Minutes of Meeting of the Regional Health Forum West, Held On

Minutes of Meeting of the Regional Health Forum West, held on Tuesday 28 th September, 2010 at 2.00pm in Room 1, Education Centre, HSE Offices, Merlin Park, Galway Miontuairiscí cruinnithe an Fhóraim Réigiúnach Sláinte, ar an Mháirt, 28th Meán Fómhair, 2010 ag 2.00 i.n, sa an tIonad Oideachais, Feidhmeannacht na Seirbhíse Sláinte, Páirc Mheirlinne, Gaillimh.

Chairperson /Cathaoirleach Councillor Pádraig Conneely

Members Present /Comhaltaí i Láthair Cllr Liam Blaney Cllr Michael Hourigan Cllr Tom McNamara Cllr Rose Brennan Cllr Gordon Hughes Cllr Brian Meaney Cllr John Carroll Cllr Colm Keaveney Cllr Michael Mullins Cllr Tom Connolly Cllr John Kelly Cllr Paul Murphy Cllr Joe Cooney Cllr John Kennedy Cllr Annie May Reape Cllr Ger Fahy Cllr Frank McBrearty Jr Cllr Gerry Reynolds Cllr Laurence Fallon Cllr Sean McGowan Cllr Jerome Scanlan Cllr Jimmy Harte Cllr John “Rocky” McGrath Cllr Tony Ward Cllr Imelda Henry Cllr Bernard McGuinness Cllr Seamus Weir Cllr Mary Hoade Cllr Gerry McLoughlin

Apologies /Leithscéalta Cllr Declan Bree Cllr Tim Broderick Cllr Ciaran Brogan Cllr Richard Butler Cllr Catherine Connolly Cllr Michael Crowe Cllr Gerry Murray Cllr Malachy Noone Cllr Kevin Sheahan

In Attendance /I láthair freisin Mr. John Hennessy, Regional Director of Operations, HSE West Mr. Francis Rogers, Asst Nat Director, Human Resources, HSE West Mr. Liam Minihan, Asst Nat Director, Finance, HSE West Ms. Chris Kane, Office of the Regional Director of Operations, HSE West Ms. Catherine Cunningham, Office of the Regional Director of Operations, HSE West Mr. Bernard Gloster, Local Health Manager, HSE West Mr. Pat Dolan, Area Operations Manager, HSE West Sligo/Leitrim Mr. John O’Brien, National Director and ISA Manager (Interim) HSE Mid West Mr. Frank Murray, Area Operations Manager, HSE West, Mayo Dr. David O’Keeffe, Clinical Director, Galway University Hospitals Mr. John Hayes, Area Operations Manager, HSE West, Donegal Mr. Paudie O’Riordan, Chief Ambulance Officer, HSE West Dr. Jacky Jones, Functional Manager Health Promotion, HSE West, Mr. Michael O’Brien, Mayo General Hospital, HSE West Mr. Joe Molloy, Assistant National Director, Estates Dept. HSE West

Apologies /Leithscéalta Mr. Pauric Sheerin, Chief Ambulance Officer, HSE West ______

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301/29/10 Minutes /Miontuairiscí The minutes of the previous meeting held on the 25 th May, 2010 were proposed by Councillor Gerry Reynolds, seconded by Councillor Tom Connolly and adopted.

302/29/10 Matters Arising /Nithe ag éirí Councillor Brian Meaney requested an update in terms of the answers to Questions during the period of the Industrial Action. Action: Mr. John Hennessy undertook to have all replies out to the members in advance of the next meeting of the Forum.

303/29/10 Chairman’s Business /Gnothai an Chathaoirligh Item Deferred

304/29/10 Reports by Chairpersons of Committees/Tuairiscí Cathaoirligh na gCoistí Councillor Tom McNamara, Chairperson of the PCCC Committee reported on the last meeting of the PCCC Committee as follows:

The last meeting of the PCCC Committee took place on Tuesday 7 th September, 2010 in Room 1 the HSE Offices, Merlin Park, Galway. A total of 9 members attended the meeting.

Minutes & Matters Arising Minutes of last Committee meeting on May 11 th were agreed.

Matters arising from the Minutes & Actions: • Page 3 re no. of staff employed by HSE’s Central Business Unit is currently 31, not 32 – this Corporate Planning and Corporate Performance Directorate also includes the Business Intelligence Unit and HealthStat section. • Cllr. Connolly to revert to Forum regarding City Council plans for reconfiguration & upgrade of Westside pitches site; suggestion for HSE (Health Promotion) involvement in future plans. • A/RDO to raise possibility of CE schemes being used to assist in staffing for palliative care day services in Mid- West. • A/RDO to request HSE Estates office to undertake formal assessment on suitability of St. Anne’s premises in Taylor’s Hill, Galway for use by HSE.

Concerns were expressed about high numbers on waiting lists for hospital in-patient public beds who are then referred to National Treatment Purchase Fund – private sector expanding while public beds are being reduced. Councillors also indicated risks involved in change of discharge procedure where patients are released home at a much earlier stage following treatment.

Action – Local management to arrange briefing sessions to apprise local Oireachtas & Forum members them of cost saving measures proposed and impact these will have on local services. These briefings will take place once current discussions with unions have been completed, and in advance of next Forum meeting on 28.9.10.

Finance Dept will provide details of 2008 & 2009 budgets for comparison purposes with 2010 at next Forum.

A/RDO will request Estates Manager to examine issue of HSE-owned empty premises and expenditure on leasing premises by HSE – presentation to be made on this at next Forum.

Update on Croom Orthopaedic Hospital in Limerick will be given to Cllr. Scanlon – reduction in services may be due to annual funded targets being exceeded due to high levels of winter breakages in January.

A/RDO to seek clarification on recycling of Aids & Appliances and reasons why some items, e.g. crutches, are not reused.

AoB A/RDO indicated that the Regional Health Forum office is now amalgamated within the Regional Director of Operations office for HSE West.

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Update on Ballymote primary care facilities provided to Cllr. Bree who will follow up with Sligo County Council.

Next Meeting of the Regional Health Forum, West – PCCC Committee The next meeting of the PCCC Committee will take place on Tuesday 7 th December, 2010 – venue to be confirmed at a later date.

Councillor Austin Francis O’Malley, Chairperson of the Hospital Committee reported on the last meeting of the Hospital Committee as follows:

The last meeting of the Hospital Committee took place on Tuesday 7 th September, 2010 in Room 1 the HSE Offices, Merlin Park, Galway. A total of 17 members attended the meeting.

Minutes & Matters Arising Minutes of last Committee meeting on May 11 th were agreed.

− An update was requested on the rolling theatre closures and what theatres in Galway were actually operational today. A/RDO responded that 16 out of 18 theatres in UHG and both in Merlin Park Hospital were functioning on that day, 7.9.10.

− While praise was given for the various Health Promotion initiatives currently running throughout the West, request was made for a balanced approach to be taken to service reductions and the value of such projects in light of reductions in critical frontline services.

− Interviews for Consultant posts at Portiuncula (Paediatrician, GI & Colorectal) to be held by end Sept; meanwhile, locums are in place.

− Concerns expressed re high rates of absenteeism and queried how much of this is due to staff stress levels being exacerbated by the current climate of uncertainty and service reductions. This level of detail may not be available. Areas with high levels of absenteeism are targeted by HR for intervention – Chris Kane will contact HR and circulate absenteeism rate details for HSE West. − Concerns expressed about recent shortage of staff on night duty at Nenagh General Hospital - General Manager to contact Cllr. John Carroll directly.

− Proposed €50m extension to Sligo General – Cllr. Henry questioned the logic in the current climate for such a project to proceed. Chris Kane clarified that the project has only been approved to proceed to design stage and is for improvement/upgrade of facilities to meet HIQA standards and includes single room isolation requirements.

