Hospital Trusts

Questions (632)

Billy Kelleher

Question:

632. Deputy Billy Kelleher asked the Minister for Health when he will publish the International Evidence Review on Independent Hospital Trusts undertaken by the Health Research Board at his Department's request; and if he will make a statement on the matter. [9612/13]

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Written answers (Question to Health)

A literature review of Independent Hospital Trusts was requested from the Health Research Board by my Department in 2012 to inform policy development. It formed part of a wider review of academic literature in the preparation of the forthcoming report on the establishment of hospital groups. It is being further considered by my Department as its findings are relevant to related policies such as the future development of Hospital Trusts and the role of regulation in the future health system. With regard to publication, the Deputy will be aware that it is regarded as best practice for academic articles and reviews to undergo peer review prior to publication. It is anticipated that the literature review of Independent Hospital Trusts will go through this process and will be published in due course.

Hospital Trusts

Questions (633)

Billy Kelleher

Question:

633. Deputy Billy Kelleher asked the Minister for Health if, in view of the fact that Scotland and New Zealand, countries of similar population to Ireland, have experienced difficulties with independent hospital trusts, he considers this to be an appropriate model to follow here; and if he will make a statement on the matter. [9613/13]

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Written answers (Question to Health)

In preparing the Report on the Establishment of Hospital Groups as a Transition to independent Hospital Trusts, consideration was given to a wide breadth of international and national academic literature and reviews on relevant issues such as hospital reform, quality healthcare provision, financial management of healthcare, academic health linkages and organisational reform. As part of this work, cognisance was taken of the findings of the comparative review carried out by the Health Research Board (HRB) of independent hospital trusts in a number of countries and the factors identified as contributing most to successful trusts. These considerations, and the comprehensive consultation process undertaken with stakeholders, have informed the development of recommendations on the formation of specific groups and arrangements for the management and governance of all groups. These recommendations have been considered and endorsed by a Strategic Board composed of representatives with national and international expertise in health service delivery, governance and linkages with academic institutions.

Lessons learnt from other jurisdictions as well as the learning gained from the operation of the hospital groups will be taken on board in creating the legislative framework for hospital trusts here. The intention is, of course, that the trusts and the reformed health system within which hospital trusts will operate will be designed in a way that best suits Irish requirements and this will be done in a way that seeks to avoid difficulties encountered in other jurisdictions.

Health Care Infrastructure

Questions (634)

Billy Kelleher

Question:

634. Deputy Billy Kelleher asked the Minister for Health the role he sees for the market in the provision of health care here; and if he will make a statement on the matter. [9614/13]

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Written answers (Question to Health)

The Irish health care system has been based on a mix of public, voluntary non-for-profit and private provision for many years. Part of the debate about the future of our health system overall has been about the most appropriate role for the private sector, and the balance to be drawn between it and the public and voluntary sectors. The Government is committed to the continued development of a mixed health care system in Ireland, drawing on the strengths of all three sectors. That said, we are committed to the development of a single-tier health service, in which the distinction between ‘public’ and ‘private’ patient is removed. We can no longer accept a situation where patients can queue-jump because they can afford to pay for faster access.

Within this context, I believe that the free market has an important role to play, provided that the system is regulated effectively to protect quality and to control costs. For example, private hospitals play an important role in delivering acute services in Ireland, and private companies also deliver community based services, such as home supports for older people. The move to Universal Health Insurance will involve a very important role for the private sector, in which health insurers will compete for business in a manner designed to drive efficiencies and offer customers choice between funders of health care. While the overall approach to reform will be informed by the experience of other countries and best practice the system as a whole will be uniquely Irish. Whatever the precise configuration of services as between public, voluntary and private, and whatever the exact role of a regulated free market within the system, my priority is to ensure that all patients and clients receive the best possible service for the lowest cost, in the setting that is most appropriate to their needs. The reform of our health system will be developed on these principles.

