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Wednesday, 30 Jan 2013

Written Answers Nos. 188-193

Proposed Legislation

Questions (188)

Anne Ferris

Question:

188. Deputy Anne Ferris asked the Minister for Health his plans to introduce legislation to govern do not resuscitate orders; and if he will make a statement on the matter. [4701/13]

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Written answers

From a governance perspective, in the specific case of nursing homes, Regulations and Standards for End-of-Life Care require that the registered provider must have protocols and policies in place in relation to end-of-life care. The registered provider must ensure that there is an individual care plan for each resident and that this is formally reviewed and updated with each resident in accordance with the resident’s changing needs and circumstances.

Decisions about do not resuscitate (DNR) orders relate to a complex medical intervention, namely cardiopulmonary resuscitation (CPR). Therefore, providing guidance as opposed to specific legislation would represent a better approach to governing the use of DNR orders. Guidelines would allow for greater flexibility to ensure that decisions relating to DNR orders are made on the basis of an individual assessment of each case. With this in mind, the HSE’s National Consent Advisory Group has developed a specific policy for DNR orders as part of its National Consent Policy. The HSE’s National Director of Quality and Patient Safety has approved the policy and it will be submitted to the senior management team in the coming weeks, after which it will be disseminated for implementation.

Hospital Staff Issues

Questions (189, 196)

Thomas P. Broughan

Question:

189. Deputy Thomas P. Broughan asked the Minister for Health if he will confirm that the EU Working Time Directive, 2008/33/EC, is being implemented in relation to junior doctors in all hospitals here ; if he will also review the conditions within which junior doctors are currently training and working; and if he will make a statement on the matter. [4702/13]

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Finian McGrath

Question:

196. Deputy Finian McGrath asked the Minister for Health his views on correspondence regarding junior doctors (details supplied); and if he will make a statement on the matter. [4786/13]

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Written answers

I propose to take Questions Nos. 189 and 196 together.

S.I. No. 494 of 2004 European Communities (Organisation of Working Time) (Activities of Doctors in Training) Regulations 2004, which transposed the EU Working Time Directive for doctors in training (junior doctors), provides for:

- A maximum 48 hour average working week;

- A 30 minute rest break every 6 hours during period on-site on-call;

- 11 hours rest every 24 hours or equivalent compensatory rest before return to work; and

- 35 hours continuous rest per week or twice a fortnight or 59 hours continuous rest per fortnight.

The 2010 Contract of Employment for junior doctors reflects these provisions. The contract also provides that junior doctors shall not be required to work more than 24 consecutive hours on-site. A related agreement between the HSE and the Irish Medical Organisation provides that the contract is subject to the requirements of the Directive.

The Government is committed to achieving compliance with the European Working Time Directive in respect of junior doctors by 2014 and I have emphasised to the HSE the high priority the Government and I attach to this issue. While there has been a significant reduction in the weekly hours worked by junior doctors in recent years, typically they continue to work approximately 55 hours per week. Further work is therefore required to achieve compliance with the requirements of the Directive.

In January 2012, a detailed plan for the achievement of compliance by junior doctors with the Working Time Directive was submitted to the EU Commission. The plan affirmed Ireland's commitment to achieving compliance with the Directive over a three-year time period. It committed to implementing the measures necessary, including: new work patterns for medical staff, transfer of work undertaken by junior doctors to other grades, and the organisation of hospital services to support compliance. The Health Service Executive’s Service Plan for 2013 specifically recognises the need to address the issue as a priority, stating that there will be a particular focus in the acute hospital service on the achievement of compliance with the European Working Time Directive amongst the junior doctor workforce, in line with the Implementation Plan submitted to the Commission. The HSE is currently finalising its National Operational Plan to support the implementation of the National Service Plan 2013. This will specify in greater detail the actions to be taken during the year in relation to EWTD compliance. A key priority for the HSE in 2013 will be a further reduction of average weekly hours worked and also a reduction in the duration of shifts undertaken.

