CEO's Report to NEC - September 15, 2007
NEC Meeting 15th September 2007 – CEO’s Report
This report covers activities from the 30th June 2007, date of the last NEC meeting.
Campaigns
Election Campaign – Sick Waiting
In my May Report I stated that we had sent copies of our campaign information to all newly elected members of parliament. Once the Dail convened a number of parliamentary questions were raised concerning CF issues. It was reported in the media that one independent TD had secured the promise from the Taoiseach for a 34 bed unit at St Vincent’s University Hospital. I met with the TD concerned in Dail Eireann and will report the findings of this meeting under Medical Issues. Other TD’s forwarded on replies that they had received from the Minister of Health as a result of their direct approaches and will also be summarised under Medical Issues. The election campaign also resulted in a meeting with the Taoiseach in Government Buildings on 5th September.
Meeting with the Taoiseach
A meeting took place today 5th September 2007 between representatives of the Association (Sean O’Kennedy- Chairperson, Dr C Gallagher, Maria Daly – PWCF Representative, Godfrey Fletcher – CEO) and An Taoiseach. In attendance with the Taoiseach, was the Minister of Health & Children, Prof Drum (CEO of the HSE), Ms Louise McMahon (HSE Network Manager), Fionnuala Duffy (HSE), Denis O’Sullivan (Dept of Health & Children), Paul de Freine (HSE estates management), Michael Scanlon (Secretary General, Dept of Health & Children), and Ms Mary Doyle (Dept of Taoiseach).
The Association thanked and acknowledged the progress that has been made with funding allocations for specialist CF staffing even though there were delays in the recruitment process. The Association stressed the reason for the meeting was to express the frustration of our members at the lack of acceptable facilities in CF centres across the country and to get a firm commitment for the speedy development of dedicated facilities for CF particularly at St Vincent’s University Hospital and Cork University Hospital. The Taoiseach had also made aware of the requirement for Galway. The Taoiseach welcomed the opportunity to meet with the delegation and appreciated the seriousness of the situation, he stated that he was committed to CF and highlighted the significant contribution in revenue funding the government has put into CF. He also stated that he understood that the HSE Review of CF Services was undergoing some final amendments. Minister Harney confirmed that the current CF facilities were far from ideal and she wants to do what is appropriate and she did not understand why a CF unit was not already in place at St Vincent’s. Professor Drum stated that he believed that with the run out of the current committed investment in CF staffing that Ireland would be meeting world class standards. This was questioned by the CEO and left to one side as our main priority was facilities. The HSE architect informed the meeting that planning permission already had been submitted for a 120 single bed general hospital replacement wing of which CF would be a part. This would ensure best utilisation of the limited space available at the hospital. He believed that this building could be fast tracked. He also stated that the previous plans that had been submitted in the past for a CF unit would now be inappropriate. The meeting was assured that capital funding was available. It was made very clear to the meeting by Prof Drum that the critical issue for any CF unit was if there was to be a requirement of additional on-going funding for staff. If for example St Vincent’s can manage a new CF unit by allocating existing staff to the unit then there would be no problem. If there is a substantial increased revenue requirement then the project will not be approved by the Dept of Finance. Professor Drum was also handed a letter from the consultants at Cork University Hospital outlining the issues they have in developing the CF service in Cork. The CEO stated that there was already verbal commitment within the hospital for the reallocation of in patient facilities but there was a specific requirement to find an equitable solution for a day care facility.
The CEO insisted that the meeting cannot end unless there is a clear indication of what the next steps in the process will be. The Taoiseach instructed the architect to meet with both St Vincent’s and Cork University Hospital and identify what options there are available space wise so that CF patients can get speedy access to single bed en-suite rooms, this was to include interim solutions if necessary before a dedicated unit can be made available. It was stressed that any interim solutions would and could not develop into long term solutions. In addition the hospitals would be approached regarding their solution to staffing allocations and their capability to work within existing revenue budgets.
In conclusion there was commitment from the Taoiseach, Minister Harney & Prof Drum to put appropriate facilities in place immediately for CF with strict instructions that this has to be done within revenue budgets. We must be aware that this process will take time but we will maintain pressure on the Government and the HSE and will work with them to find a solution. A letter has been sent to the Taoiseach thanking him for the meeting and confirmed that we were expecting communication on progress within the month.
Medical Issues
Transplants
There have been three lung transplants this year on Irish CF patients and one further non CF in Newcastle. We are also relieved that the Mater has now successfully carried out their first double lung transplant on an Irish CF patient. David Fitzgerald and I met with the Newcastle team on the 3rd July. We were given access to the whole transplant team and were impressed with the openness and sincerity of the meeting. Our objective was to identify if Irish patients were at any disadvantage as a direct result of which transplant list they were on. Both David Fitzgerald and I are not in a position to comment in detail on our findings until we have the opportunity to review some of our Newcastle findings with the Mater. We have requested a meeting and still have not been given a date.
