Written Answers Nos. 1162-1182
1164. Deputy Niall Collins asked the Minister for Health if he will confirm the current status of the previously commitment to provide ambulatory care centre at Tallaght Hospital, Dublin, if he will appreciate the importance of the issue; and if he will make a statement on the matter. [48512/12]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply.
1165. Deputy Terence Flanagan asked the Minister for Health the reason Metanium and Aternon are not available in chemists here and they are in Northern Ireland; and if he will make a statement on the matter. [48516/12]
View answerMetanium is a medicinal product used to treat nappy rash. For a medicinal product to be placed on the market in Ireland the manufacturer must make an application to the Irish Medicines Board (IMB) for an authorisation. The manufacturer of metanium has not made an application to the IMB to authorise metanium and consequently there are no metanium products available at present on the Irish market.
Ateronon is a food supplement. I have been advised by the Food Safety Authority of Ireland that the sale of Ateronon is not prohibited in Ireland and there are no regulatory reasons preventing its sale in pharmacies in Ireland.
1167. Deputy Finian McGrath asked the Minister for Health not to cut the Disability Services at Prosper Fingal, Swords and Prosper Services in Portmarnock as a matter of urgency [48537/12]
View answerAs the Deputy's question relates to service matters I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1168. Deputy Gerry Adams asked the Minister for Health if he will provide details of the type and frequency of North South engagement his Department undertakes; the current priorities in this area; the number of whole time equivalent staff assigned to these matters; the grades involved and the amount of time each grade spends on North South Activities as a proportion of their WTE employment; the co-ordination arrangements that have been put in place; if there are any current vacancies in North South Co-operation unites; the duration of this vacancy and the steps being taken to fill the vacancy [48547/12]
View answerMy officials and I are involved in ongoing North South engagement. Ongoing priorities for advancing cooperation include those being progressed through the structures of the North South Ministerial Council; the plenary meeting of the Council took place last Friday 2 November in Armagh and the Health and Food Safety Sectoral took place in July last. There is ongoing engagement at official level. Collaboration takes place on a wide range of health and social care issues including, for example, Radiotherapy Services, Paediatric Congenital Cardiac Services, Health Promotion, Cancer Research, Food Safety and Suicide Prevention. Co-operation and Working Together (CAWT) is involved in cross-border collaborative working in the field of health and social care and also manages and delivers a range of activities that are being supported by the EU Structural Fund Initiative - INTERREG IVA.
A Principal Officer, an Assistant Principal Officer (0.8 WTE) and a Higher Executive Officer, within the Capital/EU/International and Research Policy Unit have responsibilities that includes North South matters. In addition there is bilateral engagement between officials across my Department and officials in the Department of Health and Social Services and Public Safety in Northern Ireland on specific issues. It is not possible to quantify how much of an individual's time is spent engaged solely on North South activities. There are no specific vacancies relating to North South.
1170. Deputy Gerry Adams asked the Minister for Health the number of vacancies at present in the community mental health teams across here and the location and grade where the vacancy occurs [48591/12]
View answerAs this is a service matter the question has been referred to the HSE for direct reply.
1171. Deputy Gerry Adams asked the Minister for Health the number of vacancies at present in the child and adolescent mental health teams here and the location and grade where the vacancy occurs [48592/12]
View answerAs this is a service matter the question has been referred to the HSE for direct reply.
1172. Deputy Terence Flanagan asked the Minister for Health his views on the home help cuts in 2012; if he will protect home help hours in Budget 2013; and if he will make a statement on the matter. [48601/12]
View answerThe HSE has a statutory responsibility to live within the budget voted to it by the Oireachtas. In this context, the HSE recently developed a range of proposals to address funding pressures overall by the end of 2012. Most of the measures agreed focus on areas that do not have a direct patient impact. It is a priority of the Executive to minimise the impact on patients and clients of any spending reductions. In relation to home help, hours will continue to be based on a review of individual needs and no current recipient of the service and who has an assessed need will be without a service. The position in relation to 2013 is being considered in the context of finalising the Estimates and Budgetary process for next year.
