Written Answers Nos. 537-54
537. Deputy James Bannon asked the Minister for Health when orthodontic treatment assessed as necessary three years ago will be provided in respect of a person (details supplied) in County Longford whose condition has deteriorated in the interim; and if he will make a statement on the matter. [11295/13]
View answerThe HSE provides orthodontic treatment to patients based on their level of clinical need. An individual's access to orthodontic treatment is determined against a set of clinical guidelines and priority is given to patients with greatest needs. The HSE has been asked to examine the specific query raised by the Deputy and to reply to him as soon as possible.
538. Deputy James Bannon asked the Minister for Health if he will provide an update regarding an appointment for urgently needed hip replacement surgery in respect of a person (details supplied) in County Longford; and if he will make a statement on the matter. [11300/13]
View answerThe 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.
539. Deputy James Bannon asked the Minister for Health if he will allay fears of persons (details supplied) in County Westmeath regarding further cuts to the disability sector by the Health Service Executive and Department of Health, following severe cuts over the past four years amounting to 15% in funding, which has seriously disrupted operational service at a centre in which a relation of theirs is residing; and if he will make a statement on the matter. [11301/13]
View answerThis Government currently provides funding of over €1.5 billion to the Disability Services Programme through the HSE’s National Service Plan for 2013, and is committed to protecting frontline services for people with disabilities to the greatest possible extent. The Minister for Health is working to ensure that protection is afforded to the disability sector, and the Social Care area as a whole.
In 2013 the HSE is seeking to maximise the provision of services within available resources and to maintaining a consistent level to that provided in 2012, by providing the following specialist disability services: residential services to over 9,000 people with a disability; day services to over 22,000 people with intellectual and physical disabilities; respite residential support for over 7,500 people with intellectual and physical disabilities; 1.68m hours of Personal Assistant / Home Support Hours. In relation to the specific queries raised by the Deputy, as these are service issues they have been referred to the HSE for direct reply.
540. Deputy James Bannon asked the Minister for Health the reason a person (details supplied) in County Longford has not been issued a medical card on medical and hardship ground; and if he will make a statement on the matter. [11306/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
541. Deputy James Bannon asked the Minister for Health if he will provide clarity in respect of the criteria regarding personal assistants for persons over the age of 65 years and the reason persons over this age cannot avail of this service unless they have previously been assigned an assistant, as this is causing extreme hardship; and if he will make a statement on the matter. [11308/13]
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.
542. Deputy Brendan Griffin asked the Minister for Health if he will consider an approach to help suicide prevention (details supplied); and if he will make a statement on the matter. [11309/13]
View answerSuicide is a tragedy that we are constantly working to prevent and also working to give more support to the families affected. Dealing with the current high levels of suicide and deliberate self harm is a priority for this Government. The HSE's National Office for Suicide Prevention (NOSP) has developed a range of initiatives designed to support people who are suicidal and also supporting their families, friends and peers in recognising and responding appropriately to signs of emotional distress and suicidal thoughts.
Key initiatives progressed by the NOSP in 2012 include the continuation of the National Awareness Campaigns which, last year, specifically targeted men and young men, the provision of a wide range of awareness and training programmes including safeTALK and ASIST (Applied Suicide Intervention Training) which trains participants to become more alert to the possibility of suicide in their community, the funding of partner agencies and projects, and the development of the recently launched Guidance for Post-Primary Schools on Mental Health & Suicide Prevention developed with the Department of Education and Skills.
While my Department has no plans to consider an approach similar to the "crashed lives" campaign, the Department of Health is currently in discussions with the NOSP to agree a strategy for suicide prevention in 2013 having regard to the increased funding available this year and the concerns around suicide generally. Priority initiatives will include the further development of existing National Mental Health Awareness campaigns to promote help seeking; increased training for GPs and practice staff; the training of acute hospital staff on suicide and self harm intervention; the development of the SCAN (Suicide Crisis Assessment Nurse) model which allows for crisis interventions at primary care and continued investment in voluntary agencies providing frontline services.
