Announcement

Collapse
No announcement yet.

Consultants to report on DF Medical Service

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Consultants to report on DF Medical Service

    You may have heard that there is a tender out looking for consultants to investigate how best the DF Medical Service should be delivered. Extracts from tender documentation:

    [QUOTE]The modernisation process in the Irish Defence Forces (DF) is ongoing. As part of this process, the Minister for Defence wishes to ensure that medical services appropriate to the roles of the DF will be available on a sustainable and value for money basis into the future.

    There are acknowledged and enduring difficulties with medical provision in the DF. A Partnership Sub Committee has been considering these difficulties for some time. In addition the ‘Towards 2016 Action Plan’ for the DF requires progress on the development and implementation of a revised structure for the delivery of medical services for the DF.

    With this in mind, the Minister wishes to invite tenders for consultancy to consider and make recommendations on how best the required medical services for the DF might be delivered.

    The main elements required in the study are:

    • A review of the medical input required for the DF in the light of the roles and operations of the DF.

    • An assessment of the current arrangements for the provision of medical services.

    • A recommendation regarding sustainable future provision of the required medical input.

    • A work plan, outlining the main projects necessary, with timescales and a costing matrix for the implementation of recommendations.

    A project team consisting of both military and civilian personnel will manage the project.

  • #2
    1.2 Background

    The DF consists of a Permanent Defence Force (PDF) and a Reserve Defence Force (RDF). It provides the capabilities for joint (Army, Air Corps and Naval Service) military operations at home and Multinational Peace Support Operations overseas. The Permanent Defence Forces have a strength of 10,500 personnel with a Medical Corps of approximately 260 personnel. (Appendix 1 refers). Part of the Medical Corps is the Army Nursing Service (ANS) with strength of 23. The Reserve Defence Forces consists of an Army and Naval Reserve with an established strength of over 12,000 personnel with 294 from Reserve Medical Units.


    The Medical Corps is a Combat Service Support (CSS) Corps of the DF.
    The objectives of the Medical Corps are:

    • To maintain and promote health and well-being for members of the DF.

    • To maximise the medical readiness of the DF for operational activities both at home and overseas.

    • To provide field medical support in operational and training settings both at home and overseas.

    The mission of the Medical Corps is:

    ‘To ensure and co-ordinate the provision of Medical, Dental and Pharmaceutical support to the Defence Forces in the execution of their roles as assigned by Government’.

    In recent years, the DF has experienced difficulty in attracting and retaining doctors to work as Medical Officers (Commissioned Officers working as doctors, dentists and pharmacists in the Medical Corps).
    While the benefits accruing to the DF of formal linkages to civilian medical hospitals and medical facilities have long been recognised, no formal arrangements have yet been completed.
    The challenge is to establish a structure that delivers medical expertise in an efficient, effective and economic manner to the DF.

    Section 3 Statement of Requirements

    The successful tenderer will be required to consider and make recommendations on how best medical services for the Defence Forces might be delivered. The consultancy will consist of 4 phases as follows:

    a. Phase 1: A review of the current and future medical requirements for the DF in light of the missions, roles and likely operations of the DF.

    This should include:
     Provision of primary medical care service.
     Provision of secondary medical care service.
     Provision of occupational medical care service.
     Provision of dental service.
     Provision of overseas (mission) medical service.
     Provision of an Army Nursing Service.
     Other.

    b. Phase 2: A comprehensive assessment of the current arrangements for the provision of medical services.

    This should include:
     The manner in which primary, secondary, occupational and dental requirements are met.
     Recruitment of Medical Officers (doctors, dentists and pharmacists), members of the Army Nursing Service and career progression.
     Structure, organisation and management of medical services.
     Civilian medical contractors and retired Medical Officers.
     Value for money.
     Other.

    c. Phase 3: Recommendations for the delivery of services.
    A “vision” / blueprint for the future; outlining the options available to achieve the appropriate level of medical services for the DF. The recommended approach should represent value for money and should be achievable within the existing resource envelope for medical provision in the DF. Recommendations should address issues arising from the assessment phase.

