Maman Poulet | Clucking away crookedly through media, politics and life

A Bad Week

September 28th, 2012 · Irish Politics

Labour party members received an email from Eamon Gilmore this afternoon.  Subject is ‘a bad week’, it appears to be an attempt to soothe concerned/upset members.  He’s been busy while away in New York. I doubt Róisín Shortall will be that impressed.

Dear ,

REGRET AT ROISIN’S RESIGNATION

* The resignation of Roisin Shortall has been a great disappointment to me and something I would prefer hadn’t happened..

* Roisin has been a valued colleague for many years and has made a huge contribution to the Labour Party recently in her role as Junior Minister in the Department of Health and previously as one of our most resolute and prolific spokespersons in Opposition, and as a member of the Public Accounts Committee.

* She is somebody for whom I have the highest regard and who had worked extremely hard in her portfolio in the Department of Health.

ALEX WHITE TO BE OUR NEW MINISTER FOR PRIMARY HEALTH CARE

* Yesterday I proposed Alex White as Minister of State at the Department of Health with responsibility for Primary Care and I’m looking forward to working with him in his new role in implementing the commitments in the Programme for Government on health service reforms.

* As he has shown in his role as Chairman of the Oireachtas Committee on Finance, Public Expenditure & Reform and previously as Labour Leader in the last Seanad, Alex is a politician of immense ability and intellect, and as a public representative, is Labour through and through.

* I have no doubt that he will prove to be an excellent addition to Labour’s ministerial ranks.

 

PRESSING AHEAD WITH OUR PRIMARY CARE COMMITMENTS

* Labour has long advocated a shift towards primary care services as the fairest way of advancing efficient health care.

* To fulfil that commitment, I worked very closely with Roisin in advancing the important reform of primary health care through the political system, particularly in recent weeks and months, as did my ministerial colleagues and staff in my office. And let’s be clear, working together we made significant progress:

  • As part of the reform towards universal primary care, with the removal of cost as a barrier, we are extending free GP care to categories under the Long Term Illness Scheme.
  • Legislation to provide for this phased extending of a publicly funded GP service without fees will be introduced in the Oireachtas in the coming weeks.
  • The Programme for Government committed to Primary Care Centres as a priority area. As part of that commitment, funding of €115 million has already been earmarked for primary care centres across the country. These primary care centres have the potential to meet 95% of people’s day-to-day health and social care needs.
  • These Primary Care Centres will effectively act as a one-stop shop that will provide the first point of contact for the majority of the population in the years ahead, along with taking the pressure of our acute hospitals.

* It is sad and disappointing that Roisin will not be there to see these measures through to their conclusion, given the great work she has already done in these areas.

* But Labour in Government is committed to implementing the commitment in the Programme for Government to fundamentally reform primary health care.

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For those who can, please stand

September 26th, 2012 · Disability, Equality, Irish Politics, Paralympics, Recession

It has been a busy month.

When the Paralympics began I like many other people with disabilities wondered what the impact would be on the attitudes of the general public, primarily whether messages of rights and equality and respect would outweigh expressions of pity and sympathy.

I didn’t know that during the Paralympics in Ireland we would see the single most important action by people with disabilities against a government decision whilst our Paralympians were putting in record performances in London.

The discussions about the decision to cut Personal Assistant hours, home help and home care packages continued over the month with more attention given to policy and place of people with disabilities in Irish society. (Opinion piece by Donal Toolan in the Irish Times and analysis by Deaglan De Bradun are still worth reading.)

This government have failed to equality and poverty proof the measures they have taken since coming into office. When I have called for discussion regarding equality and rights based measures I’ve been told by politicians and analysts alike that these things are not important.  Despite pointing out that there may be opportunities to save money and improve the quality of life of many people with disabilities by both listening to people with disabilities and their supporters and including them in the decisions, reform has remained off the government agenda.

Labour Party politicians in particular point to the protection of primary social welfare payments as an example of how they have protected the most vulnerable. What the demonstration and turn around has shown is the equal importance of services for many in maintaining a quality of life and inclusion in society.

