REGIONAL HEALTH FORUM - DUBLIN NORTH EAST FÓRAM RÉIGIÚNACH SLÁINTE - BAILE ÁTHA CLIATH AGUS AN TOIRTHUAISCEART MINUTES OF MEETING HELD ON MONDAY, 22 ND MARCH, 2010 AT 2:00PM IN THE FORUM MEETING ROOM, HSE, DUBLIN ROAD, KELLS Members Present: Cllr. Christy Burke Cllr. Nick Killian Cllr. Mags Murray Cllr. Tommy Byrne Cllr. Eithne Loftus Cllr. Tom O Leary Cllr. Kieran Dennison Cllr. David Maxwell Cllr. Patrick O'Reilly Cllr. Ann Dillon-Gallagher Cllr. Séamas Mc Grattan Cllr. Joe Reilly Cllr. Anthony Donohoe Cllr. Brian McKenna Cllr. Bill Tormey Cllr. Robbie Gallagher Cllr. May McKeon Cllr. Seán Kenny Cllr. Gerry Murray Not in Attendance: Cllr. Colm Markey Cllr. David O Connor Cllr. Michael O Dowd Cllr. Larry O Toole Apologies: Cllr. William Carey Cllr. Paddy McDonald Cllr. John Redmond Cllr. Oliver Fox Cllr. Mary O Shea Officials Present: Mr. Ray Mitchell, Director, Regional Health Office - Mr. Stephen Mulvany, Regional Director of Operations - Integrated Services Directorate Mr. Willie Rattigan, Interim Hospital Network Manager Ms. Rosarii Mannion, Assistant National Director HR Mr. David Gaskin, Local Health Manager - Meath Ms. Anne O Connor Local Health Manager - Dublin North West Mr. Brendan Casey, General Manager Cavan/Monaghan Dr. Edel McGinnity, GP, Mulhuddart/Tyrrelstown PCT Ms. Rosaleen Harlin, Area Communications Manager - Minutes of Regional Health Forum 1 22 nd March, 2010
Cllr. Bill Tormey, Chairperson, opened the meeting by welcoming all the members to the 23rd meeting of the Regional Health Forum. The Chairperson advised the members that notification had been received from Cllr. Tom Brabazon that he was resigning from the Forum and that he had asked the Director to write to Dublin City Council seeking a nominee to replace Cllr. Brabazon on the Forum. The Chairperson then invited the Director to introduce the staff present. The Director introduced the managers and advised the meeting that due to the Public and Civil Service industrial action the usual administrative support staff would not be present at the meeting. 1. Adoption of minutes of meeting held on Monday, 25 th January, 2010 The minutes of the meeting held on Monday, 25 th January, 2010 were adopted by the Forum on the proposal of Cllr. Christy Burke and seconded by Cllr. Robbie Gallagher. 2. Presentation on Primary Care Teams Ms. Anne O Connor, Local Health Manager - Dublin North West and Dr. Edel McGinnity, GP made a presentation to members on Primary Care Teams (PCTs) in (copy appended to the official minute). Dr. McGinnity gave a presentation on her experience of being part of a PCT. Members thanked both Ms. O Connor and Dr. McGinnity for their presentations and a discussion took place where members raised the following issues:- Query in relation to a map of each PCT in each county; Are PCTs located in purpose built buildings or working out of old buildings; Issue of locating all GPs in one centre or area; Issue of communicating with patients/clients, especially elderly; When will teams be up and running in Cavan; Risk that very rural areas will loose out to more populated geographical areas, similar to Broadband or ESB in the past; That the teams should have all the key professionals and, in as far as is possible, should all be in one building; Clarification on Airside Swords PCT centre and Balbriggan centre; How many teams will be in place in Fingal/Dublin North; Clarification on what happens if GPs do not participate; If difficulty arises for developers in getting financing for PPPs, can HSE examine existing infrastructure in the area for suitability for PCTs; Concern at time commitment for meetings etc for GPs; When will Navan PCTs centres come on stream and are the HSE built or PPPs; Is PPP the best model; Issue of PCT premises for Clongriffin/Donamede; Co-operation of GPs in County Louth with PCTs; Where are eight teams going to be located in County Louth; Suggestion that stroke units should be developed; Concern at closure of beds in Virginia Health Care Unit; Estimate of what it would cost to deal with loss of beds in Virginia as a result of having to respond to HIQA requirements; Concerns in relation to the proposed new Coolmine drug addiction clinic and request for information on how location was chosen and if other alternative locations were looked at; Suggestion of visit to Virginia Health Care Unit; Request for confirmation for next meeting that x-rays are being examined in all hospitals in DNE and that GP letters are being opened and dealt with; Query in relation to date for opening of new A&E unit at Our Lady of Lourdes Hospital; Minutes of Regional Health Forum 2 22 nd March, 2010
Ms. O Connor, Dr. McGinnity, Mr. Stephen Mulvany and other managers present responded to the questions and comments from the members as follows:- A national map showing where the PCTs will be located to be provided to the members; Some teams are in new centres and others are in existing buildings. All of the new buildings, either HSE or PPPs, will have teams in them; Each team will serve a catchment area and therefore no patient should be without a GP; Acknowledged that communication between professionals, and between professionals and patients, does arise and is something that requires on going attention and improvement and the HSE is committed to this. PCTs, where all professions are working together, will greatly improve communication; The functioning of the remaining nine PCTs in Cavan Monaghan is contingent on GP participation and engagement. Work is ongoing in this regard. Four of the nine teams are targeted to be in place by the end of 2010 with the remaining five teams in development; It is planned to have teams in all the areas identified and no area will be without a team; The aim is to have all key professionals in one building. However, it was noted that it is not essential to have all in one building but what is most important is the clinical meetings which are the key important element of the PCT; Update on Airside Swords centre and Balbriggan to be provided to the members; The total number of teams for Dublin North West is 24, of which eight teams are already in place. A further five teams are targeted to be in place by the end of 2010. The total number of teams for Dublin North is 