding all health and personal continued guidance and support community services in their Areas. social services, both statutory and during 1997. Furthering our efforts to ensure voluntary, in Counties Dublin, Deanam comhbr6n le gaolta agus client satisfaction, our Board Kildare and Wicklow. Briefing le cairde na f6irne a fuair bas i appointed a Director of Customer sessions were organised for all our rith na bliana, agus leo siud ar Services and Appeals during 1997 staff. who will work to ensure citizens' an bhfoireann a bhfuair gaolta During the year our Board entitlements are met. Our Director leo bas. continued to work in partnership has consulted with statutory and with statutory and voluntary voluntary agencies including agencies. These included the local

Eastern Health Board Bord Slainte an Oirthir ANNUAL [( E i> () R T 1997

Health promotion activities in our CONTINENCE Board's region are co-ordinated Fifty-three per cent of women aged through health promotion 20 and over suffer at some stage committees in each community care from incontinence and 70% can be area and through a central health cured with simple treatment. Our promotion committee. These have Board's Continence Promotion Unit, special knowledge of a variety of Health in conjunction with a number of health and related areas and professional organisations, produced represent both professional and a treatment and referral guide to Promotion administrative staff. The activities bladder and bowel control following which took place in 1997 were part childbirth. of national health promotion campaigns or were locally based and MENTAL HEALTH aimed at responding to particular local needs. Our Board participated in a national suicide study which was initiated to examine preventative measures which might be introduced to address this very serious problem. The study, in which general practitioners and psychiatrists are taking part will continue in 1998.

In 1997 we seconded three staff to the Mental Health Association of Ireland to further the aims of the MHAI to help the mentally ill and promote positive mental health. These development officers, in partnership with our Board and other agencies, developed a range of mental health programmes, including the Public Speaking Project in Schools, and provide regular programmes to community and specialist groups. Sampling a selection of food at the Health Promotion Day at Summerhill Health Centre, Rakeeah Rasaq and her son Denis, with Public Health Nurse, Susan Cremin. ALCOHOL EDUCATION

Through our Community Alcohol HEALTH PROMOTION Services we continued to provide RESOURCE UNIT education and preventative In 1997, special funding was programmes to community groups received from the Department of and health service providers on the Health to establish and develop a responsible use of alcohol and early health promotion resource unit in detection of alcohol related our Board, headed by a Health problems. Promotion Officer who will be taking up appointment in 1998. DRUGS EDUCATION The unit will provide training and resource material to health and Six Drugs Education Officers were other professionals to maximise employed in the course of the the effectiveness of health year, with another four expected promotion activities throughout in early 1998. The Education our Board. Officers are actively involved in

Eastern Health Board Bord Slainte an Oirthir A N N U A L K I; P O R T 19 9 7

substance misuse education, ELDERLY In November our Board held a co-ordination of education and conference entitled The Older Our Board provided funding and prevention initiatives in liaison Consumer and the Health Service in staff support to the Dublin Healthy with voluntary, statutory and collaboration with the Office for Cities Dark Horse Venture project, an community groups in the region. Health Gain, Age and Opportunity, award scheme for older persons We provided training to schools the Department of Health, and the which help them to remain socially, teachers and youth leaders in the National Council on Ageing and physically and mentally healthy. region, delivered 16 Community I Older People. Drug Awareness Programmes and The Dark Horse venture is an award held 13 Inter-Agency Drugs scheme for people over 55 years, ] Unintentional injury, especially Education Programmes. i The term Dark Horse refers to the falling, is a serious health problem hidden talents that we all have. among elderly people because of its During the year, our Board, in Certificates are awarded to | frequency and significant association with the National participants who take up a ] morbidity/mortality. Our Board I University of Ireland, Maynooth, completely new activity and keep it initiated a pilot project in south east developed a certificate level up for one year. The activities fall Dublin in 1997 to improve home training programme in addiction into four categories: (1) giving and safety among the elderly. studies. Twenty people sharing, (2) learning and doing (3) completed the course exploring and exercising and (4) NATIONAL CAMPAIGNS in 1997. generations working together, sharing skills with young people. Our Board collaborated with the SMOKING Our Board provided funding to Age Health Promotion Unit of the Action to enable the Association to Department of Health, the Irish Heart Our Board continued to work with continue their work of developing a Foundation, and the Irish Cancer the national Smoking Action Society on a number of major health network of organisations and people Target Group on a number of promotion campaigns during 1997, concerned with ageing and older specific anti-smoking campaigns, including National Healthy Eating people. We provided a member of including the "I have to say No" week, Europe Against Cancer week staff on secondment for six months campaign. This campaign and Irish Heart week. to work with Age and Opportunity provides retailers with signs and to organise a national conference to leaflets which support them in promote positive ageing, encourage "saying no" to children under 16 intergenerational understanding and DUBLIN HEALTHY years of age who try to by to promote the independence of CITIES PROJECT cigarettes. older people. Dublin Healthy Cities Project is an initiative of the World Health Organisation's European office, designed to implement the principles of health for all at local level. Our Board is collaboration with the local authorities in Fingal, South County Dublin, Dun Laoghaire-Rathdown and Dublin Corporation, with the Health Promotion Unit of the Department of Health and the Office for Health Gain under the auspices of the Dublin Healthy Cities Project,the first phase of the Dublin Healthy Cities plan was launched by the partners in July. The key strategies to be tackled in the plan are nutrition, alcohol, smoking, housing, accidents, drugs, environment, and Cllr. Anne Devitt, Cathaoirleach, Fingal County Council and EHB Board Member, launching the Dublin Healthy Cities Plan. active living. Following a period of

Eastern Health Board Bord Slainte an Oirthir ANNUAL REPORT 1997

consultation with the public, In the 1996-97 school year, 4,744 Project, our Board and Dun voluntary and statutory agencies, the pupils in 76 schools in our region Laoghaire-Rathdown County Council first phase of the plan will be participated in the programme. launched a pilot community launched in mid-1998. Teachers of 2nd and 5th Classes accident initiative in the delivered the programme to pupils Dundrum/Ballinteer area. There has and encourage parents to support the been a very good response and HEALTH PROMOTING message. Teachers are provided with support for the initiative from the HOSPITALS back-up by visiting public health local community . The main aim of the initiative is to reduce accidents nurses. James Connolly Memorial Hospital by creating a greater awareness and continued to play a lead role in the An ongoing information campaign understanding of accident, providing Irish network of health promoting called 'Growing up with smoke- knowledge and skills to avoid hospitals. The aim is to expand the Protect your children from passive accidents and encouraging people to services provided, from the smoking' was launched on National alter the behaviour which can immediate acute problems of the No Smoking Day 1997. This produce accidents. patient, to supporting behavioural campaign is being run by our Board's change to improve health. The staff in conjunction with the hospital has developed a number of Department's Health Promotion Unit ACTIVE LIVING PROJECT initiatives including 'stop-smoking' and aims to educate people on the In July, a pilot active living project clinics. dangers of exposing children to was launched by Fingal County cigarette smoke. Training was Council and our Board in the provided for GPs and health Swords area. The aim of the project professionals on the campaign. is to encourage all age groups to become more active. Many FOOD AND HEALTH community and sporting organisations in the Swords area This peer-led nutrition project , have lent their support to the initially developed in project. The project reflects the aims Blanchardstown, was extended to of active living outlined in the the Clondalkin and north inner city Dublin Healthy Cities Plan as well as areas during the year. Volunteers the strategy being developed by the took part in a 10-week course and Board to promote physical activity after training ran courses themselves and to increase the number of people on nutrition and on cooking healthy taking regular exercise. family meals. Our Board participated in a number of public education campaigns SCHOOL LIAISON organised by the Office for Health Gain. These included: Our Board's staff, in particular public health nurses and area Dr. Garry O'Toole with Siobhain Kelleher © The production of a video, j of Glendalough National School, winner medical officers, were in regular alerting people to the signs and I oftheEHB's Co. Wicklow'Stop Smoking' contact with schools, providing | poster competition symptoms of meningitis and the advice and information on health importance of getting rapid hygiene and other matters to medical treatment. This video, \ SMOKEBUSTERS teachers and pupils. which was produced jointly with the Meningitis Research This is an anti-smoking programme Foundation will be available in aimed at primary school children COMMUNITY ACCIDENT 1998. aged 7-11 years to educate them PREVENTION INITIATIVE about the health hazards of smoking. © A campaign to promote the use of Accidents are one of the major It is being implemented by our child resistant containers for causes of early death and injury in Board in collaboration with the Irish medications which it has been Dublin. Among young people, the Cancer Society, the Health shown would reduce the risk of are the single greatest cause of lost Promotion unit at the Department of poisonings to children by one- years of life. In May, under the Health and the Department of third. This campaign will be auspices of the Dublin Healthy Cities Education. launched early in 1998

Eastern Health Board Bord Slainte an Oirthlr A N N Li A ]. R li p O I! T 19 9 7

Staff members of our Board sit on O To ensure effective participation 12 of the 13 Local Area Partnership of representatives on partnership committees which aim to promote boards and operational subgroups.

sustainable local development in O To facilitate the sharing of consultation between statutory and experience and knowledge voluntary agencies, and the local internally and with other Community communities. statutory agencies.

The local area partnerships have O To assist with the assessment of and initiated action to redress the lack needs in local areas. of childcare and educational O To assist with proposals for co- Local Area opportunities for the long-term funding with other sectors and unemployed in disadvantaged agencies (e.g. local authorities, areas. They provide local people FAS, Gardai, educational Development with an opportunity to become authorities). involved in planning and designing O To link relevant services services, resulting in more effective internally with key participants in local initiatives. Partnerships also the partnerships. bring together all the agencies O To add value to initiatives which can have a creative, developed locally (where they practical and financial input to meet our overall strategy for local development. health and social gain). Members of our Board's staff are O To help re-direct our resources also represented on five of six towards projects already catered community groups modelled on the for our target groups. local area partnerships and O To provide a link between our organised in areas which aren't management teams, service designated as disadvantaged. Our managers and our partnership Board is also represented on all 11 representatives. Drugs Task Forces in our region. There are strong links between O To link partnership local area local area partnerships and drugs action plans to our services plans. task forces at local level. G To participate in the design, planning and development of The objectives for our Board's integrated area plans with local involvement in partnerships are: authority planners.

r

Cllr. Roisin Shortall TD., Chairperson of the Eastern Health Board, with Mr. John Maher of PACE Workshop at the opening of the patio garden development at Ashgrove House, Navan Road, Dublin. The garden was created by PACE which provides services for individuals leaving prison or under the supervision of a probation officer.

Eastern Health Board Bord Slainte an Oirthir ANNUAL REPORT 1997

The local area partnerships in the SAOL SCOOPS AWARD: The Eastern Health Board's SAOL Project Board's area are: won the FAS North Dublin Community Services Award.

© Ballymun

© Blanchardstown o Coolock, Kilbarrack, Darndale & Donaghmede (Northside Partnership)

© Finglas & Cabra

© Clondalkin,

© Tallaght

O Bray

<5 Ballyfermot

Dun Laoghaire-Rathdown, Rathfarnham (Southside Partnership) From left Ms. Anna Keogh, participant, Ms. Cathleen O'Neill FAS Supervisor, An Taoiseach, Mr. Bertie Ahem, who presented the award, Ms. Carmel Dunne, Local Area Development Co-Ordinator and Member of Saol Management and Mr. Seamie & North & South Inner City Lambe, Inner City Renewal Group and Member of Saol Management. Q Kimmage, Walkinstown, Crumlin & Drimnagh (KWCD Partnership) 9 A communications network that complied a profile of their existing facilitates good working services or planned services and ® Rialto, Kilmainham, Inchicore & relationships and internal developed a strategy to deal with the Bluebell (Canal Communities partnership across disciplines and local drugs problem. The Partnership programmes within our Board Government allocated £10 million to North Kildare & Offaly (OAK © and which ensures adequate support proposals recommended for Partnership) information flow between our funding in the service development Board and the partnerships was plans of the local drug task forces. Community groups based on the established. Partnership model in the Board's area are: # A mechanism for responding to Priorities for 1998 local authority planners and the © Arklow © to involve all the 19 areas with development of integrated area ® Balbriggan (Co-operation Fingal) action plans was introduced. the consultative structure.

© Kildare (ASK) © to evaluate the effectiveness of our inter-agency co-operation and © Lucan Local Drug Task Forces the benefits for the community, © Rathmines (CESL) compared to projects involving single agencies. © Wicklow Town The Government established 12 local drug task forces following the © To forge stronger links with other The following has been achieved in acceptance of the recommendations statutory agencies involved and 1997: of the first report of the Ministerial assist in establishing local Task Force on Measures to Reduce O Consultative structures were set statutory fora in each the Demand for Drugs. Local drug up in 8 of the 19 partnerships in disadvantaged area. task forces were established in all our region to link partnership the above local area partnership © To develop a training programme action plans to our Board's service areas except the OAK and Bray for staff involved in local area plans. Partnership areas. development projects. d A procedure was agreed for assigning health representatives to Our Board provides the co­ @ To develop ways in which staff various multi agency working ordinators and a representative on working in this sector can have groups and boards. each task force which comprise direct access to those most directly involved in voluntary © A support mechanism was representatives of statutory bodies, and community bodies at the established for those involved in voluntary agencies and community representatives. The task forces local level. partnerships.

Bord Slilnte an Oirthir Eastern Health Board ANN (J A I, R R I' o R •[' 1997

The Customer Services Department's main office is located at the Board's Total Number of Headquarters' at Dr. Steeven's Contacts 146,270 Hospital. It was established to This represents a 14% increase in provide access to up to date, clear, ' activity levels over the previous accurate and detailed information | year. Customer and advice on all aspects of health i and personal social services provided by our Board and how to ^ The Customer Services Department Services avail of them. The Department is j is the catalyst for customer services committed to providing this indivi­ development throughout the Board's i services. Department dual, comprehensive and specialised service in an efficient, effective, I The Customer Services Department: equitable and user friendly manner. O offers advice and assistance throughout our Board to ensure that services are customer friendly. | O provides advice and assistance to various organisations in our region on joint initiatives and to other Health Boards setting up Customer Services Departments.

© provides presentations to outside agencies on our Board's services and on the development of a customer focus in their organisations.

O participates in a wide range of The work of the Department is exhibitions and conferences on all targeted to the Health Strategy's our health and personal social The busy Customer Services Department emphasis upon increasing the located at the Eastern Health Board HQ., services. Dr. Steeven's Hospital, Dublin. customer orientation of services. Health Promotion: A free phone service (1800 520520) is provided and for those who The Department ensures that all the telephone or call personally, services latest health promotion literature is are provided in a client friendly, available. informal environment with a facility for private interviewing when Health Centre: necessary. A minicom facility is available to provide a service to the Customer service facilities were deaf community. The offices are initiated during the year in our open Monday to Friday from 9 a.m. health centres at Swords, Roselawn, to 5 p.m. including lunchtime. Ballymun and will also implemented in all our new health centres. Activity Level 1997 Training and Development Number of To underpin our commitment to Freephone calls 42789 customer services, the department co-ordinates and develops suitable Number of training and development Switchboard calls 70,262 programmes to improve staff skills Personal Callers 33,219 and knowledge and to enhance the quality of service to our clients.