    Specific recommendations should address:
     The appropriate structure to meet the medical requirements of the DF.
     The appropriate balance between the provision of medical services by the Medical Corps and provision from external sources.
     Recruitment, retention and career progression of Medical Officers (doctors, dentists and pharmacists) and members of the Army Nursing Service.

    d. Phase 4 Implementation Plan.

    A work plan should be completed identifying the major projects necessary to meet the blueprint for services. Estimates of the resource requirements should be given to enable the delivery of the major projects along with possible timescales for their delivery. Phasing should be considered, particularly where the delivery of the overall solution/ programme is likely to be lengthy.
    Information Note on the Defence Forces Medical Services

    Background

    The Medical Corps is a Combat Service Support Corps of the Defence Forces.
    The objectives of the Medical Corps are:

    • To maintain and promote health and well-being for members of the DF.

    • To maximise the medical readiness of the DF for operational activities both at home and overseas.

    • To provide field medical support in operational and overseas settings.


    The mission of the Medical Corps is:

    ‘To ensure and co-ordinate the provision of Medical, Dental and Pharmaceutical support to the Defence Forces in the execution of their roles as assigned by Government’.

    The focus of the military medical service is to provide:

    • Primary care.

    • Acute trauma management.

    • The introduction and supervision of preventative and informative medical programmes.

    • The implementation and supervision of field medical training.

    • To provide an occupational medical service.

    • To provide expert advice on the provision of Medical Care and Support in a military setting to the General Staff.

    The range of services provided by the Medical Corps includes:

    • A military occupational medical service.

    • A primary medical care service.

    • A secondary medical care service.

    • A preventive medical care service.

    • Provision of medicines and dressings.

    • Dental services.

    • A Field Medical service.

    • Training.

    • Maintenance of medical records.

    • Medico- legal services.

    • Advisory service on medical issues to commanders.


    Serving members of the PDF are provided with free medical treatment up to General Practitioner (GP) level within Military Medical Facilities (MMF) by Medical Officers of the DF. The DF is dependent on civilian health care facilities for the provision of hospital inpatient, day care and consultancy services for members of the organisation. The Department of Defence meet the costs of most external medical services. The services of civilian GP’s are regularly engaged to provide primary care when Medical Officers are not available.

    The families of serving members of the DF have no entitlement to the provision of any medical services by the Medical Corps, either directly or indirectly. The Medical Corps does not have the capability, nor is it their role, to provide civilian medical services for families of members of the DF. The sole exception to this is the clinic for families of personnel serving in the Defence Forces Training Centre (DFTC) Curragh Camp, where, for historical reasons, the Medical Corps has provided a General Practitioner service to the families of enlisted personnel who are serving with military Units based on the Curragh.

    Military activity can be hazardous and stressful. Commanders at all levels must be conscious of any physical or psychological constraint that might impinge on an individual’s ability to perform the full range of duties. There is a responsibility on commanders and a duty of care not to unnecessarily place personnel in a position whereby their health might be put at risk due to their physical and mental health condition. There is a requirement for a commander to have access to medical advice in the preparation and planning for operations and training exercises, thereby reducing risk and having the necessary medical support readily available. It is essential, that the Medical Corps has detailed and up-to-date information on the medical status of personnel.






    Current Structures

    The reorganisation of the Medical Corps, which was effected as part of the Defence Forces Review Implementation Plan (DFRIP) in November 1998, redirected the focus of military medical care from a predominantly hospital based service to one in which primary care, occupational medicine and field medical support would emerge.

    The Medical Corps facilities are as follows:

    • St Bricins Military Hospital, Dublin.

    • Three (3) MMF’s located in: Cork, Athlone, Curragh.

    • Seventeen (17) Medical Centres, one (1) in each permanently occupied barracks.

    While St. Bricins retains the title of a hospital, it no longer functions as such. The following services are provided at St Bricins:

    • Primary Care (GP) type services, including post hospital reviews.

