Cochlear Implants

Questions (676, 679, 714)

Gerald Nash

Question:

676. Deputy Gerald Nash asked the Minister for Health if the Health Service Executive intends to upgrade and enhance the audiology unit in Beaumont Hospital, Dublin; if the HSE intends to make resources available to enable all children who require bilateral cochlear implants to have the essential procedure carried out; and if he will make a statement on the matter. [9838/13]

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Billy Kelleher

Question:

679. Deputy Billy Kelleher asked the Minister for Health the outcome of the business plan submission made by Beaumont Hospital, Dublin, for consideration in the 2013 Service Plan for the provision of bilateral cochlear implants; the action being taken and the timeframe involved; and if he will make a statement on the matter. [9855/13]

View answer

Gerry Adams

Question:

714. Deputy Gerry Adams asked the Minister for Health further to Parliamentary Questions Nos. 671, 735 and 736 of 19 February 2013, the steps that will be put in place to deal with children who suffer late onset hearing impairment or deafness which may not be picked up in new born screening; the way this group will be affected by any decision that the Health Service Executive and Beaumont Hospital, Dublin, come to in relation to cochlear implants; if he envisages an age cut off point; if guidelines will be put in place to identify which children are suitable for bilateral implants; and if he will ensure that those children who suffer from late onset hearing impairment will not be discriminated against. [10229/13]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 676, 679 and 714 together.

The HSE undertook a National Review of Audiology Services. The National Audiology Review Group developed a comprehensive set of recommendations to address the inconsistencies and inadequacies in audiology services which are contained in the HSE Report of the National Review of Audiology Services published in April 2011.

This report provides the blueprint for the planning, development and delivery of HSE audiology services, from new- born screening to assessment and management of adults and children with hearing problems, including cochlear implantation. That report included a recommendation that continued ring-fenced financial support be provided for the cochlear implant programme but at levels which allow for simultaneous bilateral implantation for children.

Since then, the HSE Audiology Clinical Care Programme was formed to oversee the implementation of the recommendations detailed by this report. Progress is being made on the modernisation of audiology services in Ireland with the introduction of a universal national programme of new-born hearing screening a key priority.

Beaumont Hospital is the centre for delivering Ireland’s national cochlear implant programme, with surgical provision for patients under six (6) years carried out in the Children’s University Hospital Temple Street. While no dedicated programme for simultaneous or sequential cochlear implantation is being carried out in Ireland at this time, some bilateral implantation has already occurred for patients, mainly very young children with certain medical conditions such as a history of meningitis or blindness. It is estimated that there are approximately 200 children in Ireland today who may be suitable for a second implant. Not all suitable patients proceed with the second implant when appraised of all the issues involved.

I am aware that Beaumont Hospital, HSE Management and the HSE’s Audiology Clinical Care Programme have met recently to discuss a joint process to identify the options for developing and resourcing a programme of simultaneous and sequential cochlear implantation. An important element of this will be the development of clear clinical criteria to prioritise clients for assessment and follow on implantation. The HSE has advised that these plans will be progressed through the HSE 2014 estimates process.

Hospital Staff

Questions (677)

Michael Creed

Question:

677. Deputy Michael Creed asked the Minister for Health if he will outline in broad detail the main achievements of the renegotiated contract with hospital consultants; and if he will make a statement on the matter. [9839/13]

View answer

Written answers (Question to Health)

In September 2012, following intensive engagement between health service management and the consultant representative bodies at the Labour Relations Commission, a comprehensive set of measures was agreed. The agreement encompasses a range of flexibilities to enhance productivity and efficiency and to maximise the availability of consultants, as key clinical decision-makers. These measure include:

- Consultant availability for rostering for any five days out of seven as opposed to weekdays;

- Rostering of consultants on a 16/7 (8 a.m. to midnight) or 24/7 basis in services where this is required;

- Clinical Directors having a much strengthened management role in respect of consultants, with reporting relationship for all consultants to the Clinical Director;

- Consultant cooperation with a range of measures to support improved Community and Mental Health services;

- Consultant compliance with the contractual requirements regarding private practice;

- Expeditious processing and signing of claims by consultants for submission to private health insurers.