Eastern Health Board Bord Slainte an Oirthir ANN U A 1.. REP O R T 1997

1 During 1997 our Board established a The further development of the Out separate programme to provide of Hours Crisis Information Service. services specifically for children and An increase in the fostering families. allowance of £10.00 per week for There are 365,132 children under children under 12 years. the age of 18 in our Board's area. The The appointment of additional Children allocation for services to children child care staff in Children's and families in 1997 was £39.082m. Residential Centres to improve the and There were 1,348 children in our quality of care by enhancing Board's care in December 1997. supervision and staffing ratios. Families Of these, 1,036 were in foster care and 312 were in residential care. The expansion of the family During the year 106 host families support services in all community participated in our supported care areas. This has proved to be a lodgings schemes and 198 most effective, accessible and flexible support service for placements were made during 997. families. During 1997, a total of £4.253m was spent on the development of new A regional residential unit to services and the expansion of provide care for children aged 10- existing services for children and 12 years with emotional and families. behavioural difficulites was opened and plans were further advanced for the provision of two special care units .

A Training Officer was appointed in late 1997. New multidisciplinary and inter-agency training initiatives will be developed during 1998.

The allocation of funding to the National Children's Nursery Association and the National Childminder's Association of Ireland.

The allocation of additional funding to a number of preventive projects, managed by voluntary agencies, for young people at risk.

Margaret Acton and Sharon Moore with The appointment of social workers some of the young participants in the New Initiatives and psychologists to prepare court Dochas Project, Clondalkin, an EHB reports in custody and access cases Teenage Health initiative. New service initiatives in 1997 under the relevant sections of the included - Child Care Act 1991, Family Law The establishment of a support and Act 1995 and Domestic Violence counselling service for victims of Act 1996. During 1997 our Board domestic violence. received 134 requests for reports. Seventy six of these were The development of an outreach completed by year end. service for begging children. This is part of our programme to identify The purchase of three residential and promote the welfare of child care centres from the Sisters of vulnerable and at risk children.

Eastern Health Board Bord Slainte an Oirthir A N N Li A I RE P O R T 19 9 7

Children in Prostitution The Working Group on Children in Prostitution which consisted of M representatives from the key statutory and voluntary agencies reported during the year.

Key recommendations included:

• Provision of sufficient number of quality placements which children can access.

• Provision of specific services, which are accessible and flexible enough to respond to the diverse needs of children in a non- stigmatising way.

Our Board is in the process of Ms. Lin Mulligan, Ms. Catherine Berkeley, Ms. Colette O'Donovan, Ms. Catherine Rafter implementing these and other and Mr. Liam Lynch in celebratory mood after receiving their Marte Meo Diplomas. recommendations.

Our Lady of Charity, who withdrew year. Of the confirmed cases 436 Advisory Committee from the direct provision of were for neglect, 228 for sexual residential services during the year. abuse, 179 for physical abuse and 80 The Child Care Advisory Committee met on seven occasions during the The complete refurbishment of Tabor for emotional abuse. year. It produced two reports - on House residential child care centre. Crisis Intervention fostering services and on children at The refurbishment of a number of risk who are not responding to During the year there were 3,480 centres providing child care and current intervention services. referrals to our Crisis Intervention family support services. Service, which provides a social Planning took place on a number of work service at night and during the Early Intervention significant developments in relation weekends for out-of home children. Our Board is committed to the to Out of Home children: This represented an increase of over provision of early intervention O The establishment of a new 700 referrals on the previous year. services for children through initiatives such as day nurseries and emergency residential centre for There were seven Irish children the Community Mothers Programme. children under 12 years. placed for adoption by our Board In 1997 our Board provided 90% O The provision of a residential during the year while there were 204 funding towards the cost of nursery centre for adolescents in applications for intercountry places in disadvantaged areas of the partnership with a voluntary adoption. region. agency. *i*rr~ O The establishment of a 24 hour reception centre with day and some residential facilities.

Child Abuse

A total of 2,082 cases of suspected child abuse were reported to our Board in 1997. Of these 724 related to neglect, 638 to sexual abuse, 511 related to physical abuse and 80 to emotional abuse.

There were 833 cases of abuse confirmed in our area during the The new Creag Aran Special Unit for children.

Eastern Health Board Bord Slainte an Oirthir ANNUAL REPORT 1997

The Community Mothers Nurses to children in our region. SPEECH AND LANGUAGE Programme is an effective method Clinics were also held by the nurses THERAPY of offering parents support in their during the year at which advice, Up to 14 per cent of children child rearing task. It is based on a support and information were given. nationally have some form of home visiting strategy in which In addition, the Public Health trained Community Mothers Nurses conducted breastfeeding speech or language impairment and supported by Family Development support groups, health education in our Board's Speech and Language Nurses help to empower parents to schools and the community, Therapy service aims to assist these enable them to achieve their parenting skills training and children and young people to potential and develop their skills. In pregnancy prevention courses with overcome many different 1997, a total of 1,192 families teenagers. communication problems. received visits from 152 Community Speech and Language Therapists Mothers. Breastfeeding support A paediatric development are involved in the assessment, visits by Community Mothers or examination scheme is carried out diagnosis, management and Family Development Nurses by Area Medical Officers and during treatment of these disorders and totalled 1,080. There were the year, 24,642 babies were offered clients of the service are seen at 413 parents and toddler sessions appointments. In addition 15,093 health centres, special schools, were facilitated. pupils in 334 primary schools received school medical child psychiatry/child and family examinations during the year. There clinics, pre-schools or special Children in residential care 312 were 67,639 hearing vision tests classes in primary school. In severe carried out in schools. cases, children receive therapy at Children in foster care 1,036 the Board's Language Unit at Children visited by Public Ballinteer. No children were placed for Health Nurses 235,473 adoption 7 Each of the 10 Community Care Babies attending develop­ areas has at least four Speech & Applications for intercountry mental examination 16,425 Language Therapists and the total adoption 204 number of children referred for Children assessed by Speech assessment by the service in 1997 Percentage of schools & Language Therapists 3,926 was 3,870. In 1996, there were teaching Stay Safe 3,978 children referred. Programme 90.4% School pupils examined at school medicals 15,093 In 1997, 53 per cent of children Notification of suspected referred were aged under four cases of child abuses 2028 Visits by children to years. In 1996, the under-fours dental services 208,806 accounted for 57 per cent of Confirmed cases of children referred. child abuse 833 Children's hearing and There has been a small increase in vision tests in schools 67,639 Parents visited by the numbers of children referred Community Mothers 1192 who are identified as having a Immunisation severe speech and language Referrals to Crisis Intervention The numbers of GPs participating in problem. This has arisen both from Service 3480 the Primary Childhood increasing public awareness of the Immunisation programme during service as well as changes in the referral system and in caring for Maternity and Infant Care 1997 was 653. The recommended schedule for the Primary people who have a problem with Services Immunisation Programme is that speech or language.

All children born in our Board's babies receive their 3 in 1 The Ballinteer Language Unit caters region receive a visit from a Public (diphtheria, pertussis and tetanus) forup to 30 of the most severely Health Nurse soon after discharge polio and Hib immunisations at two, affected children and a further 56 from maternity hospital. These visits four and six months of age. The children are assessed at special continue until the child is aged combined uptake of 2 in 1 and 3 in 1 language classes held at primary three, or longer if the child has at 12-months of age by babies born schools at Tallaght, Churchtown special needs. During 1997, 235,473 in the first quarter of 1997 was 72.2 and Drumcondra. visits were made by Public Health per cent.

Eastern Health Board Bord Slainte an Oirthir Pictured

SUPPLEMENTARY complaints/appeals procedure, with WELFARE APPEALS a client input. It is hoped client feedback, which will be a vital part Our Board's supplementary welfare of the new procedures, will result appeals service provides an not only in an improved service to independent and impartial appeals our clients but will also enable them Appeals process to clients who are to have an input into policy making dissatisfied with decisions relating and the planning of future services. to Supplementary Welfare The new procedures are aimed at Service Allowance. During 1997 there were resolving problems at front line staff 2,100 appeals decided. Of these, 359 level wherever possible. Where this were allowed, 1,600 refused, eight is not feasible there will be two were withdrawn and 383 were under other levels of appeal - to the local consideration at the end of the year. Area or Hospital Complaints/ There was further liaison between Appeals Manager and to the our Board and the Department of Regional Complaints/Appeals Social, Community and Family Manager. Affairs regarding the new right of The Regional Appeals Manager will appeal to the Department's Chief be assisted, where necessary, by Appeals Officer. This new complaints panels which may development is expected to begin in include independent lay or April 1998. professional members.

Protocols will be put in place for New Complaints Appeal access, recording, screening and Procedure evaluation of complaints procedures.

A new complaints/appeals The new complaints/appeals procedures for all our services was procedures provide for a approved by our Board during the considerable amount of staff training year. The objective of the new and consultation and a small procedures is to provide a fair, number of additional staff. objective, easily accessible system which will offer a speedy resolution No. of appeals to problems. undecided at 1-1-97 263 These procedures are a development of our partnership with the Appeals received 2087 community and wide-ranging consultations were carried out with Appeals refused 1600 our clients through organisations 359 and voluntary groups to ascertain Appeals allowed how they would like to see Appeals withdrawn 8 complaints handled.

Our Board is committed to the No. of appeals concepts of excellence, customer undecided at 31-12-97 383 service and an open and transparent

Eastern Health Board Bord Slainte an Olrthir A N N U A 1. R E I' O II J' 1 9 9 7

This Programme was established in Our Board continued to provide a September 1997 in line with our wide range of residential, Boards policy of re-orienting therapeutic, community work, day services towards the provision of a activation, counselling and respite seamless service for care groups. It services to people with physical arid is responsible for the planning and sensory disabilities, both through Services for development of services for persons our therapists and in partnership with disabilities. The Programme with a number of voluntary agencies. consists of three main area, physical Persons with & sensory disability, learning Development funding of £1.2m disability and training, facilitated the extension or Disabilities rehabilitation and employment, enhancement of a number of existing which is a undertaken by a services, including psychiatric subsidiary company of our Board, services for the hearing impaired, Eve Holdings Ltd. personal assistant services, home care attendant services, day activation and respite, and early ^ services for children. The additional j funding also facilitated the opening of an additional thirteen beds in the Young Chronic Sick Unit at Peamount, which was initially opened in 1996 with twelve beds, and the provision of eight semi- independent residential places at the Blackrock Barrett Cheshire Home.

The Board distributed £3.042m in community grants made available by the Government in October 1997 for the purchase, by voluntary organisations of aids, appliances and training equipment and technology, and is liaising closely with the The Hawthorns, Blackrock, the first of a organisations involved regarding the series of village complexes for persons disposal of these funds. with learning disabilities. Services for Persons with Physical & Sensory The needs assessment which is Disabilities being compiled by a public health specialist attached to the Board's The total allocation for directly Department of Public Health, and provided services for persons with the work on the compilation of a physical & sensory disabilities in data-base for people with physical 1997 was £13.39m. In addition, a and sensory disabilities continued sum of £11.88m was allocated to during 1997 and it is anticipated that over 50 voluntary organisations these essential planning tools will providing a wide range of respite, become available in 1998. residential, therapeutic, rehabilitative, support and developmental services. Included in Services for Persons with the services funded through Learning Disabilities voluntary agencies are approximately 300 Day Activation Services for persons with learning places, 120 residential places and a disabilities are provided directly by Personal Assistant service for 30 our Board and by voluntary persons participating in an organisations funded by our Board independent living project. and funded by the Department of

Eastern Health Board Bord Slainte an Olrthir ANNUAL R II P O R 1' 1 9 9

Health. The services of all community was significantly and autism. This service will organisations are co-ordinated advanced with the opening of enhance the quality of service through the Co-ordinating Hilltop House, Naul (7 residents), provided to these clients groups. Committees which are chaired by Glebe House, Malahide Road, Approval was also received to the Programme Manager, Services for Swords (7 residents), Pink House (7 commence an undergraduate Persons with Disabilities. residents) and the Hawthorn R.N.M.H. Programme at St. Ita's Complex (30 residents). Expenditure on services for persons Hospital and the first student intake with learning disabilities totalled Renovations were completed to all is planned for October 1998. £36.5m in 1997. Of this a total of these residences in 1997 and by £13m was expended directly by our early 1998 all of the residents will In 1997 a total of £0.900m was made Board while £23.5m was paid to have moved in. available in capital grants for the over 50 voluntary organisations. learning disabilities services. A total Upgrading of existing facilities at St. of twelve agencies including our Ita's Hospital continued with In 1997 additional funding of Board benefited from this allocation. £2.660m was made available by the £0.300m spent on renovations and Department of Health to provide 64 purchase of equipment in 1997. A public health specialist assigned new residential places, 50 to assist with research and the Planning permission has been emergency/respite beds, 155 new evaluation of needs of persons with applied for the development of a day places and funding for the a learning disability. village complex at Clonmethan transfer of 50 residents from Lodge, Oldtown, Co. Dublin. There are now 2,622 residential accommodation in St. Ita's to places, 4,821 day places and 2,237 community residences. At the end of 1997 a consultant children in special education in the psychiatrist was appointed to The Boards' policy of relocating region. Of those in residential care Community Care Area 9 (Kildare) to clients with learning disabilities 2,476 also receive a day service. A address the mental health needs of from existing accommodation at St. total of 779 persons also avail of persons with a learning disability Ita's Hospital, Portrane, to the respite care.

Ball Pool therapy at the St. Joseph's Service for persons with learning disabilities, based at the St. Ita's Hospital complex.

Eastern Health Board Bord Sl&inte an Olrthir A N N I; A I. I< i: lJ () |{ T

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51 ?.iS-3fSr A N N V A I. REPORT 1997

There axe currently about 125,270 commence the preparation of a roll people aged 65 years and over and on 10 Year Action Plan for Elderly 10,558 people aged 85 and over Persons 1999 - 2008. It is expected living in our Board's area, an that the working group will have increase of 7,828 and 1,595 completed the report in early 1998. respectively over the last five years. Older In 1997 our Board provided a wide It is further estimated that our range of services for older people Board's elderly population will both community and Persons continually increase over the residential/hospital based. At coming years and by 2011, there community level the services will be 176,034 aged 65 and over provided included general living in our area. practices, community nursing and community paramedical services Our Board is conscious that in including services to elderly order to meet the future needs of mentally infirm patients. While at our elderly population a range of in-patient level a range of services services must be put in place included respite/intermittent care, which will allow older people to convalescent/rehabilitation care, remain at home for as long as long stay care and day unit care possible and when that is no longer were supplied. possible to provide a range of quality in-patient residential Other services included facilities. rehabilitation/stroke service, day centres/clubs, nutritional service, continence promotion, support for carers, home improvement scheme, mobile day hospital and subvention towards care in private nursing homes.

Community £ Ward Teams Six further Community Ward Teams were established during 1997 in Community Care areas 1,3,4,8, Kildare and Wicklow bringing to a total of 23 the number of Community Ward Teams in place in our Boards area.