    • ENT and Ophthalmology clinics (provide by external civilian consultants).

    • Psychiatry, Physiotherapy, Radiology, Pathology and Dental Services (including Periodontal treatment).

    • Pharmacy

    • Hospital laboratory.

    • X-Ray facility.

    St. Bricins Military Hospital and the three (3) MMF’s have associated infirmaries for the care of “living in” personnel (largely recruits and other training course students) who may become injured or ill. Physiotherapy facilities are also available at the MMF’s in Cork and the Curragh.

    Current Strength (Medical Officers + ANS) vs. Establishment

    Profession Establishment No. Current Strength (as at Feb 07)
    Medical Officers (Doctor) 47 22
    Dentists 8 4
    Nurses 23
    Pharmacists 5 4
    Psychologist 1 1
    Periodontist 1 1

    Comment


    • #3
      A key issue at this time is the acknowledged shortage of Medical Officers (Doctors) in the Medical Corps. The establishment for doctors provided for in the new organisation of the DF introduced following the White Paper on Defence 2000 is forty-seven (47). The current strength of Medical Officers in the DF is twenty-two (22). There has been recruitment of Medical Officers annually but the number attracted to work in the DF has only served to address natural wastage.

      In addition to medical officers and the ANS a key component of the Medical Corps are the variety of skilled military medical staff who provide technical assistance, paramedic and administrative support.



      TECH SGT MAJ CS CQMS SGT CPL PTE 3* TOTAL
      AMC Medics (2) 1 1 4 14 28 48
      AMC Medics (1) 3 2 7 6 30 48
      AMC Medics Ambulance Atts (2) 3 3 4 4 7 21
      Dental Hygienist (4) 1 1
      Dental Lab Tech Crown & Bar (5) 1 1 2
      Dental Surgery Asst (3) 4 2 6
      Emergency Medic Tech (3) 2 1 26 30 25 84
      Lab Tech (6) 1 1 1 3
      X-ray Medic (2) 1 1
      TOTAL 2 9 6 45 59 93 214



      Location of Medical Officer Staff

      At the end of November 2007, the distribution of medical officer staff was as follows:



      Directorate St. Bricins Cathal
      Brugha Cork Athlone Curragh Naval Base Baldonnel
      Air Corps Overseas Total
      Med Officers (Doctor) 2 * 7 1 3 3 3 1 1 1 22
      Dentists 2 1 1 4
      Nurses 8 4 9 1 1 23
      Pharmacists 1 1 1 1 4
      Periodontist 1 1
      Psychologist 1 1

      Notes:
      * Includes the Officer Commanding the hospital, a Pathologist and the Defence Forces Psychiatrist. Two (2) civilian GP’s and two (2) civilian consultants provide services to the hospital.
      There is no establishment for Nurses in the current Administrative Instruction, CS 2. Each Brigade has 1 x Brigade Medical Officer; these are stationed in Cathal Brugha- Dublin, Cork, Athlone, Curragh.
      Three MO’s will shortly deploy overseas to CHAD (1 x St Bricins & 2 x Curragh).


      Civilian Infill

      The services of civilian General Practitioners must be regularly engaged to provide primary care. The DF is also dependent on civilian health care facilities for secondary and tertiary hospital services. Difficulties, such as extended waiting times in the public health system have a resulting adverse effect in the provision of services to members of the DF.

      Problems with recruitment and retention of doctors in the PDF

      Since 1996, the rate of retirement and the resignation of Medical Officers have been running at approximately three times that of recruitment. The resulting shortfall in Medical Officers has resulted in a number of challenges. These include:

      • Appropriately evaluating and dealing with individual cases of long term sickness,

      • The need to recruit short term contract Medical Officers for Overseas Service and

      • A lack of continuity in the medical care of individual members of the organisation.