In addition more cost effective arrangements for funding of continuing medical education are currently being finalised.

The Labour Court issued its recommendations regarding a number of further issues on 6 November last covering historic rest days, ongoing rest day arrangements and the fee for the provision of a second opinion as required under the Mental Health Act, 2001. The recommendations relating to the latter two issues are binding. Health service management are now engaged in implementation of the measures covered by the LRC and Labour Court processes.

I look forward to all consultants embracing the changes agreed at the LRC and accepting the terms of the Labour Court recommendations, in the interests of providing the most appropriate and cost-effective services to patients.

Health Services Staff

Question No. 679 answered with Question No. 676.

Questions (678, 738)

Michael Creed

Question:

678. Deputy Michael Creed asked the Minister for Health the progress he is making in respect of absenteeism in the public health service; and if he will make a statement on the matter. [9840/13]

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Andrew Doyle

Question:

738. Deputy Andrew Doyle asked the Minister for Health his views on the reports that more than ten percent of employees in the health service are calling in sick, particularly in some areas (details supplied); the measures he has brought forward to tackle this problem to date; the success of his measures so far; and if he will make a statement on the matter. [10312/13]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 678 and 738 together.

The absenteeism rate in the HSE in 2012 was 4.79%. This is a reduction from the 2011 rate of 4.9%. Rates remain well below absenteeism levels of 5.76% in 2008 and 5.05% in 2009.

Absenteeism is still unacceptably high and additional measures have been put in place to ensure tighter control and more robust performance management in this area. The HSE has strengthened its policies and procedures on absence management including putting in place the following measures:

- Action plans for all sites for the management of absence over 3.5%

- Analysis and reporting of certified and uncertified absence on each hospital site and community care area- Monitoring adherence to Attendance Management Policies such as return to work interviews, counselling and referral to Occupational Health

- Disciplinary process for a number of staff.

New arrangements for access to paid self-certified sick leave have been agreed for all employees in the public and civil service arising from a 2012 Labour Court Recommendation. This provides that employees may only be granted up to a maximum of 7 days’ self-certified sick leave in a rolling 24-month period, with effect from 1s November 2012. This represents a halving of the previous entitlement.

Question No. 679 answered with Question No. 676.

Home Help Service Provision

Questions (680)

Michelle Mulherin

Question:

680. Deputy Michelle Mulherin asked the Minister for Health the hourly rate paid to home help workers that are directly employed by the Health Service Executive in County Mayo; the number of home help hours currently provided by these directly employed workers; and if he will make a statement on the matter. [9864/13]

View answer

Written answers (Question to Health)

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

Mental Health Services Provision

Questions (681, 682, 683)

Dan Neville

Question:

681. Deputy Dan Neville asked the Minister for Health the number of the promised 99 child and adolescent community mental health teams that have been delivered to date; and the number of these that are fully staffed. [9867/13]

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Dan Neville

Question:

682. Deputy Dan Neville asked the Minister for Health the number of children on the waiting list for child and adolescent mental health services; and the number that were under 16 years of age. [9868/13]

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Dan Neville

Question:

683. Deputy Dan Neville asked the Minister for Health the percentage of the health budget that is spent in the children's mental health services. [9869/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 681 to 683, inclusive, together.

When A Vision for Change was published in 2006, there were 49 child and adolescent community mental health teams and 12 dedicated acute inpatient beds for children. Today, there are 58 community based CAMH teams and 44 acute inpatient beds, (12 in Dublin, 12 in Cork and 20 in Galway). The increase in bed capacity is reflected in an almost 50% decrease in admissions of children to adult units since 2008.

An additional 22 beds are scheduled to come on stream in 2013, (8 in Cork and 14 in Dublin), giving a projected Child and Adolescent in-patient bed capacity of 66 by the end of 2013. Planning permission has also been granted to construct a 24 bed in-patient facility on the Cherry Orchard site, Dublin and this is expected to be completed by the end of 2013/ early 2014.

Additional funding totalling €70 million has been provided as part of the last two Budgets primarily to strengthen Community Mental Health Teams for both Adults and Children. This funding is expected to provide almost 900 additional posts. The majority of the first tranche of an additional 150 Child and Adolescent Community Mental Health Team posts are expected to be in place by the end of March 2013.

