Cllr. Anne Carter Cllr. Michael Kennedy Cllr. Joe Reilly

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1 REGIONAL HEALTH FORUM - DUBLIN AND NORTH EAST FÓRAM RÉIGIÚNACH SLÁINTE - BAILE ÁTHA CLIATH AGUS AN TOIRTHUAISCEART MINUTES OF MEETING HELD ON MONDAY 26 TH MARCH, 2007 AT 2:00PM IN THE FORUM MEETING ROOM, HSE, DUBLIN ROAD, KELLS Members Present: Cllr. Charlie Boylan Cllr. Dessie John Ellis Cllr. Padraig McNally Cllr. Declan Breathnach Cllr. Deirdre Heney Cllr. Patrick O Reilly Cllr. Gerry Breen Cllr. Frank Maher Cllr. Tommy Reilly Cllr. Terry Brennan Cllr. Hugh McElvaney Cllr. Tomás Sharkey Cllr. Christy Burke Cllr. Gerry McGuire Cllr. Tom Stafford Cllr. Ciaran Byrne Cllr. Brian McKenna Cllr. Bill Tormey Cllr. Ann Dillon-Gallagher Cllr. May McKeon Cllr. Leo Varadkar Apologies: Cllr. Seamus Murray Not in Attendance: Cllr. Anne Carter Cllr. Michael Kennedy Cllr. Joe Reilly Cllr. Eugene Cassidy Cllr. Gerry Murray Cllr. Joe Corr Cllr. Aodhán Ó Riordáin Officials Present: Mr. Ray Mitchell, Director, Regional Health Office -. Mr. Chris Lyons, Hospital Network Manager - North East Mr. Willie Rattigan, Contracts and Utilisation Manager - Dublin North Mr. Pat Dunne, Local Health Manager - North Dublin Ms. Anne Marie Hoey, Local Health Manager Louth Ms. Rosaleen Harlin, Area Communications Manager, Dublin North East Ms. Ethna McQuillan, Senior Administrative Officer, Regional Health Office -. Ms. Katherine Murphy, Regional Health Office Ms. Lorraine Timmons, Regional Health Office - Minutes of Regional Health Forum 1 26 th March, 2007

2 The Chairperson, Cllr. Gerry Breen, opened the meeting by welcoming all the members to the seventh meeting of the Regional Health Forum. 1. Adoption of Minutes of meeting held on Monday 22 nd January, The minutes of the meeting held on Monday 22 nd January, 2007 were adopted by the Forum on the proposal of Cllr. Frank Maher, seconded by Cllr. Tom Stafford. Cllr. Hugh McElvaney sought further clarification in relation to an issue he raised at the Forum meeting of 22 nd January, 2007 concerning charges for patients being transferred from hospitals to nursing homes. Cllr. McElvaney was advised that the matter would be checked for him. Cllr. Hugh McElvaney proposed that Standing Orders be suspended to allow for discussion on the location of the new regional hospital. Cllr. Breen suggested that as there was a presentation on Acute Hospital Services in the North East later in the meeting that the matter be discussed at that stage. Cllr. McElvaney agreed to the suggestion. 2. Chairperson s correspondence. The Chairperson advised the meeting of the apology received and updated members on the appointment by Fingal County Council of Cllr. Ciaran Byrne to the Forum. 3. Report by Chairpersons of Committees Acute Hospital Services and Population Health Committee. Cllr. Frank Maher gave a report to the meeting on the third meeting of the Acute Hospital Services and Population Health Committee which took place on Monday 26 th February, 2007 (copy appended to the official minute). The report was noted by the Forum. Primary, Community and Continuing Care Committee. Cllr. May McKeon gave a report to the meeting on the third meeting of the Primary, Community and Continuing Care Committee which took place on Monday 26 th February, 2007 (copy appended to the official minute). The report was noted by the Forum. 4. Presentation on Oral Health, Dental and Orthodontic Services Ms. Anne Marie Hoey, Local Health Manager Louth, made a presentation to the meeting on Oral Health, Dental and Orthodontic Services (copy appended to the official minute). Members thanked Ms. Hoey for her presentation and a discussion took place where members raised the following issues:- Request for information in relation to water fluoridation; Concerns in relation to waiting list figures; Concerns in relation to the employment ceiling; Continuation of the orthodontic service at Louth County Hospital; Minutes of Regional Health Forum 2 26 th March, 2007

