HSE Staff Remuneration

Questions (308, 309, 323, 324)

Mary Lou McDonald

Question:

308. Deputy Mary Lou McDonald asked the Minister for Health the net saving to the Exchequer if all Health Service Executive pay, excluding hospital consultants, was capped at €100,000. [49135/12]

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Mary Lou McDonald

Question:

309. Deputy Mary Lou McDonald asked the Minister for Health the gross saving to the Exchequer if all Health Service Executive pay, excluding hospital consultants, was capped at €100,000. [49136/12]

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Mary Lou McDonald

Question:

323. Deputy Mary Lou McDonald asked the Minister for Health the net saving to the Exchequer if all Health Service Executive pay excluding hospital consultants were capped at €100,000. [49184/12]

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Mary Lou McDonald

Question:

324. Deputy Mary Lou McDonald asked the Minister for Health the gross saving to the Exchequer if all Health Service Executive pay excluding hospital consultants were capped at €100,000. [49185/12]

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Written answers (Question to Health)

I propose to take Questions Nos. 308, 309, 323 and 324 together.

As this is a service matter it has been referred to the Health Service Executive for direct reply.

Hospital Waiting Lists

Questions (310, 334)

Bernard Durkan

Question:

310. Deputy Bernard J. Durkan asked the Minister for Health the progress made to date toward a reduction of waiting lists and times in respect of all surgical procedures at all public hospitals throughout the country; and if he will make a statement on the matter. [49139/12]

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Bernard Durkan

Question:

334. Deputy Bernard J. Durkan asked the Minister for Health if he will set out the extent of the reduction of waiting lists for various medical or surgical procedures in respect of all public hospitals throughout the country over the past two years; the areas that have most shown improvement in this regard; his aspirations for such areas; and if he will make a statement on the matter. [49222/12]

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Written answers (Question to Health)

I propose to take Questions Nos. 310 and 334 together.

As set out in the HSE Service Plan for 2012, the access targets for 2012 in-patient and daycase treatment are as follows:

No adult should have to wait more than 9 months for an in-patient/daycase procedure date; no child should have to wait more than 20 weeks for an in-patient/daycase procedure date; no patient should have to wait more than 13 weeks (3 months) for a routine GI endoscopy procedure.

There have been significant improvements in access to scheduled care (elective surgery - in-patient or daycase) since the Special Delivery Unit (SDU) was formed. The SDU's Scheduled Care Team was tasked with improving access to elective surgery and lowering waiting lists and the most recent Progress Report on the New Access Targets, which set out progress towards the targets by the end of Q3, shows the following.

In-patient 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 is now working with the NTPF to build on the current work being undertaken by the HSE and to begin the systematic collection of outpatient waiting time data at an individual patient level. The collation and analysis of OP waiting time data in this standardised format will enable the SDU and NTPF to target resources towards those patients who are waiting longest and ensure that they are seen and assessed. In parallel with reducing the numbers of longest waiters, the SDU will also work with the HSE Clinical Programmes to reform the structure, organisation and delivery of OP services to ensure that the right patient is seen and assessed by the right health professional at the right time.

Bullying in Schools

Questions (311)

Bernard Durkan

Question:

311. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the Health Service Executive has been in a position to assist victims of school bullying; and if he will make a statement on the matter. [49140/12]

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Written answers (Question to Health)

As this is a service matter the question has been referred to the HSE for direct reply.

Health Services Expenditure

Questions (312, 313, 317)

Bernard Durkan

Question:

312. Deputy Bernard J. Durkan asked the Minister for Health the extent to which it has been found possible to identify areas and causes of expenditure overruns throughout the health services by the Health Service Executive; and if he will make a statement on the matter. [49141/12]

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Bernard Durkan

Question:

313. Deputy Bernard J. Durkan asked the Minister for Health the saving to date achieved throughout the public health sector in each of the past three years to date; and if he will make a statement on the matter. [49142/12]

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Bernard Durkan

Question:

317. Deputy Bernard J. Durkan asked the Minister for Health the extent of savings made by his Department throughout the health services in each of the past three years to date; the way front-line services were affected; the impact on administration; and if he will make a statement on the matter. [49146/12]

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Written answers (Question to Health)

I propose to take Questions Nos. 312, 313 and 317 together.