      Over a number of years doctors and dentists pay in the DF had fallen significantly behind that paid to Public Sector equivalents. This has resulted in major difficulties in recruiting and retaining doctors and to a lesser extent dentists. Following on from the ongoing review of the Defence Forces Medical Service, agreement was reached with the Department of Finance to effectively link the pay of military doctors and dentists in the Medical Corps with Public Health doctors and dentists. The intention is to enable the DF to compete with the Public Health Sector when recruiting in the future.

      Following on from the improved pay structure a new recruitment campaign was undertaken in 2007 for Medical Officers (doctors). Unfortunately, the results of this campaign were disappointing. In 2008 applications have improved from non-Irish nationals.

      Pay, however, is not the only issue. Young doctors in terms of their future career prospects may also view the clinical setting and experience offered by the Medical Corps in the DF as relatively limited. This is especially so in the context of the modern Irish Health System where postgraduate training of all doctors for specialist registration is now mandatory. This has served to reduce the potential number of young doctors who might consider a Commission as an Officer in the DF and service in the Medical Corps.


      Recent Medical Officer Appointments:
      Number of Doctors Appointed Year
      2 2007
      2 2006
      4 2005
      1 2004
      1 2003[/QUOTE]

      Comment


      • #4
        Will there be any place for civillian (PHECC) qualified paramedics in this scheme do you know DeV??
        Go Mairidís Beo

        Comment


        • #5
          What scheme? This is tender documentation - most of the above outlines the current situation within AMC.

          DOD is going to commission a consultancy company to do a report on AMC. It will be 4 phased, see above in post #2.

          Comment


          • #6
            Originally posted by DeV View Post
            What scheme? This is tender documentation - most of the above outlines the current situation within AMC.

            DOD is going to commission a consultancy company to do a report on AMC. It will be 4 phased, see above in post #2.
            Ok ok! my question probably should be about utilisation of civvie skills and on another thread..:redface:
            Go Mairidís Beo

            Comment


            • #7
              does anybody know if the still take on nusres, what for and how much there paid

              Comment


              • #8
                I've never heard of vacancies being advertised.

                No nurses were recruited between 97 and 03 anyway, however 3 civilian nurses were recruited in 1998http://www.irlgov.ie/debates-03/27May/Sect13.htm

                The ANS isn't a large organisation, there are only 23 nurses in the ANS.

                Comment


                • #9
                  Originally posted by DeV View Post
                  I've never heard of vacancies being advertised.

                  No nurses were recruited between 97 and 03 anyway, however 3 civilian nurses were recruited in 1998http://www.irlgov.ie/debates-03/27May/Sect13.htm

                  The ANS isn't a large organisation, there are only 23 nurses in the ANS.
                  The Finance Dept Estimates for 2008 show for 25 in 2007 and 30 for 2008 are some being recruited?????

                  Comment


                  • #10
                    Originally posted by DeV View Post
                    1.2 Background

                    The Permanent Defence Forces have a strength of 10,500 personnel with a Medical Corps of approximately 260 personnel. (Appendix 1 refers). Part of the Medical Corps is the Army Nursing Service (ANS) with strength of 23. The Reserve Defence Forces consists of an Army and Naval Reserve with an established strength of over 12,000 personnel with 294 from Reserve Medical Units.

                    They might try and give them acurate figures at least before anyone sets about project set up and costing matrix!
                    "The Question is not: how far you will take this? The Question is do you possess the constitution to go as far as is needed?"

                    Comment


                    • #11
                      Originally posted by DeV View Post
                      A key issue at this time is the acknowledged shortage of Medical Officers (Doctors) in the Medical Corps. The establishment for doctors provided for in the new organisation of the DF introduced following the White Paper on Defence 2000 is forty-seven (47). The current strength of Medical Officers in the DF is twenty-two (22). There has been recruitment of Medical Officers annually but the number attracted to work in the DF has only served to address natural wastage.

                      ........
                      Pay, however, is not the only issue. Young doctors in terms of their future career prospects may also view the clinical setting and experience offered by the Medical Corps in the DF as relatively limited. This is especially so in the context of the modern Irish Health System where postgraduate training of all doctors for specialist registration is now mandatory. This has served to reduce the potential number of young doctors who might consider a Commission as an Officer in the DF and service in the Medical Corps.