3 Lack of orthodontic services for the Cavan/Monaghan area. Suggestion for a service in Cavan; In relation to the old system, where if the waiting list for orthodontic services reaches a certain limit the patient was then referred to a private practice, is this practice still in place?; In relation to the training of consultant orthodontists, can the HSE examine the option of sponsoring and providing training in other countries?; Lack of services for children after sixth class; How long must a child suffer in pain until they receive an appointment?; What is the average timeframe for orthodontic treatment to be completed by? What is the situation with orthodontic treatment being provided at Louth County Hospital in conjunction with the Paediatric Transfer Protocol? Ms. Hoey responded to the questions and comments from the members as follows:- Agreement that a presentation on water fluoridation would be arranged for the next meetings of the committees; It is a key priority to maintain or reduce current waiting times for clinical assessment appointments; The HSE recognise that the recruitment of additional staff is a challenge. However, the HSE are currently seeking to recruit an additional consultant orthodontic for the region; There will be no change in the Orthodontic service at Louth County Hospital; Currently there are no plans for an orthodontic service in Cavan; Ms. Anne Marie Hoey to provide response in relation to old system of private referral once waiting list has reached limit; Ms. Hoey advised that the Review Report on Orthodontic Services addresses training issues; Children are screened in 1 st, 4 th and 6 th Class. If the child is receiving treatment in Sixth class this treatment will continue; A child experiencing pain will receive an emergency appointment; The timeframes for orthodontic treatment depend on the treatment required. For a significant malformation it would be estimated that treatment would take place over an 18 month to two year period; Within Dental Services a very small percentage of children require a general anaesthetic for treatment. In this instance Louth patients are now referred to Our Lady of Lourdes Hospital, Drogheda. 5. Presentation on Acute Hospital Services in the North East Mr. Chris Lyons, Hospital Network Manager North East, made a presentation to the meeting on Acute Hospital Services in the North East (copy appended to the official minute). Members thanked Mr. Lyons for his presentation and a discussion took place where members raised the following issues:- Clarification in relation to the length of time a person could expect to wait from arriving in an accident and emergency department to being admitted to a bed; Current position in relation to the location of the new regional hospital; Concerns in relation to the waiting times in the accident and emergency department at Cavan General Hospital; Impact on final decision in relation to submissions received in respect of proposals for the new regional hospital; Concerns in relation to future services at Monaghan General Hospital; Minutes of Regional Health Forum 3 26 th March, 2007

4 Clarification in relation to the membership of the consortium involved with the decision of the location of the new regional hospital; Clarification in relation to the use of helicopters by HSE officials; Number of questions from Cllr. Tomás Sharkey in relation to hospital services in the North East; Has the Director of the Regional Health Office informed the HSE of the rejection by the Forum of the Teamwork report?; What actions have been taken since the November meeting of the Forum where it was agreed to keep the Paediatric Transfer Protocol at Louth County Hospital under review? In the statement by Dr. Mary Hynes (that minor injuries to children could be carried out at a normal accident and emergency department without the need for a consultant paediatrician to be present) can clarification be given in relation to this statement?; Request for list of hospital services not available in the North East and the numbers of patients travelling to Dublin for hospital treatment and procedures; Clarification in relation to the recent reports where expectant mothers have to wait until the 20 th week of their pregnancy for their initial antenatal appointment at Our Lady of Lourdes Hospital, Drogheda; Has the planning application been submitted for the extension of the accident and emergency department at Our Lady of Lourdes Hospital, Drogheda? When will the approved extra staff come into place? In relation to the new accident and emergency department for Our Lady of Lourdes Hospital, Drogheda, will the building of the two new floors delay this project? Have the HSE considered using helicopters for the transport of patients from hospital to hospital?; Possibility of ambulatory care teams being allowed to carry out more treatment in order to reduce pressures on accident and emergency departments; Will the new regional hospital only serve the counties of Louth, Meath, Cavan and Monaghan or will it serve North Dublin also? Mr. Lyons responded to the questions and comments from the members as follows:- The process of assessing patients in an accident and emergency department will speed up with the introduction shortly of the Acute Medical Assessment Units. These units are staffed by consultant physicians and have immediate access to diagnostic support, e.g. x- ray, laboratory testing and their overall purpose is to assess medical patients quickly and effectively. This process is to be implemented in Cavan General Hospital and Our Lady s Hospital, Navan initially with Our Lady of Lourdes Hospital, Drogheda by the end of the year; The HSE are in final discussions with the consortium involved in relation to the location of the new regional hospital for the North East. It is hoped to sign off on the location of the site in the next week or so. This will be followed by a 14 day cooling off period; In relation to the waiting times at Cavan General Hospital, 40% of patients have to wait over 24 hours. This should decrease significantly with the introduction of the Acute Medical Assessment Unit; Anyone may submit a proposal in relation to the location of the new regional hospital and all submissions will be examined; Monaghan General Hospital will continue to play an important role in providing a range of in-patient services, diagnostic, rehabilitation, step-down and follow-up services; The consortium involved in the decision on the site of the new regional hospital is made up from a number of groups and organisations with expertise in health and associated services; The HSE are not aware of the use of helicopters by HSE officials; It was proposed that Cllr. Sharkey would submit his questions in writing to Mr. Chris Lyons as they were considerably detailed; Minutes of Regional Health Forum 4 26 th March, 2007