The Teams which provide a multidiscipliniary outreach service to older people in their own homes Residents enjoying an evening at Cuan facilitate the early planned Ros, Navan Road, Dublin. These objectives are set out in the discharge of older people from the Report "Review of Services for the acute hospital setting by the Elderly - 4 Year Action Plan from provision of rehabilitation and 1995 - 1998". adopted by our Board support in their homes. They also in 1995. allow older people remain in their own home for as long as possible To address the continuing service and in some cases prevent the need needs of older people the CEO for the older person to access the nominated in late 1997 a acute hospital setting. multidisciplinary working group to

Eastern Health Board Bord Slainte an Olrthir ANNUAL RE P O R T 1 9 9 7

Psychiatry of Old Age Partnership with Private Nursing Voluntary Organisations Home Care Three Departments of Psychiatry of At the end of 1997 a total of 124 Old Age have been established in There is an extensive range of private and voluntary nursing homes our Board's area based in areas services provided by voluntary were registered with our Board. Of 1,2,3,6 and part of 7. The service agencies on behalf of our Board. these 112 homes were fully based in South East Dublin in This involves over 140 organisations registered and 12 homes had partnership with St John of Gods such as:- conditional registration. and St Vincent's Hospital, Elm Park © Carers Associations. developed a community based O Home Helps There were a total of 4,496 places outreach service in October 1997 O Meals on Wheels available in these private/voluntary with a development of four posts O Day Centres homes and at 31st December 1997 specifically for that service. © Clubs and other groups. our Board was subventing a total of 2,586 persons.

In January 1997, 30 contract private nursing home places for older people were brought on stream and a further 44 places came on stream in November 1997. The total of 74 places will be retained in the system in 1998.

Other Developments

O Our Board entered into an agreement with Leopardstown Park Hospital to provide an The new Community Unit for the Elderly at South Circular Road, Dublin. additional 17 long stay places for s at the hospital in January 1997. Community Units Our Board has also liaised with for the Elderly partners in the business and local O An additional post of Nutritionist authorities via the Reach Out came on stream in early 1997 to Awareness Scheme and with other Our Board has plans for the assist the Nutritional Advisor for agencies such as Age and development of thirteen strategically the Elderly to expand that service. Opportunity, Age Action Ireland to located community units including further the development of services day units throughout our Board's for older people. Activities in 1997 area in the coming years. The first of these units opened at Cuan Ros, the Domiciliary visits to the elderly by Public Health Nurses 113,142 second, a 25 bed unit, at Sir Patrick Number assisted by Home Help Service 4,446 Dun's, became operational in 138 February 1997 providing a wide Voluntary organisations providing Meals on Wheels range of day care and in-patient Number of Voluntary Day Care Centres and Clubs 159 services for older people. Number of chiropody applications approved 14,275 Number of approvals issued under the Home The 50 bed community unit at Improvement Scheme South Circular Road was completed for the Elderly 520 in late 1997 and is due to open in Private Nursing Home Places 2,693 early March 1998, while the 50 bed Long Stay Care Places(including Psychiatry of Old Age) 1,862 community unit at St Clare's is due Respite Care Places 115 to be completed in April 1998. A 410 further 25 bed unit for older people Assessment/Rehabilitation places(residential) opened at Peamount Hospital in Welfare/Convalescent beds. 314 February 1997. Day Hospital and Day Care Unit places. 398

Eastern Health Board Bord S141nte an Oirthir 1 Customer Focus

During the year, we have developed Age and Opportunity procedures to involve the elderly in decisions about the delivery of Conference ! services through seminars and conferences; directories of services, I patient information handbooks and I carers' seminars. Our Board met with a large group of carers on the Northside of Dublin during the year j to get their views as to the needs of I carers in order to shape service ! provision.

In November, 1997 a conference, "The Older Consumer - A Challenge for the Health Services", was held in Malahide. This was a joint initiative between our Board, Age & Opportunity, the National Council on Ageing and Older People, the Ms. Mamo McDonald, Cathaoirleach Age & Opportunity, Dr.Mary Hurley, Director of Community Care EHB, Cllr. Roisin Shortall, T.D. Chairperson, EHB, Dr. Tom Moffat, Office for Health Gain and the T.D. Minister of State, Department of Health & Children, Mr. P.J. Fitzpztrick CEO, EHB Health Promotion Unit of the and Ms. Catherine Rose, Director, Age & Opportunity at the Age & Opportunity Conference in the Grand Hotel in Malahide. Department of Health. The conference was a forum for health service providers, organisations representing the interests of older O Registration of Births, Deaths and services provided, either by statutory Marriages people and older people themselves or by voluntary agencies. The to examine how consumerism can be O Child Psychiatry findings and recommendations of developed in the health service. A the report are being used plan and I O Speech and Language Therapy target services at this particular video was produced specially for the Clinic conference to enable older people to group. O Adult Psychiatry recount their experience of the health service. i In addition, services for the elderly Physical Recreation ! included the provision of long-stay Under the auspices of Dublin Baggot Street Community and short-stay accommodation, Healthy Cities Project, our Board Hospital divided between respite care and helped organise a National Senior direct GP access. The hospital also The following clinics were held in Games Festival in Morton Stadium, provided a rehabilitation day care the hospital: Santry, in September. Over 1,000 service staffed by nurses, older persons participated and O Skin Clinic physiotherapists and occupational demonstrations were given on a therapists. The community O Psychology wide variety of recreational and rehabilitation/stroke service O Developmental Screening continued to operate. physical activities.

O Phlebotomy Reach Out Awareness Survey of Vulnerable O Continence Advisory Clinics Campaign Adults O Radiography Our Board, in partnership with A survey of vulnerable adults living O Child Welfare Clinics Dublin Corporation, other statutory in the greater Dublin area was O Community Welfare Services agencies and voluntary bodies, and completed in 1997. The objective with sponsorship from the business O Stoma Care Clinic was to establish the number of community, continued the Reach O Dental Services people living in the community Out - Be a Good Neighbour whose life experiences have made O Physiotherapy (Out-Patient) Campaign during 1997. We part- them unable or unwilling to accept funded the cost of producing

Eastern Health Board Bord Slainte an Oirthir A N N IJ A L. R li 1' O R '1' 1 9 9

Home Improvement Scheme for the Elderly

Our Board with funding from the Department of the Environment, carried out repairs/improvements to 299 houses of elderly persons to improve their living conditions. Measures were taken to identify and eliminate hazards, to prevent accidents and to increase security while repairs/improvements were carried out. Smoke alarms were also installed. A new training base was established in Community Care Area 4 in 1997 for a new housing repair team, which will significantly reduce the backlog of cases that has built up in the area over the last Successful participants in the EHB's Care Assistants' Course who were presented with three years. certificates at St. Mary's Hospital, Phoenix Park. thermometer cards for use by elderly in their own homes in order to prevent hypothermia.

Home Help Service Our Board participated in a national review of the Home Help service under the auspices of the Department of Health and the National Council on Ageing and Older People. A broad-based group was established by our Board to progress the recommendations contained in our review of the home help service. The EHB's Howe Improvement Scheme for the Elderly, which is operated by Eastern Community Works Ltd., won the Community Services Category in the F.A.S. Community Initiative Awards 1997 - Dublin and Wicklow region. (L-R) Mr. Matt O'Connor, Secretary Carer Support of the Eastern Health Board, with Mr. Gerry McCarthy, General Manager, and Mr. Paddy Service Brennan and Mr. Aubrey O'Brien, Directors of Eastern Community Works Ltd. Our Board continued to fund Crosscare to provide a programme Accident Prevention for about 200 carers, mainly of Our Board initiated a pilot project to older people, on the Northside of improve home safety among the Dublin, providing support, elderly. Unintentional injury, information and advice. A carer especially falling, is a serious health support service continued to be problem among elderly people provided on the southside at because of its frequency and Baggot Street Community significant morbidity/mortality. The Hospital. Funding was also project, which is part-funded by the provided to Fingal Counselling National Council on Ageing and Services and to Soroptomist Older People will be evaluated in International towards the cost of late 1998. their services for carers.

Eastern Health Board Bord Slainte an Oirthir A N N U A t REP O R I' I 9 9

Our Board provides a Homeless O A Consultative Board comprising Persons Unit in Charles Street representatives of the major which offers an emergency housing authorities concerned, accommodation service on behalf the Eastern Health Board and of the local authorities and an voluntary organisations providing income maintenance service. services for the homeless. The Emergency accommodation was arranged for 4,000 persons or © An administrative Director with families during 1997. responsibility for co-ordinating Homeless activities of the Initiative. The Homeless Initiative which was The psychiatric service component launched at the end of 1996 is provided by the specialist continued to operate effectively. homeless programme operating at The Initiative was set up to secure better co-ordination and delivery of St. Brendan's Hospital. There are services for the homeless. It has a 16 acute beds dedicated to the particular role in ensuring the homeless service at the hospital. development of responses which The day programme and outreach will enable homeless people to service was transferred to a more become settled and more out of the suitable location in Ushers Island cycle of homelessness. in 1997. The specialist service also Administrative arrangements have provides support to persons placed been established jointly between in sheltered housing with the Dublin Corporation and the Eastern Salvation Army in Granby Row and Health Board comprising: Focus Housing, Stanhope Street. There are 3 community residences O A management group of senior with 37 places dedicated to the officials of the Eastern Health homeless psychiatric service. Board and Dublin Corporation.

Usher's Island Day Programme and Outreach service for the Homeless.

DO Eastern Health Board Bord Slainte an Oirthir A N N IJ A L K E H O R T 1 9 9 7

Our Board's objectives regarding the health education materials and the travelling community are: engagement of Travellers as community health workers O To assess Traveller health needs providing services to support our Board's nursing and dental staff. O To develop in consultation with Traveller Groups, a health Services for education programme aimed National Travellers' Health specifically at Travellers Conference

Travellers O To develop models of Traveller Our Board, in association with Pavee participation in health promotion Point, organised the first national and prevention conference on Travellers' Health

Travellers participating in the which was held in May 1997. There Primary Healthcare Certificate O To make special arrangements course, which is formally where necessary to encourage and was a large attendance at the accredited by Trinity College, conference which included statutory Dublin and the Eastern Health permit Travellers to avail of Board. primary care services and voluntary service providers and members of the Travelling O To liaise closely with other community. relevant statutory and voluntary agencies providing services to Services Travellers to ensure better targeting of services. Services were provided to the Travelling Community at our Board's health centres or from our Customer Focus Board's Mobile Clinic which The particular health needs of visited a large number of Traveller Travellers as customers continued to halting sites. Specially assigned be developed through their public health nurses worked in involvement in focus groups and areas with a significant numbers conferences, the development of of Travellers.

Eastern Health Board Bord Slainte an Oirthir A N NUAL R [• i> o R 19 9

with our Board carried out research to identify the knowledge, attitudes and practices of traveller women in relation to their health and use of existing health services. The findings highlighted a lack of knowledge in relation to screening and family planning issues, a strong desire for more information and barriers to accessing existing services. An educational video has now been produced with the participation of traveller women addressing issues such as cervical screening, breast screening, antenatal and postnatal care, family planning and the menopause. Preparation of an accompanying factsheet is in train.

The following developments took place in 1997:

O A Primary Health Care Project for Travellers in partnership with Clondalkin Travellers Development Group.

O The joint development in partnership with Clondalkin Travellers Development Group of health promotion leaflets.

O Training and orientation for health service personnel on developing mutual understanding and an understanding of Travellers, their culture, beliefs and way of life.

O Collaboration with Pavee Point in a training programme for Traveller women under the 'New Opportunities for Women' (NOW) Training Programme which will prepare them to enter the health A quilt which represents various aspects of primary health care for travellers which was designed and made by the Community Health Worker Members of the Travelling work-force. The programme is Community. being formally accredited by Trinity College, Dublin. Traveller Women: challenges, which undermine their health. The need for health O Development of health promotion The Plan for Women's Health services to engage in on-going posters on nutrition, with published by the Department of consultation with these groups Traveller participation. Health in 1997 identified traveller was emphasised in the O A major revievv of the PC-based women as one of the groups of consultative process on women's information system on the Mobile women who experience particular health. Pavee Point in conjunction Clinic.

Eastern Health Board Bord Slainte an Oirthir ANNUAL H t P o R T 1 9 9

of screening programmes for breast The Eastern Health Board's and cervical cancer, the provision of Women's Health Plan was drafted as enhanced family planning and the Board's response to the National maternity services, the improvement Plan for Women's Healthin of services for women who are conjunctionwith the Women s victims of violence, increased Health Advisory Committee. It was availability of counselling services agreedby the Boardin November Women's and removal of the barriers which 1997, for submission to the make it difficult for disadvantaged, Department of Health and Children. traveller and disabled women to Health The Eastern Health Board Women's access services. Health Plan responded to the main

objectives for the health services for The following is a summary of women as outlinedin the National Women's Health initiatives during

Women's Plan. 1997:

These are: Teenage Health Initiative O to maximise the health and social gain of Irish women; The consultative process on women's healthin 1995 highlighted O to create a woman-friendly health teenage pregnancies as a health service; issue. In response, the above initiative evolved and commenced O to increase consultation and in 1996. The target group for this representation ofwomen in the project is early school leavers and health services; such groups are accessed through

© to enhance the contribution of the various youth organisations. Funding was provided for six such health services to promoting initiatives within the youth sector. women's healthin the developing Trainingin relationships and sex world; education/sexual health was made

The Plan addresses twelve key available to 30 youth workers,who issues relevant to women's health in turn implemented programmes including the availability and within their organisations, and accessibility of informationin catered for approximately 150 relation to health, the development young people.In addition a programme entitled "Baby ThinkIt Over" is runningin conjunction with some of the youth organisations, and with certain existing school programmes. Baby ThinkIt Over is a lifelike doll which highlights to young people the reality and responsibility of caring for a new infant. We have currently seven dollsin circulation. Research was conductedon needs assessment in relation to teenage sexual health.

Violence against Women

Voluntary agencies providing services to victims of domestic President Mary Robinson chats with Ms. Terri Morrissey, Chairperson °fj°ibj<"eas' ^ violence were supportedby Mr. Pat. McLoughlin, Programme Manager EHB, and Mr. Gerry Kenny, EHB at Section 65 Grants.An Awareness opening of the Aoibhneas Women's Refuge in Coolock.