Primary Care Centre Provision

Questions (635)

Michael McGrath

Question:

635. Deputy Michael McGrath asked the Minister for Health further to Parliamentary Question No. 1052 of 16 January 2013, if he will confirm the exact date in June 2012 that the development of a primary care centre at Deanrock, Togher, Cork City, was added to the public private partnership list and to confirm the person who made this decision. [9624/13]

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Written answers (Question to Health)

Delivery of healthcare infrastructure is a service matter. Therefore your question has been referred to the Health Service Executive for direct reply.

Cancer Screening Programmes

Questions (636)

Robert Dowds

Question:

636. Deputy Robert Dowds asked the Minister for Health his views on the statement in the BreastCheck programme's annual report for 2011 that sustainability of the programme's current level of service at the current resource levels in the long term is unlikely. [9637/13]

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Written answers (Question to Health)

I welcome the publication by the HSE's National Cancer Screening Service of the BreastCheck Programme Report for 2011-2012. The report outlines the significant advances that have been made by BreastCheck in recent years and demonstrates the contribution that the continued investment in screening has made to outcomes such as improving cancer survival rates. Breast cancer survival is now estimated at 80.7% (2004-2007), up from 75.1% (1998-2002).

The health services continue to experience very significant budgetary challenges alongside increased demands for services. The savings targets to be achieved by the HSE are required in order to meet the Government's fiscal targets. However, the BreastCheck Programme Report acknowledges that while there are challenges in the context of limited resources, the National Cancer Control Programme and the National Screening Service are committed to the continued provision of a world-class breast screening programme, which delivers a reduction in mortality from breast cancer for women in Ireland.

In addition, my Department commissioned an Efficiency Review of the BreastCheck Screening Programme in order to prepare for the age extension of BreastCheck to women up to the age of 69 years, as provided for in the Programme for Government. The review makes a number of recommendations on how the screening process could be enhanced to increase the number screened. My Department will continue to work with the HSE to ensure that national priorities and Programme for Government commitments are met.

Health Services Staff

Questions (637)

Robert Dowds

Question:

637. Deputy Robert Dowds asked the Minister for Health the number of radiographers employed by the Health Service Executive in each region for the past four years for which data is available. [9638/13]

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Written answers (Question to Health)

The number (WTE excluding career break) of radiographers of all types, employed by the Health Service Executive in each region of the HSE for the past four years, is set out in the table.

31/12/2009

31/12/2010

31/12/2011

31/12/2012

Dublin Mid-Leinster

331.02

325.37

323.01

322.79

Dublin North-East

215.51

231.04

217.63

212.13

National

6.54

67.55

63.72

61.13

South

212.13

211.04

210.82

205.52

West

201.55

196.66

188.86

192.11

Total

966.75

1013.66

1004.04

993.68

'National' in the table above refers to services provided on a national basis, for example the Breast Check programme.

Health Services Provision

Questions (638)

Tom Fleming

Question:

638. Deputy Tom Fleming asked the Minister for Health if he will examine the application for orthotics in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [9642/13]

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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.

Nursing Homes Support Scheme Applications

Questions (639)

Tom Fleming

Question:

639. Deputy Tom Fleming asked the Minister for Health if he will examine the fair deal application in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [9648/13]

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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.

Medical Card Eligibility

Questions (640, 668)

Michael McGrath

Question:

640. Deputy Michael McGrath asked the Minister for Health when he plans to provide medical cards to persons on the long term illness scheme; and if he will make a statement on the matter. [9663/13]

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Peter Mathews

Question:

668. Deputy Peter Mathews asked the Minister for Health if he will provide an update in relation to the provision of free general practitioner care; and if he will make a statement on the matter. [9800/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 640 and 668 together.

The Programme for Government commits to reforming the current public health system by introducing Universal Health Insurance with equal access to care for all. As part of this, the Government is committed to introducing, on a phased basis, GP care without fees within its first term of office. Primary legislation is required to give effect to the Government commitment to introduce a universal GP service without fees. Legislation to allow the Minister for Health to make regulations to extend access to GP services without fees to persons with prescribed illnesses is currently being drafted by the Office of the Attorney General and the Department and it will be published shortly. Implementation dates and application details will be announced in due course. An annual budget of €15 million was provided for the first phase of the roll out of GP care without fees.

