REGIONAL HEALTH FORUM - DUBLIN NORTH EAST FÓRAM RÉIGIÚNACH SLÁINTE - BAILE ÁTHA CLIATH AGUS AN TOIRTHUAISCEART

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1 RGIONAL HALTH FORUM - DUBLIN NORTH AST FÓRAM RÉIGIÚNACH SLÁINT - BAIL ÁTHA CLIATH AGUS AN TOIRTHUAISCART MINUTS OF MTING HLD ON MONDAY, 26 TH JANUARY, 2009 AT 2:00PM IN TH FORUM MTING ROOM, HS, DUBLIN ROAD, KLLS Members Present: Cllr. Anne Carter Cllr. Hugh Mclvaney Cllr. Mary O Shea Cllr. Ann Dillon-Gallagher Cllr. May McKeon Cllr. Joe Reilly Cllr. Dessie llis Cllr. Padraig McNally Cllr. Peter Savage Cllr. Deirdre Heney Cllr. Gerry Murray Cllr. Bill Tormey Cllr. ithne Loftus Cllr. Mags Murray Cllr. Frank Maher Cllr. Patrick O Reilly Not in Attendance: Cllr. Paddy Bourke Cllr. Anne Devitt Cllr. Tommy Reilly Cllr. Christy Burke Cllr. Finnan McCoy Cllr. Tomás Sharkey Cllr. Ciaran Byrne Cllr. Brian McKenna Cllr. Tom Stafford Cllr. ugene Cassidy Cllr. Seamus Murray Apologies: Cllr. Charlie Boylan Officials Present: Mr. Ray Mitchell, Director, Regional Health Office - Dublin North ast Mr. Tadhg O Brien, Assistant National Director - PCCC Mr. Stephen Mulvany, Hospital Network Manager - North ast Ms. Angela Fitzgerald, Hospital Network Manager - North Dublin. Dr. Nazih ldin, Head of Health Promotion - Dublin North ast Mr. Joe Sheeky, Asst. National Director of Finance - Dublin North ast Ms. Rosarii Mannion, Asst. National Director of HR - Dublin North ast Mr. Peter Smyth, Asst. National Director of states - Dublin North ast Ms. Liz Oakes, Childcare Manager - North Dublin Ms. Rosaleen Harlin, Area Communications Manager - Dublin North ast Ms. Ann Martin, Press Officer, Area Communications Manager s Office - Dublin North ast Mr. Robert Kidd, Hospital Network Manager s office - North Dublin Ms. Katherine Murphy, Regional Health Office - Dublin North ast Ms. Lorraine Timmons, Regional Health Office - Dublin North ast Minutes of Regional Health Forum 1 26 th January, 2009 Dublin North ast

2 The Chairperson, Cllr. Hugh Mclvaney, opened the meeting by welcoming all the members to the seventeenth meeting of the Regional Health Forum Dublin North ast. 1. Adoption of minutes of meeting held on Monday, 24 th November, The minutes of the meeting held on Monday, 24 th November, 2008 were adopted by the Forum on the proposal of Cllr. Gerry Murray and seconded by Cllr. Padraig McNally. Cllr. Anne Carter proposed an amendment to the minutes in relation to her query concerning the use of trolleys at Beaumont Hospital. 2. (i) Service Plan 2009 Mr. Ray Mitchell introduced senior management to the members. Mr. Mitchell informed members that the presentation is based on activity at 2008 levels and that the Service Plan will remain under constant review in light of the evolving national situation. Ms. Rosarii Mannion, Mr. Joe Sheeky, Mr. Tadhg O Brien, Ms. Angela Fitzgerald and Mr. Stephen Mulvany made a presentation to members on the HS Service Plan 2009 (copy appended to the official minute). Members thanked senior management for their presentation and a discussion took place where members raised the following issues:- Request for list of expenditure on rented properties and evaluation of use in Dublin North ast; Challenges facing service providers; Need for HS to implement VFM savings in relation to suppliers contracts should be reviewed; Update in relation to MAU at Cavan General Hospital; Confidence of management in protecting services; Provision of beds for the elderly in the North ast; Details of new emergency department at Our Lady of Lourdes Hospital, Drogheda; Overcrowding at Our Lady of Lourdes Hospital; Opening of transit lounge at Our Lady of Lourdes Hospital; Locations of 44 Primary Care Teams; Home support hours compared to last year; Number of patients taking up hospital beds on any given day; Request for update on theatre in Cavan General Hospital; Request for update on capital works on ward at Cavan General Hospital; Reconfiguration of services to introduce stroke units; Collection of unpaid hospital fees; Lean Study in relation to management/administrative posts; Staff working arrangements on-call compared to rotas; Review of the consultant contract; Need to renegotiate costs in relation to Smithfield geriatric unit; Impact of reductions of agency staff and overtime; Benchmark for absenteeism; Impact of cost containment measures on the home help service; Clarification on the reduction in training expenditure; Reasons for reduction in mental health overtime; Clarification in relation to mental health services - closing ten beds and opening six; Request from last meeting regarding clarification on access and parking for staff of Connolly Hospital, Blanchardstown with the M50 upgrade; Concerns in relation to Connolly Hospital, Blanchardstown and Beaumont Hospital; Position on dexa scanner for Connolly Hospital, Blanchardstown; Minutes of Regional Health Forum 2 26 th January, 2009 Dublin North ast

