Billy Kelleher
Question:231. Deputy Billy Kelleher asked the Minister for Health the chronic disease management programmes that were introduced in 2013; and if he will make a statement on the matter. [31722/14]
Written Asnwers Nos. 231-240
Health Services
As this is a service issue, the matter has been referred to the HSE for direct reply to the Deputy.
Patient Safety
Billy Kelleher
Question:232. Deputy Billy Kelleher asked the Minister for Health when the Patient Safety Agency's work with the Health Service Executive and the State Claims Agency to develop a risk-based approach to provision of indemnity to services and professionals was completed; and if he will make a statement on the matter. [31723/14]
Action 7.3.1 of the Health Reform Programme is that the Department of Health will work with the HSE and the State Claims Agency to develop a risk based approach to provision of indemnity to services and professionals.
The State underwrites indemnity for all public services and the professionals who provide them. In effect, this means that the State carries the risk of services which may not be safe or which do not align with national policy goals. This system of enterprise liability is managed through the Clinical Indemnity Scheme. My Department is working with the HSE and the State Claims Agency (which operates the Clinical Indemnity Scheme) to ensure that the indemnity provided to services aligns with health systems policy. The Patient Safety Agency has not yet been established, but this does not hamper the development of the risk-based approach to the provision of indemnity.
The first stage in this process is the development and operation of a new upgraded database system, developed by the State Claims Agency, which will capture information on adverse events. The National Adverse Event Management System (NAEMS) went live in 119 State authorities under the remit of the State Claims Agency on 16 June, 2014 and since that date all incidents from the HSE are held on the new upgraded system. The system is being rolled out initially over the coming months, with training being provided to its users.
Agreement will be reached by the end of 2014 between the State Claims Agency, the HSE's Patient Safety Directorate and my Department on the criteria for enabling this system to provide end to end adverse event management, root cause analysis and policy audit tools. This will, in turn, allow for the development of performance benchmarks on clinical and non-clinical risks and claims performance, which will underpin a risk pooling approach to the Clinical Indemnity Scheme.
Departmental Reports
Billy Kelleher
Question:233. Deputy Billy Kelleher asked the Minister for Health the findings and recommendations of the review conducted by his Department in conjunction with the Health Service Executive of corporate functions and resources staff and budget of the various corporate-support-shared services as they currently exist within the HSE; and if he will make a statement on the matter. [31724/14]
The review of corporate functions and resources, staff and budget of the various corporate/support/shared services as they currently exist within the HSE is ongoing. This review is being undertaken in parallel with the establishment of the revised divisional organisational structure, shared services and governance arrangements in the HSE. The HSE is working towards a December 2014 completion date for this review in line with the Service Plan requirements.
Departmental Budgets
Billy Kelleher
Question:234. Deputy Billy Kelleher asked the Minister for Health the way his Department has developed programme based budgeting in 2013; and if he will make a statement on the matter. [31725/14]
Successful transformation of our health services requires a corresponding transformation of the existing funding model. The first stage in transforming this funding model is to clarify funding streams through the creation of directorates and corresponding programme based budgets. In Vote terms, programme based budgets have already been established for the Primary Care Reimbursement Service and NHSS - Fair Deal. During 2013, due to the imminent establishment of the Child and Family Agency, the determination of a Children and Family Services budget took primacy, given the need to transfer the provision from the Vote of the Health Service Executive to the Vote of the Minister for Children and Youth Affairs.
My Department will continue to work with the HSE and the Department of Public Expenditure and Reform to develop a new Programme Based Budgeting system. However, given the multitude of financial systems in operation in the HSE, this work will be dependant on the development and roll out of an integrated financial management system. A detailed business case for a new finance operating model, including the procurement of a new Integrated Financial Management System for the wider health service, has been submitted to my Department. The business case is under consideration within my Department and the Department of Public Expenditure and Reform.
Care of the Elderly Provision
Billy Kelleher
Question:235. Deputy Billy Kelleher asked the Minister for Health when the single assessment tool for older people services was rolled out; and if he will make a statement on the matter. [31726/14]
As this is a service matter it has been forwarded to the HSE for direct reply.