543. Deputy Patrick O'Donovan asked the Minister for Health if, due to the increased numbers of medical school graduates due to complete their training in 2013, there will be a sufficient number of medical intern places for EU and non EU graduates of medical schools here; and if he will make a statement on the matter. [11316/13]
View answer556. Deputy Joe McHugh asked the Minister for Health further to Parliamentary Question No. 649 of 26 March 2013, if he will make a statement to Dáil Éireann regarding the envisaged roles for 2014 graduates; and if he will make a statement on the matter. [11395/13]
View answerI propose to take Questions Nos. 543 and 556 together.
The issue of an adequate number of intern places in the Irish medical system is a priority for my Department and for the HSE. The intern year is an integral part of medical training and a medical practitioner cannot be fully accredited without it. Under the provisions of the Medical Practitioners Act 2007 it is a matter for the HSE to assess, on an annual basis, the number of intern training posts required by the health service. There were 572 intern posts available in Ireland for the July 2012 intake, an increase of almost 70 posts since 2007. All 2012 EU graduates from Irish medical schools who sought an intern post here that year and met the HSE eligibility criteria were successful in securing a post. Indeed, to date there have been sufficient posts for all EU graduates from Irish medical schools and a number of additional posts for some non-EU applicants.
My Department is in regular contact with the HSE in relation to the issue of intern places with the aim, in so far as is possible, of providing a sufficient number of intern places for Irish/EU graduates from Irish medical schools. It should be noted that under EU law intern posts must be open to graduates from other EU countries and the HSE has no control over the numbers applying. The HSE will have approximately 80 additional posts available for interns commencing their training in July 2013. In total there will be in the region of 650 places available for 2013. Furthermore, my Department and the HSE are working towards providing an adequate number of intern posts for the 2014 intake to cater for the increased number of Irish/EU graduates from Irish medical schools that year. The HSE consider that there will be sufficient capacity and funding to ensure that every EU graduate of the six Irish medical schools can access an internship both years.
544. Deputy Frank Feighan asked the Minister for Health his plans for the roll-out of a national cancer screening programme with specific reference to the involvement of Roscommon County Hospital. [11318/13]
View answerThe HSE's national colorectal screening programme, BowelScreen, commenced in November 2012 and is being introduced on a phased basis to men and women between the ages of 60-69 years. When fully implemented the programme will offer free screening to men and women aged 55-74 every two years. The screening test, known as a Faecal Immunochemical Test (FIT), is a home based test and approximately 94 to 95 per cent of people will receive a normal result and will be invited for routine screening again in two years time. A small number, in the region of five to six per cent, will receive a not normal result and will require an additional test. They will be referred for a colonoscopy to a Screening Colonoscopy Unit within a hospital contracted by the HSE’s National Cancer Screening Service (NCSS) for provision of this service.
Over half of the initially selected fifteen candidate screening colonoscopy units have been accredited to date, giving geographic spread to support the screening programme, and maintaining service requirements for symptomatic patients within national targets. The remainder of units continue to work to achieve this benchmark. Also a number of additional units, including Roscommon County Hospital, are pursuing NHS Joint Advisory Group (JAG) accreditation and the NCSS continues to work in close partnership with Roscommon County Hospital in this regard. The HSE is working to develop the appropriate capacity in colonoscopy services nationwide to support the introduction, sustainability and growth of the screening programme, while maintaining and enhancing the capability of the symptomatic endoscopy service.
545. Deputy Joe McHugh asked the Minister for Health if he will provide an update on the review of medical cards for persons aged over 70 years; his views on the possible impact on elderly persons who do not have family or professional access to administrative supports in respect of participating in the reviews; and if he will make a statement on the matter. [11320/13]
View answer561. Deputy Joe McHugh asked the Minister for Health with reference to withdrawal and renewal of medical cards, if he will provide assurances to elderly persons with mental health issues; and if he will make a statement on the matter. [11433/13]
View answerI propose to take Questions Nos. 545 and 561 together.