Services for People with Disabilities

Questions (641)

Finian McGrath

Question:

641. Deputy Finian McGrath asked the Minister for Health the support available in the case of a person (details supplied) in Dublin 9. [9666/13]

View answer

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.

Smoking Ban

Question No. 643 answered with Question No. 617.

Questions (642)

Finian McGrath

Question:

642. Deputy Finian McGrath asked the Minister for Health the reason there is a clamp down on designated smoking areas in pubs as this has an impact on jobs. [9667/13]

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Written answers (Question to Health)

Smoking is prohibited in most enclosed workplaces under section 47 of the Public Health (Tobacco) Acts, 2002 and 2004. Environmental health officers have had enforcement powers to inspect premises and ensure that they are in compliance with the legislation since its commencement in 2004. As the Deputy is aware, the work place ban was introduced to protect third parties such as workers, from the ill-effects of exposure to second-hand smoke. The World Health Organisation Report on the Global Tobacco Epidemic, 2009 - Implementing Smoke Free Environments, noted that smoke free environments result in either a neutral or positive impact on businesses including the hospitality sector.

Question No. 643 answered with Question No. 617.

Food Safety Authority Investigations

Questions (644, 645, 646, 647)

Éamon Ó Cuív

Question:

644. Deputy Éamon Ó Cuív asked the Minister for Health the date on which he has first made aware of the adulteration of processed food products with horse meat; the action he took on foot of this notification; and if he will make a statement on the matter. [9681/13]

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Éamon Ó Cuív

Question:

645. Deputy Éamon Ó Cuív asked the Minister for Health the date on which his Department was first made aware of the possible adulteration of processed food products with horse meat; the action taken on foot of this notification; and if he will make a statement on the matter. [9682/13]

View answer

Éamon Ó Cuív

Question:

646. Deputy Éamon Ó Cuív asked the Minister for Health the date on which the Food Safety Authority of Ireland first became aware of the adulteration of food products with horse meat; the reason he was not the lead Minister dealing with this issue as responsibility for both food safety and the FSAI rests with his Department; and if he will make a statement on the matter. [9684/13]

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Éamon Ó Cuív

Question:

647. Deputy Éamon Ó Cuív asked the Minister for Health as the Minister with responsibility for food safety, if he is satisfied with the integrity of the ingredients of Irish processed black and white puddings and sausages and that no adulteration of these products is taking place; and if he will make a statement on the matter. [9685/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 644 to 647, inclusive, together.

The Food Safety Authority of Ireland (FSAI), as part of their monitoring and surveillance programme on labelling of foods, carried out a small survey in November 2012 to investigate the authenticity of meat products and, specifically, to check on the type of animal species in meat products. A total of 27 beef burger products were analysed. The FSAI then arranged further intense testing of the samples to validate the correctness of the initial analysis and to quantify the amount of horse DNA in each sample - the results of these tests were received on 11 January 2013. These results showed that, of the 10 burgers found to contain horse DNA, one contained 29% horsemeat, another 0.3% and the remainder had less than 0.1%. Traces of horse DNA were also detected in batches of raw ingredients, including some imported from other Member States. The FSAI communicated this information to the Department of Health on the 14th January 2013. The FSAI confirmed at the time that there were no food safety issues.

As this was not a food safety issue and there was no threat to public health it was proper that the Department of Agriculture, Food & the Marine took the lead role with regard to the incident as they have primary responsibility relating to primary food processing. Accordingly, since the initial test results were confirmed, that Department has conducted further tests on numerous establishments to identify the exact source of the equine DNA and work is ongoing in this regard. Furthermore, the Minister for Agriculture, Food & the Marine has initiated and led a rapid and collective response to the horsemeat incident in Europe in his capacity as President of Council of Agriculture Ministers.

While this is not a food safety issue, officials from my Department are in daily contact with the FSAI in relation to the ongoing horsemeat incident in Europe to ensure there remains no threat to public health. Since January, extensive sampling and testing of beef products by both regulatory authorities and the food industry has been undertaken. Testing is continuing in Ireland and elsewhere. A major EU wide programme of testing of beef products for the presence of equine DNA is now underway. While many sausage and black and white puddings are pork rather than beef based products, to date no evidence has emerged to suggest they are the subject of adulteration.