In relation to the individual case raised by the Deputy, this has been referred to the HSE for direct reply, as it is a service matter.
1174. Deputy Billy Kelleher asked the Minister for Health his plans to introduce bed re-designation in 2013; if this proposal must be approved by Cabinet; if it will require primary legislation; his views on the VHI's claims that it will result in a 45% increase in health insurance premiums; the discussions he has had with private insurers in relation to this issue; and if he will make a statement on the matter. [48638/12]
View answerA system of bed designation has been in place in public hospitals since the 1990s. Under this system, most beds are either designated as public beds or private beds: there is a small number of non-designated beds, such as those in Intensive Care Units.
Under the current framework, private in-patients who occupy public beds in public hospitals are not levied the daily maintenance charge, which ranges from €586 to €1,046 in most public hospitals.
The Comptroller and Auditor General reported in 2010 that 45% of in-patients treated privately by their consultants were not charged for their maintenance costs because they were not occupying designated private beds.
As part of Budget 2012, I announced that I intended to bring forward legislation to provide for the charging of all private patients in public hospitals, irrespective of whether they occupied a public or a private bed. In view of the significant potential cost implications for private health insurers, I subsequently indicated that I would be prepared to postpone implementation of the legislation until 2013 provided that the funds targeted for the current year were raised through a system of improved cashflow from the private insurers. Arrangements for this improved cashflow have now been agreed with the insurers, and the legal details are being finalised.
In relation to charging all private patients in public beds, the issue will be dealt with as part of the budgetary process for 2013. I will being legislative proposals to Government on the matter in due course.
I am committed to keeping the cost of health insurance premia as low as possible. With this in mind, my Department is working closely with the four health insurers, through Consultative Forum on Health Insurance. The objective is to minimise costs, while always respecting competition law.
1175. Deputy Róisín Shortall asked the Minister for Health the position regarding speech and language therapy in respect of a child (details supplied) in Dublin 11; and if he will make a statement on the matter. [48641/12]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1176. Deputy Róisín Shortall asked the Minister for Health the position regarding speech and language therapy in respect of a child (details supplied) in Dublin 9; and if he will make a statement on the matter. [48642/12]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1177. Deputy Joe McHugh asked the Minister for Health if he will update Dáil Éireann on the deliveries to date by public hospitals of targets that were set out by the Special Delivery Unit which he established following his appointment as Minister for Health; if he will update Dáil Éireann on the rewards system that may apply in respect of the delivery or surpassing of targets set out by the Special Delivery Unit; and if he will make a statement on the matter. [48644/12]
View answerIn the current economic climate, the acute sector must reduce its costs in order to deliver the agreed level of activity within the resources available to it. In terms of service delivery, we must concentrate on getting the best possible services for patients from the budgets available to us. This means we need to focus on how beds are used, on the throughput of patients, on reducing length of stay to international norms and on having as many procedures as possible carried out as day cases rather than inpatient work, thus maximising also the efficient usage of operating theatre facilities.
Performance management by hospitals will be measured against a scorecard based on access, quality and finance. This scorecard is part of the HSE’s Service Plan for 2012. I will set the access targets. Quality targets will be determined by the acute medicine programme, which was devised as part of the HSE’s Clinical Programmes: this sets the standards and operational guidelines (including clinical care pathways, discharge planning, staffing, rosters) for managing and delivering acute medicine in hospitals. Its implementation is essential to the success of the SDU as it sets the standards and clinical performance against which the hospital is measured. Finance targets will be determined as the ability of the hospital, and later of Hospital Groups, to remain within budget.
Performance management of hospitals, and later of Hospital Groups, against the financial, access and quality indicators, will be based on the CompStat (Comparative Statistics) management performance approach used in the New York Police Department. This combines monthly data across a series of metrics on hospital performance with monthly performance management and review meetings attended by area and hospital senior management.