Bord Sl&inte an Oirthir Eastern Health Board A N N LI A L R L I' O R T 1 V

Training Course was funded for Information Community Care Social Workers | Lesbians A Women's Health Information Promoting Mental Health. A grant | A Conference on lesbian health was paid to ARC Trust which Booklet on Family Planning, J was grant-aided. I provides support for people Pregnancy, Cervical and Breast i receiving treatment for cancer. A Cancer was launched in April grant was also paid to Northside 1997. Booklets (disability proofed) i Women in Counselling Service, which is a 1 on contraception, antenatal care Prison : community based training and J and menstruation as well as audio | Eastern Health Board outreach counselling service. tapes on contraception were | workers are involved in a drug ' produced. j awareness group in conjunction with the Probation and Welfare Reproductive Health ' The staff of the Board participated j Service and the education unit of Women s Health Services were ! in a Women's Health Exhibition | the women's prison. A drugs provided (free for GMS women) at held on 1st and 2nd June 1997 in j awareness course was provided as Irish Family Planning Association the RDS, at which information on | well as an assertiveness, HIV | Clinic at Tallaght, the Well Woman women's health issues was I prevention and women's health I Clinic at Coolock and at designated disseminated. | issues. As a result of the course, a general practitioner clinics. Home small number of women have Birth Grants were paid for 105 Choosing a requested rehabilitation. home confinements. Breastfeeding Healthier Lifestyle courses by Public Health Nurses were held on four occasions. Funding was provided to Slainte Women in Section 65 Grants were paid to Pobal to run programmes in Prostitution Cherish, Cura, Irish Family disadvantaged areas in Dublin 15, Our Board's Women's Health Planning Association, Life, Pact and Bray. This is a group working Project was established to meet and Well Woman Centre in respect for health behaviour change by I the special health needs of of pregnancy counselling services. promoting a more holistic women in prostitution. During the Grants were also paid to NAOMI approach to health and living. ; year, the project continued to and Accord. Their work is concerned in j provide services as follows: particular with giving people I Women with living in communities of high O An outreach team which is Disabilities unemployment access to both street and clinic based i information on complimentary and provides women with The Special Needs Committee, ! approaches to health which helps | advice, support, referral and which was set up to examine the j people to take more control over condoms needs of women with physical and their lives. It aims to create a more O A drop-in clinic which is both sensory disabilities met on nine positive approach to health. occasions. This committee informal and friendly and is researched and disability proofed European Week Against Cancer is staffed by a female team who the information booklets described an annual event, during which a provide advice on sexually under the section entitled campaign is held to draw attention transmitted diseases, cervical Information. A course on Disability to the importance of early smear tests, family planning and counselling. Awareness was held was health detection and action in relation to workers. cancer. This year the focus was on In addition, the Ruhama Project women's cancers. During the week which is funded by our Board 6th to 11th October 1997 a poster Consultation continued to provide training and and media campaign highlighted education programmes for women The Women's Health Advisory the need for regular smear tests in prostitution. Th.6 project, Committee met on nine occasions. and frequent breast checks. In which is managed by the Sisters This Committee was. established by connection with the campaign, 34 of Charity and the Good Shepherd our Board in 1996 and includes workshops/ information sessions Sisters, also provides a staff from our services and were held throughout the Board's befriending service to women in representatives of the National area for members of the public and prostitution though its mobile Women's Council. staff of the Board. outreach service.

Eastern Health Board no Bord Slainte an Oirthir A N N U A L R !•: P () R T 1 9 9

One of the greatest challenges facing shows that the 15-20% who our Board is the provision of complete these programmes are services for drug misusers. It is likely to stay drug free and have a likely that the number of heroin life free of crime. addicts in the greater Dublin area is Detoxification may be carried out on not less than eight to ten thousand. an in-patient or out-patient basis. In­ Heroin use is also evident in Co. Services for patient detox is more effective than Wicklow and to a lesser extent in Co. out-patient detox. An evaluation of Kildare. Drug our detox unit (Cuan Dara) showed Our strategy is to promote a drug that 39% of those who completed free lifestyle, develop outreach the detox and aftercare programme Misusers contact with drug users and provide were still drug free after 10 weeks. effective treatment locally. Our Many will subsequently relapse and Board is responsible for providing, aftercare/rehabilitation is crucial in co-ordinating and funding treatment the months following detox. programmes in the region with the Methadone maintenance is the most exception of the Drug Treatment evaluated form of treatment in the Centre at Trinity Court which is management of heroin addiction. funded directly by the Department of There is clear and consistent Health. evidence that this form of treatment Heroin addiction is a chronic achieves significant reductions in relapsing condition, the treatment is heroin use and crime and a lowered expensive and it is difficult to give a risk of premature death including definite answer as to what overdoses. treatments are effective. A variety of treatments are available to drug Treatment misusers. Clients may go to a Treatment is provided by general therapeutic community such as practitioners in their own surgeries Coolmine which is grant aided by and in addiction centres, in satellite the Board where they live within a clinics, the mobile clinic or in community setting and learn to live specialist detoxification units. The drug free and receive counselling total number of persons treated at and support. International research addiction centres, satellite clinics and by general practitioners was 3,661. The number of treatment places increased by 998.

General practitioners

23 additional general practitioners, bringing the total number to 81 provided treatment for stable drug misusers in their own surgeries.

Addiction centres

Addiction centres are facilities where the following services are provided; information for parents, community groups, schools, education and HIV prevention services, primary care, addiction counselling, community welfare, methadone dispensing and aftercare Staff members at the gym in Soilse Rehabilitation Centre.

Eastern Health Board Bord Slilntc an Oirthir A N N U A 1. R E I' O R T 1 9 9 7

/ rehabilitation. These centres are a Detoxification Helpline base from which our Board's medical, nursing, counselling, An extension of the Cuan Dara A freephone telephone helpline outreach and community welfare detoxification unit was carried out to was established which operates staff operate. A new addiction centre expand and increase the number of from 10 a.m. to 5 p.m. on a in Patrick Street, Dun Laoghaire beds from 12 to 17. There were a Monday to Friday basis. The opened in April 1997. total of 142 admissions to the unit. helpline provides information, An evaluation of the first years support, guidance and referral for Satellite clinics activity in Cuan Dara was carried those concerned with any aspect of out. It showed that 71% successfully drug misuse. The service was Satellite clinics are operated by completed the detox programme, extensively advertised in schools, general practitioners who have been 26% of all patients were drug free Health Board buildings, doctors trained in drug misuse. These after 10 weeks. 34% of those who surgeries and the media. general practitioners have access to completed the detox programme the specialist medical and were drug free after 10 weeks and Emergency services and counselling staff at the addiction 39% of those who completed the assessments centre and prescribe methadone at detox and aftercare programme were the clinics which is dispensed by drug free after 10 weeks. Planning Emergency services and retail pharmacists. Urine screening commenced for a 20 bed assessments were established in Baggot Street, City Clinic, Domville House and the Aisling Clinic. This provided urgent assessments at our addiction centres for clients seeking treatment.

Needle exchange

Needle exchange programmes are an important strategy to contact intravenous drug misusers who are at risk of HIV transmission. The number of needle exchange clinics increased by 2 from 9 to 11 and 842 new attenders availed of needle exchanges.

Addiction Counsellors, Annie Tudor and Shay Henegan, in the recreation area at Cuan Dara Detoxification unit at Cherry Orchard Hospital, Dublin. Sexually transmitted diseases (STD) and counselling are also undertaken. downstream detoxification unit STD clinics were established in Seven new satellite clinics were which will enable more effective use Baggot Street for the Gay Men's opened during the year i.e. Bray, of the specialist detoxification beds. Health Project and for the Mounttown Fitzgerald, Jobstown, Women's Health Project. A Brookfield, Deansrath, Darndale and Information, education survey on men in prostitution Mountjoy Street. and prevention services was launched and a seminar on women in prostitution was held. Mobile clinic Six Education Officers were employ­ ed in the course of the year. The The mobile clinic provides initial Education Officers in consultation Voluntary organisations services to the more chaotic users with voluntary/statutory organisa­ Voluntary organisations have who are addicted to opiates, are tions and community groups have played a key role in the injecting their drugs and are been assessing and identifying gaps provision of various services in incapable of stabilising on in education provision and devel­ the area of drug misuse. £2.2 methadone maintenance. The clinic oping appropriate responses. An million was grant aided to was extended to Ballymun in 1997 anti-heroin campaign was launched voluntary organisations which and an additional 35 treatment and a conference and poster represents an increase of £0.7 places were provided. campaign on ecstasy were held. million.

Eastern Health Board m Bord Slainte an Olrthir A N N U A I. K I: 1' (> K T 19 9 7

Drug workers, Frank McDaid and Siohhuh O'Neill, viewing art work done hv voung clients in the Out­ patients' Detoxification f '•% Programme, based at Fortune House.

Dr. Eamon Keen tin . Consultant Psychiatrist at :v ; Cuan Dura, fe V,e.i»!•{..•• > •• Cherry Orchard Hospital, with 1 Seumus Noone -'A # viewing a painting depicting the journey to recovery from drug addiction. V

*31 ' AX •

V. :\ s l c r n Health Mo a r d ANNUALREPORT 19 9 7

0 To assist with proposals for co- © A mechanism for responding to funding with other sectors and local authority planners and the agencies (e.g. local authorities, ' development of integrated area FAS, Gardai, educational action plans was introduced. Social authorities). O To link relevant services Development internally with key participants in the partnerships. SMILE, O To add value to initiatives Our Board's mission is to build developed locally (where they strong links within our Board with YOU'RE ON meet our overall strategy for local area partnerships that facilitate health and social gain). the delivery of services of HEROIN excellence, responding to the needs O To help re-direct our resources of communities and resulting in towards projects already catered health and social gain in partnership for our target groups. areas. O To provide a link between our The local area partnerships have management teams, service initiated actions to redress the lack managers and our partnership of training, child care and representatives. educational opportunities for the O To link partnership local area Ta*th >•••, |m fltiiHi itiNMN, wttb ttr*him «*a My t*Ma| sttrMltv*.Itfm »•» tak« Iwrth, U*w Ik* fact*. long term unemployed in action plans to our services plans. 1=^ disadvantaged areas. They provide a © To participate in the design, vehicle for the integration and co­ planning and development of EHB public education poster. ordination of statutory agencies at integrated area plans with local the point of service delivery. They LOCAL DRUG authority planners. encourage and facilitate the TASK FORCES The following has been achieved: involvement of local people in the The Government established 12 local O Consultative structures were set planning and design of services, drug task forces following the up in 8 of the 19 partnerships in resulting in the ownership and acceptance of the recommendations our region involving local respect for local initiatives. The of the first report of the Ministerial network meetings (of our pooling of resources has the Task Force on Measures to Reduce potential to provide more integrated representatives on boards and the Demand for Drugs. Local drug services, complements and adds subgroups of partnerships) and task forces were established in the value to direct statutory provision. meetings with heads of following areas; north inner city, Our Board has representatives on 12 disciplines in those local areas. south inner city, Rialto / Inchicore, of the 13 boards of partnerships in The purpose of these structures Ballymun, Ballyfermot, Finglas / designated disadvantaged areas and was to link partnership action Cabra, Crumlin, Coolock, 5 of the 6 community groups in non- plans to our Board's service plans. Blanchardstown, Clondalkin, designated areas. We also have O A procedure for assigning health Tallaght and Dun Laoghaire representatives on all of the 12 drug representatives to various multi (southside). Our Board provides the task forces in our region. There are agency working groups and co-ordinators and a representative on strong linkages between the task boards. each task force which comprise forces and partnerships at local representatives of statutory bodies, © A support mechanism was level. The objectives for our voluntary agencies and community established for those involved in involvement in partnerships are: representatives. partnerships. © To ensure effective participation O A communications network that The task forces complied a profile of of representatives on partnership facilitates good working their existing services or planned boards and operational subgroups. relationships and internal services and developed a strategy to © To facilitate the sharing of partnership across disciplines and deal with the local drugs problem. experience and knowledge programmes within our Board The Government allocated £10 internally and with other and which ensures adequate million to support proposals statutory agencies. information flow between our recommended for funding in the ® To assist with the assessment of Board and the partnerships was service development plans of the needs in local areas. established. local drug task forces.

Eastern Health Board Bord Slainte an Olrthir A N N 1.1 A L. R E P O K T 19 9 7

There was a major increase in the for their basic income as well as rent number of persons seeking asylum supplements and other payments in Ireland during 1997. Most and remain so until such time as persons / families seeking asylum in their application for asylum is Ireland either arrive in, or decided. subsequently make their way to the As part of our Board's agency Eastern Health Board area. There are Asylum arrangement with the housing on average 300 new arrivals per authorities regarding services for the month. Seekers homeless, asylum seekers are placed Our Board provides dedicated in emergency accommodation by our income maintenance, emergency Board's specialist unit acting on accommodation and medical behalf of these authorities. The services for asylum seekers. Asylum accommodation is generally tourist- seekers are not entitled to work type hostel or bed and breakfast within the State and are accommodation. The cost of consequently ineligible to receive providing this accommodation is unemployment assistance. They are met by the housing authorities. therefore dependant on Our Board has contracted with 6 Supplementary Welfare Allowance General Practitioners to provide emergency medical services to asylum seekers awaiting medical cards and to ensure that asylum seekers have immediate access to medical services on arrival in this country. A screening service for infectious diseases and updating of immunisation is also provided.

Enjoying the Eastern Health Board Christmas Party held at the Board's Unit for Asylum Seekers.

Eastern Health Board Bord Sl&inte an Oirthir A N N (J A 1. REP O K r 1997

I I A total of £117.364m was spent on ! accommodation and the recruitment acute hospital services and services of additional staff. This service | for the elderly in 1997, development was completed in 1997. ! The Acute Hospitals Service ensures I that each of our Board's hospitals | The 1997 allocation made provision ! Acute j fulfils its role as part of the network | of £0.095m for the development of of Dublin hospitals and provides radiology services and support ; quality care at the most appropriate | services associated with the Hospitals J level. This includes the co­ | appointment of a second orthopaedic ordination of all Accident and surgeon at the hospital. These Emergency services in the region. I service developments will be fully \ completed on the appointment of a i Our Board has direct management consultant radiologist. responsibility for James Connolly I j Memorial Acute Hospital, St. I A special allocation of £0.030m was I Columcille's Acute Hospital, Naas provided in the 1997 budget towards | Acute General Hospital and Cherry | the equipment costs for the day | Orchard Hospital. | surgery services. This equipment I was purchased in 1997 and the new extended service is fully operational. JAMES CONNOLLY £• MEMORIAL HOSPITAL The 1997 allocation also made provision of £0.030m for the Service Developments 1997 development of occupational The sum of £0.400m made available therapy services at the hospital. The in the 1997 allocation enabled-the recruitment process for the hospital to open an additional 20 additional staff is being finalised and beds for four months during the it is envisaged that this service winter to meet increased demands development will be fully completed from the Accident and Emergency in early 1998. service during this peak period. 1997

Approval was received for a grant of Out-Turn £0.350m for the purchase of a C.T. Scanner. The full development Day Surgery 2,680 i included building new Medical Day Cases 1,562

Discharges 8,280 PHIIK Bed Days 116,780

Out Patients 51,030

No. of Operations 6,390

Radiology

No. of Scans

C.T. Scans 58,758

Pathology

No. of Tests 915,603

Accident &• Emergency

No. of Attendances 33,460

Speech & Language The CT-Scanner which was installed at James Connolly Memorial Hospital, Blanchardstown,during the year. Treatment Units 7,900

Eastern Health Board Bord Slainte an Oirthir ANNUA!, REPORT 1997

I:;:B D:::II:::bib

The new £30m General Hospital whichwill be built at Naas, Co. Kildare.

ST. COLUMCILLES medical equipment. This money was Out-Patients 17,809 used to purchase modern anaesthetic HOSPITAL Number of Operations 2,716 and endoscopy equipment for the Service Developments 1997 theatre department. Radiology Examinations 37,050 A total of £0.050 m was allocated for A special allocation of £0.300m was Pathology Tests 105,500 the development of surgical services made available in 1997 for the A&E Attendances 33,100 at St. Columcille's Hospital as part of upgrading of the electrical services the overall development of the in the hospital. This work was Physiotherapy Department of Surgery for South completed in 1997. Attendances 33,550 East Dublin. An additional Surgical Activities Registrar and two Theatre Nurses NAAS GENERAL HOSPITAL were recruited. Out-turn 1997 (Est.)

The appointment of a second Admissions 5,610 Service Developments in 1997 consultant surgeon in 1997 has Discharges 5,615 An Observation Unit (13 places) was improved the level of general opened in May, 1997 to meet the surgery cover within the hospital. Bed Days 45,140 increased demands from the A special allocation of £0.086m was Day Cases 1,695 Accident and Emergency service provided in 1997 for the purchase of during the year.

A Bed Manager was appointed and a bed Utilisation Study by our Board's Public Health Specialists was carried out.