The health service budget has been reduced by €2.5 billion over the last three years. The number of health service staff has fallen from a peak of 111,000 in 2007 to less than 103,000 now. As we are all aware, the country still faces serious challenges in respect of the public finances, and in order to meet the targets agreed with the Troika, there will be further reductions in the level of resources allocated to the health sector.

The 2010 Budget for the health services provided for €659m in pay savings and €400m in non-pay savings. The pay savings of €659m took account of general pay reductions, and higher reductions for those on higher pay on foot of the Report of the Review Body on Higher Remuneration along with savings associated with the moratorium on recruitment and promotion. The non-pay savings of €400m concentrated on areas which would not have a significant impact on front-line services, such as reductions in drugs costs, further economies in areas such as procurement, and improved private income collection by public hospitals. In 2011 further price reductions were applied in relation to pharmaceuticals, to achieve full year savings of €200 million in the cost of drugs. Further reductions in GP fees under the Financial Emergency Measures in Public Interest (FEMPI) Act 2009 were applied, and the charge for treating private patients in public hospitals was increased by 21%. Along with further procurement economies, and reductions in pay as a result of the voluntary exit schemes, the objective was to mitigate as far as possible against affecting front-line services.

Expenditure plans for 2012 were set in the context of stabilising the fiscal situation whilst protecting services to the greatest degree possible. As with other sectors, the Health sector incurred a reduction in the resources allocated to it. The gross current budget for the Health Sector for 2012 was some €183m less than the 2011 allocation. However, the underlying reduction was greater because of the need to provide for unavoidable cost increases in areas such as superannuation, demand-led schemes and Fair Deal. There was also a need to commence implementation of some priority commitments in the Programme for Government. The HSE's National Service Plan indicated that in order to meet the Government's targets and to provide for unavoidable pressures, savings of €750m will need to be achieved in 2012.

The HSE is overspent by €374m to the end of September. There is intensive engagement between my Department and the Health Service Executive to address the excess expenditure. In the short term, to address the 2012 position, I have instructed the Executive to impose cash limits on agency and overtime. Furthermore, there will be more rigorous management of absenteeism, travel and subsistence will be limited, and stock management will be intensified in order to better manage cash. Other measures are also being undertaken in order to achieve a balanced budget, including the use of capital to fund revenue and the transfer of Department funds to the HSE on a once-off basis.

As I have outlined in this House on previous occasions, I have instructed the HSE that efficiencies must be achieved in the first instance before patient services are affected and in this regard, patient safety must be paramount.

National Children's Hospital Location

Questions (314)

Bernard Durkan

Question:

314. Deputy Bernard J. Durkan asked the Minister for Health if he has satisfied himself as to the availability of the most suitable readily accessible site for the provision of the proposed new children's hospital; if he has examined the merits of a greenfill site for the project; if the preparatory consultancy and research costs to date are likely to be more beneficial in a greenfield site situation; and if he will make a statement on the matter. [49143/12]

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Written answers (Question to Health)

Following the refusal of planning permission by An Bord Pleanála for the new children's hospital on the Mater site, I established a Review Group chaired by Dr Frank Dolphin (the Dolphin Group) to advise on next steps. Their report was presented to me on 8 June last. On Tuesday, I announced the Government’s decision to develop the new children’s hospital at the campus of St James’s Hospital in Dublin. In identifying the new site, the Government has carefully considered the report of the Dolphin Group along with detailed supplementary information on cost, time and planning which was subsequently sought from those members of the Group with the relevant technical expertise.

This decision has been made in the best interests of children, with clinical considerations being of paramount importance. It is essential that the new children’s hospital can deliver best clinical outcomes for our children. Co-location with an adult hospital has been deemed essential by the Dolphin report, and by all previous reports on this issue, while tri-location with a maternity hospital is optimal. Greenfield sites do not offer this opportunity and therefore the Dolphin report excluded greenfield sites from consideration. Co-location, and ultimately tri-location with a maternity hospital, on the St James's campus will support the provision of excellence in clinical care that our children deserve.