                      Recent Medical Officer Appointments:
                      Number of Doctors Appointed Year
                      2 2007
                      2 2006
                      4 2005
                      1 2004
                      1 2003
                      [/QUOTE]

                      Dail debates on Thursday last [10th April 2008] had an interesting feature on this..


                      Defence Forces Medical Services.

                      8 Deputy Seymour Crawford asked the Minister for Defence the percentage of members of the Permanent Defence Force by rank and brigade or formation who had an annual medical examination in each of the years from 2002 to 2007, inclusive; and if he will make a statement on the matter.

                      19. Deputy Paul Kehoe asked the Minister for Defence the number of members of the Permanent Defence Force who have not had an annual medical examination for one, two and three years from 31 December 2007 retrospectively; and if he will make a statement on the matter. [13511/08]

                      Deputy Tom Kitt: I propose to take Questions Nos. 8 and 19 together.
                      All members of the Permanent Defence Force are required to undergo an annual medical examination. In 2007, a total of 8,111 annual medical examinations were conducted with a shortfall of 2,323. The figures in respect of earlier years are being collated and will be provided to the Deputies as soon as they are available.

                      The shortage of medical officers in the Medical Corps was the principal reason that not every member of the Defence Forces underwent a medical examination in the years in question. Due to operational constraints, personnel sometimes are not available to attend for examination at the scheduled times. Personnel due to serve overseas, those wishing to extend service and recruits and cadets at initial grading are among those prioritised for medical examination.

                      The services of civilian medical practitioners are used to provide back-up to the Medical Corps to ensure the primary health care requirements of the Defence Forces are met. Annual medical examinations are part of the occupational medical service of the Defence Forces and the preference is, therefore, that they be conducted by serving medical officers.

                      The challenges facing the Medical Corps have been recognised for some time and a review of the provision of medical services is ongoing as part of the modernisation agenda for the Defence Forces. The representative associations are involved with the Department in this review. The scope of the review includes the level of service to be provided to members of the Defence Forces and the resources required for the delivery of that service.
                      Given the ongoing issues and mindful of the need to make progress in this area, it has been decided to engage consultants to make recommendations on the best means of meeting the medical requirements of the Defence Forces. The process of engaging the consultants is under way.

                      Deputy Jimmy Deenihan: Does the Minister of State believe the Defence Forces have the capability to provide all their personnel with an annual medical examination at present? It is a simple question. Obviously, there is a difficulty if more than 2,000 personnel did not undergo a medical examination. The Minister of State will agree the health of the organisation is paramount and that each member of the Defence Forces should undergo a medical check-up every year. People tend to be reluctant to undergo medical check-ups, especially the male element of the Defence Forces. It is important that such check-ups should be both available and obligatory on an annual basis.
                      It also is highly important for the Defence Forces to monitor the health and fitness levels of their personnel at all times. Is a general medical report on the health status of the Defence Forces issued on an annual basis?

                      Deputy Tom Kitt: The introduction of consultants to consider the matter indicates the present position must be improved. It constitutes an indication that something must be done. However, sick soldiers receive the requisite care and the services of civilian medical practitioners are used to back up the Medical Corps to ensure the primary health care requirements arising in barracks are met. One must acknowledge there is a recruitment problem.

                      More importantly, the major improvements in pay that were introduced recently have not resulted in significant recruitment. These issues must be addressed. The Medical Corps is not immune to the wider challenges that exist in the medical field. Non-Irish national doctors have been employed in the health sector and it is no longer unusual. Similarly, in the Defence Forces, suitably qualified doctors have served and continue to serve. Every effort is being made to deal with the issue and there is a fundamental need to do so. That is the reason the consultancy is being carried out. I will keep the House abreast of developments in this regard.