Approval was received from the Department of Health to the temporary appointments of an additional consultant general physician and consultant general surgeon. These appointments which were made in November 1997 will result in enhancing the quality of patient service, reduction in outpatient waiting lists and provision of more adequate consultant cover for these specialities.

The appointment of two anaesthetic President Mary Robinson with Dr. John Fennell and Mr. Norbert Rodon on the occasion registrars during 1997, through of her visit to St. Colmcille's Hospital, Loughlinstown, Co. Dublin at the invitation of the internal redeployment of posts has Friends of St. Colmcille's.

Bord Slainte an Oirthir Eastern Health Board

L A N IN r A I. R [•; p O i: ! l 9 ...

improved the level of anaesthetic AMBULANCE SERVICE Arklow Base cover within the hospital. | Service Developments 1997 A sum of £0.05 million was made •The pharmacy was enlarged and available in our special allocation to upgraded during 1997 at a cost of | Training provide three staff for a new station £0.025m. at Arklow. During the year three staff j The sum of £0.145 million was were recruited and are being trained Out-Turn 1997 1 made available in the 1997 to Emergency Medical Technician allocation. This enabled the Admissions 5,287 (E.M.T.) standard for this station. | Ambulance Service to progress the Bed Days 47,343 training programme as follows: Ambulance Station Upgrading Day Services 805 O Seven students commenced With the £0.05 million made Outpatients 14,800 Emergency Medical Technician available in a special allocation, (E.M.T.) Training at the National upgrading works were carried out at Theatre 768 Ambulance Training School. James's Street Station and Sluice Radiology Examinations 43,000 facilities were provided at Naas, O Nine staff qualified as work Pathology Tests Maynooth and Athy Stations. 125,731 based assessors, to assess E.M.T. Accident & Emergency students Attendances 28,000 OVERSEAS MEDICAL O Fifteen Control Staff completed SERVICES an Emergency Medical Dispatch programme. CHERRY ORCHARD Under EU Regulations our Board may, subject to certain conditions, HOSPITAL O Forty staff commenced a Driver refer a person, living within our Training Conversion Course. Service Developments 1997 Board's area, to another European 0 Ten staff completed Induction Union member State for medical The laboratory applied for Courses (2) treatment which is not available in accreditation as an official food Ireland. A small number of cases laboratory under the "Health may be referred to non-EU member Ambulance Equipment (Official Control of Food) countries for treatment where such Regulations, 1996". A special allocation of £0.08 treatment is not available in EU member States. A total of £0.132m was allocated to million was made available for the purchase of ambulance equipment the laboratory in 1997 in order to There were over 100 applications for in 1997. Items purchased: assist with its preparation for overseas medical services received attaining accreditation as an official O Hi-tech Spinal Boards in 1997. Of the total number of food laboratory. applications received, approximately O Paedi Packs 95 met the required conditions and Bed Days were approved. The total cost of O Patient Handling Slings Out-turn 1997 these cases, including continuing treatment costs, is £1.140m. Infectious Disease O Resuscitators Services 12,037

Services for the Elderly 37,296 Ambulances Minibuses Taxis Services for Young Out-turn 1997 Out-turn 1997 Out-turn 1997 Chronic Disabled 8,657

Services for HIV/ Dublin 52,611 75,444 20,330 AIDS Patients 3,830

Services for Drug Wicklow 3,156 10,950 387 Misusers 3,484

Number of Tests Kildare 11,278 22,625 1,760 Public Health Laboratory 136,100 TOTAL 67,045 109,018 22,477

Eastern Health Board Bord Slainte an Oirthir KUatKtUttMOl jtwjww

jawau#"*. rSHAJUShU *3HAJU8MA r\ lUldl Ul £.1/0111 Wtib Sptiiil UiltJUll)' vv Giiax o illLjl t_l'Ulllg on Community Services by our supplementary welfare payments, Board during the year. cash payments, additional assistance to disabled persons, In addition £79.585m was spent on welfare homes for older people, the provision of free CP and grants to agencies providing home Community pharmacy services to the 344,156 help and meals-on wheels- medical card holders in Dublin, services and to other voluntary Services Wicklow and Kildare. welfare agencies. A further £77.81m was spent on the provision of supplementary welfare Medical Services to 99,213 persons and £44.4m was In addition to the free primary care spent on providing rent and service provided for all medical card mortgage supplements to 46,854 holders other medical services people who would otherwise be provided during the year included ophthalmic servicesand, medical & surgical appliances.

Community Drugs Schemes

The Drugs Refund Scheme entitles all non medical card holders to a refund of all drugs costs in excess of 90 a quarter. During 1997, our Board paid out a total of 13.83m for 69,000 claims.

The long-term Illness Scheme entitles patients with specific long- term illnesses to obtain drugs and medicines, free of charge, for their illness. There were 23,500 persons covered by this scheme during 1997 CUr. Roisin Shortall TD., at a cost of 8.82m. Chairperson of the Eastern homeless. The total cost of both Health Board, presents the these schemes is recouped from the The Drug Cost Subsidisation Minister for Health & Department of Social, Community & Children, Mr. Brian Cowen Scheme enables patients who do Family Affairs. TD., with an oil painting of not qualify for the medical card or Gallileo done by one of the clients at Soilse, the EHB's A wide range of community based long-term illness scheme, but who drug rehabilitation project, at health and personal social, and have a long term medical condition the official opening of Deansrath Health Centre at welfare services were provided by requiring drugs to a refund of the Clondalkin. the Community Services Programme: cost of drugs in excess of 32 per month. During the year, 33,400 O Community protection including persons availed of the scheme at a food hygiene, food standards, total cost of 15.6m. drug controls, health education and other preventative services. The High Tech/High Cost Scheme enables patients who are prescribed O Community health services listed high cost/high tech drugs to including GP and pharmacy obtain these drugs free of charge services, home nursing services, from their community pharmacist. domicilary maternity services, A total of 3,485 patients availed of family planning, dental, this scheme an overall cost of 8.2 m ophthalmic and aural services. during 1997. A N N U A I. R If, 1' O K T 1 9 9 7

joint development with Bray The Health (Community Pharmacy development with local general UDC and the Department of Contractor Agreement) Regulations practitioner groups. Neilstown was Social, Community, and Family which were introduced in 1996 officially opened in October. Three Affairs. being fully operational in 1997. GP's work from this centre.

These Regulations lay down cirteria A property at Castledermot which The new centre for Ballymun was for the opening fo new Community was identified for use as a health planned as part of the Urban Pharmacies, including the centre was bought and renovations Renewal Project for Ballymun. establishment by our Board of an begun. The centre will have a full range Assessment Board to make a Planning and design work was of community services. The recommendation as to the need for completed for new health centres in estimated cost is £5m. the new Pharmacy at a particular Celbridge and Athy and building location. begun. Planning permission was Planning commenced on the There were 13 new applications sought and granted for a new health development of primary care received for Community Pharmacy centre in Kiltalawn and construction facilities in the South Inner City Contractor Agreements, during the is due to commence in 1998. and Tallaght. year.

O 1 Application withdrawn

O 5 Granted

O 4 Refused

O 3 Still in the Assessment Board process

Six Assessment Boards sat to look at the Applications. /

Health Centres and Other Facilities

Community Services are delivered from 150 premises which include Area Headquarters, Health Centres, EHB staff members, Denise McDonnell and Margaret Kenny at the Community Clinics and facilities, opening of the new Swords Health Centre. welfare homes and day centres for Our Board seeks to ensure that Following the completion of the elderly. As part of the Capital community services are delivered planning and design work, the Development Programme the though a network of premises which refurbishment of Lusk health centre, following work was undertaken are accessable to the communities the extension to Baltinglass health during the year. they serve, suitably designed and centre and the provision of a new equiped for the services they are New health centres at Howth, health centre in Kiltegan are all due intended to accommodate and Swords and Deansrath were to be completed in 1998. provide a pleasant and therapeutic completed and services commenced. environment for both customer and Deansrath was officially opened in The refurbishment and extension to October and provides community Stillorgan health centre following staff. health services for the West fire damage during 1997 has begun. The objective is to provide premises Clondalkin area. It also provides a Planning and design work at South to meet established service needs, day nursery. Earl Street health centre was designed to high standards and to Building work was completed on the completed and refurbishment will maintain an ongoing programme of new primary care centres at commence in 1998. maintenance and upgrading of existing premises, with particular Neilstown, Killinarden and Site acquisition for a new health emphasis on extending the level of Brookfield West Tallaght. The centre in Bray is under customer services provided at local projects in Neilstown and negotiation. This project is a centres. Killinarden represent a joint

Bold Slainte an Oirthir Eastern Health Board a n n i' a l n I; p o r I' i y y ?

No. of health centres inout area 123

No. of District Day Care Units 23 a & !7>«££ No. of Day Centres/ clubs for the elderly (grant- aided by our Board) 124

No. of Voluntary organisations (grant-aided) providing services for the elderly 245

No. of chiropody applications approved 13,707

No. of medical and surgical appliance applications approved 23,828

No. of ophthalmic appliances (children) approved 8,557

No. of ophthalmic appliances (adults) EHB Chairperson,. Cllr. Boisin Shortall TD., and Dr. Liam Lynch, cutting the tape at the approved 21,793 official opening of the Neilstown Primary Health Care Centre, Clondalkin.

No. of aural appliances (children) provided 68

No. of aural appliances (adults) provided 870

No. of geriatrics on the register 55,262

No. of developmental clinics held 3,362

No. of children offered appointments 24,642

No. of children who attended 16,425

No. of children who needed further The new Neilstown Primary Health Care Centre in Clondalkin. attention 5,200

No. of national schools No. of home visits by No. of maternity cash in the Eastern public health nurses- grants paid in 1997 793 Health Board's area 579 (excluding visits when no-one was in)320,906No. No. of applications under the No. of vision tests Maternity & Infant carried out in schools 37,379 of home visits Care scheme £11,510 when no-one was in 63,587 No. of audiometric No. of persons receiving No. of persons covered by tests carried out in Domiciliary Care medical cards on schools 30,260 Allowance on 31 December 1997 344,156 31 December 1997 3,052

Eastern Health Board Bord Sl£inte an Oirthir 1¾VLJU/ Centres

IU11..I .11111 L 1:1:111. IIP!• ;i1 •• 1 !l!::11 1 h

,¾. {• "U "'i computerisation developments. A j In addition to providing a wide range of Welfare Services our Board's total of £303,469 was available to the Community Welfare Services provide counselling and advice to clients on Health Board in 1997 from its money management and household budgeting - CWOs very often act as portion of the savings and this will advocates for clients in difficulties with debtor agencies. As a front line officer be invested in general practice 1 the CWO is very influential in encouraging clients such as alcoholics and developments in 1998. gamblers to avail of clinical/counselling services. The establishment of three major The Community Welfare Service administers various Welfare Services on an general practice pilot centres was agency basis for the Department of Social, Community, and Family Affairs: significantly advanced in 1997. A ' O Supplementary Welfare purpose-built medical centre in O Basic Payments to persons with no income Neilstown, North Clondalkin, was O Exceptional Needs Payments officially opened in October 1997.

O Back to School Clothing & Footwear Scheme The Neilstown Primary Healthcare O Rent and Mortgage Supplements Centre in Clondalkin, Dublin, is the O Other Supplements (heating, diet, travel etc.) first Primary Healthcare Centre which has been funded jointly by The number of individual clients and families who availed of the various General Practitioners and our schemes during the year were: Board to come on stream. It is expected to provide a blueprint for Supplementary Welfare 99,213 overall cost £75.531m the development of general practice throughout the Board's area. This Basic Payments/Back to School Scheme 40,770 overall cost £18.887m new centre has been funded through a combination of Supplements (heating, diet, travel) 15,020 cost £ 1,739m investment of local GPs' savings, achieved through the indicative Rent and Mortgage Supplements 46,854 overall cost £44.4m drug budgeting scheme, and grants from the Board. Three general

The Rent and Mortgage supplement scheme is administered by our Board on practitioners practise from this an agency basis on behalf of the Department of Social, Community and Family centre, providing a wide range of Affairs. Approximately 70% of the clients who availed of Rent Supplements services to the community. were single. The total cost of the scheme is recouped from the Department of The other two centres in Rossfield Social, Community, and Family Affairs. and Killinarden, west Tallaght, were developed jointly by our Board and a The Community Welfare Service also administers the National Fuel Scheme group of GPs in each case. Both developments provide a range of The number of clients who availed 1,306 with an overall cost of community health services which of the scheme was rn 1 n will be fully integrated with the Primary Care Services. These centres As a result of the continuing increase in the number of asylum seekers will be opened in 1998. appiying for accommodation and basic income, it was decided to establish a separate unit to deal with their needs. Over 3,000 asylum seekers applied to Capital funding totalling £275,000 our Board for benefits in 1997, compared to 883 the previous year. was also allocated for 14 specific capital developments in general practice in 1997. General Practice Unit doctors) achieved savings on their During 1997 the General Practice indicative drug budgets totalling The objective of the General Practice Unit achieved the Health Strategy £619,339. In addition, 179 doctors Unit is to facilitate, support and target by introducing basic will be entitled to bonus grants in develop general practice and assist computerisation into 80% of GMS 1998 totalling £1,270,787, based on general practitioners to prescribe practices in our Board's area. This their prescribing in 1997. This appropriately and cost-effectively. was achieved through initiatives funding will be invested by doctors such as the provision of grant aid to in practice development, including In 1997, 26% of GMS general 86 practices and holding software equipment, structural and practitioners in our Board's area (134 demonstrations. Computer training ANNUAL R t P O R T 1997

ft

Members of the Eastern Health Board GP. Unit, (back L-Rj Dr. fohn Lappin, Dr. Sean McCarthy, Dr.Noel O'Gorman, Dr.Philip Aherne, Dr. Kieran Harkin, Dr. Bill Fegan. (Front L-Rj Dr. Kevin O'Doherty, Dr. Yvonne Rafter, Dr. Philip O'Connell, Dr. Aidan Culhane, Dr. Niall O'Cleirigh, Dr. Ellard Eppel. sessions were held for 49 doctors Under the scheme £20,000 was arrangements for general and 42 practice staff. In addition, a allocated to buy clinical practitioners in St Vincent's and St Computer Resource Officer was equipment for 43 doctors. James's Hospitals. available to deal with GPs' queries In 1997 the GP Unit took over the The maintenance of an accurate, up- on computerisation. administration of the Dublin to-date database on general practice in our Board's area is ongoing. Initiatives to provide an enhanced Regional Vocational Training range of services on a shared basis Scheme which was re-named the Under the Health [ Amendment ] Act among general practitioners were Eastern Regional General Practice 1996, a range of services was continued during the year. Fifteen Training Programme. This scheme extended to persons who had pilot projects covering provides vocational training for contracted Hepatitis C through physiotherapy, dietetics and general practitioners. The Unit receiving contaminated blood or counselling were funded directly provided grant aid to the 15 blood products including Human by the Unit. The pilot period for practices in our Board's area Immunoglobulin - Anti - D. The total these projects concludes in 1998 involved in this training. number of health services cards and they are being evaluated In 1997 the Unit continued to issued under the Act now totals 494. during their operation. administer the palliative care The health services card entitles the recipient to avail of a range of The Unit continued to encourage scheme and the screening community based services, including the employment of practice programme for children in disadvantaged areas. medical practitioner services, support staff by general community pharmacy, home nursing practitioners. Grant aid was The education of general and home help services, dental, provided to doctors who were practitioners was supported by the counselling, ophthalmic and aural employing a practice nurse for the Unit through the provision of services first time. As a result, there was a financial assistance to the Irish 15% increase in the number of College of General Practitioners for A senior member of staff monitors nurses employed in general the running of specific courses service delivery, in consultation with practice over the year. dealing with minor surgery and the Department of Health, the other practice management. Health Boards and the representative A clinical equipment scheme was groups for Hepatitis C sufferers, to continued for general practitioners Unit doctors continued to play an ensure that these are provided who did not achieve indicative active part on the liaison and flexibly, consistently and equitably drug budget savings in 1996 but therapeutics committees of the major and in a manner responsive to the who succeeded in improving their hospitals and succeeded in needs of the service card holders. drug budget performances in 1997. introducing sharps disposal