As the remainder of the information sought by the Deputy relates to more detailed matters, the questions have been referred to the HSE for direct reply.

Pharmacy Regulations

Question No. 685 answered with Question No. 626.

Questions (684)

Thomas P. Broughan

Question:

684. Deputy Thomas P. Broughan asked the Minister for Health the number of pharmacists the Pharmaceutical Society of Ireland inspected in 2011 and 2012 and to date in 2013; the number of pharmacies that were asked for a random sample of prescriptions for inspections; the average number of prescriptions requested during an inspection and of the sample requested the number of pharmacies that were either unable to provide a copy of the prescription requested or had some regulatory defect with the prescriptions dispensed; and if he will make a statement on the matter. [9871/13]

View answer

Written answers (Question to Health)

The Pharmaceutical Society of Ireland (PSI) carries out inspections pursuant to two main sections of the Pharmacy Act 2007:-

- Inspections are carried out under Section 19 as part of the registration process for retail pharmacy businesses. Prescriptions are not reviewed as part of these inspections.

- Inspections are carried out under Section 67 to review compliance with the Pharmacy Act, regulations made thereunder and medicines legislation including the Medicinal Products (Prescription & Control of Supply) Regulations 2003 (as amended). Prescriptions are reviewed as part of these inspections.

The data obtained during inspections in 2011 and 2012 was not recorded on a computer database. Therefore the PSI manually checked 20% of inspection reports in order to ascertain the average number of prescriptions checked per inspection completed during 2011 and 2012 respectively. The figures set out below are based on these calculations. Detailed information regarding regulatory compliance with prescription legislation is not readily available for 2011 and 2012.

2011

Year

Inspection Type

Number of Inspections

Completed

Prescriptions Checked

2011

Section 19

Inspections

95

Not applicable

2011

Section 67 Inspections

170

An average of 4.12 prescriptions were checked per pharmacy inspected.

2012

Year

Inspection Type

Number of Inspections

Completed

Prescriptions Checked

2012

Section 19

Inspections

97

Not applicable

2012

Section 67 Inspections

75

An average of 6.6 prescriptions were checked per pharmacy inspected.

Inspection findings are recorded in a computerised database since the start of 2013. The figures set out below represents actual figures for 2013.

2013

As at the 25th February 2013, the PSI has carried out a total of 96 inspections of retail pharmacy businesses.

Year

Inspection Type

Number of Inspections

Completed

Prescriptions

Checked

Unable to provide a

copy of the prescription

Regulatory Defect

2013

Section 19

Inspections

10

Not applicable

Not applicable

Not applicable

2013

Section 67 Inspections

86

The results of 68 inspections have been recorded / analysed in the computerised database.

A total of 272 prescriptions were checked across 68 inspections.

An average of 4 prescriptions were checked per pharmacy inspected.

Retail Pharmacy Businesses were unable to provide the prescription in the case of 49 (18.01%) prescriptions requested.

Regulatory defects were noted in respect of 165

(60.66%) prescriptions reviewed.

It should be noted that failure to present the prescription does not necessarily constitute a regulatory defect. There are circumstances where pharmacies are legally entitled to return prescriptions to patients.

Question No. 685 answered with Question No. 626.

General Medical Services Scheme Administration

Questions (686)

Robert Troy

Question:

686. Deputy Robert Troy asked the Minister for Health the policy for the transfer of a GMS list when a principal general practitioner retires; currently there is an issue whereby a locum doctor who has worked in a GP practice at a location (details supplied) in County Westmeath for the past nine and a half years will not be offered the GMS list by the Health Service Executive following the retirement of the GP; and if he will make a statement on the matter. [9942/13]

View answer

Written answers (Question to Health)

As the Deputy's question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Dental Services Provision

Questions (687)

Éamon Ó Cuív

Question:

687. Deputy Éamon Ó Cuív asked the Minister for Health if he will provide details of the free dental services available to persons with medical cards; the waiting list for these services; if persons who lose fillings are entitled to have them replaced under this service; the delay in providing this treatment; and if he will make a statement on the matter. [9948/13]

View answer

Written answers (Question to Health)

The Dental Treatment Services Scheme (DTSS) provides access to dental treatment for adult medical card holders. The service is provided by contracted dentists. As funding has been capped at the 2008 level of €63 million, the HSE prioritises for treatment patients with special needs, high risk patients and those who have greater clinical needs. A free oral examination every calendar year and free emergency dental treatment with a focus on relief of pain and sepsis are available to all eligible patients, regardless of their medical condition. This includes 2 fillings, all extractions and a number of complex treatments.