3 Clarification in relation to review of special arrangements concerning children s services; Danger of limiting services due to restrictions on travel and subsistence; Request for future report on children and family services; Request for update on primary care centre for Balbriggan; Request for statistics on D-DOC; Significant wastage occurring up until now re the reduction in mental health overtime; Fears and concerns in relation to the safety of patients. Systems have not had time to be checked and monitored prior to implementation; Request for number of children in care in Dublin North ast; Request for details of activity levels in North ast hospitals; Request for report on analysis of home helps in Dublin North ast. Senior management responded to the questions and comments from the members as follows:- List of expenditure on rented properties for North ast has been made available. The same for Dublin North to be forwarded to members; Acknowledgement of challenges facing service providers; There has been agreement with some suppliers on fixed pricing for National negotiations are on-going in relation to procurement. The HS are also working with Sustainable nergy Ireland (SI) in relation to cost savings; There has been significant progress made on the MAU at Cavan General Hospital in the past number of weeks. The unit will be opened in approximately two months when staffing arrangements have been finalised; Management are aware that it will be difficult to maintain the same level of service with the current economic situation. Developments have taken place since the publication of the Service Plan which reduce the HS s cost base. It is important to look at opportunities for efficiencies; Beds for the elderly were purchased in this month for the North ast; The new Phase 1 block at Our Lady of Lourdes Hospital, Drogheda will have a new emergency department at ground floor level and will yield a net additional 48 beds in the three floors over ground floor. The exact designation of the capacity at each floor is currently being finalised. The emergency department is expected to be opened mid 2009 and the remaining floors by early 2010; Seasonal factors have to be taken into account regarding overcrowding. Much work has been done recently between management and clinicians to alleviate the problems; The transit lounge at Our Lady of Lourdes Hospital has been opened and will help alleviate pressures on beds; Locations of Primary Care Teams to be forwarded to members; The home support hours mentioned are for disability services, not elderly services. 2.4m hours are provided per annum with 13,000 people per month benefiting. In relation to elderly services, a total of 1,900 home care packages were provided in 2008; In Dublin North the numbers of delayed discharges on any given day ranges from 180 to 200 (Mater Hospital 100 approx, Connolly Hospital 35 approx). The North ast figures are Cavan General Hospital six approx and Monaghan General Hospital 18 approx.; Update on theatre and capital works on ward at Cavan General Hospital to be forwarded to members; A presentation will be made on the National Capital Plan when it is approved; The Department of Health and Children are due to publish a report shortly on stroke units; Debt collection for the HS has been a challenge for some time. If a patient is unable to pay for services there is a waiver scheme available. The HS continues to work on the issue of collection of outstanding debts. The on-going streamlining of services will have regard to patients who genuinely can not pay; Minutes of Regional Health Forum 3 26 th January, 2009 Dublin North ast

4 A lean study has been completed in relation to HS management/admin staff. The report did not suggest there was an excess of management/administrative staff in the Dublin North ast area. The report will be forwarded to members; It is agreed that savings need to be addressed in relation to working arrangements. Negotiations on this issue will be progressed though Towards 2016; The consultant contract 2008 has been agreed and is being implemented; The HS have started negotiations in relation to costs involved with Smithfield; The issue of agency staff is matter for the particular manager concerned; The benchmark maximum limit for absenteeism is being set at 3.5%; Home help services have not been cut and funding for this service has increased by 500m over the past five years; Mandatory training will continue and all other training will be monitored; The reduction in mental health overtime relates to adult mental health services, not children s mental health services; The six beds that were opened in relation to mental health services were children and adolescent beds and the ten that are closing are adult beds. This is in line with the mental health strategy A Vision for Change which recommends service reconfiguration of wards and transfer of patients to more appropriate settings; Response to be issued to members regarding access and parking for staff of Connolly Hospital, Blanchardstown; Presentation on Dublin hospitals to be prepared for next meeting; Position on dexa scanner for Connolly Hospital, Blanchardstown will be examined; Special arrangements in relation to children s services occur where the HS can not meet the child s needs, e.g. very challenging behaviour. This would mean that the child could not be accommodated in a HS residential service. The HS are currently reviewing all special arrangements; Frontline staff will not be effected due to restrictions on travel and subsistence; Presentation on children and family services to be prepared for future meeting; An update on the primary care centre for Balbriggan to be forwarded to members once legal agreements have been concluded; Presentation on D-DOC to be arranged for future meeting; The reduction in mental health overtime will not impact on services; There are higher risks to patients by providing a full range of acute hospital services across the five sites. Additional home care packages will be provided in the community to lessen the strain on hospitals along with the following:- - mergency ambulance services; - Patient transport services; - Advanced emergency paramedic services with pre-hospital thromblsyis rapid response; - Six additional beds at Medical Assessment Unit, Cavan General Hospital; - New six bed observation ward at Cavan; - New six bed admissions ward at Cavan; - New 26 bed rehabilitation/step down unit at Monaghan General Hospital. The HS s aim is to ensure the highest quality service possible; Details on number of children in care in Dublin North ast to be forwarded to members; Details of activity levels in North ast hospitals to be forwarded to members; Report on analysis of home helps in Dublin North ast is being progressed. Cllr. Hugh Mclvaney proposed a motion That the Regional Health Forum Dublin North ast seeks from HS an eleventh hour U-turn in relation to the closing down of beds in Monaghan General Hospital and ask that the beds be left open for the future. The motion was seconded by Cllr. Padraig McNally. Minutes of Regional Health Forum 4 26 th January, 2009 Dublin North ast