Current Financial Position – HSE West Bernard Gloster, Acting RDO, presented a briefing made to Galway & Mayo Oireachtas members on 3.9.10 regarding the current financial status of HSE West. This included an overview of the budgetary challenges placed upon HSE West this year and the obligation to break-even by year end, despite budgetary reduction by €128m, and also meet Service Plan targets. The presentation also focussed on actions currently underway and further actions which will be required to achieve a targeted reduction of €12m per month to year end (July figures projected year end deficit of €65.7m). Copy of the presentation was circulated to the Councillors.

Several Councillors indicated their frustration about the lack of communication from HSE management to date and the impossible situation that puts them in with regard to constituents and media.

Concerns expressed by several Councillors regarding current waiting lists (including ENT waiting list for children) and exacerbatory effect of current budgetary shortfall and recruitment moratorium.

Viability questioned of having consultants work two sites both in Sligo General & Letterkenny General rather than patients having to travel for consultation/treatment, Councillors stated that they feel that services should be provided in each hospital and not just because consultant staff have to travel. Chris Kane responded that issue of consultant co-location is not simply travel, but also involves out-patient support staff including nurses, assessment & surgery

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facilities, theatres, etc. So it is more cost efficient to have the consultant based at one hospital but covering the Sligo/Donegal region.

Chris Kane also gave presentation on the financial situation specifically in Acute Hospitals in the region (also circulated to Councillors). By end August 2010 the total no. of beds closed since 2009 was 349. Some have been converted to day beds and some 7-day wards have been converted to 5 day services. Targets for elective surgery have exceeded funded levels in some sites so any further elective surgery in these areas may be curtailed for the remainder of 2010. Day care will replace in-patient care where appropriate and pre-assessment clinics will obviate the need to admit patients a day before surgery. HSE is exploring more efficient ways of doing things and staff and unions have been playing a crucial role in this.

Bernard Gloster, A/RDO, confirmed that there are no plans to downgrade Mayo General Hospital or to close Merlin Park Hospital. Any reduction in services may occur in sites where funded targets have already been exceeded or for quality of care or safety issues. An analysis is underway on acute hospitals in Roscommon and Galway to examine population needs and how services can best be organised to provide services for future.

Action – Local management to arrange briefing sessions to apprise local Oireachtas & Forum members of cost saving measures proposed and impact these will have on local services. These briefings will take place once current discussions with unions have been completed, and in advance of next Forum meeting on 28.9.10.

Update on Croom Orthopaedic Hospital in Limerick will be given to Cllr. Rose Brennan & Cllr. Ger Fahy – reduction in services may be due to annual funded targets being exceeded due to high levels of winter breakages in January.

Issue of Capital funding for Limerick Regional Maternity Hospital was raised.

Chris Kane to circulate members with figures on income currently due to Galway University Hospital from private insurers.

Next Meeting of the Regional Health Forum, West – Hospital Committee The next meeting of the PCCC Committee will take place on Tuesday 14 th December, 2010 – venue to be confirmed at a later date.

The approved Minutes of the Committee Meetings were circulated with the Minutes of the meeting as follows: 1. PCCC Committee Meeting held on the 11 th May, 2010 2. Hospital Committee Meeting held on the 11 th May, 2010

305/29/10 Up-to-date overall finance position on HSE West (Mr Liam Minihan, Assistant National Director of Finance/Mr John Hennessy, Regional Director of Operations) 306/29/10 Overall approach to cost containment and management of services to the end of 2010 (Mr John Hennessy, Regional Director of Operations, supported by relevant Area Operations Manager)

The Chairperson suggested that Items 5 and 6 be taken together. This was proposed by Councillor Colm Keaveney and agreed by the meeting.

Mr. John Hennessy gave a briefing to the Forum members. He outlined the context, the HSE priorities, the challenges in which the HSE operates and the Management approach and highlighted the actions underway to date. He also set out the further requirements that would be necessary in terms of accelerated controls between now and the end of the year.

Mr. Liam Minihan, Director of Finance, then gave a briefing outlining the financial performance and the current year end deficit projection.

Following the Presentations, there was a Question and Answer session with all members. The key issues from this discussion are as follows:

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• Many members expressed concern with regard to the clarity of the additional actions that are required between now and year end. Mr. Hennessy advised members that briefings have been provided locally to politicians, unions and staff and that the last quarter would be a continuation of reductions and management of services efficiently that delivers service within the budgetary constraints.

Action: It was agreed that local briefings would be held in the last week of October to update members both on the September outturn and further actions required.

• Many members expressed the view that we should be able to carry over the projected deficit of €49.5M into 2011.

Mr. Minihan advised the meeting that we are legally obliged to break even in 2010 and it is not possible to operate a rolling budget.

• Many Councillors asked as to what was the position with regard to deficits at local sites. Mr. Hennessy advised the members that key priorities are patient safety and quality of service within allocations and that no assurances could be given to any individual site as there is an absolute requirement on HSE West to break even.

• There was a considerable discussion in relation to the amount owed by Private Health Insurers.

Mr. Liam Minihan advised the meeting that outstanding private patient debt at end June was €42m. Of this €32m relates to current year and €10M is over 1 year old.

Action: Mr. Liam Minihan agreed to provide a more detailed breakdown of the €10M debt and the reasons behind it.

• Many members expressed concern at the reduction in Home Help Services in the community.

Mr. John Hennessy advised the members that the Home Help Service is a protected service and will continue to be a priority so that we deliver on targets set out in the Service Plan for 2010. However, he advised that this service, together with all services, will continue to be reviewed to ensure that there is ongoing efficiencies and value for money.

Action: Catherine Cunningham to provide update in relation to Home Help figures for Roscommon and Mayo to Councillor John Kelly.

• Some Councillors expressed concern in relation to absenteeism rates at various sites.

Mr. Francis Rogers advised that absenteeism across the West is currently 5% which has a cost of €5M for the West and that a reduction of 1% would achieve a €1M saving. Mr. John Hennessy confirmed that there are ongoing initiatives to address this absenteeism level as the continuation of current practices with reduced resources would put additional pressure on frontline services.

There were queries in relation to the cost of rent in the HSE West and in relation to vacant properties.

Mr. Joe Molloy advised that significant progress has been made in relation to the management of all properties and that a single approval process for the entering into new arrangements has now been agreed. He advised the members that a 10% reduction in cost in the period 2008 to 2009 had been achieved and that the current focus is on the most expensive and those most closest to end of lease.

There were number of queries in relation to the indicative budget reduction for next year.

Mr. Liam Minihan advised that based on current indications, it is likely that the HSE will be required to seek 600m to 700M in savings in 2011. He advised that the reduction for the West would be dependent on a number of budgetary decisions

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and that it would be difficult, at this point, to assess the level of reduction for the West. However, he did confirm that all Local Managers are assessing activity levels for 2011 based on a potential reduction of €80M.

At 5pm, it was agreed to suspend the Standing Orders to clear the Agenda.

Concerns were expressed by a number of members about under funding in the West.

Mr. John Hennessy confirmed to members that recent resource distribution reports would suggest that funding actually favours the West but there are then disparities within the West and these would be examined in the context of 2011.

Agenda Item 7 This item was dealt with in the terms of the general responses.

308/29/10 Questions /Ceisteanna The answers to Questions were circulated to members. However, at 6.20pm, as there was no longer a quorum available, the meeting concluded.

W29Q634 – Cllr Tony Ward Can the HSE please inform the meeting of what plans are in place to save €5.5M at Portiuncula Hospital, Ballinasloe and €1.8M at Roscommon County Hospital by the end of the year? Where does the HSE intend to make the savings? HSE Reply: Response to follow as soon as possible.

W29Q635 – Cllr Tony Ward Can the HSE please inform the meeting of how many Home Care Packages and Home Help hours were provided in Co. Roscommon to date for 2010 and what the budget was for 2009 and 2010? HSE Reply: The number of Home Care Packages to date for 2010 for Roscommon is 190. The 2009 HCP Budget is 1238071 The 2010 HCP Budget is 1290173 The number of Home Help hours provided to date for Roscommon is 160,452.

