Written Answers Nos. 634-656
634. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 354 of 14 February 2013, if the model of care document for the national asthma programme was completed by the end of March as indicated in that reply; if not, the reason for same; and if he will set a specific date for the completion of this key document. [22463/13]
View answer635. Deputy Róisín Shortall asked the Minister for Health the person within his Department or within the Health Service Executive with operational responsibility for the completion of the model of care document for the national asthma programme; and the person who has overall operational responsibility to implement the national asthma programme. [22464/13]
View answer636. Deputy Róisín Shortall asked the Minister for Health the economic modelling, if any, that has been undertaken by his Department or the Health Service Executive to identify the savings that would accrue at hospital level were the primary care element of the national asthma programme to be implemented in full; and if any such economic assessment has identified the overall seed capital required to fund the programme at primary care level. [22465/13]
View answer641. Deputy Mattie McGrath asked the Minister for Health when the first phase of the national asthma programme will be implemented; and the initial actions that will be taken in order to implement the programme and the deadlines for these actions. [22518/13]
View answer642. Deputy Mattie McGrath asked the Minister for Health the reason implementation of the national asthma programme was not prioritised in the 2013 Health Service Executive Services Plan with more than one person a week dying from asthma and 470,000 people here living with this respiratory disease that is particularly prevalent in children, with one in five Irish children suffering from the disease; and if he will make a statement on the matter. [22519/13]
View answerI propose to take Questions Nos. 634 to 636, inclusive, 641 and 642 together.
The National Asthma Programme, which commenced in 2011, is one of a number of chronic disease programmes established in the HSE’s Clinical Care Directorate aimed at bringing a systematic approach to changes in how services for patients are delivered. The overarching aim of the Programme is to reduce the morbidity and mortality associated with asthma in Ireland and to improve clinical outcomes and the quality of life of all patients with asthma. A key component is the improved management of people with asthma in primary care, thereby, avoiding emergency attendance at General Practitioner (GP) out-of-hours services, at hospital emergency departments and in-patient admission services.
The initial focus of the work of the Programme has been primarily on:
- The development and implementation of national asthma guidelines based on international best practice for acute and ongoing asthma management and national asthma education initiatives for patients and health care professionals; and
- The organisation and better integration of national asthma services at primary and secondary care levels through the development of a national model of care.
The acute adult and Paediatric asthma guidelines and associated care pathways, treatment protocols and care bundles have now been developed for use in primary and secondary care settings. The acute adult asthma guidelines, which are available online at www.hse.ie , are currently being revised.
The National Asthma Programme is currently working on developing a National Model of Care for Asthma. The National Clinic Lead for Asthma, supported by the programme's GP Lead, have responsibility in the HSE for the development of the model of care for asthma. The Integrated Services Directorate has operational responsibility for implementation of the programme, supported by the Clinical Strategy & Programmes Directorate. The proposed implementation plan will detail how physicians, nurses, and other health care professionals will work with engaged patients to make the clinical decisions most appropriate to the patient’s circumstances; while collaborating with specialist colleagues in providing a safe, seamless patient experience within the health system in Ireland. This is a key deliverable of the National Asthma Programme for 2013. The National Asthma Programme had to prioritise the submission of the Adult Asthma Emergency Guidelines to the National Clinical Effectiveness Committee which had a deadline of March 2013. The Model of Care for Asthma will be ready for stakeholder consultation by the end of quarter 2. It is anticipated that it will be completed by the end of quarter 3 this year.
As 85% of asthma is managed in primary care without the requirement for hospital specialist services, the National Asthma Programme is currently undertaking work to look at providing a yearly programme of assessment for asthma in primary care called Chronic Disease Watch – Asthma (also referred to as Asthma Check). The development of Asthma Check is being done in conjunction with the Irish College of General Practitioners (ICGP). Asthma Check outlines the step-by-step process for implementation of guideline based asthma management in primary care to deliver optimal outcomes for patients. The aim being to facilitate the implementation of best practice asthma guidelines in primary care in order to improve asthma control. This will reduce acute exacerbations and thus their associated overall costs with fewer hospital bed days and less time off school / work. It will also ensure that patients with asthma maximize their quality of life.
The National Asthma Programme expects that savings would be made in, GP out-of-hours visits, Emergency Department attendances and bed days used by implementing the programme. In addition, a 10% reduction in asthma deaths each year is targeted by the programme. Consideration is being given to carrying out an economic analysis of the implementation of the acute asthma guidelines with the support of HIQA. I am satisfied that good progress can be made in the ongoing development of the National Asthma Programme in 2013.