Eastern Health Board Bord SISinte an Oirthir A N N li A I, R li P () R I 19 9 7

Dental Services Children's Services

For the past number of years our Board has been progressively adopting a planned targeted approach to the delivery of oral health services to national school children by screening children in second, fourth and sixth classes and where necessary referring them for treatment in our Board's dental clinics. This school based approach I

puts an important emphasis on •ziy dental health education and fcr prevention. The provision of fissure sealants for vulnerable teeth is an important element of this At work at the Eastern Health Board's Regional Orthodontic Unit, Consultant Orthodontist, preventative programme and 105,649 Dr. Triona McNamara (left) and Dr. Tom Leonard, Senior Clinical Dental Surgeon. fissure sealants were carried out 4. Medically compromised adults people included in the categories during 1997. Dental Health and children listed above were able to avail of Educators continued there talks treatment under the Dental programme to national school pupils 5. Drug Misusers Treatment Services Scheme for to promote good oral health 6. The Homeless eligible medical card holders. practices. 7. Asylum Seekers In addition an accident and emergency service for the relief of 8. Physically disabled patients Adult Services oral pain and infection is available 9. Elderly patients, whether at home Medical card holders between the for all children under 14 years or in residential care ages of 16-34 years and those aged without appointment. During 1997, 13,754 units of 65 and over are provided with The total number of visits by treatment were provided to persons routine dental treatment. An children during 1997 was 208,806. with learning disabilities, physical emergency service is available to all disabilities and medical conditions medical card holders and those There was no waiting period for which make dental treatment without any natural teeth are routine dental treatment for children provision difficult. Many more entitled to dentures. These services during 1997.

Services for Special Needs Groups m • (j'ii During 1997 the eight Senior i) Clinical Dental Surgeons specifically appointed to target services for Special Needs groups developed a strategy for providing services to specific target groups.

Those identified as having a special need include:

1. Patients'attending special schools /, ' s*« and sheltered workshops

2. Psychiatric inpatients and * • b i • outpatients

3. Travellers Lorna Carpenter at the Unit's Orthopantomogram

/; Eastern Health Board Bord Slainte an Oirthlr A N N U A I. R E 1> () R T L 9 9

Treatments provided by the Board's dental staff to eligible patients in 1997. O EHB Health Centre, Old County Road, Crumlin O Dental Clinic at Naas Hospital TREATMENT Children Adults O EHB Health Centre, St. Cronan's, 182,118 27,800 Attendances with appointment Main Street, Bray

Attendances without appointment 26,688 3,490 O EHB Health Centre, Drumfinn Road, Ballyfermot Fillings 58,816 7,827 At the end of December there were Extractions 26,560 4,947 no category 1 patients awaiting orthodontic treatment. There were 105,649 — Fissure sealants 5,517 patients on the category 2 waiting list at the end of December Scale & Polish 16,235 4,476 1997. This is a significance Endodontic treatments 666 231 reduction from 10,676 which were awaiting assessment in September Failed appointments 56,819 6,643 1996 when the Regional Orthodontic

Dentures fitted 534 3,255 Department opened.

Other treatments including (x-ray, 95,993 6,888 1997 Activities: specialist referral, crown/bridge fitting, Assessed 3,585 dressings, fluoride application, oral hygiene, instruction & drugs prescribed) Started treatment 2,287

Discharged 1,250 are provided by our Board's Dental Orthodontic services are provided Did not attend 2,926 Surgeons working from our 140 from our Board's Regional Cancelled 3,277 community-based surgeries at 65 Orthodontic Department at St. locations, and by 219 private James's Hospital. Debond 110 practitioners working from their own Eight Senior Clinical Dental Review 2,743 premises under contract to our Surgeons carry out comprehensive Board. orthodontic treatment on a full-time No. of appointments 38,177 basis under the supervision of our During 1997 more than 92,200 adults Consultant orthodontist. In addition, Units of treatment 27,547 in our area received free dental a dental hygienist, two treatment under the Dental radiographers, and 10 dental surgery In 1997 clinical staffing levels in the Treatment Services Scheme at a cost assistants are employed in the Regional Orthodontic Department of £2.7m. department. had been increased to include nine senior clinical dental surgeons, nine The 1997 objective to approve all Satellite Orthodontic Assessment dental surgery assistants, two applications for dental treatment to Clinics were provided at: radiographers and one part-time eligible persons under the Dental senior registrar. Treatment Services Scheme within six weeks was achieved. A maximum waiting period of 30 days was achieved by the year's end. Dr. Triona McNamara, Regional There were approximately a quarter Consultant and of a million attendance at our local Nurse Ann Marie O'Connor in the dental surgeries during 1997. Sterilization However, it is to be regretted that Department of the over 63,000 people either failed to Regional Orthodontic Unit. attend or made late cancellations of scheduled appointments.

Orthodontic Services:

Eastern Health Board Bord Sliinte an Oirthir A N N U A I. 1¾ [•: P O [( T 19 9 7

row Planning continued during the year to obtain additional office accommodation and staff. It is expected that these measures, which will provide a much speedier service to the public, will be in place in 1998.

| Environmental ' Health Services

The environmental health service deals with prevention, detection and control of environmental hazards which affect health. These include food control, hygiene education, port health, communicable disease Eastern Health Board staff at work in the Office for Begistration of Births Marriages and surveillance and pest control. Deaths, Joyce House, Dublin. Our responsibility is: Registration of Births, | the Family Law Act 1995, have also 1. to ensure food safety and to increased, the work volume of the Marriages and Deaths protect food from any Registrars and Superintendent Our Board is responsible through microbiological, toxic or other Registrar's office. our office at Joyce House, Lombard contamination that can render it Street, Dublin, for the registration There has been a 114% increase in unfit for human consumption and issuing of 40% of all certificates the number of certificates issued by 2. to ensure that when food is of birth, marriage and death required the office in the last 10 years. purchased, it is of the nature, every year in Ireland. 1 In 1997, 83,000 people called to substance and quality demanded In recent years, demands on the [ the Registrar's Office at Joyce The area of food control, including service have increased dramatically House, Lombard Street, to register the registration and inspection of as Dublin becomes a major European or obtain certificates. More than food premises, continued to expand population centre. The workload of 128,000 certificates were issued during the year with Dublin's growth the office has also increased as a during the year and receipts and as a major tourist centre. Over the result of increased births in the city's charges for registration and last number of years, there has been maternity hospitals and deaths in certificates amounted to £463,000. an enormous growth in the number Dublin hospitals of persons from of pre-prepared meals eaten, either outside the region. The Registration of Births Act 1996 came into force in October in restaurants or pre-packaged. Over Additional requirements of new 1997 and introduced new format the year a number of major sporting legislation to take account of birth registers and certificate events and concerts have also been changing social attitudes, such which includes for the first time held at outdoor venues and large as the Domicile and Recognition of the surname of the child as well as numbers of food stalls tend to trade Foreign Divorces Act 1986, the the mother's occupation and at these events. The environmental Status of Children Act 1987, the address. health officers liaise with the Stillbirths Registration Act 1994, and organisers of major events to ensure suitable arrangements to cater for those attending. 1996 1997 In anticipation of the introduction of Birth Certificates issued: 87,138 96,532 the new Hygiene of Foodstuffs Death Certificates issued: 14,255 14,310 Directive, a working group of environmental health officers have Marriage Certificates issued: 15,509 17,454 been preparing an Information Pack totals 116,902 128,296 for food proprietors on the requirements concerning new food No. of Personal callers: 78,000 83,000 safety systems. This Directive will

Eastern Health Board Bord Slainte an Oirthir ANNUAL R E P O R T 1 9 9

VT< ^ rr\ \ //"-I r - jj' -1 ,^1 '«?•" *3 -rs:. 1U> fv-iN* 'Jr* 4

Recipients of Food Hygiene Certificates following courses conducted by Eastern Health Board EHOs at Windsor Car Auctions, Tallaght, Co. Dublin. require food proprietors to ensure from the Dublin Institute of A number of Environmental Health that all food workers are trained or Technology for a period of seven Officers were seconded to work on supervised to a level commensurate months and gave graduates the special projects with the World with the duties they perform. necessary practical experience Health Organisation and the newly needed for their Degree. established Food Safety Authority. Our Board, in conjunction with the Environmental Health Officers No. of Food Hygiene Registration Applications — 688 Association, provided certified Food premises inspected — 8,153 training for 604 food workers during 1997. Air Pollution Monitoring Stations Operated — 68 544 During the year, the Environmental Air Pollution Complaints Processed — Health Officers routinely enforced Noise Pollution Complaints Processed — 602 the legislation dealing with the Bacteriological Water Sampling — 2,932 advertising and sale of tobacco 1,019 products. Chemical Sampling — Fluoride Sampling — 289 Our Board continued to operate agency services for the Local Rodent Infestation Complaints — 7,260 Authorities in its region through the Rodent Treatments Conducted — 8,667 Environmental Health Officers. The Within our Board's area there are 4,479 premises which are classified as range of work included the high risk for the purposes of food control, broken down as follows: following: Manufacturers — 253 O noise control Wholesalers — 52 O air quality monitoring Retailers — 1,063 O housing Restaurants & Other Caterers — 3,111 O planning & public health nuisance abatement Food Borne Infections O water sampling Gastro intestinal infections were the most frequently reported diseases in the Eastern Health Board in 1997. The following infections were reported: Professional practice was provided for Environmental Health graduates • Infection • Numbers • Gastro-enteritis

Eastern Health Board 61( Bord Slainte an Olrthir A N N U A L K E P (.) K T 19 9 7

I The adult mental health services aim | SPECIALIST SERVICES j to achieve the best quality of life for each individual through the FORENSIC SERVICE ' Adult ' provision of high quality, client- centred services. The service The Forensic Service, based at the encompasses all elements of mental , Central Mental Hospital, Dundrum, ! Mental health provision and operates in a provides a national psychiatric ' spirit of partnership with the j service and a therapeutic | Health . voluntary sector in order to provide environment to clients. A liaison | a comprehensive and J advice service is also provided to the complementary range of care. other health boards on the management of clients presenting 1 A continuum of services are with significant challenging | provided within the region which ! behaviour. The out-patient service is are structured to offer a full range of located at Ushers Island. A national treatment to clients with minimum specialist day programme is also disruption to their normal way of provided for perpetrators of sexual life. These services include: abuse. O Prevention and early identification PSYCHIATRIC SERVICES O Assessment, diagnosis and FOR THE DEAF treatment services A psychiatric out-patient service for O In-patient care i adult deaf is provided by our Board O Community-based residences from the Dublin North Central O Rehabilitation and training Catchment Area.

The majority of treatment facilities Plans for the development of this are provided within the community service on a pilot basis were agreed 1 or with a combination of community in 1997 and will be implemented in and in-patient care. The core the near future to strengthen the services are provided in each of the current service in the provision of ten catchment areas from a network clinical assessment, diagnosis, of hospitals, health centres, day J i treatment and family support. It is hospitals and day centres, i also proposed to establish a database complemented by community-based as part of the overall development. residences and training facilities. Our Board provides these services I HOMELESS MENTALLY ILL directly in eight catchment areas while services in two areas are A psychiatric service for the provided on a contract basis by the homeless mentally ill is provided by Hospitaller Order of St. John of God the specialist homeless programme and by St. Patrick's Hospital/St. operating at St. Brendan's Hospital. James's Hospital. The mental health There are sixteen acute beds service activity for the region in dedicated to the homeless service in 1997 was as follows: St. Brendan's Hospital.

o Number of out-patient clinics held 5,245

0 Attendances 117,374

o Number of community residences 83

o Number of residents 723 Q In-patient admissions during 1997 6,550

O Discharges during 1997 6,411

0 Number of people attending day hospitals/day centres 5,305

Eastern Health Board Bord Slamtt an Oirthir ANN U A I. REP O R T 1 9 9

demand for occupational therapy intervention.

In 1997 the range of services provided were: O Assessment and intervention with people with occupational performance deficits

O Carer support

O Mental health promotion

O Community developments

O Staff training and development

O Student training

O Research The new Psychiatric Unit at Tallaght to which the Acute Services and St. Loman's Hospital will be transferred. The service has an establishment of thirty-one posts working in twenty placed in sheltered housing with the The day programme and outreach different locations and in a range of Salvation Army in Granby Row and services for the homeless mentally acute, rehabilitation and community- Focus Housing, Stanhope Street. ill transferred from St. Brendan's based services. Hospital in 1997 to a much enhanced community facility at OCCUPATIONAL Ushers Island. THERAPY SERVICES SOCIAL WORK SERVICE The service has an establishment of There are three community The Occupational Therapy Service is twenty-two posts covering mental residences dedicated to the homeless involved in a period of change and health services in the region. mentally ill. The specialist service development in response to current Fourteen are dedicated to adult also provides support to persons health strategies and to a greater

Recepients of Certificates in Forensic Psychiatric Nursing at the St. Brendan's Hospital Graduation Day are: Back Row (L-R): Aidan Brennan, Gerard Cullen, Kevin Fletcher, Raymond Sweeney, Dermot O'Brien, Pat Preston, Paul Quigley and Michael Bambrick ACNO. Front Row (L-R): Thomas Conniffe, Imelda Murphy, Mary Tuohy, Anne Meade, Eleanor Newe, Thomas Clare ACNO, John Clare and Joe Scales.