Before that protest I watched Inside the Department where ministers and advisors and civil servants appeared to spend more time talking about how something would look rather than the substance of any policy area.  I am sure that there are serious discussions held on policy areas and indeed we saw discussions with the sectoral interests but they appeared to be going through the motions.

I didn’t see any passion or any values (beyond those of spin) during the programme.  Throughout this government I have seen championing of small moves and u-turns as huge victories by the Labour Party. However equality and rights have been replaced by the insipid mantra of  ‘fairness’ with no interest in examining what is fair and how you measure it.  When the cuts to HSE funded home supports were initially announced there was largely silence apart from Colm Keaveney and Aodhán Ó Ríordáin.

Politicians talk about how they know about ‘these people’ when asked about people who use Personal Assistants and home helps – largely however people are seen as clients or people who attend TD’s offices not as those who live full lives. The failure to introduce rights based legislation in 2005 is largely ignored, the failure to conduct assessments of need remains unspoken.  Those who live in congregated settings are not mentioned.  In the past 12 months Disability has been spoken as a drain on the public finances, in terms of those in receipt of social welfare payments and the services which we are provided with.

Earlier this year Minister Kathleen Lynch held a listening exercise with people with disabilities, the results of which have yet to be published.  From my table I heard people talk about transport, the environment, equipment, assistance to access communities and employment and education. I also heard people who are employed  talk about the cost of medication, transport, increased energy costs and how they receive no support towards these. There was very little talk about social welfare, this is not to say that income is unimportant, however services and supports, the respect and opportunity they afford and how they are provided are clearly very important as we could see by the efforts of those who protested at government buildings this month.

I was asked at the time if I thought the protests by people with disabilities was this governments ‘medical card’ moment – referring to the previous decision to cut medical card entitlements for some older people. I said no. I didn’t think this will damage the government fundamentally.  I do think however that for people with disabilities and their interaction with government that something has changed.  The general public have seen people with disabilities at home and abroad in a new light.  Elite athletes competing for their country and themselves and people with disabilities ‘putting it up’ to the government over cuts to services.

Those who were present at Paralympic events were invited to stand if they could at the medal ceremonies.  At home many others stood with people with disabilities while they said that they would not return to the institution be that a formal or informal (family care) one.

The government have this week been damaged again by politics over policy, politics over passion as Róisín Shortall resigned after months of difficulty and a lack of commitment to policy, transparency and accountability by her own party and their partner in government. Senior ministers trot out excuses about the country having lost it’s economic sovereignty – however for many living in this country values, dignity and respect remain important.

It appears that these dilemmas of values and policy and resisting reform and no more looking after number one have evaded senior members of the Labour Party. They are locked into a programme for government and repayments to gamblers and bullheaded senior ministers who can get on with no-one which leads to 44 people being held captive in acute hospital settings when they do not need that care for the past six months and hundreds of others for weeks and months on end.  The country continues to be in a shambles economically and morally.  We’ve had resignations before but Róisín Shortall’s is very different from the likes of Willie Penrose – she opposed a decision being taken to feather Reilly’s electoral bed and she criticised the lack of commitment to the Programme for Government including free GP care for the most ill, care in the community for the most vulnerable.  Equality, fairness, values and passion from someone who could stand.

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Parents against everything?

September 20th, 2012 · Irish Politics

The long awaited publication of the wording for the Children’s Rights Referendum has been widely welcomed.  Since the publication I have been listening to experts and the Minister for Children discuss the merits of the proposal.

I do hope in the coming weeks that some discussion will be on the care system, the lack of supports for many parents in that system and the proceedings and how they occur.  The conditions in our family courts are often worse that a cattle market, we don’t hear about that due to the in camera rule.  Hopefully there is discussion of this matter also.

The McKenna judgement (1995) maintains that both sides should have equal airtime in a referendum debate. So another part of yesterday has been waiting to see who arrives to say they don’t agree with the wording.  We might be waiting a while longer. (And we might need a referendum on the Judgement and it’s impact).

However Kathy Sinnott the former MEP has in the past few months claimed that the referendum would mean enforced vaccinations (no it won’t) and has written a six part series in Alive about why we should not protect children in our constitution.

And then there is the Alliance of Parents against the State.

No I had not heard of them until yesterday either.