W29Q636 – Cllr Gerry Murray To seek assurances that there will be no further ward closures at Sligo General Hospital and no reduction in frontline staff. HSE Reply: Sligo General Hospital is presently implementing a Cost Containment Plan in order to significantly reduce its current budget deficit. The plan encompasses a whole series of measures across all areas of Pay, Non Pay and Income. The plans are designed as far as is possible to minimise the impact on service delivery and front line services. At present, 60 beds are closed in the hospital as part of the Cost Containment Plan and these will continue to year end. It is not envisaged at this time that further bed/ward closures will be made, however all matters require to be reviewed monthly in the context of monitoring the savings being achieved. The situation will be reviewed in light of our 2011 budget allocation. Reductions in staff numbers, as part of the Cost Containment Plan, have been subject to discussions with the various Health Sector Unions. These are presently being concluded.

W29Q637 – Cllr Declan Bree Recognising that a commitment was given by the Minister for Health and a guarantee was given by the National Cancer Control Programme (NCCP) that women requiring follow up (surveillance) mammograms would continue to receive the service in Sligo General Hospital and further recognising the fact that to date there is no follow up (surveillance) mammogram service in Sligo General Hospital, I ask that this Health Forum: (a) be advised as to the action taken by the HSE Management to have the guarantee from the NCCP and Minister adhered to. (b) be provided with details of the backlog of patients awaiting mammograms at Sligo General Hospital

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(c) be advised as to whether University Hospital Galway currently has the capacity to deal with any backlog from Sligo General Hospital. HSE Reply: Sligo follow-up patients are being given appointments to attend the symptomatic breast unit in Galway University Hospital for their follow-up mammograms. 13 patients are due their mammogram. A list of 61 patients sent to Galway in the last two weeks have all been scheduled for appointment. Patients attending the Medical Oncology/Radiotherapy OPD Clinics are then referred to Galway for scheduling. The 13 patients outstanding have attended OPD Clinics in late August/September. Currently the two National Cancer Control Programme posts have not been backfilled, this is due to the recruitment moratorium. Galway University Hospital cannot currently provide an outreach service to SGH from Galway due to the radiographic shortages.

W29Q638 – Cllr Declan Bree That the Health Forum be provided with up to date details, including the identity of each property rented by the H.S.E. in Sligo and Leitrim, the purpose for which each property is used by the HSE, the annual rent paid for each property and the rent paid per square ft, the date on which the rental agreement was entered into in respect of each property.” HSE Reply: Response to follow as soon as possible.

W29Q639 – Cllr Declan Bree That the Health Forum be provided with a detailed breakdown of the waiting lists in respect of (a) those seeking in-patient care in each department in Sligo General Hospital, and (b) the number of people waiting for day-case procedures in the hospital, (including those less than 3 months on the waiting lists) and the period of time they are on the waiting lists.” HSE Reply:

W29Q640 – Cllr Declan Bree That the Forum be provided with a breakdown of the number of beds closed in Sligo General Hospital and in every hospital in the Health Forum West region, in December 2008, December 2009 and in September 2010.”

Letterkenny General Hospital No of beds 2008 & 2009 26 Jan – Aug 2010 26 Aug 2010 – to date 19

Sligo / Leitrim Dec 2008 10 Dec 2009 72 Sept 2010 59/61

Galway University Hospitals Dec 2008 64 Dec 2009 100

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Aug 2010 140

Mayo General Hospital Dec 2008 27 Dec 2009 27 Dec 2010 27

Roscommon County Hospital Dec 2008 9 Dec 2009 11 Sept 2010 17

Portiuncula Hospital Dec 2008 Nil Dec 2009 16 Sept 2010 16

Acute Hospitals – Mid West Nenagh Dec 2008 Nil Dec 2009 23 Sept 2010 23

Ennis Dec 2008 10 Dec 2009 34 Sept 2010 41

St. Johns Dec 2008 24 Dec 2009 10 Sept 2010 24

Croom Dec 2008 Nil Dec 2009 Nil Sept 2010 13

Mid West Regional Hospital Dec 2008 15 Dec 2009 15 Sept 2010 45

W29Q641 – Cllr Michael Mullins Can I ask the Director if he agrees that Portiuncula Hospital is being given an unrealistic financial challenge, in light of the fact that the their ability to generate income is being severely restricted by the non filling of Consultant Surgical Posts and is it true that their income is further decreased by case mix losses, which is directly linked to Hospital activity?. HSE Reply: The delay in the non-filling of Consultant Surgeon posts at Portiuncula Hospital has had a direct effect on surgical referrals to the hospital and associated income. I can confirm that the two vacant Consultant Surgeon posts have recently been advertised and we are awaiting the interview process to commence.

W29Q642 – Cllr Michael Mullins I understand that Portiuncula Hospital has the capacity to generate significantly more private patient income, given that it has 23 Private Beds and 46 Semi Private Beds. Will the HSE consider using this capacity to help reduce the long waiting lists in some of the other Hospitals in the Region, and help ease the financial pressure on Portiuncula? HSE Reply: Portiuncula Hospital has well established existing links with UHG. The Hospital wants to continue to strengthen, explore and develop services in an effort to alleviate waiting lists at other hospitals in the Region.

W29Q643 – Cllr Michael Mullins

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Can the HSE confirm if there is a significantly higher level of Corporate Staff in the HSE West Region than in parts of the Country? My information is that in the Dublin/Mid Leinster area, there are 496 Corporate employees to a total of 32,000 others, while in the HSE West Region, there are 825 Corporate staff to 26,000 others. HSE Reply: The table below details position regarding Corporate staff in the four Areas of the HSE. The corporate staff % is similar in the West and South as against the Dublin Mid-Leinster and Dublin North East, which is less. However, it should be noted that Area West is made up of 3 former Health Boards (North West, West and Mid West) whereas the other areas are made up of 2 former Health Boards. Also, the corporate functions across the Areas are not similar because of function developments over the years and function redeployments to front-line services. A more detailed analysis of corporate functions make-up in each Area is being prepared.

HSE Area Total Corporate WTE Corporate % West 26,795.00 813 3.03 Dublin Mid-Leinster 32,828.00 473 1.44 Dublin North East 23,865.00 322 1.34 South 24,750.00 714 2.88

W29Q644 – Cllr Michael Mullins When will the Director be in a position to bring his proposals for the Galway/Roscommon Hospitals to the elected members for discussion? HSE Reply: Director will be in a position to provide a position for the Galway/Roscommon Hospitals in Quarter 4 (Oct - Dec) 2010

W29Q645 – Cllr Sean McGowan At the September meeting of the Regional Health Forum West, I will ask the Executive what are the plans for the continuation of the Rheumatology service in Our Lady’s Hospital Manorhamilton, there is a lot of concern within the locality that the service is to be re-located to Sligo General. HSE Reply: There has been much change within the Rheumatology Service in the North West Region over the past 2 years. 2 Permanent Consultant Rheumatologists were recently appointed who will have responsibility for the delivery of the service across the region of Donegal, Sligo and Leitrim. This is a significant step forward for the Region given that for the last number of years, the service was delivered by locum Consultants – the result of which are significant waiting lists for patients requiring treatment and review. There is a clear need to ensure that the service is delivered in line with best practice as outlined in a number of National and International Reviews (including the Comhairle Rheumatology Review 2004 and Irish Society of Rheumatology recommendations). In line with this therefore, the acute inpatient service for the Region will be delivered in Sligo General Hospital. Key to this decision are factors such as gaining training recognition for junior doctor posts within the service, and the provision of the Acute Inpatient Service in an Acute Hospital setting. Both day case and outpatient sessions will continue to be provided in Our Lady’s Hospital as well as Inpatient Rheumatology rehabilitation. Treatment practices have changed dramatically over recent years in Rheumatology with the move to day case treatments where previously patients would have required longer inpatient stays. In line with this therefore, there will be a reconfiguration of beds in Our Lady’s Hospital. Discussions are taking place within the service as to how this will be implemented as well as the potential to utilise some capacity in the delivery of medical day service treatments from SGH. We will continue to review the provision of the service across the region over the coming months. It is our aim to deliver the most responsive service possible to all patients within the region, however, within the context of staffing reductions and financial constraints.