Accident and Emergency Departments Waiting Times

Questions (648)

Brendan Griffin

Question:

648. Deputy Brendan Griffin asked the Minister for Health if he is satisfied with the current waiting times at the accident and emergency department in Kerry General Hospital; if there is an adequate complement of staff currently working in the the A&E; the way current waiting times compare with the previous five years; and if he will make a statement on the matter. [9687/13]

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Written answers (Question to Health)

In relation to the query on staffing raised by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy in this matter. In relation to the waiting times, I have asked the Business Intelligence Unit, within the Health Service Executive, to respond directly to the Deputy.

Health Services Reports

Questions (649)

Joe McHugh

Question:

649. Deputy Joe McHugh asked the Minister for Health with reference to the Fottrell Report 2006, the NCMET Report, and the Second Interim Report on the Implementation of the Reform of the Intern Year April 2012, his views on the health service's usage of available talent; if he envisages improved returns on State investment in medical education; his further views on the impact of the intern year process on the personal welfare of medical graduates; and if he will make a statement on the matter. [9692/13]

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Written answers (Question to Health)

Arising from the recommendation of the Report of the Undergraduate Medical Education and Training Group (Fottrell 2006), to significantly increase the medical student intake of the Irish medical schools, the number of intern posts available within the HSE increased from 488 to 650 (the expected number of posts for the July 2013 intake). The HSE anticipates that all EU graduates from Irish medical schools who meet the eligibility criteria for intern posts and who desire to remain in Ireland for an internship starting in July 2013, will be accommodated within the Irish public health service. The HSE has in place formal agreements with the Intern Training Networks/Universities regarding the provision of the Medical Council accredited National Intern Training Programme.

The main reforms of the intern year as recommended by the Report of the National Committee on Medical Education and Training (NCMET) have been implemented by the HSE in collaboration and consultation with the Medical Council and the relevant educational partners at both undergraduate and postgraduate level. The HSE has formal agreements in place with the recognised postgraduate medical training bodies in Ireland regarding the provision of specialist medical education and training to the Non Consultant Hospital Doctor (NCHD) cohort in Ireland. These agreements set out the number of doctors to be trained by each training body both by year of training and by specialty. This number is determined by the HSE following consultation with the training bodies and consideration of current and future workforce requirements for qualified specialists.

The HSE also has formal agreements in place with the recognised postgraduate medical training bodies in Ireland regarding the provision of professional development programmes to NCHDs not engaged in specialist training in Ireland. The objective of these programmes is to facilitate this cohort of doctors to maintain their professional competence. In recent years the HSE has invested significantly in the expansion and development of existing and new specialist medical training programmes including the development of a basic specialist training programme in Emergency Medicine; the expansion and reconfiguration of specialist training in Anaesthesia; and an increase in GP training numbers from 120 per year to 157, in line with GP workforce requirements.

In addition, the HSE has implemented two scholarship programmes specifically targeting NCHDs in their latter stages of training. The first programme enables NCHDs to undertake specialist training in novel medical areas abroad with a view to returning and developing their new expertise within the Irish health service as specialists. The second programme supports NCHDs in undertaking an integrated PhD research programme with their higher specialist training, thereby further developing high quality relevant clinical research in Ireland.

Hospital Trusts

Questions (650)

Maureen O'Sullivan

Question:

650. Deputy Maureen O'Sullivan asked the Minister for Health if he considers that criteria such as existing partnerships, existing geographical links and patient access to appropriate services will be key in choosing the appropriate partnerships in his Department's project plan for the establishment of acute hospital groups which would support the co-location of the Rotunda and Mater Hospitals, Dublin, as indicated by KPMG report of 2008; if, at the very least, he will not make a final decision until after the publication of the review of maternity models of care currently being undertaken by the Health Service Executive; and if he will make a statement on the matter. [9695/13]

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Written answers (Question to Health)

A key stepping stone to the introduction of Universal Health Insurance will be to develop independent not-for-profit hospital trusts in which all hospitals will function as part of an integrated group. As a first step on that journey, hospitals will be aligned within groups on an administrative basis. The rationale behind the establishment of hospital groups and trusts is to support increased operational autonomy and accountability for hospital services in a way that will drive the service reforms and provide the maximum possible benefit to patients.