Eastern Health Board Bord Slainte an Olrthir ANNUAL REPORT 1997

mental health. In 1997 the range of ACUTE PSYCHIATRIC COMMUNITY ALCOHOL services provided related to: UNITS IN GENERAL SERVICES O Client accommodation HOSPITALS The community alcohol services are O Family referrals: marital The Government and Board policy of delivered from four local centres: problems, substance abuse, providing acute psychiatric units in gambling, domestic violence general hospitals was advanced in 1997. Baggot Street Hospital ' O Individual counselling covering Areas 1, 2 & 3 Currently, acute psychiatric units are j O Social isolation located in St. James's Hospital, Mater

1 Hospital and Naas General Hospital. Tallaght Alcohol Treatment Unit O Financial problems and social covering Areas 4, 5 & 9 welfare queries Considerable progress was made in O Referrals for nursing home the development of a 56 bed acute Stanhope Street Centre assessments and placements unit in the Adelaide and Meath Hospitals Dublin, incorporating the covering Areas 6, 7 & 8 O Tracing: adoption National Children's Hospital in Tallaght. This will facilitate the re­ After intervention around primary Lincara Centre, Bray location of the acute in-patient needs (money and housing etc.) covering Area 10 services from St. Loman's Hospital much of the social work focuses on in 1998. the carers and family of the client. It is at this interface that real Progress was made on the planning There is a residential unit at quality change can be achieved and of a new acute psychiatric unit at Barrymore House, North Circular much preventive work occurs. St. Vincent's Hospital, Elm Park. Road. The service provides Some mental health work and educational and preventive other family therapy work is often Progress was made on the planning programmes in addition to involved as well as mental health of a new acute psychiatric unit at detoxification and counselling education. James Connolly Memorial Hospital, services. Blanchardstown. Progress was made on the planning of a new acute Referrals for treatment are made psychiatric unit at Beaumont COMMUNITY by a variety of people e.g. self. Hospital. PLANNING AND 52%, psychiatric hospitals 11%, DEVELOPMENT probation service 15%, GP 5% and various services 17%. In keeping with Government and PSYCHIATRIC NURSE Board policy, major reorganisation TRAINING During 1997 there was a total of the mental health services from The first psychiatric nursing attendance of 14,742 at the various institutional to community-based registration/diploma programmes services. There were 1189 new care continued in 1997. were developed with both Dublin clients. A planning brief for an extended City University and Trinity College care/rehabilitation unit was Dublin and allowed for the completed representing a major establishment of two schools of component of the planning process nursing from September 1997. Forty for the future development of student places were provided, community-based residential twenty to the Eastern Health facilities. Board/Dublin City University north side school and twenty to the Research and evaluation of Eastern .Health Board/Trinity College current service provision for Dublin south side school. This offenders with mental illness represented a major advancement in commenced in 1997 with a view the development of psychiatric to assessing and planning the nursing and an investment in future most suitable facilities for the staffing resources of our Board. future delivery of services.

/S5\ Eastern He. a 1th Board Bord Slainte an Oirthir A N N UAL R E P O R T 1997

The Personnel Department, 900 staff were appointed. through effective personnel and Responsibility for recruitment was human resource management devolved to some locations. The policies and procedures and number of staff applying for job- through advice and assistance to sharing increased with a total of line managers promotes good staff 532 job-sharers concluding Personnel relations and development so that contracts with our Board. staff may achieve their full Department potential. Superannuation In 1997 our Board employed in Superannuation awards for 1997 excess of 9,000 whole time reflected 1996 levels. Our primary equivalent staff across a wide range objective is to ensure that retiring of professions and grades in many staff are granted their appropriate locations throughout the region. benefits as near as possible to date of retirement. The early retirement Staff Training and scheme for nurses was introduced Development in 1997 and a small number availed of it. Training and development enable staff to acquire knowledge and skills Employee Relations necessary for their demanding positions. Our main objective is to create, maintain and develop good working During the year, management relationships among all staff through development programmes were consultation with staff and designed and implemented across negotiation with their many disciplines. representatives. The workload is

A steering group was established to diverse and ranges from providing facilitate our Board's training and information on terms and conditions development initiative in line with and response to once off queries to the Management Development the handling of specific, individual Strategy. and collective claims.

An induction pack and staff hand Health, Safety and book was introduced; diploma training for general and Welfare

psychiatric nurses was initiated. Our Board's safety management Fifty three staff were sponsored on programme continues to monitor external courses leading to a the area of safety. Safety audits qualification in health service were reviewed and updated and a management; staff continued to total of 214 safety audits were pursue third level study courses carried out. Twenty-one of these with financial assistance from our were first round audits in new Board. premises. The remainder were third round audits largely of Recruitment community based premises. Safety statements were reviewed and The implementation of a new updated in line with the new computerised recruitment system audits. A scheme of Job Safety in September improved the Analysis was piloted in two areas. efficiency of processing Our training activities continued competitions. Approximately with general health & safety 5,000 applications were received training for groups such as nurse during the year, from which over managers, childcare workers and

nrj Bord Slainte an Oirthir Eastern Health Board UCJ (L-Rj Ms. Helen Flint, EHB Director of Nursing and Development, CUr. Roisin Shortall TD., Chairperson of the Health Board and Prof, john Carroll, DCU, at the launch of the EHB's new Co-ordinating Strategy for the Development of Continuing Education for Nurses. other community workers, with Counselling and which included training needs specific training in manual Information Services analysis, the establishment of handling and the prevention and education committees representing management of violence and There continues to be a high demand different clinical specialities, focus aggression across many disciplines for individual counselling with the groups and site visits. Another throughout our Board's area. number of new referrals remaining development was the establishment Eighteen middle and senior steady. A number of group referrals of further sites for accreditation as managers are currently being was also received during the year, nursing or practice development sponsored on a certificate course 110 staff participated in workshops units. A public health nursing team in 'Safety and Health at Work' in on stress and stress management, a and a multidisciplinary team in an University College Dublin. policy document on bullying in the acute psychiatric unit are well workplace was introduced. advanced on the route to Occupational Health accreditation. Nursing Development Nursing Research and Units at St. Mary's and St. It was another busy year in our Development Columcille's Hospitals continued to occupational health department develop research projects. with an increase in attendances. A It was an exciting year for the Implementing individualised patient number of policies were reviewed Department of Nursing Research & care remained a priority, with and updated and education and Development. Our Board's first Baltinglass Hospital and St. Brigid's information on the revised policies strategy document for nursing Home introducing patient care plans. is ongoing. Health promotion for entitled Continuing Research The first computerised nursing audit staff in the workplace includes Education and Development in system was piloted successfully. Post programmes on stress partnership with An Bord Altranais registration seminars, study days and management, weight loss and was launched. The report was the management/staff development smoking. result of a consultative process courses for nurses continued.

Eastern Health Board uu Bord Sliinte an Olrthir ANNUAL REPORT 1997

EHB Winners

At the award of the British Council/Chevening Fellowship to Dr. Colm Leonard and Dr. Vincent Tormey were (from left) Mr. Stephen Dorman, Managing Director of Glaxo Wellcome; Dr. Conor Burke, Consultant Respiratory Physician, fames Connolly Memorial Hospital; Dr. Rrendan Colgan, Medical Director, Glaxo Wellcome; Pr. PJ. Fitzpatrick, CEO Eastern Health Board; Mrs. Veronica =&sas% Sutherland, British Ambassador; Dr. Colm Leonard,; Mr. Harold Fish, President of the British Council and Prof. Leonard Poulter.

Francis Murphy, Ward Sister at the EHB's Bru Chaoimhin, Cork Street, Dublin, and winner of the 1997 Milton Education Award.

The EHB members of the Dublin Psychiatric Services Hurling team in high spirits before their Intel rivals ended hopes of a victory in the Leinster Hurling Championships as well as the The Eastern Health Board's Eurospideal Dublin round of the contest. soccer team, Management, Coaches and supporters who departed in September for Italy to take part in this international tournament for European healthcare workers. (Front L-R) Frances McNamara, Suzanne Creaven, Suzanne Bushnell, Derek Hall, Paul Browning, Dave O'Brien, Adrian O'Donohue, fohn Donovan and Derek Bauer, with (back L-R) Gerry Reid, Kevin Brady, Blaithnaid Duane, foe Lawlor, Brendan Melia, Colm Coffey, Adrian Charles, Paul Gorman, Brian Callaghan, Larry Bathe, Brian O'Conchubhaire, Tom Mahon, Philip Doyle and Eddie Matthews.

Ha*itfn K « v. i t Soar a Bord Sliiiite an Olrthir .... .K. r ' : -=¾¾¾ "'Vs- " i-- -¾.. AN N (I A L R I; P o R T I 9 9 7

I The Department of Public Health's O A review of the Implementation core objectives are to determine the of the Dublin hospital initiatives. | health status of the population, O Assessment of hospital bed needs. I identify health needs and evaluate I services O Development of primary care i centre in Tallaght Hospital. Department j The functions of the department include: O Development of primary care services in Dublin inner city. of Public | O Studies to determine the health j status of the population O A general practitioner satisfaction survey with a hospital outpatient O Assessing the service needs of Health department. different population groups O A patient satisfaction survey of | O Contributing to the planning OPD attendees. process O Project to prevent falls among O Participation in evaluation, older people. including determining outcomes and the measurement of health O Cancer Plan for the EHB region in and social gain conjunction with the regional Directors of Cancer services.

O Accident and Emergency mapping study.

Qm GE€YOU O Establishment of a Stroke Register ARRESTED in three hospitals. O The setting up of a Physical and Sensory Disability Database.

O Developed new protocols for the management of cases of E Coli 0157, legionnaires disease, and leptospirosis.

O A review of the statutory notification system for infectious diseases. EHB public education campaign on the dangers of Ecstasy. © Co-ordination of the laboratory O Participation in the prevention, Surveillance system and the surveillance and control of infectious disease bulletin, age diseases including infectious specific prescribing rates of diseases medication in the EHB area.

O Contributing to the development O Drug utilisation and prescribing of new health information costs in the EHB region. systems O Extent of usage of drugs of limited O Health services research clinical value.

O Evaluation of services, which O Action plans for accident involves measuring health and prevention in children and older social gain and examining people. outcomes. O Survey of sources of information Work undertaken by the Department on acute poisoning in accident or individual specialist in 1997 and emergency departments of included: Dublin hospitals.

Eastern Health Board ULJ Bord Slainte an Oirthir A N N U A L REP O R T 1 9 9

O EHB plan for women's health. Pharmaceutical Society of Ireland Health Promotion and the Department of Health. Data O Four-month followup study of from all doctors who prescribe The folic acid action group elderly patients discharged from Methadone will be included on a initiated, in collaboration with the acute general hospitals in the Central Methadone Treatment List, Masters of the maternity hospitals, Eastern Health Board region. which will be part of the overall an annual survey of 300 women at public antenatal clinics. O Survey of knowledge and use of information system. Aggregate data Significantly more were aware of folic acid at public antenatal from the Central Methadone the importance of taking folic acid clinics Treatment List will be produced on a monthly basis and more detailed before conceiving (76% compared O Ongoing evaluation of analysis will be done at frequent with 54% in 1996), knew that folic Smokebusters Programme 1996- intervals. acid can prevent NTDs (57% 1997. compared with 39% in 1996), and had taken folic acid peri-conception O Participated in the national Evaluation (16% compared with 6% in the Health Boards' study on suicide. Evaluation of an initiative to previous year). O Mapping and population increase generic prescribing in the calculations for new areas and Eastern Health Board area was Health Status districts to be created under the undertaken. Intervention included a Measurement Eastern Regional Health visit from a GP prescribing advisor, Authority. simple documentation on generic A EUROCAT study of the survival of prescribing and liaison with 389 children born with Down's O Development of a menu based pharmacists. The intervention was Syndrome in our area between 1980 analysis system for determining successful for the majority of the and 1989 showed that survival was immunisation coverage in each drugs examined and is now being 88% at one year and 82% at 10 Community Care Area. extended to other areas of our years. The presence of a congenital Board. heart defect reduced survival to © a menu for the analysis of 72%. The major causes of death epidemiological data among the cohort of Down's provided by GPs. Needs Assessment Syndrome children studied were O Design and data collection for a The plan for women's health congenital heart disease (47.3%), follow-up evaluation of the published by the Department of leukaemia (10.9%),septicaemia, community mothers programme. Health in 1997 identified Traveller meningitis (10.9%) and respiratory women as one of the groups of infection (9.1%) O Analysis of the drugs cost women who experience particular subsidisation scheme and also challenges, which undermine their the hardship scheme for Eurosurveillance health. Pavee Point in conjunction provision of certain drugs to Ireland is represented on the with our Board, carried out research GMS patients. European infectious disease to identify the knowledge, attitudes bulletin, Eurosurveillance, aimed at O Mapping of a deprivation index and practices of traveller women in disseminating information on for DEDs in our area in relation to their health and use of infectious diseases relevant to collaboration with the existing health services. The Europe, by a public health specialist Department of Community findings highlighted lack of in our Board. Health in Trinity College. knowledge in relation to screening and family planning issues, a strong © Development of new information desire for more information and European Programme for systems barriers to accessing existing Intervention Epidemiology services Training Methadone Treatment An educational video has now been Our Board continues to participate Services review group produced with the participation of in the European programme for An implementation group has been traveller women addressing issues Intervention Epidemiology Training put in place with representation such as cervical screening, breast (EPIET). Dr. Thomas Grein, an from the Eastern Health Board, the screening, antenatal and postnatal EPIET Fellow from Germany is Drug Treatment Centre, The Irish care, family planning and the based in the Department of Public College of General Practitioners, the menopause. Health.

Eastern Health Board Bord Slainte an Oirthir A N N [J A L R E 1' O R T 19 9 7

INFORMATION service will greatly improve internal TECHNOLOGY STRATEGY: and external communication in the coming year. A modern, new information systems strategy for our Board was developed Continence Products System: during the year and will be A new initiative is being piloted in | implemented during the coming the management of the various Management years. It will: incontinence wear products used in | O Provide comprehensive the home care of our clients. A Services management information on all system has been implemented to aspects of our Board's services. streamline the delivery and stock i O Provide standard information on control of these products and the number and type of services improve the quality of the service to 1 accessed by our clients, to enable the client group. us to further develop a seamless Recruitment System: care service A new recruitment system was It also provides the framework for introduced in the Personnel the implementation of modern Department. information technology throughout Speech and Language: the Board. A system was developed to assist A comprehensive review of our our community speech and language existing systems and infrastructure therapists manage their caseloads as was completed and a plan for Year efficiently as possible. It was 2000 compliance developed. implemented throughout most of our Community Care Areas. EU PROJECTS: The Management Services TRAINING AND SUPPORT: Department successfully bid for two Over 1,000 training courses in EU projects in 1997, Intercare and information technology were SITYA, in partnership with a provided to staff throughout the number of health agencies. These Board, in our fully equipped, state-of projects will allow the EHB to -the-art training rooms in Dr. develop enhanced services in Steeven's and St. Mary's Hospitals. particular using Internet technology While clerical/administrative staff to link GPs, hospitals and have traditionally availed of these community services (Intercare] and courses, there is now an increasing to develop information Support for seamless care (SITYA). number of professional grades participating. NEW IMPLEMENTATIONS: With over 1,500 users of personal computers in our Board and with an A pilot implementation for our expected grown in the area, we network infrastructure was initiated anticipate that we will support in Wicklow and will form the between 2,500 and 3,000 users blueprint for major network before the end of 1999. implementations during 1998. This infrastructure will provide improved While providing support for existing communications, direct dial systems, the Department also facilities, electronic mail and a provides assistance in buying, new platform for modern applications. equipment an in offering access to the soon to be established . Eastern Health Board staff learning their New email service: way around computer software package's 'Information Technology Resource in the Computer Training Room at A central 'electronic mail post office' Unit' for staff interested in a broad Dr. Steeven's Hospital during one of a was installed in Dr. Steeven's range of information technology number of training sessions held during the year. Hospital. This electronic mail topics.

.in Eastern Health Board mj Bord Slainte an Oirthir ANNUAL REPORT 1997

The Technical Services Department health centres in Athy and Kiltegan provided professional technical and on the extension and advice and support to our Board on refurbishment of existing centres in matters relating to buildings, plant Baltinglass, Lusk, Coolock and and equipment. Centenary House, Dun Laoghaire. Planning and design of new health Technical Naas Hospital Development - Sketch centres in Fortunestown, Celbridge, design for the expanded project was Newbridge, Bray, Ballymun, Cherry prepared. Orchard, Darndale and Derrinturn Services were advanced. J.C.M. Hospital Development -

Preparation of the planning brief Special Care Units for Children - Department continued and a design team Planning and design of Special Care appointed. An extension to the X-ray Units for Children in St. Loman's department to accommodate the C.T. Hospital and St. Ita's Hospital were Scanner was designed and 'progressed. constructed.