The National Oral Health Office of the HSE issued Standard Operating Procedures to dental contractors in November 2011 to provide clearer guidance to them on the application of DTSS prior approval requests. The Standard Operating Procedures confirm that high risk patients are to be prioritised for approval for treatment. All fillings as required and complex care including root canal treatment, gum treatment and dentures are available to such patients subject to prior approval by the HSE.

If a patient is not deemed high risk or vulnerable and a filling has already been provided in the previous five years, a replacement filling on the same tooth is not approved. For patients who are high risk or vulnerable, a replacement filling may be approved if a satisfactory explanation as to the clinical necessity for the repeat treatment is given by the dentist.

There are no waiting lists for this service.

General Practitioner Services

Questions (688)

Joanna Tuffy

Question:

688. Deputy Joanna Tuffy asked the Minister for Health if he will provide an update on the estimated cost of introducing free general practitioner visits for all children aged six years and under; and if he will make a statement on the matter. [9951/13]

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Written answers (Question to Health)

No exercise has been undertaken to estimate the cost to introduce free General Practitioner care to children aged 6 years and under.

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. The first phase of this process is the extension of access to GP services without fees to persons with prescribed illnesses. This legislation 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.

Health Services

Questions (689)

John McGuinness

Question:

689. Deputy John McGuinness asked the Minister for Health the supports and services given by the autism team and autism nurse to a child (details supplied) in County Kilkenny; the number of occasions the team met with the parents of the child; if the team have responded to the concern that the child may now be suffering depression; and if he will make a statement on the matter. [9993/13]

View answer

Written answers (Question to Health)

The particular issue raised by the Deputy is a service matter for the Health Service Executive. Accordingly I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Medical Card Delays

Questions (690)

John McGuinness

Question:

690. Deputy John McGuinness asked the Minister for Health if an application for a full medical card will be expedited in respect of a person (details supplied) in County Kilkenny. [9994/13]

View answer

Written answers (Question to Health)

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Hospital Procedures

Questions (691)

John McGuinness

Question:

691. Deputy John McGuinness asked the Minister for Health if an operation at Waterford Regional Hospital will be arranged as a matter of urgency in respect of a person (details supplied) in County Kilkenny; and if he will expedite the matter. [9995/13]

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Written answers (Question to Health)

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.

Hospital Services

Questions (692, 694, 737)

Seán Kenny

Question:

692. Deputy Seán Kenny asked the Minister for Health the position regarding staffing levels in the epilepsy unit at Beaumont Hospital, Dublin; when the unit will open; the way the unit will operate; the level of staffing in the unit; and if he will make a statement on the matter. [10025/13]

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Terence Flanagan

Question:

694. Deputy Terence Flanagan asked the Minister for Health the reason the epilepsy unit in Beaumont Hospital will only open soon on a phased basis; the reason it is not fully staffed; the steps he will take to ensure that the unit opens as soon as possible; and if he will make a statement on the matter. [10040/13]

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Michael McGrath

Question:

737. Deputy Michael McGrath asked the Minister for Health when he expects the new epilepsy monitoring unit at Cork University Hospital to be opened; and if he will make a statement on the matter. [10289/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 692, 694 and 737 together.

Cork and Beaumont are two of six regional centres which have been identified by the HSE's Clinical Care Programme for Epilepsy for the provision of specialist epilepsy services. Developments so far under the Programme include the opening of Rapid Access Clinics at four of these centres, including Beaumont, St James’s, Galway and Limerick. The Rapid Access clinics are led by Advanced Nurse Practitioners (ANPs). Under the Programme, 10.5 (WTE) Advanced Nurse Practitioners (ANPs) have been recruited to lead these clinics so that a total of 12 ANPs are now in place across the four centres, delivering services on site and on an outreach basis.