5 The Director of the Regional Health Office has informed the HSE of the rejection by the Forum of the Teamwork report; Forum members have been kept appraised of at every meeting of the Forum and its Acute Hospital Services and Population Health Committee in relation to the review of the Paediatric Transfer Protocol; List of hospital services not available in the North East and the numbers of patients travelling to Dublin for hospital treatment and procedures to be produced; The planning application has been submitted for the extension of the accident and emergency department at Our Lady of Lourdes Hospital, Drogheda; In relation to the approved new staff, interviews are to be held in early June for 22 midwifes and three consultant anaesthetists; The new accident and emergency department at Our Lady of Lourdes Hospital, Drogheda is due to be completed in March or April next year. The two extra floors will commence the following year; The provision of helicopters for patient transport is not a viable option for this region due to small geographical area involved and also the absence of helipads on the hospital sites. As the area has a good road network transport by road is the best option available; It is planned to train ambulatory care teams to carry out more treatment; The new regional hospital will primarily serve the North East counties. 6. Health Service Executive Updates Mr. Ray Mitchell, Director of the Regional Health Office gave a report to the meeting which dealt with the following:- North East Regional Hospital Location Study Public Consultation; North East Health Information Campaign launched; Chairman of the Hospital Development Board of the New National Paediatric Hospital Appointed; Key elements of Primary Care Programme are progressing well; Mental Health Services - HSE publishes new mental health resource pack for GPs; - HSE launches National Service User Executive for Mental Health; Nursing Home Subvention - Nursing Home Subvention Guidelines; - A Fair Deal; HSE Libraries Online win best egovernment health award for 2007; HSE to save over 250m in drug costs; HSE Community Games launches strategic plan to promote social and cultural inclusion Request for Submissions Official Languages Act 2003; Clean Your Hands Say No to Infection. Members thanked Mr. Mitchell for the updates. Minutes of Regional Health Forum 5 26 th March, 2007

6 8. Motions That the HSE initiate measures to provide for the many homeless persons in Dublin suffering from mental ill health. Submitted by Cllr. Gerry Breen The response as circulated was noted by the Forum. That this Forum calls on the Junior Minister, Noel Ahern to address this Forum in relation to the serious cocaine and general drug problem that is blighting our communities. Submitted by Cllr. Dessie Ellis As the mover of the motion was not present at the meeting the motion, in line with Standing Orders, was lost. Recognising that hundreds of medical card holders in Tyrrelstown cannot attend their local health centre, this Forum calls on the HSE to investigate changing the GMS regulations in relation to new GPs becoming eligible for a GMS lists in rapidly developing areas. Submitted by Cllr. Leo Varadkar On the proposal of Cllr. Leo Varadkar the motion was adopted by the Forum and it was agreed that the Forum write to the Minister of Health and Children. That this Forum deplores the further withdrawal of services at the Louth County Hospital, Dundalk through the suspension of new referrals to the respiratory clinic by the consultant respiratory physician due to workload created by lack of consultant manpower in the region and the HSE not providing adequate resources required to run a services across two sites. Submitted by Cllr. Tomas Sharkey On the proposal of Cllr. Sharkey the motion was adopted by the Forum. 9. Questions The responses to questions submitted by members for the meeting were circulated. 10. Date and time of next meeting. It was agreed that the next meeting of the Regional Health Forum would be held on Monday 28 th May, 2007 at 2:00pm. Signed: Cllr. Gerry Breen, Chairperson, Regional Health Forum. Minutes of Regional Health Forum 6 26 th March, 2007