Written Answers Nos. 240-249
240. Deputy Bernard J. Durkan asked the Minister for Health if a review will be undertaken regarding the recent refusal of a medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [12083/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
241. Deputy Gerald Nash asked the Minister for Health the current provision of ambulance services in the Drogheda, Dundalk and general County Louth area; the number of paramedic personnel engaged in the service; if the Health Service Executive plans to retain the existing number of ambulances in the service; if the Health Service Executive intends to continue with current levels of staffing; and if he will make a statement on the matter. [12084/13]
View answerThe National Ambulance Service (NAS) is not a static service. The Service deploys its resources in a dynamic manner and works on an area and national, rather than a local, basis. The dynamic deployment of ambulance resources ensures that the nearest appropriate resource is mobilised to the location of any incident.
The NAS has been taking a number of steps to improve response times. These include development of a Performance Improvement Action Plan, an Intermediate Care Service, the control centre reconfiguration project and a trial emergency aeromedical service. Following a referral to the Labour Court under the Public Service Agreement, the NAS is currently progressing a number of efficiencies arising from LCR 20313, including the issue of removal of overtime built in to rosters. New rosters are now in place and are operating successfully. In relation to the specific queries raised by the Deputy, as these are service matters they have been referred to the Health Service Executive for direct reply.
242. Deputy Michelle Mulherin asked the Minister for Health if he will outline the investigations that have taken place at Mayo General Hospital following the death of a person (details supplied); the steps that have been put in place to ensure the prevention of a similar occurrence in the future; and if he will make a statement on the matter. [12085/13]
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 within 90 minutes of diagnosis, 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 (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.
If transport to UHG 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 Hospitals, 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 HSE National Ambulance Service (NAS) and through the HSE Clinical Care Programmes, outlines the actions required by hospital and NAS staff when a STEMI patient is to be transferred from a hospital 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 NAS 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 NAS 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 the clinical programme lead of the Acute Coronary Syndrome Programme, and the Director of the NAS 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 re-circulation 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 NAS 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 NAS 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.
243. Deputy Aodhán Ó Ríordáin asked the Minister for Health the reason six trainee medical scientists in Beaumont Hospital, Dublin, who are close to the completion of their five month clinical placement which is a compulsory part of their training, have yet to receive their monthly trainee allowance of €903.98 despite the Health Service Executive memo dated 6 February 2013 outlining that all trainees were entitled to such an allowance; and if he will give an assurance that this allowance will be paid prior to the completion of these trainees' placements [12086/13]
View answerThe HSE has in the past confirmed to all health sector employers that Student Medical Scientists on placement must be paid the monthly training allowance as set out in my Department's consolidated salary scales. This allowance was approved for continued award to new beneficiaries, following the review of public sector allowances conducted in 2012. The current rate payable is €813.58 per month. The HSE memo dated 6 February 2013 reiterated in clear terms to hospitals that this allowance should be paid to all Student Medical Scientists on work placement. As the payment of this allowance in Beaumont Hospital is a matter for the HSE in the first instance, the Deputy's enquiry has been referred to the Executive for direct reply.
244. Deputy Michelle Mulherin asked the Minister for Health the action he will take to ensure that persons living in rural areas, in particular in County Mayo, who suffer a heart attack will receive treatment at their nearest cardiac specialist unit at University Hospital Galway within the medically desired time of 90 minutes; and if he will make a statement on the matter. [12087/13]
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 90 minutes is not feasible, then STEMI patients are taken to the nearest emergency department (eg Mayo General or Portiuncula) for thrombolysis, to stabilise the patient before transport. They are then transferred to UHG for assessment as to whether further intervention is needed.
245. Deputy Jack Wall asked the Minister for Health further to Parliamentary Question No. 455 of 18 October 2011, the position regarding an application for orthodontic treatment in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [12109/13]
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 patient (details supplied) had an assessment by the Consultant Orthodontist in the HSE Orthodontic Unit in St. James's Hospital on 23 March 2011. The outcome was that the patient is not eligible for HSE orthodontic treatment as she does not meet the HSE Orthodontic eligibility guidelines. This was communicated to the Deputy in a reply from the HSE dated 18 October 2011.
246. Deputy Róisín Shortall asked the Minister for Health if he will commit to producing an implementation plan for the national neurorehabilitation strategy; and if he will ensure that this is done in time for the upcoming European Brain month in May. [12120/13]
View answer247. Deputy Michael Creed asked the Minister for Health the position regarding the national neurorehabilitation strategy; if he will request the Health Service Executive to prioritise an implementation plan for this strategy; and if he will make a statement on the matter. [12124/13]
View answerI propose to take Questions Nos. 246 and 247 together.
The report "National Policy and Strategy for the Provision of Neuro-rehabilitation Services in Ireland 2011 - 2015" published in December 2011, is the overarching policy on neuro-rehabilitation services. There are no proposals to publish an implementation plan in respect of this report as the report includes proposals for a framework for the future of neuro-rehabilitation services in Ireland. It also contains proposals on implementing the report including key elements such as: guiding principles; implementation structure; methodology for implementation; and information and communication. The report recognises that given the current economic climate, the focus in the short to medium term has to be on re-configuration of services, structures and resources and the enhancement of the skills and competencies required to meet the changing context.
248. Deputy Joanna Tuffy asked the Minister for Health the up to date position with the nursing home support scheme fair deal review; when he expects the review to be complete; if he intends to publish the review report; and if he will make a statement on the matter. [12185/13]
View answerA public consultation to inform the review was concluded in July 2012. A summary report of the submissions received was published on the Department's website in December. Work will continue on the review in the coming months and the Department will shortly be seeking tenders through the public procurement process for external input to this review. It is envisaged that the review will be completed in 2013.
249. Deputy Bernard J. Durkan asked the Minister for Health the position regarding eligibility for a medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [12217/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