Scheduled Care
The SDU Scheduled Care Team was tasked with improving access to elective surgery and lowering waiting lists. There have been significant achievements in Scheduled Care since July 2011 when the SDU was formed.
Inpatient and daycase surgery
- Overall waiting list numbers have decreased from 56, 020 to 51, 955, a drop of 7%
- The number of adults having to wait more than 12 months is down from 2,732 to 408, a drop of 85%
- The number of adults having to wait more than 9 months is down from 6,277 to 2,342, a drop of 63%
- The number of children having to wait > 20 weeks is down from 1,712 to 670 a decrease of 61%
GI endoscopy
The SDU began to tackle long waits for routine GI endoscopy services (i.e. scopes) in May 2012 and:
- Since May 2012 overall waiting list numbers for scopes have decreased from 13,349 to 8, 904, a drop of 33%
- Those having to wait > 3 months (the target for 2012) have decreased from 5,062 to 1,711, a drop of 66%
Outpatients
The initial priority for the SDU was trolley waits and daycases. It has now begun to work on improving access to outpatient services. The SDU and NTPF are on trajectory to take over the reporting of outpatient waiting times from the HSE from Oct 2012.
For the first time individual patient level waiting time data will be available at national level where data will be automatically extracted from all hospitals providing an outpatient service in the same format on a weekly basis. This is a major achievement by the SDU / NTPF in overcoming huge IT incompatability, data quality and other resource issues.
The next step will be to reform the delivery of outpatient services in hospitals, critically examining processes and identifying areas for improved efficiency.
Unscheduled Care
The SDU was tasked with improving access to emergency care. Very significant progress has been made with the result that for significant numbers of patients, the experience in our EDs has been markedly improved.
- The number of patients waiting on trolleys in EDs has reduced by 22% from January to September, compared to the same period last year (or 13,450 fewer patients)
- The number of patients waiting on trolleys has fallen from a record of 569 on 5 January 2011 to 144 on 26 October 2012
- The 30 day moving average (average number of trolleys over 30 days) has fallen by 35% in 12 months, from 302 on 5 September 2011 to 197 on 7 September 2012
- The SDU’s focus in relation to unscheduled care is now moving to patient journey time (attendance to admission/discharge) with that aim that 95% of ED attendees are discharged or admitted within 6 hours of registration and nobody waits more than 9 hours
- The SDU is working intensively to develop best practice hospital sites for patient pathways through unscheduled care.
With regard to a possible reward system, the principle of rewarding good hospital performance is one that I would generally endorse. Hospital budget allocations for 2013 are being carefully considered and I may consider some type of reward system within that context.
1178. Deputy Maureen O'Sullivan asked the Minister for Health if he plans to introduce a registration system for health and social care workers next year that will charge social care workers €295 to register; if he will consider reducing the fee or equalising it in proportion to other professionals such as nurses, €88, and teachers, €65; his response to their concerns that the fee of €295 would be an added burden on the already reduced salaries of 14% or 25% for new graduates entering the heal service; and if he will make a statement on the matter. [48648/12]
View answerThe Health and Social Care Professionals Council (HSCPC) and the 12 registration boards to be established under the Health and Social Care Professionals Act 2005 are responsible for protecting the public by regulating health and social care professionals. The Council (also known as CORU) was established in March 2007 and is working to put in place the necessary structures for registration, education and fitness to practise for the 12 health and social care professions, including social care workers, designated under the Act.
The first registration board to be established, the Social Workers Registration Board, which does not include Social Care Workers, was established in August 2010, and the associated Social Workers Register opened for receipt and processing of applications on 31st May, 2011. A second registration board, the Radiographers Registration Board, was established on 16th December, 2011 and its register is expected to be established in the near future. Three further registration boards, the Dietitians Registration Board, the Occupational Therapists Registration Board, and the Speech and Language Therapists Registration Board are currently in the process of establishment and it is also proposed to establish the Physiotherapists Registration Board either before the end of this year, or in early 2013.