W29Q646 – Cllr Sean McGowan At the September meeting of the Regional Health Forum West I will ask the Executive, has any progress been made with regard to restoring the G.P service one day a week in the Primary Care Centre in Dromod. The local community are anxious that the GP service be restored as quickly as possible. Has any progress been made with

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the provision of a Chiropody service, and also at a time when Diabetes and obesity are on the increase in the Country that the Diabetic nurse would hold a clinic at the centre once a month? HSE Reply: The GP’s in Mohill, at our request, opened a clinic in Dromod each Tuesday for a number of months. However, the GP was only seeing 4-5 patients which did not justify the presence of a GP at the PCCC. The HSE, therefore, does not have any immediate plans to restore the GP service to Dromod as the costs would not justify the provision of a service particularly when all GP services are delivered in Mohill and Carrick-on-Shannon. Chiropody patients are presently seen in both Mohill or Carrick-on-Shannon and the HSE have no plan to provide a Chiropody Service in Dromod. The waiting list for Chiropody Services is not significant at present. Sligo/Leitrim Primary Care Services employ 0.9 WTE Diabetes Nurse Specialists. The Nurse works 2 days per week in Leitrim and West Cavan supporting 8 General Practices. It is not currently planned to provide a clinic at Dromod PCCC.

W29Q647 – Cllr Sean McGowan To ask the Executive what is the up to date position in relation to the provision of the new Community hospital / day centre at Carrick-on Shannon and has a design team been appointed for the Community Nursing unit in Ballinamore, when is work scheduled to start on the project? Has the funding been secured for both of these projects? HSE Reply: The member will be aware that the 2006 – 2010 NDP Plan provides for the development of a Community Nursing Unit (20 bed), a Day Centre for Older People and a Primary Care Centre in Ballinamore. Approval to appoint a Design team and progress to tender stage was granted in April 2008. Design Stages 2 and 3 are completed and Leitrim County Council granted Planning Permission for the development on the 26th November 2009 (subject to a number of conditions). The Design Team are now finalising detailed design documents, tender drawings and contract documents. Application will be made to the National H.S.E for inclusion in the 2011 – 2016 NDP plan, and for approval to procure contractors to complete the proposed works.

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W29Q648 – Cllr Jerome Scanlan I will ask at the September meeting as to the total spend by the HSE West on the Rental of properties within our executive area in each of the last 3 Financial years and what the total projected rental spent for 2010 is expected to total.

HSE Reply:

Total Projected Rental spend for 2010

MidWest 2010 2009 (projected) full year amt €1,666,557 €1,713,503 year to date (end Aug) €1,111,174 €1,167,279 year to date (end Sept) €1,247,745 €1,301,775

West Year to date - 2010

YTD Aug09 YTD Aug10 2 017777-33706 D A 81,356.59 96,541.95 RENT UCHG 2 027777-33706 D A 0 0 RENT Merlin Park 2 117777-33706 D A 49,543.48 52,620.91 RENT MGH 2 127777-33706 D A 286.16 284.49 RENT RCH 2 167777-33706 D A 5,768.61 5,453.54 RENT Ambulance Service 1 LG7777-33706 D A 1,027,293.13 1,057,219.50 RENT LHO G 1 LM7777-33706 D A 104,455.52 100,975.12 RENT LHO ME 1 LR7777-33706 D A 515,792.28 413,711.38 RENT LHO RC 570,150.60 582,653.02 RENT Other (Corporate incl NHO and PCCC HQs) 1 007777-33706 D A 2,354,646.37 2,309,459.91 RENT TOTAL WHB (excl PH)

Summary 2007 2008 2009

5,516.07 53,075.10 324,068.33 RENT UCHG 0.00 0.00 0.00 RENT Merlin Park 1,781.60 50,777.60 67,086.89 RENT MGH 0.00 0.00 572.32 RENT RCH 12,675.02 11,742.21 8,428.93 RENT Ambulance Service 1,960,051.48 2,056,567.20 1,411,905.10 RENT LHO G 41,669.66 95,821.08 62,351.88 RENT LHO ME 873,893.54 779,799.69 645,390.51 RENT LHO RC 611,262.36 587,605.23 801,396.11 RENT Other (Corporate incl NHO and PCCC HQs) 3,506,849.73 3,635,388.11 3,321,200.07 RENT TOTAL WHB (excl PH)

North West Please see YTD Rents for 2009 &2010 as requested. There may still be some accruals outstanding for Sept 2010.

Analysis Acct_descp_1 2009 2010 Basis 403940 RENTS €2,815,617.08 €2,897,293.04 Aug YTD 403940 RENTS €3,205,560.15 €3,027,814.55 Sept YTD

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Year to date HSE West figures – Summary:

NorthWes t reduced by €200k

MidWest reduced by €50k

Galway, Mayo, Rosc reduced by €45k

Total reduction: €295k

Estimated annual reduction €350k approx.

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HSE West Property Rentals & Vacant Properties

Location Number of Number Number Comments Cost Cost Cost non Leasehold of Properties of Vacant 2009 2008 2007 Properties Leased Properties

Donegal 136 92 13 Planned for disposal, 4 currently under review

Sligo Leitrim 95 81 3 Planned for disposal

Total NW 231 173 16 €3,723,116 €4,522,230 €3,870,965

Mayo 135 37 3 2 Planned for disposal

Roscommon 54 19 2 Planned for disposal

Galway 217 139 6 Number of disposals in hand. Others in review/planning Total GMR 406 195 11 €3,321,200 €3,635,388 €3,506,849

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Reviews and Disposals under Total MW 215 80 14 way/planned €1,713,502 €1,783,929 €1,925,814

Total HSE West 852 448 41 €8,757,818 €9,941,547 €9,303,628

Vacant properties include 8 Sites 19 Former Health Centres/Dispensaries

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W29Q649 – Cllr Jerome Scanlan I will ask what the annual budget for Croom Orthopaedic Hospital was in each of the last 3 Financial years what the actual out turn was against budget, how this years point in time performance is against budget and what the budget totals. HSE Reply: The Management Account details for Croom Orthopaedic Hospital are as follows: Year Budget Actual 2007 13,698,797 13,158,783 2008 13,376,980 14,514,613 2009 12,168,461 13,858,874 2010 6,546,517 8,713,786 - FOR THE PERIOD JAN. TO AUGUST. The 2010 Budget is currently 9,911,883.euro.

W29Q650 – Cllr Annie May Reape When will the Rheumatology Clinic commence at Mayo General Hospital now that there is more than one Consultant in Galway - this is a long standing request by the 20,300 people suffering from Arthritis in Mayo. HSE Reply: Neither of the existing consultants have a contractual commitment to MGH but a proposed appointment under the QCCC initiative will have a sessional commitment.

W29Q651 – Cllr Austin Francis O’Malley How many occupational therapists are employed by the H.S.E in the west region and how many patients are on a waiting list? HSE Reply: Total Occupational Therapy grades in Area West @ 20 th September 2010: 254

Local Health Office Waiting List North Tipp/East Limerick 1000 * (122 of which relate to Children’s Services / in partnership with Enable Ireland) Limerick 850 Clare 268 Roscommon 178 Galway 1033 Mayo 245 Donegal 302 Sligo / Leitrim 335

W29Q652 – Cllr Pádraig Conneely Why was the Contract for Mr. Ciaran Brady, Consultant in Paediatric Urology, not renewed by UCHG? How many patients are awaiting treatment in this Department and how many children are on the outpatients waiting list? HSE Reply: Mr. Ciaran Brady was employed as a Locum Consultant Urologist covering the leave of the other 4 Consultants over a 2 year period. He particularly covered and supported Mr. Rogers as he was developing and implementing the Rapid Access Prostrate Cancer Programme. This Programme increased the volume of cancer patients attending the Hospital. To support Mr. Rogers further as the Cancer Service was expanding, Mr. Brady commenced on a full-time Locum bases in February 2010 until August 2010.