I understand that the Deputy is referring to the new eligibility rules for medical cards for persons aged over 70 years, announced in the Budget 2013. These rules will not take effect until later in 2013, after primary legislation has been enacted. The implementation date will be announced and publicised in advance by the Department and HSE. As is the current situation, the revised thresholds will apply to gross income. There is provision for discretion by the HSE to grant a medical card in cases of "undue hardship" where income guidelines are exceeded and this provision will not be effected.
In the case of all reviews and renewals of medical cards, the HSE offer assistances to individuals in assessing their situation under income limit thresholds, as some may be unsure about their gross income or have concerns or difficulties in relation to self-assessment. This will continue to be case after the legislation is enacted and will be further bolstered by staff in local health offices who provide information, support and assistance to individuals in relation to their eligibility on an ongoing basis. They can also provide information on the current status of a review, being in a position to track the application on the centralised Primary Care Reimbursement Service (PCRS) office in Finglas.
546. Deputy Dara Calleary asked the Minister for Health if his attention has been drawn to an incident (details supplied) at Mayo General Hospital on 17 August 2012 which was the subject of a recent inquest; if he has sought an explanation from the national ambulance service as to its response on the day; and if he will make a statement on the matter. [11321/13]
View answerFirstly, I wish to offer my sincere condolences to the relatives of the person who died. Under the Acute Coronary Syndrome Programme, patients with symptoms and ECG findings indicative of a STEMI-type acute heart attack are treated according to the National STEMI Protocol, which was officially launched in October 2012. It has been in use in the west of Ireland since July 2012. Under the protocol, if patients can be transported to a primary PCI centre providing 24/7 treatment of STEMIs, then they are brought directly to that centre. The primary PCI centre in the west of Ireland is the cardiology centre in University Hospital Galway. This unit has 2 cardiac catheter laboratories and a dedicated team of interventional cardiologists, nursing, technical and radiography staff on call 24/7. Based on international best practice, a unit such as this will serve the population of the west of Ireland for management of STEMI.
If transport to Galway within 90 minutes is not feasible, then STEMI patients are taken to the nearest emergency department equipped to stabilise patients, such as Mayo General or Portiuncula, for thrombolysis (administration of clot-bursting drugs) to stabilise the situation. They are then transferred to UHG for assessment as to whether further immediate intervention is needed. This is accepted international best practice for management of STEMI patients, particularly in remote areas. In addition to the national protocol, the Code STEMI Protocol, approved by the Medical Director of the NAS and through the HSE Clinical Care Programmes, outlines the actions required by hospital and NAS staff when a hospital STEMI patient is to be transferred to a PCI centre.
The incident raised by the Deputy was reported to the National Incident Management Team at national and regional level for review. The Ambulance Service also carried out an internal review and in parallel requested an independent review, which was conducted by the State Claims Agency. A review was also conducted between the Ambulance Service and Mayo General Hospital to ensure that the CODE STEMI protocol is followed for this type of incident.
The outcomes of the reviews have been raised with Prof Kieran Daly, project lead of the Acute Coronary Syndrome Programme, and the Director of the National Ambulance Service, Robert Morton and actions highlighted by these reviews have been implemented. These include training of staff, a written protocol between Mayo General Hospital and the NAS, additional auditing of calls within the Ambulance Control and the recirculation by the NAS of the Code STEMI protocol. Since this incident, all such transfers are treated as an emergency and six STEMIs have occurred in Mayo General, all following the protocol.
In relation the incident itself, the HSE National Ambulance Service has informed me that, at 19:30 on 17 August 2013, the patient began to experience symptoms and, about an hour later, self-presented to Mayo General Hospital Emergency Department, where an ECG was carried out. At 21.06 the National Ambulance Service received a call from Mayo ED to organise an emergency transfer from Mayo to Galway for a patient with a myocardial infarction. However, the patient was described as for angioplasty, not as a Code STEMI, and the CODE STEMI protocol was not initiated. At 21.20, an ambulance was assigned. Mayo ED was notified that an ambulance was en route, but the ED advised that the patient was being thrombolysed and the ambulance was not required.