Nursing Homes Support Scheme Eligibility
Billy Kelleher
Question:236. Deputy Billy Kelleher asked the Minister for Health if he will provide the findings of the review of the fair deal scheme to assess its applicability to other sectors such as the disability and mental health residential sectors; and if he will make a statement on the matter. [31727/14]
When the Nursing Homes Support Scheme commenced, a commitment was made that it would be reviewed after three years. The reason for allowing this period to elapse was to ensure that the Scheme had bedded in and that established trends would be available in order to inform the work of the Review. The Review is being carried out by my Department in collaboration with the HSE, with analysis and recommendations provided by an external service provider on specific issues which required specialised expertise.
One of the Terms of Reference for the Review is to consider the extension of the scheme to community based services and to other sectors (Disability and Mental Health). The elements of the Review that relate to the Nursing Homes Support Scheme itself are well-defined, but an effective assessment of the Scheme for the future requires consideration of where it fits within the spectrum of services and supports for older people, and of how the make-up of and balances within this spectrum may change over time. This exercise is broader than was first envisaged and the various issues arising are now being systematically considered with a view to completion and publication as early as possible.
Palliative Care Services
Billy Kelleher
Question:237. Deputy Billy Kelleher asked the Minister for Health if he will provide details of the prospective funding model for palliative care; and if he will make a statement on the matter. [31728/14]
In line with recommendations contained in Future Health - A Strategic Framework for Reform of the Health Service 2012 - 2015, the HSE is currently working on a Prospective Funding Model for Palliative Care which will assist in integrating and accounting for palliative care across all funding streams and delivery models.
An Expert Group on Prospective Funding in Palliative Care was established in May 2012 to produce a report with recommendations about the development of this Prospective Funding Model for the consideration of the HSE and the Department of Health. The Group is chaired by Professor Charles Normand, Professor of Health Policy and Management, Trinity College Dublin, and includes a representative of my Department.
It is expected that an interim report will be submitted to the Department of Health in Q3 2014 which will include:
- a review of international approaches to palliative care funding;
- a description of the best practice model of palliative care provision;
- a description of current data collection systems for palliative care activity;
- a description of the current funding system for palliative care; and
- a definition of the current spend on palliative care with unit costings for specialist palliative care provision.
Ambulance Service Provision
Billy Kelleher
Question:238. Deputy Billy Kelleher asked the Minister for Health when the reconfiguration of the ambulance service will be complete; and if he will make a statement on the matter. [31729/14]
The National Ambulance Service is continuing to modernise and reconfigure its services, to ensure that emergency pre-hospital care is delivered in an appropriate and timely manner. A significant reform programme is currently underway which will provide a clinically driven, nationally co-ordinated system, supported by improved technology. In that regard, additional funding of €3.6 million and 43 staff have been provided in the National Service Plan 2014. Ongoing performance improvement projects include;
- completion of the single national control system, due in 2015;
- the introduction of the Intermediate Care Service, for routine and non-emergency transfers, allowing emergency vehicles to focus on emergency situations;
- the move to on-duty rostering and the development of a national rostering system.
Work is ongoing on all of these projects. For details of time frames of each element of the programme, I have forwarded the Deputy's question to the HSE direct reply to him.
Medical Card Eligibility
Bernard Durkan
Question:239. Deputy Bernard J. Durkan asked the Minister for Health the procedure to date followed in the determination of eligibility for a medical card in the case of a person (details supplied) in County Kildare; the reason for the extraordinary delay; and if he will make a statement on the matter. [31731/14]
The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has issued to Oireachtas members.
Ambulance Service Response Times
Gerry Adams
Question:240. Deputy Gerry Adams asked the Minister for Health if he will seek a review of the ambulance cover in County Louth on 24 June 2014 when a person (details supplied) died; the number of ambulance crews that were available that day; the reason the closest ambulances to Dundalk were 27 and 29 minutes away; the reason there was a seven minute delay between the 911 call and the request to Louth Fire Service for ambulance assistance; and if he will make a statement on the matter. [31736/14]
Firstly I would like to express my sympathy to the family of the person concerned.
The National Ambulance Service is satisfied that all appropriate procedures were followed with regard to the handling of this tragic incident and that all available resources were deployed. Out of respect for the family concerned, I do not wish to comment further on this matter. With regard to the specific information requested by the Deputy, I have forwarded the question to the Health Service Executive for attention and direct reply to him.
Concerning ambulance capacity in any given area, the Deputy will be aware that there are currently three separate reviews taking place into the provision of pre-hospital emergency care nationally. These reviews will cover all aspects of the service, from governance to the level of resources needed to deliver a safe and effective service now and into the future. I am confident that these reviews will inform the development of a modern, clinically driven system, properly resourced, for appropriate and timely services to the benefit of patients.