I intend to move quickly now to put in place all the necessary structures and governance arrangements to enable the delivery of this project as quickly as possible and to the highest quality. This Government regards the building of the new children’s hospital as a key priority and no effort will be spared in expediting its completion.

Nursing Home Services

Questions (315)

Bernard Durkan

Question:

315. Deputy Bernard J. Durkan asked the Minister for Health the extent to which comparisons continue to be made between average weekly patient costs in public and private nursing homes each caring for patients with similar dependancy and comparable scale and quality of services; and if he will make a statement on the matter. [49144/12]

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Written answers (Question to Health)

Since the introduction of the registration and inspection regime for nursing homes in July 2009, all nursing homes are required to meet the same core standards.

It has been acknowledged that there are variations in the cost of care in respect of public and private nursing homes. Historically, public nursing homes have employed a greater number of nursing staff and, therefore, had higher nursing to patient ratios than many nursing homes in the private sector. This has contributed to the higher cost of care. With regard to dependency levels, the Long-Stay Activity Statistics for 2010, prepared by the Department of Health, indicate that at end-2010, 83.7% of residents in public nursing homes were of high and maximum dependency. In private nursing homes, 59.7% of residents were in the same category. The Deputy should be mindful that these are self-reported survey results. However, the HSE is committed to implementing a single assessment tool for older people. In addition to uniformly assess dependency levels, the introduction of such a tool would enhance quality and efficiency, promote value for money, facilitate access to long-term residential care and community services and ensure that older people are cared for in the most appropriate setting.

The HSE is committed to examining all options to maximise the resources available for nursing home care, e.g. skill mix, rostering arrangements and reconfiguration etc. The HSE is currently finalising a review of the cost of care in public nursing homes.

Finally, the review of the Nursing Homes Support Scheme, which is expected to be completed in 2013, will examine the overall cost of long-term residential care in public and private nursing homes and the effectiveness of the current methods of negotiating/setting prices.

Health Services Staff Issues

Question No. 317 answered with Question No. 312.

Questions (316)

Bernard Durkan

Question:

316. Deputy Bernard J. Durkan asked the Minister for Health the cost difference between the use of agency nursing staff as opposed to temporary whole or part time staff; and if he will make a statement on the matter. [49145/12]

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Written answers (Question to Health)

As this is a service matter it has been referred to the Health Service Executive for direct reply.

Question No. 317 answered with Question No. 312.

Health Services Staff Issues

Question No. 319 answered with Question No. 28.

Questions (318)

Bernard Durkan

Question:

318. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the numbers of junior hospital doctors, consultants, nursing or other staff levels have fluctuated annually over the past five years to date; the number who have retired or resigned for whatever reason; and if he will make a statement on the matter. [49147/12]

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Written answers (Question to Health)

The Government has decided that the numbers employed across the public service must be reduced in order to meet its fiscal and budgetary targets. The health sector must make its contribution to that reduction. The Deputy's specific enquiry in relation to health sector staffing levels has been referred to the Health Service Executive for direct reply.

Question No. 319 answered with Question No. 28.

Health Services Provision

Questions (320)

Michael McGrath

Question:

320. Deputy Michael McGrath asked the Minister for Health if his attention has been drawn to the impact that any further cuts to a foundation (details supplied) will have on those who depend on the services provided by this organisation; if he will take this into account in framing the budget for the foundation for 2013; if he will carry out an impact assessment of any further budget cuts for the foundation; and if he will make a statement on the matter. [49154/12]

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Written answers (Question to Health)

As 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.

Pending completion of the national estimates, budgetary and service planning process for 2013 it is not possible to predict the service levels to be provided next year.

Health Services Provision

Questions (321)

Finian McGrath

Question:

321. Deputy Finian McGrath asked the Minister for Health the position regarding occupational therapy in respect of a person (details supplied) in Dublin 5. [49178/12]

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Written answers (Question to Health)

As 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.