637. Deputy Róisín Shortall asked the Minister for Health his Department's estimate of the number of persons here who suffer from asthma; the number of these who are covered by a medical card; the way these figures have been determined; and if it is possible to derive an accurate estimate from PCRS data. [22466/13]
View answerThe HSE Primary Care Reimbursement Service has advised that it does not currently collect information regarding an applicant's illness. Therefore, it is not possible to provide the Deputy with the information requested.
638. Deputy Róisín Shortall asked the Minister for Health the number of personnel in his Department with a third level qualification in health economics. [22467/13]
View answerThere is no staff in my Department with a degree or higher level qualification specifically in health economics. There are a small number of staff with degrees and masters in economic science (policy analysis) and/or who have undertaken various training courses in the area of policy analysis including subject areas relating to health economics.
639. Deputy Róisín Shortall asked the Minister for Health the information, if any, provided to a medical card holder who appeals a decision to withdraw their eligibility, that they are entitled to retain their card for the duration of their appeal; and if he will ensure that such information is provided to every person who makes an appeal. [22468/13]
View answerAny medical card holder undergoing a review to renew a medical card, who genuinely engages with the HSE in that review, will not have entitlement withdrawn before the review is complete, regardless of the expiry date shown on the medical card. In cases where a decision is made not to grant a medical card, the applicant is informed of the decision and is notified of his/her right to appeal this decision and contact details for the appeals office are provided. Where a person who previously held a valid medical card or GP visit card submits an appeal to a decision not to renew a medical card within 21 days of that decision, the card previously held is reactivated once the HSE (PCRS) is informed of the appeal by the Appeals Office.
643. Deputy Denis Naughten asked the Minister for Health the number of consultants and speciality recruited under the new consultant contract since it was introduced; the number of new contracts awarded to consultants in each speciality during this period; the number of exceptions to the new contract, the speciality and the reason the new contract was not applied; and if he will make a statement on the matter. [22523/13]
View answerSubject to overall parameters set by Government, the Health Service Executive has responsibility for determining the composition of its staffing complement. I have asked the Executive to compile the information requested by the Deputy and to reply to him directly. In line with Government Policy there has been a significant increase in the number of consultants working in the health service in recent years and this continued after the introduction of Consultant Contract 2008. There has been an increase of nearly 300 (13%) in the number of consultants (whole time equivalents) employed since June 2008.
645. Deputy Michael Healy-Rae asked the Minister for Health in view of the fact that the director of the National Cancer Control Programme has warned that the price of new cancer drugs is unsustainable and a number of costly personalised cancer drugs are about to be launched here, if he will ensure that they will not be priced beyond the reach of the general public; his plans to deal with this issue; and if he will make a statement on the matter. [22529/13]
View answerThe HSE has put a robust assessment process in place for new medicines, including cancer medicines, to ensure that the HSE can provide access to as many medicines as possible from within available resources. This includes a requirement for pharmaceutical companies to justify the proposed price for new medicines, as well as technical assessments by the National Centre for Pharmacoeconomics for medicines with significant budget implications. These assessments are used in decision making around new cancer medicines and during formal price negotiations with pharmaceutical companies. The NCCP has also put a multi-disciplinary Therapeutic Review Committee in place, specifically for the assessment of new, and on occasion existing, cancer medicines with regard to their benefits, costs and budget impact implications. In parallel to this, the NCCP has also instituted an Oncology Drug Management System for newly approved hospital based cancer medicines. This system is intended to ensure fair and equitable access across all hospitals, on a “money follows the patient” basis.
646. Deputy Heather Humphreys asked the Minister for Health if he will expedite a hospital appointment in respect of a person (details supplied) in County Monaghan; and if he will make a statement on the matter. [22533/13]
View answerImproving access to outpatient services is a key priority for the Government. Building on work already undertaken by the HSE, the National Treatment Purchase Fund has now taken over the reporting of outpatient waiting time data. For the first time data is available on www.ntpf.ie. The collation and analysis of outpatient waiting time data in a standardised format will reveal the distribution of long waiters across all hospitals. In the first instance, this will allow resources to be targeted towards those patients who are waiting longest and ensure that they are seen and assessed. For 2013, a maximum waiting time target has now been set of 12 months for a first time outpatient appointment. In parallel with reducing the numbers of longest waiters, the SDU will also work with the HSE Clinical Programmes to reform the structure, organisation and delivery of outpatient services to ensure that the right patient is seen and assessed by the right health professional at the right time. In relation to the particular query 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.
647. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide the details of any engagement he has had or plans to have with the Department of Children and Youth Affairs, regarding those children who were adversely affected by the administration of the flu vaccine drug Pandemrix and who are suffering as a consequence from the chronic sleep disorder known as narcolepsy; and if he will make a statement on the matter. [21767/13]
View answerI engage with many Departments on a wide range of health issues. However, my priority in this area, is to ensure that those affected by narcolepsy, with symptom onset post pandemic vaccination are provided with a range of services and supports to meet their health needs. The Health Service Executive has responsibility for health service delivery and at my request the HSE developed a range of appropriate services and supports to address the needs of this group. Together, the HSE and the Department of Education and Skills provide a very comprehensive range of services and supports to those affected. The HSE 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.
648. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his views on the case of a person (details supplied); if he has concerns that this case may reflect a wind-down in supports in other cases; and if he will make a statement on the matter. [21772/13]
View answerThe case referred to by the Deputy appears to refer to the provision of Mental Health services for younger people. When A Vision for Change was published in 2006, there were 49 Child and Adolescent Community Mental Health (CAMH) Teams and 12 dedicated Acute In-Patient beds for children. Today, there are 58 Community based (CAMH) teams and 39 Acute In-Patient beds nationally. Increased bed capacity reflects an almost 50% decrease in admissions of children to adult units since 2008.
The core of mental health service delivery for children or adolescents is based on Community Mental Health Teams. In this regard, 150 additional posts were allocated to Child and Adolescent Mental Health Teams in 2012, and a further 80 posts were allocated for this specific service area in 2013. Such initiatives are underpinned by the special allocation of €70 million to develop mental health over this, and last, year and do not therefore reflect, in reality, a wind down of mental health provision overall. I understand that 109 of these posts have either been filled, or have a start date shortly, and that recruitment of the balance of the new posts remains a priority within the HSE. I will, obviously, continue to closely monitor implementation of this important initiative over coming months. In the circumstances, if the Deputy wishes me to pursue the case raised by him, perhaps he would furnish me with specific or relevant details, and I will then be in a position to follow this up with the Health Service Executive. Alternatively, he may wish to do so direct with the Executive, which has responsibilities for providing health and personal social services in individual cases.
649. Deputy Aengus Ó Snodaigh asked the Minister for Health when the special review group on devising an alternative scheme to the mobility allowance will deliver a report; the persons who are on this group; the criteria used to appoint them; their terms of reference; and if he will make a statement on the matter. [18830/13]
View answer663. Deputy Joe McHugh asked the Minister for Health if he will update Dáil Éireann on plans for a proposed new allowance form for transport grants. [22710/13]
View answerI propose to take Questions Nos. 649 and 663 together.
A Project Group, which is independently chaired by a former Civil Servant, has been established to seek an alternative method to provide for the priority transport needs of people in a manner that does not run counter to the Equal Status Acts. The work of the Project Group is being supported by the National Disability Authority and includes representatives from key disability sector organisations such as the Irish Wheelchair Association, the Disability Federation of Ireland, the Centre for Independent Living, along with an independent service user and advocate for people with disabilities and a former County Council Manager with relevant experience. Both Minister Reilly and myself have instructed the Project Group to seek solutions across the whole of Government, so that alongside representatives from the Department of Health and the Health Service Executive (HSE), membership also includes representatives from Pobal and from the Departments of Transport, Tourism & Sport, Environment, Community and Local Government, Social Protection and Finance and the Revenue Commissioners.
The terms of reference are as follows:
- Examine the policy objectives which underpinned the Mobility Allowance and Motorised Transport Grant schemes, in particular in the context of current Government policy on mainstreaming of services for people with disabilities and the recommendations of the Ombudsman;
- Analyse the circumstances of those who have been benefitting from the schemes, in terms of how the schemes have addressed their transport and mobility needs, in particular as regards their independence and access to employment opportunities;
- Undertake consultation with the disability and other sectors, to ascertain views on how best to prioritise the transport/mobility needs of all those with physical, sensory, intellectual and mental health difficulties within available resources currently assigned to the schemes;
- Review other transport/mobility supports provided by the HSE or other public or voluntary sector agencies to persons with mobility needs;
- Attempt to quantify the gaps in existing services for people with mobility needs, and, together with the foregoing, devise the most efficient solution to deliver supports to those most in need, within current resources and making best use of transport supports already available;
- Make appropriate recommendations to the Minister and the Minister of State by 31st May 2013 on a solution or solutions to address priority mobility needs arising from the abolition of the Mobility Allowance and the Motorised Transport Grant schemes; and
- Following the specific first phase of the work of the group on Mobility Allowance and Motorised Transport Grant schemes led by the Department of Health, continue under the leadership of the most appropriate Government Department to examine how best to address transport needs of persons with disabilities.
The Group, who will report to Government by the end of this month, has met six times, with the next meeting scheduled for 22nd May. The results of the review will be presented to the Government before any final decisions are made on future arrangements. At this stage, I am not in a position to pre-empt the outcome of the review or the decision of Government.