I think we might have a lot of Chicken Lickens, Henny Penny’s and Goosey Loosey’s in the weeks to come.  Of course we must have robust debate on this matter and ensure people are fully informed. I don’t envy the media or the viewer/listeners or the chair of the referendum commission between now and November 10th. Lots of people (on both sides) are looking at this for a chance to make their name.  So expect to hear voices you don’t know (who maybe don’t know much about the law or children) talking about it in the weeks to come.

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Demonstration against HSE cuts to Personal Assistant services

September 3rd, 2012 · Disability, Equality

In response to the HSE cuts to Personal Assistance services and Home Care packages a group of people with disabilities under the banner of the Leaders Alliance have organised a demonstration tomorrow outside Government Buildings.  The statement below explains their concerns and the wider issues which need to be addressed in addition to rescinding the cuts.

 

Press Statement

 

People with disabilities to protest on Cuts to Independent Living Supports, ahead of Cabinet meeting

Disabled people are travelling to protest outside Government Buildings on Tuesday 4th September -coinciding with a meeting of the Cabinet –  to launch a campaign to bring an end to the appalling cuts to Personal Assistance and Home Help Services.

On Tuesday 4th September from 12:00 pm – People with disabilities, their PAs, Home Helps and families will protest against the disgraceful, retrograde and inhumane cuts to these frontline services for as long as it takes to abandon this decision.

 

Disabled people involved in this campaign have said:

‘’These cuts are illogical, and counter to Government policy. These Cuts make no economic sense and will increase costs to the exchequer and will deny people basic fundamental rights to live with dignity and choice.’’

This protest is organised by people with disabilities who require Personal Assistance and other supports to live independently in their communities as is consistent with Government policy. Supports that ensure people can receive education, obtain employment, travel to/from work, contribute and participate in many other ways within their communities. Supports which ensure that many isolated people in rural and urban settings have vital links to their communities and live lives with choice and dignity, and are not forced to access expensive hospital beds or nursing homes.

Key issues to be addressed by Government

The Government decision will mean PA and Home Help Services will be reduced or withdrawn from people throughout the country with immediate effect and will:

–                 Prevent disabled and older people from living independently in their own homes;

–                 Reduce the jobs of front-line PAs and Home Help workers.

Government Must Abandon these Cuts and

1.              Immediately assess the needs of all disabled and older people on waiting lists for personal assistance and other community based services who are currently held captive in costly acute hospital beds and nursing homes.

2.              Commit to the non-dilution of emancipative Personal Assistance Services with restrictive Home Help Services.

3.              Apply Government policy of supporting older and disabled people to live in their homes and participate in the community in order to remove pressure on costly institutions and acute hospital beds, but NOT to institutionalise them in their own homes through inadequate provision of Home Help and PA services.

4.              The Government must provide PA and Home Help employees equal status with directly employed HSE staff protected by the Croke Park Agreement.

5.              The Government must commit to ratifying the UN Convention on the Rights of Persons with Disabilities by January 2013.

6.              The Government must provide Independent Living the status it deserves and agree to transfer the social supports (i.e. PA and Home Help Services) currently provided by the Department of Health to the Department of Social Protection by January 2014.

7.              PA and Home Help Services must be available on the basis of need.

The protest against the PA cuts will begin this Tuesday morning and continue with an escalated campaign for as long as it takes for us as citizens to be given back our independence. We recognise the economic realities we face as a country. Government does have choices to reform that do not involve targeting groups already experiencing barriers to participate in Irish Society.

We are a non-aligned group of people with disabilities who use Personal Assistance services who have formed a Leaders Alliance and members are available for interview.

Join us on Tuesday 4th outside Government Buildings, Merrion Street from 12.00 PM.

 

Nothing about Us Without Us!

(if media  need contact information for spokespeople you can contact me on tips @ mamanpoulet.com and I can provide a list of numbers.)

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James Reilly emails FG members

August 23rd, 2012 · HSE, Irish Politics, Recession

Minister for Health, James Reilly wrote to members of Fine Gael today. I thought you might be interested to see the contents. A winter of discontent ahead, how patients are not going to suffer when all agency staff are cut I don’t know. Embargoes on recruitment have already decimated many services.