The New Health Centre in Kiltegan, Co. Wicklow.

St. Columcille's Hospital - Upgrading Developments for Persons with of the electrical systems was Learning Disabilities - alterations completed. Design of the extension and refurbishment of Madonna to the X-ray Department to accom­ House as a residential development modate the C.T. Scanner began. was completed and planning and design of a similar development at Community Units for the Elderly - Oldtown, Co. Dublin was The new Community Unit for the progressed. elderly on the South Circular Road was completed. Building of similar Mental Health - Planning and design units at St. Clare's began. Planning work for the refurbishment of Gallan and design of units in Lusk, Dalkey, House, Howth Road, and Units M & Maynooth and for the 2nd unit at St. N, Reilly's Hill, St. Ita's Hospital was Clare's were advanced. completed.

Health Centres - new health centre Drug Services - The extension and developments in Swords, Deansrath, refurbishment of Cuan Dara Detox Killinarden, Brookfield and Howth Unit at Cherry Orchard Hospital was were completed. Work began on new completed.

Eastern Health Board Bord Slainte an Oirthir ANNUAL K R P O K T 19 9 7

The now v k ••'•' Health 6¾.:,i;i ' <<• W*-,- Oentre in la—; Tuk"

FIRE SAFETY Hospital, Athy, and continuation of total energy consumption of over the upgrading of building services in £3m. per annum and are a good The Fire and Safety Officer St. Columcille's Hospital. indicator of overall trends. continued the Fire Safety Training Programme with the staff. Mainly due to the milder weather in ENERGY MANAGEMENT 1997 there was a decrease of 4% in Fire safety works commenced in St. energy consumption in the buildings The Technical Services Department Ita's Hospital during the year. under review. This resulted in a 3% increased the monitoring of energy decrease in energy costs. PLANNED MAINTENANCE consumption in our Board's PROGRAMME buildings. WASTE MANAGEMENT Major works undertaken during the Energy consumption in over thirty of year included: our Board's hospitals and homes are The Department now advises on the now monitored on a monthly basis. Board's Waste Management Policy to Phase 2 of the replacement of the These buildings account for reduce the amount of waste heating system in St Vincent's approximately 75% of our Board's generated.

The now Health Centre al Killinurden, Talluuhl.

Eastern Health Board Bord Sl£inte an Oirthir ANNUAL REPORT 199

modern health centre. The Major reviews of services at St. Ita's redevelopment of the former Hospital, Portrane and St. Brendan's Shopping Centre Units at Deansrath, Hospital, Grangegorman, were Clondalkin, were completed during initiated in 1997 and from the the year and its redesign as a health Estates viewpoint it is expected that centre proved most successful. significant developments will take place in 1998. Estate Negotiations for community residential houses for our Special Risk Management/ Management Hospital Care Programme were ongoing in 1997 at Tallaght, Lucan Insurance and Newcastle, Co. Dublin. Department A comprehensive Risk Management Review was completed in 1997 and Our Board also acquired a house at was presented to Management Team Main Street, Tallaght, immediately during the year. beside our existing premises, for the expansion of services here for our The review highlighted trends in AIDS/ Drugs Programme. incident reporting, occupations most at risk, identified problems regarding For the purposes of valuations our On the Acute Hospitals side the the reporting of incidents and Board's estate is not linked to the new Ambulance Base at Arklow provided an analysis of sample open values of the property market was completed on a site acquired claims settled during the year. This but is based on the determination of some years ago from the local UDC analysis shows that through prudent its reinstatement values. This and a new, state of the art 50 bed risk management, injuries and increased again in 1997 and our Community Unit for the Elderly was ultimately claims are avoidable. estate now has a gross reinstatement completed on a site at Griffith value of £440m. Barracks on the South Circular Road A review of our insurance premiums in Dublin. With the development of the five also took place. Our public liability programme structures within our premium remained at the same level On the disposal front, over 100 Board and continuing expansion of despite an extension in the level of acres of land surplus to services, it was a busy year for the cover provided. The theft and money requirements at James Connolly Estate Management Department. policies were combined with the all Memorial Hospital were risk policy at no extra cost, resulting successfully rezoned during the A house in Balbriggan and a small in a saving of £14,000 in premia. An year and will be put on the market residential complex in the South additional premium of approxi­ in mid 1998. Inner City was acquired for our mately £43,000 due as a result of an Child Care Programme. increase in our fleet under our motor The sale of some 25 acres of land policy, was waived as a result of our surplus to requirements at St. A premises was acquired in long-term claims experience for this Loman's Hospital towards the end Castledermot and plans are policy. Similarly, our computer of the year made a record £8.2m. advanced to convert it into a premium was reduced due to our healthy claims experience.

St. Paul Ireland Insurance Company were appointed as operators of the medical indemnity scheme from July and a seminar to brief area / hospital managers was held following their appointment.

Risk Management / Insurance is one of the busiest areas within our Board IS^S^STOUil and requires constant vigilance and monitoring to help control the spiralling cost of claims now so readily associated with the public

An artist's impression of the new Blanchardstown Hospital. bodies insurance market.

Eastern Health Board Bord Sl&inte an Oirthir A IN Nil A I. R E P O R T 19 9 7

Eve Holdings With the help of European Regional Development funds, EVE Holdings Eve Holdings is a subsidiary of our has been actively developing new Board and provides vocational and training facilities within the psycho-social rehabilitation community, to standards required by programmes to over 900 people in 23 the National Rehabilitation Board. A locations throughout our area. Subsidiary new service was opened in January The services primarily focus on 1997 in Tallaght to train persons in training and employment to enable the Tallaght/Clondalkin/Crumlin Companies persons with a variety of disabilities to achieve their full potential in their The ongoing development of new local communities. training facilities will continue in EVE Holdings has 23 centres in three 1998 and form an integral part of our categories - resource, training and strategy to provide comprehensive enterprise. There are currently about community persons with disabilities. 896 persons in the service and there A new General Manager was is an annual turnover of 300 people. appointed to EVE Holdings in May More than 85 per cent of those in 1997. A comprehensive and strategic Eve Holdings are persons with review of the organisation began in mental health difficulties. 13 per 1997 and is due to be completed in cent have learning disabilities and early 1998. This is aimed at two per cent have physical developing a three-year strategic disabilities. plan to drive the service development into the new Sixty per cent are male and 40 per millennium. cent are female. Seventy per cent are over 35 years and five per cent are Verville Retreat Ltd. old age pensioners. Clients come from all over our area of Dublin, The company's principal activities Wicklow and Kildare. They are are the treatment of patients with a referred by community mental mental illness and the provision of health teams, community learning accommodation for such patients. disability teams and the National Rehabilitation Board. Bradog Trust Ltd. This company provides housing facilities in the community for persons with special health and social needs

Eastern Community Works Ltd.

The company is primarily engaged in the provision of essential repairs to the homes of elderly persons. The company also acts as a payments bureau for a number of community based services.

Revolve Ltd.

The company is engaged in the supply of wheelchairs to the health service and the carrying out of repair Staff of the Bureau at Dr. Steven's Hospital. and re-cycling services for chairs.

Eastern Health Board Bord Slainte an O i r t h i r ANNUAL REPORT 19 9 7

range of health and personal social services we our Board provides was THE SUNDAY BXJaNF^S TIMES ^ r-oirntit. ami r «:<».< published by the Irish Times in October.

Our Department provided continual support on communications to all the Programmes and Functions. In Communications Department line with our Board's commitment to openness and transparency, we dealt with an average of over 100 queries a week from local regional and national print and broadcast media during the year and provided a constant input into breaking news stories to ensure balanced coverage of our services. We organised press' conferences to publicise new initiatives and developments by our Board.

We also had an input into the running of a large number of seminars and conferences.

Mr. Brian Cowen, T.D. Minister for Health and Children who officially opened the Health Boards Freedom of Information Seminar with EHB CEO, Mr. P. J. Fitzpatrick.

With the increasing public and role in organising a video alerting media interest in health affairs, the people to the signs and symptoms of growing emphasis on health meningitis which is being produced promotion and the demands of by the Office for Health Gain and internal communications in such a the Meningitis Research large organisation, 1997 was an Foundation. This is to be released in extremely busy year for the 1998. Communications Department. In October we organised a seminar The Department organised a number for the eight Health Boards on the Information Commissioner of national and local public implications of the new Freedom of Mr. Kevin Murphy education campaigns. Most notable Information Act. The seminar was were the national drive to reduce opened by Mr. Brian Cowen, T.D. We continued to publish and inappropriate use of Hospital Minister for Health & Children. The develop our staff news paper, the Accident & Emergency Departments, new Information Commissioner, Mr. Eastern Health News to provide the hard-hitting campaigns to Kevin Murphy gave the keynote information for staff on Board convey the real effects of Heroin and address. The conference was polices and developments and to Ecstasy use, the establishment of the attended by Health Board staffs from encourage feed back from staff. AIDS/Drugs Helpline and the use of all over the country. During 1997 our Department our ambulances for health initiated and developed a wide promotion. Our Department played a key role in ranging health Website for our the preliminary work for the Board. This site which will be The Department also prepared a implementation of the new Freedom launched in 1998 will be a major campaign for the Office for Health Of Information Act and participates asset to the public and will prove a Gain to cut childhood poisoning in the FOI Steering Committee. though the use of child resistant new and important tool in our containers for prescribed To mark the 25th Anniversary of the Board's mission to improve the medication, which will be launched establishment of the Eastern Health health and social gain of the people in early 1998. We also played a lead Board a special supplement on the whom we serve.

Eastern Health Board Boid S 1 £ i n t e an Oirthir A N N (J A I. RE I1 i i K T 1 9 9 7

The finance department is The Boards Central Purchasing I responsible for providing financial function dealt with contracts valued ! information to support the planning, at approximately £34m during the management and delivery of services year. and to evaluate the ongoing financial performance of the Board. It also The net expenditure of the Board on Finance ensures that suppliers, employees health services amounted to over and contracted services are paid on £468m in 1997 (£387.5m in 1996). time and that income due is In addition almost £78m was spent Department received. In addition the finance on providing Supplementary Welfare function ensures that accounting services which are analysed as standards and controls are applied follows: consistently throughout the Board and that statutory reporting Supplementary Welfare responsibilities are complied with in Allowances £m particular the provisions of the Health (Amendment) (No 3) Act Rent and Mortgage 1996 and the provisions of the Supplements 43.4 Comptroller and Auditor General (Amendment) Act, 1993. Back to School Clothing and During 1997 work has continued on footwear allowances 3.8 improved accounting, management and control arrangements. A new Supply of household goods 0.6 financial coding system was developed to support the new Other allowances 22.0 programme structure which was implemented during 1997 to focus Total allowances 69.8 services around the major care Service Management costs groups. Planning is also far 8.0 advanced with regard to upgrading Total all financial systems to deal with the £77.8 changes necessary for the year 2000, A summary Balance Sheet at 31st EMU and to implement new December, 1997 is set our on the versions of the General Ledger and following pages. other accounting support systems.

PROGRAMME ANALYSIS OF EXPENDITURE AND INCOME 1997

Programme Pay Non-Pay Gross Income Expenditure Expenditure 1997 (Net) £ £ £ £ £

General Hospital Programme 81,167,669 58,947,475 139,055,144 (13,822,841) 125,232,303

Special Hospital Programme 71,246,062 43,482,847 114,728,909 (5,519,110) 109,209,799

Community Care Programme 65,836,878 135,322,662 201,159,540 (5,430,402) 195,729,138

Addiction Services 5,271,000 10,113,000 15,384,000 — 15,384,000

Central Services 8,065,862 18,433,501 26,499,363 (4,046,403) 22,452,960

Total 231,587,471 265,239,485 496,826,956 (28,818,756) 468,008,200

Eastern Health Board Bord Sl&inte an Oirthir ANN U A I. 1¾ E P O R T 1 9 9 7

BALANCE SHEET OF THE EASTERN HEALTH BOARD AS AT 31st DECEMBER, 1997

1997 1996

£ £

Fixed Assets

Tangible Assets £147,040,231 £139,092,268

Current Assets

Stocks 4,281,127 4,001,554

Deferred Income 430,000 193,279

Debtors 48,838,188 42,724,155

Cash at bank or in hand 409,857 255,813

Total Current Assets £53,959,172 £47,174,801

Current Liabilities

Bank Loans & Overdrafts 17,495,176 15,235,159

Other Creditors 53,964,875 44,956,001

Lease Creditors 45,047 102,481

Total Current Liabilities £71,505,098 £60,293,641

Total Assets Less Current Liabilities £129,494,305 £125,973,428

Represented by Capital and Reserves

Revenue Reserves

Non-Capital Income & Expenditure Account (3,928,923) (1,689,157)

Capital Reserves

Capital Fund:-

Capitalisation Account £147,040,232

Less Deficit on Capital Income & Expenditure Account (£14,047,004) 132,993,228 127,469,306

Other Reserves 430,000 193,279

Total Capital and Reserves £129,494,305 £125,973,428

Eastern Health Board Bord Slainte an Oirthir A N N (I A 1. It I: I' O R T I y 9 7

Health Expenditure Analysis Programme Expenditure

Central Services Addiction Services £22.5m £15.3m General Hospital Community Programme Care 1 General Hospital Programme £125m £125m Programme £196m | | Special Hospital Programme £109m | | Community Care Programme £196m

| | Addiction Services £15.3m

I 1 Central Services £22.5m

Special Hospital Programme £109m

Health Expenditure Analysis Pay, Non-Pay and Income

Income £28.8m

Non-Pay £265.2 Pay £231.5m EH Pay 231.5m

| Non-Pay 265.2m

| | Income 28.8m

Health Expenditure Analysis Direct and Indirect Expenditure

Directly Managed Services £403m Grants to Agencies £94m

1 1 Grants to Agencies £94m

1 [ Directly Managed Services £403m

Eastern Health Board Bord Slainte an Olrthir ANNUAL REP O R T 1 <) 9 7

EHB Chairperson, Cllr. Roisin Shortall, T.D. showing Dr. Jim McDaid, Minister for Tourism, Sport and Recreation around the Worth Library. Dr. McDaid visited Dr. Steeven's Hospital to announce a £228,500 European Union Regional Development grant for the establishment of a medical museum in the hospital.

The administration of the new museum, which will show the development of medical practice over the past 250 years is expected to become a premier tourist attraction. It will be supported by the Historical Centre Company and the Friends of the Museum.

Mr. Mick Quinlan, Cllr. Roisin Shortall, T.D. Chairperson, Eastern Health Board, Mr. David Wyse and Mr. Pat McLoughlin, Progrmme Manager, Health Promotion, Mental Health, Addiction and Social Development at the launch of an EHB report on men in prostitution.

Cllr. Roisin Shortall, T.D., Chairperson, Eastern Health Board, the late Cllr. Tom Keenan, Cllr. Thomas Cullen, Chairman, Community Services Progrmme, Cllr. Kevin Ryan and Cllr. Dr. Bill O'Connell at the official opening of the new HealthCentre in Tinahely, Co. Wicklow.

Eastern Health Board Bord Slainte an Oirthir A N Nf U A I R L- P R T 1 9 9 7

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