Tuesday, 14 May 2013

Written Answers Nos. 120-142

Health Services Expenditure

Questions (121, 144, 704, 708)

John McGuinness

Question:

121. Deputy John McGuinness asked the Minister for Health his views on whether the Health Service Executive will reach its budget targets for 2013; and if he will make a statement on the matter. [22607/13]

Robert Troy

Question:

144. Deputy Robert Troy asked the Minister for Health his views on whether the Health Service Executive will reach its budget targets for 2013; and if he will make a statement on the matter. [22616/13]

Bernard Durkan

Question:

704. Deputy Bernard J. Durkan asked the Minister for Health if he will give an assurance that budgetary cuts he and his Department are forced to undertake arising the Memorandum of Understanding will not damage the structure of the health services to such an extent as to make the delivery of services impossible; if he will carefully review the needs and requirements of each sector throughout the health services in this regard; and if he will make a statement on the matter. [23020/13]

Bernard Durkan

Question:

708. Deputy Bernard J. Durkan asked the Minister for Health the extent to which it is intended and expected to apply savings across the health services in such a way as to ensure that extra cost-cutting is not required towards the end of the year; and if he will make a statement on the matter. [23024/13]

Written answers

Minister for Health

I propose to take Questions Nos. 121, 144, 704 and 708 together.

2013 is another challenging year for the Health Sector and the Government had to take a number of tough measures to ensure that the most vulnerable were protected and front line services maintained to the greatest extent possible. The health services has already achieved significant progress in “doing more with less” and in providing various flexibilities in line with the Croke Park agreement to date. There has been a significant reduction in the cost base of the health services over the last few years, and yet the level of service has either been maintained or increased. We are cutting the cost of services, not the services. Even after the considerable reduction in the cost base over the last few years, further substantial cost extraction is required, with €781m in savings to be achieved this year. Significant savings have been targeted in relation to the cost of prescribed drugs and medicines. A new agreement with the Irish Pharmaceutical Healthcare Association will provide savings in excess of €400m over the next three years. This will mean significant reductions for patients in the cost of drugs, as well as a reduction in the drugs bill to the State.

The level of health services to be delivered within the available funding is set out in the Service Plan. The Plan also sets out the measures required to fund unavoidable pressures and commitments made under the Programme for Government. Significant reductions in drug expenditures will be required and maximising the potential for pay savings under the Croke Park Agreement is critical in achieving the savings target. Every budget holder must achieve the expenditure targets set at the start of the year, and in line with the National Service Plan, the Regional Service Plans were prepared in the context of the challenges faced by the health services in terms of reduced staffing levels, and a reduced budget, combined with increasing demand for services.

My Department, the Department of Public Expenditure and Reform and the HSE are working collaboratively on the Financial Improvement Programme with a view to strengthening the Health Service Executive's financial and performance management and reporting systems during 2013. Notwithstanding this, there is ongoing and intensive engagement each month between officials from my Department and the HSE in the context of regular monitoring of expenditure. The HSE's Performance Report, which is published every month, provides an overall analysis of key performance data from Finance, HR, Hospital and Primary & Community Services. The activity data reported is based on Performance Activity and Key Performance Indicators outlined in the HSE National Service Plan.

The position at the end of the first quarter is showing a €27m deficit in income and expenditure terms. When account is taken of timing issues around the phasing of budgets and the shortfall in retirees to date , there is a core deficit of €11m. Projections to year end based on 1st Quarter data are being finalised by the HSE at present, in tandem with the detailed assessment of performance. The scale of the risk and challenge in achieving financial breakeven by year end remains significant as predicted in the NSP 2013 and will increase if there is an absence of continued and improved flexibility under the Croke Park Agreement.

Question No. 122 answered with Question No. 116.

Question No. 123 answered with Question No. 97.

Neuro-Rehabilitation Services Provision

Questions (124)

Sandra McLellan

Question:

124. Deputy Sandra McLellan asked the Minister for Health if funding will be provided for the neuro-rehabilitation plan published in 2011; and if he will make a statement on the matter. [22580/13]

Written answers

Minister of State at the Department of Health

The Department of Health and the Health Service Executive (HSE) have developed and published the "National Policy and Strategy for the provision of Neuro-Rehabilitation Services in Ireland 2011 - 2015". In addition, the HSE is developing its Rehabilitation Medicine Programme within the Clinical Strategy and Programmes Directorate. The Report is the overarching policy on neuro-rehabilitation services and includes proposals for a framework for the future of neuro-rehabilitation services in Ireland, 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.