                      Comment


                      • #12
                        The Minister has mentioned in the Dail the following

                        Question 389 Tuessay 29th April 2008


                        Departmental Surveys.
                        389. Deputy Bernard Allen asked the Minister for Defence if he proposes to set up an independent expert to lead a study on the way medical services for the Defence Forces might best be delivered. [16088/08]

                        Minister for Defence (Deputy Willie O’Dea): Military medical services and facilities exist to maintain the health of the Defence Forces and to support them in operational and overseas activities. The focus of the military medical service is on primary care, occupational medicine, acute trauma management, preventative medical programmes and field medical training.

                        The challenges in the medical arena have been recognised for some time and a review of the provision of medical services, in association with the Representative Associations, is ongoing as part of the Modernisation Agenda for the Defence Forces. The scope of the review includes the level of service to be provided to members of the Defence Forces and the resources required for the delivery of that service.

                        The review has already produced a Patients Charter. The agreement on the Patients Charter identifies the rights of members of the Defence Forces as patients and their obligations as users of the Defence Forces medical services. It also identifies the obligations on the providers of the services. The implementation of the Patients Charter is under way.

                        In view of the complexity of the challenge to resolve the structural, resource and other issues facing the Medical Corps and the need for concrete steps, I have decided to engage consultants to make recommendations on the best means of meeting the medical requirements of the Defence Forces. The consultancy will deal with all relevant issues affecting the sustainable provision of the relevant medical expertise and services to the Defence Forces.

                        The closing date for receipt of tenders for the provision of consultancy services was the 18 April 2008. Tender documents are currently being evaluated.

                        The development of the capacity of the Medical Corps forms part of the agreed programme for Government. I am committed to providing a sustainable medical service to meet the needs of the Defence Forces both at home and abroad.

                        Comment


                        • #13
                          There has been a Dail Answer relating to the Medical Corps

                          Thursday, 8 May 2008 [Question 491]

                          Military Medical Services.

                          491. Deputy Bernard Allen asked the Minister for Defence if his Department has implemented a patients charter for the Defence Forces which would identify the rights of military personnel in receiving medical services. [17823/08]

                          Minister for Defence (Deputy Willie O’Dea): Military medical services and facilities exist to maintain the health of the Defence Forces and to support them in operational and overseas activities. The focus of the military medical service is on primary care, occupational medicine, acute trauma management, preventative medical programmes and field medical training.

                          The challenges in the medical arena have been recognised for some time and a review of the provision of medical services, in association with the Representative Associations, is ongoing as part of the Modernisation Agenda for the Defence Forces. The scope of the review includes the level of service to be provided to members of the Defence Forces and the resources required for the delivery of that service.

                          The review has already produced a Patients Charter. The agreement on the Patients Charter identifies the rights of members of the Defence Forces as patients and their obligations as users of the Defence Forces medical services. It also identifies the obligations on the providers of the services.
                          The implementation of the Patients Charter is underway. The Military Authorities have advised that the Patients Charter has been published on the Medical Corps section of the Defence Forces Intranet site. In addition copies have been circulated, for display, to all of the Medical Aid Posts and clinics. The Brigade Medical Officers have been directed to implement its provisions.

                          However, the full implementation of the Charter is clearly dependent on the resolution of the structural, resource and other challenges facing the Medical Corps. The challenges we face with medical services in the Defence Forces go beyond the provision of the Patients Charter. It is one item on the Medical Review agenda.

                          In view of the complexity of the challenge to resolve the structural, resource and other issues facing the Medical Corps, I have decided to engage consultants to make recommendations on the best means of meeting the medical requirements of the Defence Forces. The consultancy will deal with all relevant issues affecting the sustainable provision of the relevant medical expertise and services to the Defence Forces.

                          The closing date for receipt of tenders for the provision of consultancy services was the 18 April 2008. Tender documents are currently being evaluated.

                          The development of the capacity of the Medical Corps forms part of the agreed programme for Government. I am committed to providing a sustainable medical service to meet the needs of the Defence Forces both at home and abroad.