The 9th European Day for Organ Donation and Transplantation takes place on 13th October 2007 and is being hosted this year by the Irish Kidney Association. The associated meeting will take place in Dun Laoghaire. Further details on this meeting will be circulated when we receive more information from the Kidney Association.
St Vincent’s Hospital Update
There was considerable reports in the media that an independent TD had secured confirmation from the Taoiseach for a 34 bed dedicated united for St Vincent’s. I met with the TD and reviewed the situation with him. From what I can establish his discussions are still ongoing and while support for improving CF facilities is there, there is no written ‘secret deal’ as was reported in the media. In written communication to parliamentary questions to a number of TD’s the Minister of Health stated the following concerning capital investment in CF facilities at the hospital:
1. Interim refurbishment of facilities for CF patients. These short term improvements, recently completed comprise the re-designation of 15 beds in the old St Camillus Ward to Respiratory/Cystic Fibrosis beds bringing the total Respiratory/Cystic Fibrosis beds to 44.
2. Development of a dedicated CF unit. The HSE has approved the establishment of a Project Team for the next phase of the ongoing major capital development at the Hospital. The HSE has designated the CF Unit as one of a number of priority projects to be included in this phase of development. I also asked the HSE to address in particular the identified deficits at the national adult referral centre at St Vincent’s University Hospital. My Department is advised by the HSE that recent interim improvements at the hospital have resulted in additional capacity for people with cystic fibrosis. In addition, the HSE has approved the establishment of a Project Team to progress the next phase of the ongoing major capital development at st Vincent’s. A new Unit for persons with cystic fibrosis has been identified by the HSE as one of a number of priority projects to be included in the development.
A meeting had been scheduled for the 14th September between the hospital and CFAI however this has now been postponed as a direct result of the meeting with the Taoiseach. The HSE have been instructed to find short term and long term solutions for CF facilities at the hospital. We have recognised that the HSE require time to complete their task however the Taoiseach and the HSE have been informed that we expect to be hearing back from them within the month.
Prior to the meeting I visited St Vincent’s myself to evaluate the current bed situation for myself. I visited St Camillus Ward and can confirm that the 5 x 3 bed units have been upgraded. Piped oxygen has been installed and each ward has a flat screen plasma TV. The wards appeared clean and tidy. I spoke with one CF adult who had been in for about 10 days and he was content with the ward and did comment that the toilets and showers were definitely better than on St Paul’s. On the day that I visited there were 20 CF patients the hospital – 4 were on St Paul’s (1 in 6 bed room, 1 in 3 bed room, and 2 in single cubicles, the remainder were spread over the hospital with 1 in A&E (who later got a bed).
Cork University Hospital
I met with the Southern Region / Build4Life Committee on 5th July. We concluded the importance of a strong letter of motivation from the CF team that the Association can row in behind. In discussions with the regional HSE Network Manager he said he would support CF developments if they were accompanied by a strong motivation from hospital management and the medical team. CUH currently have 103 adult CF patients and this is expected to increase to 130 by September 2008. The CF nurse was originally split between adult and paediatric care and now has transferred to adult care. There still are issues around permanent nurse specialist cover for paeds in CUH and the recruitment of another 0.5 WTE for the adult side of the service. This situation is currently being investigated. Kerry also has a concern regarding the replacement of their nurse specialist as the current cover has gone on pregnancy leave.
HSE Working Group
There is still no date set for the publication of the findings of the HSE Working Group however Taoiseach stated that he believed that it would be soon.
CF in the Media July / August
Wide scale coverage of the first CF lung transplant at the Mater Hospital
Considerable media coverage of CF as a result of the PR Campaign associated with the Tour de Munster that included an hour long chat show on Radio Kerry, and TV a.m.
The Build4Life project also received coverage on Nationwide on RTE1.
Fundraising
Year to date cumulative income (to the end of July) stands as follows:
Branch Income € 229,979
Fundraising Income € 356,130
Other income € 146,298
Total YTD Income € 732,407
Recent Events
Tour de Munster – very successful event and great participation from all branches involved – final figure still not available but believed to be in the region of €80,000
Chicago Triathlon – expected to generate approx €35,000
Allergan Golf Classic – generated approximately €16,500
Wicklow Jail sleep in - €16,500
Genworth Finance Putting Competition at European Open - €6,101
Tag Rugby Competition - €4,500
Successful Tipperary Branch race meeting
Tesco Charity of Year – Selected for the final and to present to their selection committee on 21st September.
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