In August 2010, Mr. Durkan commenced employment as a Cancer Urologist to support the growing need for cancer surgery and to expand the National Cancer Screening Programme. Mr. Brady was a General Urologist with a Special Interest in Paediatric Urology using spare capacity when other Consultants were away. Mr. Brady used the vacant Theatre and Clinics to see children and remove them from the waiting list.

Any spare capacity now available is used for the treatment of urgent cancer patients by Mr. Durkan. Any Paediatric Urology patients either waiting for surgery or to be seen by a Urologist have been transferred to Crumlin Hospital Paediatric Service.

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W29Q653 – Cllr Pádraig Conneely How many patients are on the outpatients waiting list for appointments at UCHG and Merlin Park across all Departments in both Hospitals and what is the waiting time for patients at both Hospitals for appointments and the number of years on both waiting lists? HSE Reply: Waiting List – June 2010 0 - 3 3 - 6 6 -12 12 -24 24 -36 36 - 48 Out Patient Months Months Months Months Months Months 48 Months+ Total Anaesthetics 40 51 85 139 69 0 0 384 Cardiology 149 10 44 53 19 0 0 275 Clinical Immunology 37 41 1 0 0 0 0 79 Clinical Pharmacology 5 2 6 16 54 2 0 85 Dermatology 556 381 827 1449 201 0 0 3414 General Medicine 386 204 280 414 272 55 0 1611 General Surgery 851 350 421 263 15 0 0 1900 Geriatric Medicine 26 1 1 6 0 0 0 34 Gynaecology 437 343 83 3 0 0 0 866 Haematology 52 49 41 21 0 0 0 163 Nephrology 28 28 81 141 103 110 0 491 Neurology 289 113 213 304 129 18 0 1066 Obstetrics 119 3 0 0 0 0 0 122 Ophthalmology 524 218 312 405 50 0 0 1509 Oral Surgery 325 225 333 334 4 0 0 1221 Orthopaedics 842 574 989 1003 455 309 52 4224 Otolaryngology (ENT) 620 549 873 1298 1047 368 0 4755 Paediatrics 125 132 109 43 1 0 0 410 Plastic Surgery 735 352 444 472 153 0 0 2156 Respiratory Medicine 0 0 1 21 0 0 0 22 Rheumatology 254 144 228 227 39 0 0 892 Urology 450 320 451 688 384 44 0 2337 Vascular Surgery 258 172 229 431 260 36 0 1386 Total 7108 4262 6052 7731 3255 942 52 29402

W29Q654 – Cllr Pádraig Conneely What is the current status of St. Francis Nursing Home, Newcastle Road, the current number of patients, how many beds closed and what is the number of patients on waiting list for admission? HSE Reply: The future of St. Francis as a long-stay unit has been reviewed over a number of months. Extensive discussions have taken place with all interested parties arising principally from inspections by HIQA (Health Information & Quality Agency) and the standards set down by HIQA for all nursing homes. These new standards for nursing homes cover inter alia the physical structure of buildings, numbers of toilets/showers, family rooms, meeting rooms etc. A significant difficulty was posed for the HSE, as complying with the recommendations would mean reducing the number of bedrooms at St. Francis CNU to meet HIQA’s demand for single en-suite rooms. A family visiting room, large sitting room and space for storage would also have had to be facilitated. All of these would have lead to major costs and a 50% reduction in bed numbers. HIQA did note that the work and care being given to the residents at St. Francis CNU was exemplary, and the unit was highly commended from both a nursing and care assistant point of view, as well as for food preparation, hygiene and all other care needs.

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Following discussions, it was decided that the refurbishment and reconstruction required for St. Francis CNU to continue as a long-stay unit was not a viable option. Therefore, the current status is that this community nursing home cannot be brought up to the standards demanded by HIQA because of its age and the physical structure of its buildings. An increasing demand for Day Care services at both the HSE unit in Knocknacarra and St. Francis CNU and the increasing requirements for home-care packages, as well as the need to assist more elderly persons to remain in their own home for as long as possible, has led to the decision to pursue the day care option at the facility. Following consultation with staff, unions and medical experts, the HSE is proposing that St. Francis Community Nursing Unit, Newcastle Road, Galway be developed into an enhanced Day Care facility operating from 8 a.m. until 8 p.m. daily. HSE Managers will be working with our maintenance department and the staff at St. Francis with a view to making alterations to the building in order to provide this very necessary service. Some of the Day Care services that will be provided at St. Francis CNU include meals, laundry, showering/personal care and medical care from the adjacent Primary Care Centre. Allied health professional services which will also be developed on the site include Physiotherapy, Occupational Therapy, Speech & Language and Chiropody. There are currently 28 residents in St. Francis CNU, to be reduced to 27 next week as one resident is transferring to a Nursing Home in Mayo. That will leave 11 beds closed and it is our intention to continue with long-stay until the numbers reduce to 10-15. We will then look at the possibility of transferring clients to other locations. There is no waiting list (because we will not be admitting new patients to the Unit).

W29Q655 – Cllr Pádraig Conneely How many patients did UCHG and Merlin Park refer to Private Nursing Homes for after care in 2008, 2009 and to date for 2010? HSE Reply: 2010 – MPUH and UHG (GUH) = 275 2009 - MPUH and UHG (GUH) = 616 2008 - MPUH and UHG (GUH) = 945

W29Q656 – Cllr Mary Hoade Now that planning has been granted for the Ambulance Base in Tuam, what is the reasonable time frame to except the station to be built and up and running. Has the HSE considered redeploying staff from within your own resources to Tuam, all be it on a temporary basis. If capital funding is not forthcoming in this year's budget to construct and open this Ambulance Base, will the HSE consider the offer made to them by Galway County Council, to use an existing premises in Tuam, or should funding be an issue, will the North Galway/South Mayo be left without an ambulance base. HSE Reply: To date funding has been received to progress the Tuam Ambulance Base project to Tender stage in 2010. It is expected that the project will go to Tender in the 4 th Quarter of 2010 or 1st Quarter of 2011 depending allocations of monies in the 2011 Capital Plan. It would therefore be toward the end of 2011 or early 2012 before the project is completed once funding have been allocated in the 2011 Capital Budget. While consideration to the redeployment of staff has been given, no decision has been made at this time. A full impact analysis needs to be carried out and with the demands being placed on the service within the region at present, redeployment is unlikely to happen in the short term. Consideration has been given to the generous offer by Galway County Council however, the primary issue to opening the Tuam Ambulance Base at present is not a location for a base but the staffing and funding to operate.

W29Q657 – Cllr Mary Hoade What is the Current waiting list time from when a child is referred to the Orthodontic Department until they are assessed, and treatment begins. HSE Reply: Response to waiting times for Orthodontic Treatment. 6 months for assessment and 10 months for treatment. L

ate Question

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W29Q658 – Cllr Mary Hoade Can you confirm to me what is the current situation regarding the appointment of a Senior Audiologist Scientist in the Galway area. When was this post last advertised, and how many applications did we receive. Can you confirm to me if this post is outside the embargo on recruitment. HSE Reply: Since 2002, strenuous efforts have been made to appoint an Audiological Scientist to address the needs of hearing impaired children under the age of 5 years. In spite of repeated attempts to recruit someone with the appropriate qualifications, we have been singularly unsuccessful due to the lack of eligible candidates. We have attempted to fill this vacancy on at least 8 occasions and the post was last re-advertised on 11 th January 2009 with a closing date of 29 th January 2009. The Competition was dealt with by Central Recruitment, Merlin Park. There were four applicants. The four were deemed eligible. Two overseas candidates withdrew their applications after some deliberation. Interviews were arranged for 8 th April, 2009 for the remaining two eligible applicants. This post has been impacted by the implementation of the moratorium and as a result the interviews did not take place. As we are extremely conscious that the initial assessment, fitting and review of children is vital to ensure that they have the appropriate interventions and aids required for linguistic development and as a consequence, improved social skills and educational capacity, we have arranged for a limited service to be offered to those on the waiting list. We employ a Sessional Audiological Scientist who was enlisted specifically to help clear the backlog currently provides a service to us on Saturdays.