5 The Chairperson asked for a show of hands in support of his motion. Cllr. Padraig McNally and Cllr. Patrick O Reilly supported the motion. The Chairperson asked for a show of hands in opposition to the motion. No members opposed the motion. The remaining members abstained from voting. The Chairperson declared the motion adopted by the Forum. However, members queried this as only three members had voted. The Chairperson clarified the proposed motion and asked for a second show of hands. Cllr. Padraig McNally and Cllr. Patrick O Reilly supported the motion. No. members opposed the motion and the remaining members abstained from voting. The Chairperson declared the motion carried. NAM ABSNT FOR AGAINST ABSTAIN Paddy Bourke (LAB) Charlie Boylan (SF) Christy Burke (SF) Ciaran Byrne (LAB) Anne Carter (LAB) ugene Cassidy (FG) Anne Devitt (FG) Ann Dillon-Gallagher (FG) Dessie llis (SF) Deirdre Heney (FF) ithne Loftus (FG) Frank Maher (FF) Finnan McCoy (FG) Hugh Mclvaney (FG) Brian McKenna (SF) May McKeon (IND) Padraig McNally (FF) Gerry Murray (FF) Mags Murray (FF) Seamus Murray (FF) Patrick O Reilly (FG) Mary O Shea (FG) Joe Reilly (SF) Tommy Reilly (FF) Peter Savage ( FF) Tómas Sharkey (SF) Tom Stafford (FF) Bill Tormey (FG) RSULT Minutes of Regional Health Forum 5 26 th January, 2009 Dublin North ast

6 (ii) Regional Health Forum Annual Report 2008 The report was adopted by the Forum on the proposal of Cllr. Ann Dillon-Gallagher and seconded by Cllr. Frank Maher. It was agreed that the report would be circulated to all of the Local Authorities represented on the Forum. 3. Motions. There was no business under this item. 4. Questions. There was no business under this item. 5. Health Service xecutive Updates. Mr. Ray Mitchell, Director of the Regional Health Office gave a report to the meeting which dealt with the following:- New Medical Assessment Unit at Our Lady s Hospital, Navan; Official Opening of Clones Primary Care Team; Improved Hospital Hygiene Audit Results for Cavan and Monaghan General Hospitals; Nurses and midwives pioneer new role in healthcare; Beaumont staff celebrate 21st anniversary of hospital opening; New rules for Over 70s Medical Cards; HS urges people in the high risk groups to get the Flu Vaccine; HS urges people to Use the Right Door ; HS launches Keep Safe This Winter ; HS calls on people to Keep Warm Keep Well this winter; Healthy ating Policy Launched in Monaghan Schools; Health Matters. Members thanked Mr. Mitchell for the report and raised the following issues:- Request for presentation on influenza; Request for report on composition of Primary Care Teams. Senior management responded as follows:- Presentation on influenza to be prepared for future meeting; Report on composition of Primary Care Teams to be prepared for next meeting. The report was noted by the Forum. 6. Chairperson s Correspondence. The Chairperson, Cllr. Hugh Mclvaney, welcomed recently appointed member Councillor Anne Devitt to the Forum. 7. Date and time of next meeting. It was agreed that the next meeting of the Regional Health Forum Dublin North ast would be held on Monday, 23 rd March, 2009 at 2:00pm. Signed: Cllr. Hugh Mclvaney, Chairperson, Regional Health Forum Dublin North ast. Minutes of Regional Health Forum 6 26 th January, 2009 Dublin North ast