The two Epilepsy Monitoring Units (EMUs) planned for Cork and Beaumont under the Programme will increase pre-surgical evaluation capacity. Monitoring is required for those patients with the worst effects of epilepsy, and patients at these units will require 24/7 care.

The staffing requirements to enable the units to be safely opened have been identified. I am advised that the staffing required for the unit at Beaumont includes five staff nurses, one consultant neurophysiologist and three technicians. I am advised by the HSE that, having secured recruitment approval from the National Control Group, Beaumont is progressing the recruitment of the posts necessary to support the service development.

With regard to Cork, the HSE has advised that it is the intention of the Cork University Hospital management to open the EMU in Quarter 3 of this year and this will be included in the HSE South’s 2013 Regional Service Plan.

Vaccination Programme

Question No. 694 answered with Question No. 692.

Questions (693, 707)

Pat Deering

Question:

693. Deputy Pat Deering asked the Minister for Health when the package of support promised almost 12 months ago for sufferers of narcolepsy disorder will be rolled out. [10037/13]

View answer

Billy Kelleher

Question:

707. Deputy Billy Kelleher asked the Minister for Health the progress that has been made in compiling the memorandum to bring to Government in relation to comprehensive supports and services he has committed to establishing for sufferers of Unique Narcolepsy Disorder; if he will provide a date for when the memorandum will be brought to Government; and if he will make a statement on the matter. [10156/13]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 693 and 707 together.

My priority is to ensure that children/adolescents affected by narcolepsy with symptom onset post pandemic vaccination are provided with services and supports to meet their health needs.

The HSE and the Department of Education and Skills together provide a comprehensive range of services and supports to those affected. The Health Service Executive through its advocacy unit and regional co-ordinators assist individuals affected by narcolepsy following pandemic vaccination and family members of those so affected, in accessing appropriate services and supports. These supports and services include access to rapid diagnosis, clear treatment pathways, temporary medical cards and reimbursement of expenses incurred. This includes expenses for counselling services for individuals and also for families of children affected by narcolepsy following pandemic vaccination, in cases where such services are not already available through the HSE. Multi-disciplinary assessments which allow for the appropriate individualised health and educational supports to be put in place are ongoing. The National Educational Psychological Service (NEPS) is also engaging with the HSE and with the individual schools and parents of children concerned to identify and provide educational supports for the children and adolescents affected.

My Department is considering other possible supports which may need to be put in place for those affected by Narcolepsy following pandemic vaccination.

Question No. 694 answered with Question No. 692.

Hospital Procedures

Questions (695)

Peadar Tóibín

Question:

695. Deputy Peadar Tóibín asked the Minister for Health the position regarding surgery in respect of a person (details supplied). [10041/13]

View answer

Written answers (Question to Health)

In relation to this particular query raised by the Deputy, I have asked the Health Service Executive to investigate the situation and respond directly to you on this matter.

HSE Staffing

Questions (696)

Robert Dowds

Question:

696. Deputy Robert Dowds asked the Minister for Health if there will be any recruitment of paramedics in 2013, 2014 or 2015; if there will be any process by which those wishing to become paramedics may become familiar with the job to better prepare them and if there will be any age limit placed on the recruitment of paramedics. [10101/13]

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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. However, the HSE can make staff appointments once it remains within its overall employment ceiling and has the financial resources to do so. As the recruitment of paramedics is a matter for the HSE in the first instance, the Deputy's enquiry has been referred to the Executive for direct reply.

General Practitioner Services

Questions (697)

Sandra McLellan

Question:

697. Deputy Sandra McLellan asked the Minister for Health if he will include children in the first phase of the introduction of free general practitioner care to all as well as to those with chronic illnesses; and if he will make a statement on the matter. [10105/13]

View answer

Written answers (Question to Health)

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. The first phase of this process is the extension of access to GP services without fees to persons with prescribed illnesses. It is not intended to include all children in this phase. This legislation 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.