                          Other replies on defence matters that day can be found on the Dail site http://debates.oireachtas.ie/DDebate...e=3902&Page=47

                          Comment


                          • #14
                            There was a reply in the Dail Questions on Thursday 22nd May 2008 on this point

                            Question 3

                            Consultancy Contracts.

                            3. Deputy Jimmy Deenihan asked the Minister for Defence the progress that has been made in appointing consultants to carry out a review of the Defence Forces medical services; the proposed terms of reference for the consultants; the date by which it is anticipated the consultants will submit their report to him; if he will publish the consultants’ report; and if he will make a statement on the matter. [20062/08]

                            Deputy Willie O’Dea: Military medical services and their facilities exist to maintain the health of the Defence Forces and to support them in operational and overseas activities. The focus of the military medical service is on primary care, occupational medicine, acute trauma management, preventative medical programmes and field medical training.

                            The challenges in the medical arena have been recognised for some time and a review of the provision of medical services, in association with the representative associations, is ongoing as part of the modernisation agenda for the Defence Forces. In view of the complexity of the challenge facing the Defence Forces in this area, I decided to engage consultants to make recommendations on the best means of meeting their medical requirements. The consultancy will focus on the sustainable provision of the relevant medical expertise and services to the Defence Forces.

                            The consultancy is expected to deliver the following items: a review of the medical input required for the Defence Forces in the light of their roles and operations, an assessment of the current arrangements for the provision of medical services, a recommendation regarding sustainable future provision of the required medical input,and a work plan, outlining the main projects necessary, with timescales and a costing matrix for the implementation of recommendations.

                            It is expected a contract will be awarded shortly and I expect the report to be delivered before the end of the year. I eagerly await receipt of the report and I assure the House that following consideration of the recommendations I will publish the report and engage with all of the key stakeholders on the way ahead.

                            The development of the medical corps forms part of An Agreed Programme for Government. I am committed to providing a sustainable medical service to meet the needs of the Defence Forces both at home and abroad. Notwithstanding the current situation I can assure the House that Defence Forces personnel requiring medical treatment are getting the care they need.

                            Deputy Jimmy Deenihan: This is a matter of genuine concern for the Defence Forces in view of the fact that the PWC report and also the White Paper recommend an establishment of 47 doctors. I understand we have 23 currently, ten of whom are non-nationals. It is a major issue and something that cannot just be passed over lightly.

                            Can the Minister indicate when will the consultants be appointed and commence their work? Can he give a precise date on when he expects them to report? He mentioned they would engage with all interest groups. Will they engage with RACO, PDFORRA, military personnel, the Department of Defence and the special ongoing committee that is examining medical services within the Defence Forces?
                            In his reply, the Minister might indicate how much his Department is spending on engaging civilian medical practitioners for medical care in the Defence Forces and for outsourcing various services that could be provided if he had a full establishment.

                            Deputy Willie O’Dea: I must correct Deputy Deenihan slightly - 47 is the established figure, as he rightly says, and we have 22 currently. Six are non-nationals, but of course they are properly qualified medical practitioners. Basically, in recent times we have considerably improved pay and conditions, in agreement with the Department of Finance, for people working in the medical corps of the Army. In addition, we have run a number of intensive recruitment campaigns, although unfortunately the results have been disappointing. Since 2000 some 15 doctors have left the Army, and we have only managed to recruit ten, so obviously our numbers are down.

                            As regards when the consultants will be appointed, the tender documents are being evaluated and I expect they will be in place within the next three weeks and told to get to work immediately. I understand, from speaking to various people that we expect to be in possession of the consultants’ report before the end of the year. Deputy Deenihan asked whether they would engage with RACO, PDFORRA etc. I do not know whether the consultants will directly engage with those organisations, but certainly I shall publish the report and I shall engage with PDFORRA, RACO etc. as regards what the consultants say. If the consultants want to talk directly to RACO, PDFORRA etc., I have no objection whatsoever.

                            As regards Deputy Deenihan’s financial question about the amount of expenditure on doctors we employ because we have not got the medical personnel ourselves, the point must be made that if we did we should have to pay them anyway. I do not have the figure to hand, but I will get it for the Deputy.