W29Q659 – Cllr Catherine Connolly Please clarify the position in relation to the BCG Vaccine and the optimum time for getting the injection and in particular how a waiting list has arisen and the nature and length of the waiting list in Galway City and County. HSE Reply: There are currently 1200 waiting for BCG Vaccination in the Galway Area. Galway have increased clinics to four per month and have held additional clinics in Ballinasloe over July and August to address the waiting list.

W29Q660 – Cllr Catherine Connolly Please confirm the position in relation to the Urology Department and in particular given the recent departure of one Urologist from the Department and given the waiting list of 2,352 on the Outpatient List as of 2 nd July 2010 and 830 on the Inpatient Waiting List as of the same date and please confirm what steps have been taken to fill the post and also to clear the waiting lists giving the up to date figures and also the complement of Consultants and Doctors in the Department. HSE Reply: Mr. Ciaran Brady was employed as a Locum Consultant Urologist covering the leave of the other 4 Consultants over a 2 year period. He particularly covered and supported Mr. Rogers as he was developing and implementing the Rapid Access Prostrate Cancer Programme. This Programme increased the volume of cancer patients attending the Hospital. To support Mr. Rogers further as the Cancer Service was expanding, Mr. Brady commenced on a full-time Locum bases in February 2010 until August 2010. In August 2010, Mr. Durkan commenced employment as a Cancer Urologist to support the growing need for cancer surgery and to expand the National Cancer Screening Programme. Mr. Brady was a General Urologist with a Special Interest in Paediatric Urology using spare capacity when other Consultants were away. Mr. Brady used the vacant Theatre and Clinics to see children and remove them from the waiting list. Any spare capacity now available is used for the treatment of urgent cancer patients by Mr. Durkan. Any Paediatric Urology patients either waiting for surgery or to be seen by a Urologist have been transferred to Crumlin Hospital Paediatric Service.

W29Q661 – Cllr Catherine Connolly Please clarify the position in relation to Cardio-Vascular Disease and in particular re necessary Operations/Procedures at the Regional Hospital: more specifically the number of patients on waiting lists for each speciality within the Cardio Vascular Department and the length of same, further the number of patients who have been referred to private and or other public hospitals under the NTPF in the last three years giving a list of the private and public hospitals and specifically the number allocated to each hospital from the various waiting list and please clarify the position in relation to elective surgery.

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HSE Reply: 1. Cardiac Surgery a. The cardiac surgery waiting list consists of 11 patients b. The longest waiting time is 2 months c. No patient has been referred out to NTPF or any other hospital. 2. Cardiology a. The Cardiology waiting list consists of 526 patients. 78% (411) of these patients are awaiting coronary angiography, the remainder (115 patients) are awaiting other investigations. b. The longest waiting time is 8 months c. No patient has been referred out to NTPF or any other hospital.

W29Q662 – Cllr Catherine Connolly Please give the number of private hospitals and their location in Galway and throughout the Country that public patients from both in patient and outpatient lists for the Regional and Merlin Park Hospitals have been referred giving each medical speciality involved for the last three years. HSE Reply: In relation to In-Patients and Out Patients referred from Galway University Hospitals to private hospitals nationally in the last three years the following are the names of the private hospitals and specialities referred.

In Patients Specialities referred by GUH Bon Secour Hospital, Galway Plastics, Urology, General Surgery, Ophthalmology, Vascular, Orthopaedics, ENT, Pain Relief, Gynaecology. The Galway Clinic Maxillio/Facial, Medical Endoscopy Bon Secour Cork - Beacon Dublin - Mater Private Dublin - St Francis Mullingar - Garden Hill Sligo - Barringtons Limerick - Ault Enven Kilkenny - North West Independent Derry -

Out Patients Specialties referred by GUH to listed hospitals Galway Clinic Medical Endoscopy, Ear Nose & Throat, Neurology, Opthalmology, Plastics, General Surgery, Urology, Vascular.

Bons Secour Galway -

W29Q663 – Cllr Frank McBrearty Jnr How many patients from LGH have had to travel to Galway university hospital in 2008/2009/2010 for biopsies. HSE Reply: Number for patients referred to Galway for prostate biopsy: 2008 - 171 patients referred for prostate biopsy 2009 - 174 patients referred for prostate biopsy 2010 [9 months] - 69 patients referred for prostate biopsy. In addition in 2010 138 new GP referrals were sent to the new rapid access prostate clinic in Galway without initial assessment in Letterkenny General Hospital. No breast patients had to travel to Galway for biopsies.

W29Q664 – Cllr Frank McBrearty Jnr How many patients are currently on the waiting list for hip operations in LGH and how many of these patients as of yet have not been seen by a consultant at LGH. HSE Reply: There are currently 86 patients awaiting a hip replacement operation in Letterkenny General Hospital. All of these patients would have been assessed at an Out-patient clinic by the Consultant prior to being placed on this list.

W29Q665 – Cllr Frank McBrearty Jnr After the Labour court ruling when is LGH going to adhere to this and employ the recommended number of nurses?

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HSE Reply: The outcome of the Labour Court hearing is still being considered, and indeed the full recommendation requires both the HSE and the INMO to engage at national level to agree a new agreement. It would be premature to act in advance of any such discussions and agreement being finalised. This matter cannot be considered in isolation of the HSE Moratorium on recruitment, or the cost containment measures being implemented. LGH have sought to maintain the quality of care and reduce the clinical risks associated with non-replacement of rostered students through the closure of beds within the Orthopaedic Unit and restrictions in activity in Theatre and ICU. It is envisaged these measures will continue until year end at least.

W29Q666 – Cllr Frank McBrearty Jnr What is the current waiting list for Donegal patients awaiting operations with prostate cancer and what is the recommended timeframe for these procedures. HSE Reply: There are currently two patients from Donegal waiting for radical Prostatectomy on Galway University Hospitals in patient waiting these patients are on the waiting list since the 10 th of August 2010. The waiting time for Donegal patients is the same for all patients in the HSE West. The current waiting times are 6 weeks approx from referral to consultation/review and approx 8-9 weeks thereafter for surgery. There is currently no national guideline for these procedures under HIQA or the NCCP .

W29Q667 – Cllr Joe Cooney That the HSE West outlines the funding allocated for the provision of Home Help in Co. Clare for the years 2007, 2008, 2009 and to date in 2010. HSE Reply: The Home Help Funding allocated to Clare PCCC is detailed below Year Allocation** 2007 €4,413,304.00 2008 €4,627,592.26 2009 €3,735,781.26 2010 To End of August €2,547,980.16 **Allocation for Home Help Service only. It DOES NOT include the funding for Home Care Packages

W29Q668 – Cllr Joe Cooney To ask the HSE West why funding was withdrawn for a dedicated Paediatric Urology Service at the University Hospital in Galway and the implications of this decision for children in this region. HSE Reply: Mr. Ciaran Brady was employed as a Locum Consultant Urologist covering the leave of the other 4 Consultants over a 2 year period. He particularly covered and supported Mr. Rogers as he was developing and implementing the Rapid Access Prostrate Cancer Programme. This Programme increased the volume of cancer patients attending the Hospital. To support Mr. Rogers further as the Cancer Service was expanding, Mr. Brady commenced on a full-time Locum bases in February 2010 until August 2010. In August 2010, Mr. Durkan commenced employment as a Cancer Urologist to support the growing need for cancer surgery and to expand the National Cancer Screening Programme. Mr. Brady was a General Urologist with a Special Interest in Paediatric Urology using spare capacity when other Consultants were away. Mr. Brady used the vacant Theatre and Clinics to see children and remove them from the waiting list. Any spare capacity now available is used for the treatment of urgent cancer patients by Mr. Durkan. Any Paediatric Urology patients either waiting for surgery or to be seen by a Urologist have been transferred to Crumlin Hospital Paediatric Service.