And the waiting time for treatment is another target which can’t possibly be met. I’m waiting 10 months for treatment so far myself and it won’t be fixed by September. The minister is eager to point to his targets and the extra demands, talking points for the canvass and the chat down the pub.

Batten down the hatches to the membership as the noose tightens? Or a pre budget kite?

Dear Member,

As we come into the autumn Dáil session, Health, in common with other high-spending Government departments, is going to come under tight political and media scrutiny. So I thought it would be useful to give you an update on where we’ve got to in the Health Reform Programme.

Where are we on the path to a health system that serves the patient the way the patient is entitled to be served? And where are we with the significant pressures that we currently face?

You know that there is a financial overrun in the health service. But did you know that this year we’ve had a significant increase in activity levels:

   A 6 per-cent increase in hospital admissions through emergency departments
   A seven per-cent increase in inpatient discharges
   125,000 more medical cards than last year: A total of 1.8 million medical cards (the highest number in the history of the State) and we now have 125,000 GP Visit cards.

We’re clearly doing more. But we’re also doing better.

10,000 fewer people were on trolleys in emergency departments in the first half of this year compared to last year.

That’s important and real progress – we can find no comparable improvement in any similar healthcare system anywhere in the world.

It’s all the more relevant, given that €1.5 billion has come out of the system, over 6,000 staff have left, and we have a recruitment moratorium.

So – despite the most rigorous cutbacks ever – we’re treated increasing numbers of patients in the past year safely and without subjecting them to the chaotic trolley waits that some people had begun to assume were inevitable.

That’s due to the enormous commitment of people at all levels – from hospital porters to consultants, from nurses to radiologists. They’ve responded to the new requirements of, for example, the Special Delivery Unit, in a phenomenal way.  We will continue to need that commitment because we must and can do more to deliver services against a backdrop of diminishing resources.

This year, we’ve to find savings of around €700 million in our health services – massively difficult at any time, but much more so because of the increase in activity.

The search for savings must tackle inefficiencies and waste ahead of reductions in service. We’re first tackling:

–    Excessive sick-leave.

–    Use of agency staff.

–    Overtime levels.

The combined cost of these three in 2011 was roughly three quarters of a billion Euro.

Sick leave alone in costs approximately €280 million (very close to the level of the overrun). Agency staff cost €250 million, and overtime close to €240 million.

This must and will be tackled. The message has gone out, time and again, that managers must manage money and find ways to reduce costs long before they look at the option of service reduction.

Patients come first. That’s why I set a target for the end of last year that no one should wait over 12 months for treatment. That target has been met and was followed by a target that no one should wait for more than nine months. That target should be met by the end of September.

Let me also remind you that there is now a new Head of the Health Services in Mr Tony O’Brien. Over the last year he led the Special Delivery Unit, which has a clear track record for implementing improvements. I know that Tony O’Brien will not only manage the current difficulties with a keen sense of the importance of patients, but he will lead the health services through a period of major reform as we move towards the establishment of Universal Health Insurance

Behind the measurable improvements are less visible developments, like the fact that the use of beds in our hospital system is markedly better and major advances have happened, for example, in the treatment of strokes. All hospitals that receive stroke patients now have specialised Stroke Units to prevent death and serious disability every day. Our Acute Medicine and Emergency Care programmes will greatly enhance the treatment of patients in emergency care in hospitals.

We’re clearly positioned between a rock and a hard place: No choice but to cut costs while, on the other side, facing increased demand.  The next few months will be crunch time; tough decisions with difficult implications. I can make only one promise to you as a member of the Fine Gael Party: We’ll put patients first and we’ll put reduction in services last.

Over the next weeks you will hear opposition voices predicting calamity and catastrophe in the health services. The same voices were at work earlier in the year predicting the same doom and gloom in the context of the high level of staff leaving the health services through early retirement. But remember, they weren’t right then and they won’t be right now either.

I’m grateful for your support in meeting the serious challenges that lie ahead. Fine Gael as a party has never shied away from facing challenges in the public good. And remember, the greater the challenge, the greater the opportunity to give our people the health service they need and deserve.

Very best wishes
Yours sincerely

James Reilly TD
Minister for Health

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