                            see also answer to question 5

                            Comment


                            • #15
                              Question 5

                              Defence Forces Medical Services.

                              5. Deputy Jimmy Deenihan asked the Minister for Defence the action, in view of the statement by his Minister of State in this House on 10 April 2008 that in regard to the patients charter agreed for the Defence Forces he had been assured that issues such as publicising the charter, displaying names of medical personnel and the awareness of personnel with responsibility for the management of medical care would be addressed in the coming weeks, that has been taken in each of these areas; and if he will make a statement on the matter. [20064/08]

                              Deputy Willie O’Dea: The challenges in the medical arena have been recognised for some time and a review of the provision of medical services, in association with the representative associations, is ongoing as part of the modernisation agenda for the Defence Forces. The scope of the review includes the level of service to be provided to members of the Defence Forces and the resources required for the delivery of that service.

                              The review has produced the patients charter with the agreement of all parties, which I welcome. The agreement on the patients charter identifies the rights of members of the Defence Forces as patients and their obligations as users of the Defence Forces medical services. It also identifies the obligations on the providers of the services.
                              The implementation of the patients charter is under way. The military authorities have assured me that the patients charter has been published on the Medical Corps section of the Defence Forces intranet site. In addition, copies have been circulated, for display, to all of the medical aid posts and clinics. The brigade medical officers have also been directed to implement its provisions.

                              However, the full implementation of the charter is clearly dependent on the resolution of the structural, resource and other challenges facing the Medical Corps. As I have stated, the challenges we face with medical services in the Defence Forces go beyond the patients charter. It is but one item on the medical review agenda.

                              As I have already advised, consultants are being engaged to make recommendations on the best means of meeting the medical requirements of the Defence Forces. The patients charter will inform the deliberations of the consultants.

                              Deputy Jimmy Deenihan: The feedback I am receiving from certain elements of the Defence Forces is that the content of the patients charter has not been communicated to all the rank and file members. Will the Minister ensure that this is done? Will he appoint some high-ranking office to take charge of the implementation of the patients charter? This seems to make sense. The charter is just not displayed at doctors’ surgeries and other locations in the barracks around the country. I am sure it is possible to make its content known to every member of the Defence Forces by letter.

                              Some time ago, the Minister sent a communication to everyone in the country about the national emergency plan and, therefore, it should be possible to communicate the content of the patients charter to the 13,000 military personnel in the Defence Forces. Some years ago, the content of the dignity charter was communicated and displayed widely. The same should apply to the patients charter.

                              Is there a commitment in the patients charter that every member of the Defence Forces will have a medical check in the course of any given year? I understand there is,. but last year approximately 2,000 personnel did not have a medical check.

                              Deputy Willie O’Dea: I take the Deputy’s point about communicating the content of the charter to every member of the Defence Forces. I have no doubt that this was suggested to him but what we have done was requested at meetings of the representative associations and the military. It was requested that the charter be published on the intranet site and communicated to the medical aid posts and clinics. It was also requested that the medical aid officers be instructed to implement the charter in each brigade area. Nobody made a request to me to communicate the content of the charter to every individual but I am quite open to it if the representatives want to approach me in that regard.

                              Deputy Deenihan stated the charter is not displayed at all the appropriate locations. I was informed by the people to whom I spoke in recent days that it is displayed quite prominently in certain areas.

                              Deputy Jimmy Deenihan: Not every area.

                              Deputy Willie O’Dea: It is not displayed in every area yet. Some of the measures in the charter will not be implemented until we manage to deal with the structural problems we have been discussing. I will certainly consider and talk to people about the suggestion that a particular officer be appointed to take charge of the charter.
                              There is a commitment in the charter to offering an annual medical check to every member of the Defence Forces. We hope to do better in this regard this year but, as I stated, circumstances will not be ideal until the underlying problems are dealt with effectively.

                              Comment

                              Working...
                              X