It is proposed to establish the Social Care Workers Registration Board in 2013, although considerable work will be involved before it can open its register for receipt of registrants. All of the registration boards for the remaining designated professions should be established and their registers fully operational by 2015 or 2016 at the latest.
Under the provisions of the 2005 Act, there is a two-year transitional period from the date on which the register of the members of that profession is established, during which existing practitioners may apply for registration. The name of every registrant will be published in the register, which will be accessible on-line. Only those registrants who have satisfied the registration board for their designated profession that they hold an approved qualification and are "fit and proper" to engage in the practice of the profession will be entered on the register.
The State is currently funding the HSCPC in its establishment phase (€1.937 million in 2012) and will continue to do so on a reducing basis to end 2015.
The Council which is an independent statutory body is responsible for setting the level of fees and in doing this it is mindful of the requirement for it to become self funding by end 2015.
The current fee structure is as follows:
- A registration fee of €100 for new graduates, who have obtained recognised professional qualifications within two years of applying for registration;
- An annual retention fee of €295 for registrants, including those who paid the lower rate on graduation, is payable on the annual renewal date.
Since the annual renewal fee of €295 is subject to full tax relief it reduces to €174 at the higher level of tax which compares favourably with fees levied by Union and professional bodies where no tax relief is applicable.
All health regulators are self funding by way of annual fee income. The greater the registrant base the lower the annual fee charged. Given the enormous registrant base in teaching and nursing, for example, the annual fee charged amounts to less than €100 per annum. Health regulators are single profession regulators whereas the HSCPC is charged with regulating twelve disparate professions, which can add significantly to operating costs. The twelve designated professions to be registered by the Council range in number from under 50 in the case of Clinical Biochemists to a high of 3,000 approximately for Medical Scientists, but only amount to about 20,000 registrants in total across all professions. This is an extremely low registrant base when compared to a registrant base of well in excess of 60,000 for nurses.
The HSCPC is charged with extensive statutory functions under the 2005 Act, registration being only one, and the annual fee of €295 being charged by the HSCPC is considered the bare minimum required to enable the Council to operate. The fee is on a par with that charged by other health regulators and less than some in certain cases.
In response to concerns about the level of fee, the HSCPC has reviewed the regulatory structure to establish what scope exists for further reductions in registration fees and operational costs and has adopted the following measures:
- Where an existing practitioner with the necessary experience and recognised professional qualifications, or equivalent, pays the registration fee of €295 and is granted registration during the transitional period, also known as grandparenting, the application fee will cover them for the remainder of the grandparenting period and one full year of retention of registration after expiration of grandparenting. This concession will only apply to existing practitioners availing of the transitional provisions set out in the Act;
- The Council has requested the HSE to put in place arrangements for the deduction of the registration fee from monthly salary thereby spreading the cost throughout the year;
- Finally, the Council has proposed significant restructuring of the way in which the designated professions will be registered and regulated to provide a more cost effective operating system. This will require the enactment of primary legislation in due course.
1179. Deputy Michael Lowry asked the Minister for Health if his attention has been drawn to a redundancy issue in respect of a person from the Health Service Executive (details supplied) in County Tipperary; the reasons for the delay in the processing of this application; if he is aware of the hardship and financial impact this delay has on this person; if he will ask the HSE to rectify the situation; and if he will make a statement on the matter. [48651/12]
View answerAs this is a service matter it has been referred to the HSE for direct reply.
1181. Deputy Seán Kenny asked the Minister for Health the reason a person (details supplied) in County Dublin has had their home help hours cut without assessment following their recent release from hospital [48666/12]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
1182. Deputy Finian McGrath asked the Minister for Health the position regarding a care plan in respect of a person (details supplied) in Dublin 3 [48691/12]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