W29Q669 – Cllr Brian Meaney What is the policy of the HSE in the Display of Religious Symbols, The provision of religious services customs and practices. The wearing of faith/religious based clothing, including head scarves and veils on institutions controlled, operated and/ or funded by the HSE. HSE Reply: The HSE does not have an explicit policy on any of the above. The HSE is guided by recommendations set out in the HSE National Intercultural Strategy 2007-2012 and the HSE National Intercultural Guide which highlights the need for sensitivity and appropriate accommodation where possible for clients/patients and staff. It is also

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governed by the provisions of the Equality Acts 2008 which require that the HSE treat staff, patients and clients equally and appropriately. The HSE National Intercultural Health Strategy offers clear direction in relation to the importance of providing support for staff who are from diverse ethnic and cultural backgrounds, as well as in supporting all staff in delivering culturally competent services. There is some provision of religious services through chaplaincy services across the country. This information is currently not recorded so it not possible to determine the actual provision of such service. Where this service exists, the provision is usually in a hospital or hospice setting and includes chaplaincy services across the Christian faiths. Provision for patients/clients from other faiths is organised through the support of family members and religious leaders (if available) on a needs basis. The HSE are currently undertaking research with support from the Donegal Peace III Partnership and the HSE National Office for Social Inclusion into the relevance of faith and spirituality in healthcare. The research aims to focus on the faith, spiritual and culture needs of all patients and service users. It is being undertaken in Letterkenny General Hospital and the Donegal Hospice. The purpose of the research is to look at how diverse and complex needs are currently catered for in healthcare and what supports may enable greater inclusive practice on faith, spirituality and culture for all communities. A team of researchers from St. Angela’s College of Education, Sligo are undertaking this research. We are happy to share the outcomes of this research with the Forum and Forum members as it becomes available if this is useful to this discussion. In relation to matters concerning employees while the HSE does not have an explicit policy in relation to the issues outlined above, it is normal practice in hospitals and other care settings to give due consideration to requests from employees regarding the wearing of clothing or symbols with a religious or cultural symbolism, having regard to the clinical and health and safety implications of the particular request. This is also in line with legislative direction as set out in the Employment Equality Acts 1998-2007. Given the recognition of diversity among staff working in hospitals, and indeed, in all sectors of the HSE, it is incumbent on the organisation to accommodate staff cultural needs and beliefs in an appropriate, culturally sensitive manner. www.hse.ie

W29Q670 – Cllr Brian Meaney How many, if any, Tummy Tucks and Breast reductions have been provided through the National Treatment Purchase Fund in the HSE West Area in the Last Five Years. What was the cost of providing these procedures. HSE Reply: Response to follow as soon as possible.

W29671 – Cllr Brian Meaney I request a report detailing the numbers of crutches, wheel chairs and walking aids procured in each county in the HSE West during 2009. The cost of each order for these Items and the number of items in each order. In order to ensure that this information is not deemed commercially sensitive I do not request the names of the companies that supplied these orders, But I do request a general list of the approved suppliers for this type of equipment to the HSE.

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HSE Reply:

Area Crutch Walking Aids WheelChairs No. Value No. Purchased Value No. Value Purchased € € Purchased € Roscommon 84 €2,070 210 €8,200 80 €47,500 2009 (& accessories)

Donegal 322* €15,870 200 €272,879 (PCCC) Galway 2100 €14,500 500 €13.644 2 €330

Mayo 2,025 €20,795 12 €240 €152,193

Sligo / Leitrim 2319* €23,764 * * 324 €157,686 (PCCC & Acute) Acute 6200 €45,105.10 2202 €16,939 0 0 Hospitals Mid West North 2 €88.48 145 €6,680 175 €137,395.25 Tipp/East Limerick LHO Clare LHO 0 0 24 €832 15 €4024

Limerick LHO 0 0 0 0 71 €290,000

*Crutches & Walking aids

List of general suppliers in HSE West : Medifix, Fannin, Crc, Beechfield, Med Surgical Ltd., Trulife Ltd., Mms Medical Limited, Murray Medical Equipment Ltd., O Neill Healthcare, Stylite Designs Ltd, Tools For Living Ltd.

W29Q672 – Cllr Brian Meaney I request a break down of the water and space heating costs at all acute and elderly care units operated by the HSE in the West Region during 2007, 2008 and 2009. What was paid in heating oil, gas and electricity at these units during these years. What plans, if any, are in place to provide water and space heating alternatives. HSE Reply:

LETTERKENNY GENERAL HOSPITAL

2007 2008 2009

Water Charges 96,787 103,494 105,429 Oil 385,318 504,415 317,639 Cooking Gas 9,513 6,369 5,559 Electricity 534,126 619,887 568,335

Total 1,025,744 1,234,165 996,962

St Conals

Water Charges 52,094 99,677 68,102 Oil 86,111 78,073 73,042 Electricity 162,167 137,861 142,685

Total 300,372 315,611 283,829

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DONEGAL LOCAL HEALTH OFFICE AREA

Community Hospitals Oil Gas Electricity 2009 2008 2007 2009 2008 2007 2009 2008 2007 414,024 588,009 418,262 62,847 76,374 42,190 401,192 602,242 420,010

ROSCOMMON LOCAL HEALTH OFFICE AREA

Cost of Heating Oil, Gas and Electricity 2007 2008 2009 Category

Fuel-Solid 702 2 2 Fuel-Oil 288,179 424,508 237,454 Electricity 237,573 305,750 258,775 Gas 20,574 42,265 42,438 Boiler 785 0 0 Other 0 141 42 Total 547,813 772,666 538,711

GALWAY LOCAL HEALTH OFFICE AREA

Solid Boiler 2007 Total Fuel Oil Electricity Gas Costs Other

03 Clifden District Hospital 32,454 15,967 15,203 1,284

37 St. Brendans, Loughrea 143,941 69,026 54,694 20,221

41 St. Francis Home, Newcastle 44,990 12,545 6,376 25,191 853 25

42 St. Annes Clifden 61,014 2,118 24,319 27,985 2,981 3,611

43 Aras Mhuire Tuam 46,131 17,711 26,604 1,816

44 Aras Mc Dara, Carraroe 61,327 35,371 24,037 1,919

52 Aras Ronan, Inis mor 21,702 5,549 14,176 1,147 830

411,559 14,663 174,319 187,890 30,221 3,611 855 100% 4% 42% 46% 7% 1% 0%

Solid Boiler 2008 Total Fuel Oil Electricity Gas Costs Other

03 Clifden District Hospital 52,597 34,398 16,763 1,436

37 St. Brendans, Loughrea 236,819 147,268 64,410 25,141

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41 St. Francis Home, Newcastle 44,978 20,299 5,609 18,307 763

42 St. Annes Clifden 57,289 1,902 37,924 13,349 2,744 998 372

43 Aras Mhuire Tuam 39,215 21,926 13,975 3,314

44 Aras Mc Dara, Carraroe 76,021 44,126 28,992 2,903

52 Aras Ronan, Inis mor 30,803 14,041 14,782 1,600 380

537,722 22,201 305,292 170,578 37,901 998 752 100% 4% 57% 32% 7% 0% 0%

Solid Boiler 2009 Total Fuel Oil Electricity Gas Costs Other

03 Clifden District Hospital 35,086 18,857 15,312 917

37 St. Brendans, Loughrea 138,441 76,387 39,358 22,696

41 St. Francis Home, Newcastle 58,708 19,538 11,631 23,952 3,587

42 St. Annes Clifden 42,418 610 18,306 15,309 2,538 5,655

43 Aras Mhuire Tuam 29,115 14,519 11,704 2,892

44 Aras Mc Dara, Carraroe 59,976 31,492 25,770 2,714

52 Aras Ronan, Inis mor 24,941 7,714 16,563 664

388,685 20,148 178,906 147,968 36,008 5,655 - 100% 5% 46% 38% 9% 1% 0%

MAYO HEALTH SERVICES

2007 Energy Costs Older People and MGH MCC Exp Code Amount Type Ballina District Hospital 13 131101-31402 € 26,487.83 FUEL - OIL Belmullet District Hospital 14 141101-31402 4 € 52,231.23 FUEL - OIL Swinford District Hospital 15 151101-31402 € 32,321.29 FUEL - OIL SHH 38 384401-31402 € 97,763.87 FUEL - OIL Mc Bride CNU 46 461601-31402 € 24,860.06 FUEL - OIL Dalton CNU 47 471601-31402 € 23,036.24 FUEL - OIL St Augustine CNU 48 481601-31402 € 22,532.89 FUEL - OIL St Fionnans CNU 51 511601-31402 € 31,203.38 FUEL - OIL Mayo General €205,142.05 € 515,578.84 FUEL - OIL Ballina District Hospital 13 131101-31403 € 31,906.66 ELECTRICITY Belmullet District Hospital 14 141101-31403 € 33,234.40 ELECTRICITY Swinford District Hospital 15 151101-31403 19,765.36 E LECTRICITY