27, of which eight teams are already in place and a further nineteen teams are targeted to be in place by the year end. The above developments are contingent on the capacity to meet targets within the current industrial relations; The participation of GPs is extremely important to the team and the HSE continues to work with GPs to participate in teams. During 2010 Local Health Managers in will continue to engage with GPs to ensure their participation in PCTs; The HSE, where a PPP does not materialise, can explore other options such as other existing buildings in the area that might be suitable for a PCT; It was acknowledged that the PCT team meetings can be time consuming for GPs but this is outweighed by the positives that arise by having these meetings. It was also noted that team members do communicate also via telephone and fax on a daily basis; The Navan PCTs will come on stream in 2011. Discussion on the PCT centre for Navan is on going and a decision on whether it will be a PPP or purpose built not finalised yet; An evaluation was done on what is the best model and PPP came out as the best option; Plans were being advanced for Clongriffin/Donamede centre. However, GPs pulled out as they did not think that it was viable option. A group of GPs and others have identified another site and this is now being pursued; It is intended to have eight teams in County Louth by year end and that we are confident GPs will co-operate. In relation to the out-of-hours GP co-op service, it was pointed out that in the case of County Louth, it was only the GPs in Dundalk town that are not participating in this service; Location of the eight teams in County Louth to be forwarded to the members; The suggestion on stroke units was noted; Members were advised that the older persons unit in Virginia Health Care Centre had a reduction of four beds and that this reduction was to meet with HIQA standards. It was also noted that the uptake of beds in HSE older persons units was reducing arising from the Fair Deal plan where patients can now choose a nursing home and many were now choosing to take up a place in a private nursing home. Members were also advised that the HSE were arranging a meeting with Cavan County Councillors to provide information on this issue and other health care matters; It was agreed to examine the costs that would be incurred to retain the four beds and provide to members. It was pointed out by management however that this was not a commitment to Minutes of Regional Health Forum 3 22 nd March, 2010
incur such costs, particularly given the movement by choice of patients to private nursing homes; Information requested on the new Coolmine drugs centre to be provided to members; The suggestion of a visit by the Forum to Virginia Health Care Centre was noted by management; It was noted that a national check of each hospital in relation to the examination of x-rays and letters was taking place and that if the information could be obtained for DNE in advance of the next meeting it would be provided to members. Management also advised that the allegation that there were unopened letters in Our Lady of Lourdes Hospital was untrue; Progress was being made on an opening date and that it was hoped to make an announcement in the coming weeks. 3. Motions That the HSE provide funding to purchase nursing home beds in order to allow hospitals in the city to free up beds. Submitted by Cllr. Christy Burke The motion was proposed by Cllr. Christy Burke and seconded by Cllr. David Maxwell and during the debate on the motion following issues were rasied:- Charging patients who do not move to a nursing home bed; The need for the HSE to purchase more beds. In responding to the issues raised in the course of the debate, management advised that the charging of patients would be a last resort where there was absolutely no co-operation and every effort is made to assist patients in finding a nursing home of their choice. The HSE written response to the motion is appended to the minutes. The motion was adopted by the Forum. That this Forum calls on the HSE not to remove the Admissions Unit or the Day Care Centre located at St. Davnet's Psychiatric Hospital, Monaghan. Submitted by Cllr. Brian McKenna The motion was proposed by Cllr. Brian Mc Kenna and seconded by Cllr. David Maxwell during the debate on the motion following issues were rasied:- Retention of the centre in St Davnet s; The need for day care centre in Monaghan; The figures for the usage of the unit in Monaghan. In responding to the issues raised, management advised that the mental health services in Monaghan were leaders in the field and that the HSE was centralizing the Cavan/Monaghan admission unit in Cavan as the usage of the service had dropped to below 50% in each of the hospitals. The community services over the years had been developed to a high standard in Cavan/Monaghan and this had resulted in the under usage of the admission units which was noted by the Mental Health Commission. The HSE response to the motion is appended to the minutes. The motion was adopted by the Forum. Minutes of Regional Health Forum 4 22 nd March, 2010
4. Questions The responses to questions submitted for the meeting were circulated and noted. 5. Health Service Executive Updates Mr. Ray Mitchell, Director, gave a report to the meeting which dealt with the following:- Update on Pandemic Influenza A H1N1; Roll out of the National Integrated Medical Imaging System (NIMIS); HSE and Irish College of General Practitioners joint initiative to develop Primary Care Services; HSE Plans for Mental Health in 2010; New Bereaved Relatives Area in the Emergency Department of Cavan General Hospital; Cuan Ros in TV3 documentary; Health Promotion Programmes; Cultural Diversity celebrated at St. Mary s Hospital, Phoenix Park; The report was noted by the Forum. 6. Chairperson s Correspondence Cllr. Bill Tormey, Chairperson, gave a report to the meeting which dealt with the following:- The resignation of Cllr. Tom Brabazon from the Regional Health Forum. 7. Date and time of next meeting The next meeting of the Regional Health Forum - will be held on Monday, 24th May, 2010 at 2:00pm Signed: Bill Tormey, Chairperson. Minutes of Regional Health Forum 5 22 nd March, 2010