Home Care Packages

Questions (190)

Derek Keating

Question:

190. Deputy Derek Keating asked the Minister for Health if he will investigate the homecare package for a child (details supplied) in Dublin 9. [4712/13]

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Written answers

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.

Dental Services Provision

Questions (191)

Derek Keating

Question:

191. Deputy Derek Keating asked the Minister for Health the position regarding dental treatment in respect of a person (details supplied) in County Dublin. [4713/13]

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Written answers

Dental services to children up to 16 years are provided by the Public Dental Service of the HSE. The service is targeted at children at key stages in their development. Children are given dental examinations and any follow-up treatment required at these stages. When required, emergency dental treatment is available to all children up to 16 years. The HSE has been asked to examine the specific query raised by the Deputy and to reply to him as soon as possible.

National Children's Hospital Status

Questions (192, 194)

Seán Fleming

Question:

192. Deputy Sean Fleming asked the Minister for Health if he will provide a time line for the various stages in respect of the construction of the new national children's hospital at St. James's Hospital, Dublin; when the facility will be opened to patients; and if he will make a statement on the matter. [4727/13]

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Seán Fleming

Question:

194. Deputy Sean Fleming asked the Minister for Health if he will provide the best estimate of the time line for the various stages in respect of the construction of the new national children’s hospital at St. James’s Hospital, Dublin; when the facility will be opened to patients; and if he will make a statement on the matter. [4782/13]

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Written answers

I propose to take Questions Nos. 192 and 194 together.

On 6 November last, I announced the Government’s decision to develop the new children’s hospital at the campus of St James’s Hospital in Dublin. The new children’s hospital is a key commitment in the Programme for Government and the largest project within the current Capital Plan. This Government regards the building of the hospital as a priority and no effort will be spared in expediting its completion. Following the Government decision on the location, my first priority has been to address the necessary project management structures and governance arrangements to enable the delivery of the capital project as quickly as possible and to the highest quality. The scale, complexity and vital importance of this project means we must get this element right now, and I have therefore given this detailed consideration and intend to bring proposals to Government shortly.

Pending the implementation of revised project management and governance arrangements, work is continuing on the project through the existing mechanisms, including the National Paediatric Hospital Development Board. The terms of office of most members of the Board having expired on 5 December, I have appointed senior representatives from my Department and the HSE as an interim measure aimed at ensuring effective governance and decision-making for the project to ensure that work continues without delay during this transitional phase.

The Dolphin report concluded that the existing plan for the Ambulatory and Urgent Care Centre in Tallaght would need to be revisited in light of a decision about the location. It is envisaged that there will be an urgent care centre or urgent care centres based on consideration of the geographical distribution of attendances and acuity of the patient. Following the Government's decision to locate the new hospital on the St James's campus, a review is now underway on the location and number of urgent care centres, which is expected to be complete in the coming weeks. Preliminary work in relation to the site and site preparation is ongoing, and immediate next steps will include the termination of existing contracts, following legal advice, followed by new procurement processes which will be fully compliant with statutory periods. In this regard, I welcome the fact that a significant proportion of the work that was done for the project on the Mater site, including the internal configuration and adjacencies, will be transferable to the new site, although clearly a new design for the new site is required.

In regard to the timelines, the estimation of the various stages of the project require to be developed, reviewed and validated and, once established, will be kept under scrutiny with strong and proactive project management. 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.

HSE Properties

Questions (193)

Róisín Shortall

Question:

193. Deputy Róisín Shortall asked the Minister for Health the organisation to which the Health Service Executive has leased and or rented a property (details supplied) in Dublin 11; if the premises is currently occupied; the plans the HSE has for the long-term use of the premises, including its disposal; and if he will make a statement on the matter. [4780/13]

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Written answers

Management of healthcare property estate is a service issue. Therefore your question has been referred to the Health Service Executive for direct reply.

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