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SHH 38 384106-31403 € 4,000.00 ELECTRICITY 38 384401-31403 € 97,957.38 ELECTRICITY Mc Bride CNU 46 461601-31403 € 18,028.83 ELECTRICITY Dalton CNU 47 471601-31403 € 26,763.75 ELECTRICITY St Augustine CNU 48 481601-31403 € 10,885.83 ELECTRICITY St Fionnans CNU 51 511601-31403 € 29,976.28 ELECTRICITY Mayo General €455,230.43 € 707,983.56 ELECTRICITY Ballina District Hospital 13 131101-31404 € 3,921.21 GAS Belmullet District Hospital 14 141101-31404 € 4,512.37 GAS Swinford District Hospital 15 151101-31404 € 1,544.80 GAS SHH 38 384201-31404 € 4,009.36 GAS 38 384401-31404 € 7,704.01 GAS Mc Bride CNU 46 461601-31404 € 2,292.47 GAS Dalton CNU 47 471601-31404 € 1,563.74 GAS St Augustine CNU 48 481601-31404 € 2,344.51 GAS St Fionnans CNU 51 511601-31404 € 4,001.31 GAS Mayo General €3,932.42 € 35,826.20 GAS

2008 Energy Costs Older People and MGH MCC Exp Code Amount Type Ballina District Hospital 13 131101-31402 € 41,297.23 FUEL - OIL Belmullet District Hospital 14 141101-31402 € 69,493.94 FUEL - OIL Swinford District Hospital 15 151101-31402 € 57,462.11 FUEL - OIL SHH 38 384101-31402 € 5,644.78 FUEL - OIL 38 384401-31402 € 153,132.05 FUEL - OIL Mc Bride CNU 46 461601-31402 € 30,328.28 FUEL - OIL Dalton CNU 47 471601-31402 € 30,565.99 FUEL - OIL St Augustine CNU 48 481601-31402 € 31,478.48 FUEL - OIL St Fionnans CNU 51 511601-31402 € 35,875.55 FUEL - OIL Mayo General €320,184.67 € 775,463.08 FUEL - OIL Ballina District Hospital 13 131101-31403 € 33,376.87 ELECTRICITY Belmullet District Hospital 14 141101-31403 € 34,382.18 ELECTRICITY Swinford District Hospital 15 151101-31403 € 20,920.80 ELECTRICITY SHH 38 384106-31403 € 8,000.00 ELECTRICITY 38 384401-31403 € 86,382.96 ELECTRICITY Mc Bride CNU 46 461601-31403 € 17,916.51 ELECTRICITY Dalton CNU 47 471601-31403 € 16,335.59 ELECTRICITY St Augustine CNU 48 481601-31403 € 11,006.59 ELECTRICITY St Fionnans CNU 51 511601-31403 € 16,820.84 ELECTRICITY Mayo General €447,440.15 € 692,582.49 ELECTRICITY Ballina District Hospital 13 131101-31404 € 8,728.31 GAS Belmullet District Hospital 14 141101-31404 € 11,512.06 GAS Swinford District Hospital 15 151101-31404 € 2,648.41 GAS SHH 38 384201-31404 € 4,921.59 GAS 38 384401-31404 € 6,541.27 GAS Mc Bride CNU 46 461601-31404 € 2,656.22 GAS Dalton CNU 47 471601-31404 € 1,958.87 GAS St Augustine CNU 48 481601-31404 € 3,235.64 GAS St Fionnans CNU 51 511601-31404 € 6,174.00 GAS

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Mayo General €99,911.94 € 148,288.31 GAS

2009 Energy Costs Older People and MGH MCC Exp Code Amount Type Ballina District Hospital 13 131101-31402 € 22,415.88 FUEL - OIL Belmullet District Hospital 14 141101-31402 € 55,336.12 FUEL - OIL Swinford District Hospital 15 151101-31402 € 36,969.88 FUEL - OIL SHH 38 384401-31402 € 96,799.12 FUEL - OIL Mc Bride CNU 46 461601-31402 € 16,281.73 FUEL - OIL Dalton CNU 47 471601-31402 € 11,495.34 FUEL - OIL St Augustine CNU 48 481601-31402 € 16,005.66 FUEL - OIL St Fionnans CNU 51 511601-31402 € 27,096.92 FUEL - OIL €223,128 FUEL - OIL € 505,528.65 FUEL - OIL Ballina District Hospital 13 131101-31403 € 20,266.88 ELECTRICITY Belmullet District Hospital 14 141101-31403 € 34,742.53 ELECTRICITY Swinford District Hospital 15 151101-31403 € 13,522.59 ELECTRICITY SHH 38 381601-31403 € 25,218.38 ELECTRICITY 38 384401-31403 € 69,537.81 ELECTRICITY Mc Bride CNU 46 461601-31403 € 17,490.25 ELECTRICITY Dalton CNU 47 471601-31403 € 16,403.75 ELECTRICITY St Augustine CNU 48 481601-31403 € 15,942.49 ELECTRICITY St Fionnans CNU 51 511601-31403 € 16,315.35 ELECTRICITY Mayo General €313,189.62 € 542,629.65 ELECTRICITY Ballina District Hospital 13 131101-31404 € 4,697.77 GAS Belmullet District Hospital 14 141101-31404 € 5,991.91 GAS Swinford District Hospital 15 151101-31404 € 1,963.79 GAS SHH 38 384201-31404 € 2,710.56 GAS 38 384401-31404 € 13,197.65 GAS Mc Bride CNU 46 461601-31404 € 2,446.55 GAS Dalton CNU 47 471601-31404 € 2,250.27 GAS St Augustine CNU 48 481601-31404 € 3,098.12 GAS St Fionnans CNU 51 511601-31404 € 3,370.19 GAS Mayo General €101,462 € 141,188.98 GAS

ACUTE HOSPITALS MID WEST

Description 2007 2008 2009 Regional Hospital RHD ENERGY - E.S.B. 629,251 718,347 645,823 RHD ENERGY - GAS 493,705 604,859 420,185 RHD ENERGY - OIL 3,755 10,178 5,547

Total 1,126,711 1,333,384 1,071,555

Description 2007 2008 2009 Maternity Hospital RMH ENERGY - E.S.B. 120,613 114,959 138,033 RMH ENERGY - GAS 70,818 81,029 66,556 RMH ENERGY - OIL 1,770 5,379 2,523

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Total 193,201 201,368 207,113

Description 2007 2008 2009 Croom Hospital ROH ENERGY - E.S.B. 118,187 114,441 126,542 ROH ENERGY - GAS 793 1,143 4,706 ROH ENERGY - OIL 137,515 176,008 135,864

Total 256,494 291,592 267,111

NORTH TIPP/EAST LIMERICK LOCAL HEALTH OFFICE AREA

Water Costs 2007 2008 2009

Total €37,033 €39,338 €75,634

Energy Costs 2007 2008 2009

Total €516,258 €632,942 €483,701

CLARE LOCAL HEALTH OFFICE AREA

Regional Health Forum query - Clare LHO

Heating & water costs

Costs for Costs for 2007 2008 Costs for 2009 St. Josephs Hospital, Ennis € € € Heating Oil 154,421.45 106,052.49 13,960.42 Gas 4,722.77 109,013.10 102,482.08 Electricity 97,391.42 104,276.76 112,719.64 Water rates 45,923.00 26,736.30 37,010.50