It is well recognised that the Rotunda Hospital provides leadership in maternity services obstetrics, midwifery, neonatology and gynaecology services to all of north Dublin and the northeast. Strong clinical links with the Mater Misericordiae University Hospital, including joint consultant appointments, are a fundamental support to the work of the Rotunda, and this will continue in any configuration in which the Rotunda is required to operate. It is neither intended nor anticipated that the Rotunda will be constrained by being positioned within a particular group. As well as its long standing links with the Mater, which can and should be retained, it would also be appropriate for the Rotunda to establish links with other hospitals to meet its future aspirations for sub-specialty development and to expand and consolidate the links which currently exist.

With regard to the framework within which maternity services are delivered, the Deputy refers to the KPMG Independent Review of Maternity and Gynaecology Services in the Greater Dublin Area and to a review of maternity models of care. The KPMG report, which was completed in 2008, noted that Dublin’s model of stand alone maternity hospitals is not the norm internationally and recommended that the Dublin maternity hospitals should be co-located with adult acute services and that one of the three new Dublin maternity facilities should be built on the site of the new national paediatric hospital. In regard to the review of maternity models of care referred to by the Deputy, work is currently ongoing in the HSE's Clinical Programme for Obstetrics and Gynaecology on the development of models of care for maternity services, which includes a review of current models with the development of a proposal for future developments. Both the KPMG report and the review to be carried out by the Clinical Programme will inform the delivery of maternity services in Dublin and nationally, as appropriate.

Hospital Waiting Lists

Questions (651)

John McGuinness

Question:

651. Deputy John McGuinness asked the Minister for Health if an early date for a hip operation will be arranged in the case of a person (details supplied) in County Carlow. [9720/13]

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Written answers (Question to Health)

The management of inpatient and daycase waiting lists for patients awaiting public health care is based on the principle that after urgent and cancer patients are treated, then clinically assessed routine patients should be seen in chronological order (i.e. longest waiter first). Should the patient's general practitioner consider that the patient's condition warrants an earlier appointment, he/she would be in the best position to take the matter up with the consultant and hospital involved. In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.

Vaccination Programme

Questions (652)

Billy Kelleher

Question:

652. Deputy Billy Kelleher asked the Minister for Health his plans to introduce the new Meningitis B vaccine into the immunisation programme; if so, if he will indicate how soon this will happen; and if he will make a statement on the matter. [9729/13]

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Written answers (Question to Health)

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health. The committee's recommendations are informed by public health advice, international best practice and by the National Centre for Pharmacoeconomics (NCPE). A Health Technology Assessment which includes a cost benefit analysis is carried out prior to any new vaccine being considered. This has a vital role in ensuring that care technologies, including vaccines, are used in a manner appropriate to their ability to maximise health gain and achieve value for money. Should NIAC advice recommend the inclusion of a new vaccine into the primary childhood immunisation programme in Ireland, my Department, in association with the Health Service Executive's National Immunisation Office will examine the issue.

Vaccination Programme

Questions (653)

Billy Kelleher

Question:

653. Deputy Billy Kelleher asked the Minister for Health his plans to include a chicken pox vaccine as part of the national immunisation programme; and if he will make a statement on the matter. [9732/13]

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Written answers (Question to Health)

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health. The committee's recommendations are informed by public health advice, international best practice and by the National Centre for Pharmacoeconomics (NCPE). Varicella vaccination is currently recommended by the NIAC for at-risk groups including:

- Healthcare workers without a definite history of chickenpox, or proof of immunity, particularly those working with haematology, oncology, obstetrical, general paediatric or neonatal patients

- Laboratory staff who may be exposed to varicella virus in the course of their work

- Healthy susceptible close household contacts of immunocompromised patients.