The NAS has confirmed that there were two ambulances at Mayo General ED at the time of the incident. An ambulance is not available for further duty until the patient is transferred to medical staff in the ED and the ambulance is reported as available. Depending on the previous call, once the hand-over is completed, the ambulance may need to be restocked, refuelled or cleaned before being ready for duty. Both ambulances had responded to previous calls and the hand-over of patients had not been completed at that point. The ambulance based in Castlebar was available and was tasked, in line with the transfer request from the hospital, but was stood down on advice from the hospital.
547. Deputy Dara Calleary asked the Minister for Health if he will instruct the Health Service Executive to investigate the need for the construction of a cath lab at Mayo General Hospital and the making available of an on-call cardiology team at University College Hospital Galway to travel to County Mayo to ensure that patients from County Mayo who suffer from STEMI type heart attack, STEMI-ST elevation - myocardial infraction, a sudden attack which must be treated within 90 minutes, or any serious and sudden cardiac condition receive adequate facilities, in view of the fact that many parts of the county are more than 90 minutes from UCHG; and his views on the availability of emergency cardiology services in County Mayo. [11322/13]
View answerAll patients with symptoms and ECG findings indicative of a STEMI-type acute heart attack are treated according to the national STEMI protocol, which has been defined by the Acute Coronary Syndrome Clinical Programme, in accordance with international best practice. If patients can be transported to a primary PCI centre dedicated to 24/7 treatment of STEMIs within ninety minutes, then they go directly to that centre. If transport to a PCI centre within 90 minutes is not feasible, then STEMI patients are taken to the nearest emergency department where thrombolysis (administration of clot-busting drugs) can be given, to stabilise the patient before transport to the PCI centre. This is accepted international best practice for management of STEMI patients, particularly in remote areas. Unfortunately, STEMI incidents are extremely serious and some STEMI cases have poor outcomes, irrespective of treatment.
The national STEMI protocol was launched in Oct 2012. The National Ambulance Service, with by the Emergency Aeromedical Support Service helicopter and the Coast Guard, has been implementing this protocol and patients are managed according to the protocol. The PCI centre in the West of Ireland is the cardiology centre in University Hospital Galway (UHG). This unit has 2 cardiac catheter laboratories and a dedicated team of interventional cardiologists, nursing, technical and radiography staff on call 24/7. Based on international best practice, a unit such as this will serve the population of the west of Ireland for management of STEMI incidents.
If transport to UHG within 90mins is not feasible, then STEMI patients are taken to the nearest emergency department (eg Mayo General or Portiuncula ) for administration of thrombolytic drugs, to stabilise the patient before transport. They are then transferred to UHG for assessment as to whether further intervention is needed.
548. Deputy Gerry Adams asked the Minister for Health the reason the national ambulance service proposes to remove an ambulance service in the north east; if a risk assessment has been carried out on this proposal; and the stakeholders that were consulted. [11324/13]
View answer549. Deputy Gerry Adams asked the Minister for Health if his attention has been drawn to the fact that commitments were made regarding ambulance cover in the north east when the accident and emergency in Louth County Hospital was transferred to Our Lady of Lourdes, County Louth; if his attention has been drawn to the fact that the service change brought with it an increased need for ambulance cover to respond to emergencies and also to transfer patients from the MIU in Dundalk, County Louth, to the accident and emergency in Drogheda, County Louth; and if he will make a statement on the matter. [11325/13]
View answerI propose to take Questions Nos. 548 and 549 together.
In relation to the particular queries raised by the Deputy, as these are service matters, I have asked the Health Service Executive to respond directly to the Deputy in these matters.
550. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card appeal in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [11334/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
551. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card appeal in respect of persons (details supplied) in County Kerry [11337/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
554. Deputy Patrick Nulty asked the Minister for Health if he will expedite an application for a medical card in respect of a person (details supplied) in Dublin 12; the reason for the delay; and if he will make a statement on the matter. [11393/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