650. Deputy Sean Fleming asked the Minister for Health if he is satisfied that the Health Information and Quality Authority standards in relation to emergency and ambulance services adequately measure the response time from the time of the call to the time that the ambulance arrive at the required location or if the HIQA standards just deal with the time the ambulance left its depot to go to the appropriate location which sometimes could be up to an hour away; and if he will make a statement on the matter. [22640/13]
View answerThe Health Information and Quality Authority (HIQA) published the Pre-hospital Emergency Care Key Performance Indicators for Emergency Response Times in October 2012. They developed a set of key performance indicators (KPIs), which classify 999/211 emergency calls by clinical status. Clinical Status 1 Echo calls involve life-threatening emergencies of cardiac or respiratory origin. Clinical Status 1 Delta calls involve life-threatening emergencies of other than cardiac or respiratory origin. Detailed data-sets incorporating the necessary definitions are provided in the HIQA Report. In relation to calculating response times - the clock starts when the call verification period is complete and the following details have been ascertained: the callers telephone number, the nature of the chief complaint, the Advanced Medical Priority Dispatch System (AMPDS) dispatch code and the exact location of the incident. The clock stops when the first responder or the patient-carrying vehicle arrives at the scene of the incident.
The HIQA target for first responders (a person trained in minimum basic life support and use of a defibrillator) is to meet the Echo 1 and Delta 1 incident response time (7 minutes 59 seconds) in 75% of cases. The HIQA target for patient-carrying vehicles is to meet the Clinical Status 1 ECHO incidents response time (18 minutes 59 seconds) in 85% of cases. It is acknowledged that response-time indicators should not be used in isolation. Following a review of the validity of time-based KPIs for clinical status data, and in line with international views, it is considered that clinical outcome indicators would be more appropriate, and work has begun on their development.
651. Deputy Sean Fleming asked the Minister for Health the reasons it is proposed that from 1 July 2013 one of the two ambulances that are stationed in Portlaoise will be removed from Portlaoise on Monday nights and Tuesday nights; if he is satisfied that one ambulance based in County Laois is adequate for the area; and if he will make a statement on the matter. [22641/13]
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.
652. Deputy Sean Fleming asked the Minister for Health when the fair deal will be approved for a person (details supplied) in County Laois; and if he will make a statement on the matter. [22642/13]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
653. Deputy Catherine Murphy asked the Minister for Health if he will outline Ireland's current state of preparedness in the event of a large scale viral pandemic with a significant fatality rate such as rare strains of influenza and similar outbreaks; if he will detail the stocks of antiviral medication that the State has on hand to disperse in the event of such an occurrence; if he will outline the way the recent EU agreement on cross-border health threats will aid the State's preparedness in this regard; and if he will make a statement on the matter. [22643/13]
View answerMy Department recently published the Report of a Review Group set up to examine the Irish response to influenza A(H1N1) pandemic in 2009. This Group was chaired by my Department and comprised of public health and emergency planning experts from the Health Services Executive (HSE) and its agency the Health Protection Surveillance Centre. The Report includes recommendations for a revision of the National Pandemic Plan (2007) and provides advice on operational arrangements for any future pandemic. A Working Group will be established to begin this process.
The purpose of a plan is to limit the effects of a potential pandemic and to inform the public about pandemic influenza, explain what the Government and health services are doing to prepare for a possible pandemic, and give information on what members of the public need to do if there is a pandemic. The health service response to the threat of an influenza pandemic is based on eight core elements: communications strategy, telephone hotline, responsibilities of the public, surveillance, antiviral drugs, pandemic vaccine, reorganisation of the health services and essential supplies.
Agreement to improve the European Union health security framework was secured by the Irish Presidency last week. The Decision will help Member States prepare for, and protect citizens against, possible future pandemics. The agreement strengthens risk preparedness and response planning, provides a legal basis for the Health Security Committee, improves access to pharmaceutical products, including vaccines, for Member States, and will result in clearer risk and crisis communication to the public and healthcare professionals. A crucial aspect of the agreement is the establishment of a legal basis for the coordination of vaccine procurement across the EU. This will provide more equitable access to vaccines and may reduce costs associated with vaccine procurement. The EU will also be able to trigger pandemic vaccine production itself, ultimately leading to faster vaccination in an emergency.
As the Health Service Executive has responsibility for the stock-piling of antiviral medication this matter has been referred to them for direct reply to the Deputy.
654. Deputy Brendan Griffin asked the Minister for Health if a date for a cataracts operation will be provided in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [22650/13]
View answerThe National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has recently been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists. 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 the Deputy in this matter.
656. Deputy Sean Fleming asked the Minister for Health when an appointment will be scheduled for a person (details supplied) in County Laois; and if he will make a statement on the matter. [22652/13]
View answerThe National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has recently been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
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 the Deputy in this matter.