The key priority areas, as identified in the HSE's National Operational Plan for 2013 are to:

- Map and develop Integrated Service Area level rehabilitation networks; and

- implement the model of care for rehabilitation services within the networks with a focus on community rehabilitation.

The work involved to progress networks and teams will require to be flexible and responsive to the areas identified and to their specific service profiles.

The Rehabilitation Medicine Programme has been working in collaboration with the National Disability Unit as part of an expert Working Group planning for the implementation of the Report. The Rehabilitation Medicine Programme has incorporated key elements of the Report into its own Model of Care and adopted the Strategy's recommendation of "hub and spoke" model for specialist rehabilitation services and is keen to progress with a comprehensive model for the continuation of such service into the community. This co-operation will continue in 2013.

Nursing Staff Remuneration

Questions (125, 127, 630)

Gerry Adams

Question:

125. Deputy Gerry Adams asked the Minister for Health the number of nurses who have now taken up the two year contract at reduced pay; if he will replace the scheme with the necessary recruitment of nurses on regular pay scales and employment conditions; and if he will make a statement on the matter. [22562/13]

Charlie McConalogue

Question:

127. Deputy Charlie McConalogue asked the Minister for Health if he still proposes to continue with the graduate nurse recruitment scheme; and if he will make a statement on the matter. [22602/13]

Aengus Ó Snodaigh

Question:

630. Deputy Aengus Ó Snodaigh asked the Minister for Health his plans to end the discriminatory practices in salary scales for graduate nurses; and if he will make a statement on the matter. [22416/13]

Written answers

Minister for Health

I propose to take Questions Nos. 125, 127 and 630 together.

A major objective of this scheme was to put in place more cost-effective service delivery arrangements, having regard to the high rates of expenditure on agency staffing and overtime. Applications from graduate nurses and midwives under the scheme will continue to be accepted by the HSE. In line with normal practice, the HSE will aim to facilitate applicants with offers of appointment to posts in the part of the country for which they have expressed a preference.

The scheme was introduced on the assumption that intake would be spread over an extended timeframe, especially since the scheme was being introduced some months after most 2012 graduates completed their training. The HSE has decided that applications for Phase 1, covering registered general nurses for the Acute Hospital setting and the Community, will be accepted on a rolling basis for 2012 graduates, and also those who graduated in 2010 and 2011. Phase 2, which covers General, Mental Health, Intellectual Disability and Midwifery Mental Health, Intellectual Disability, Midwifery launched in mid-February. To date eight graduate nurses have taken up employment in two locations. A further five have start dates agreed for June. Recruitment will continue during 2013 and encompass those who will be graduating in the Autumn.

Thalidomide Victims Compensation

Questions (126)

Mick Wallace

Question:

126. Deputy Mick Wallace asked the Minister for Health if he will meet representatives of the Irish Thalidomide Survivors' Society to discuss the details of his proposed Health Care Protocol; and if he will make a statement on the matter. [22620/13]

Written answers

Minister for Health

I have asked senior officials from my Department to invite the Irish Thalidomide Survivors Society to a meeting as soon as this can be arranged. Senior officials have also very recently met with representatives of the Irish Thalidomide Association. It is my hope that a way forward can be found to address issues arising for both groups.

Question No. 127 answered with Question No. 125.

Non-Consultant Hospital Doctors Working Conditions

Questions (128)

Niall Collins

Question:

128. Deputy Niall Collins asked the Minister for Health his plans to improve the working conditions of non-consultant hospital doctors; and if he will make a statement on the matter. [22589/13]

Written answers

Minister for Health

The Government is committed to achieving compliance with the European Working Time Directive in respect of non-consultant hospital doctors (NCHDs) by 2014. I have emphasised to the HSE the high priority the Government and I attach to this issue, and also the need to address NCHDs working conditions more generally.

The Health Service Executive’s Service Plan for 2013 specifically recognises the need to address EWTD compliance as a priority, stating that there will be a particular focus in the acute hospital service on the achievement of compliance with the European Working Time Directive amongst the non-consultant hospital doctor workforce, in line with the Implementation Plan submitted to the Commission in 2012.

A key priority for the HSE in 2013 will be a further reduction of average weekly hours worked and also a reduction in the duration of shifts undertaken. The Executive is bringing a strong and particular focus to the achievement of compliance with the Directive. New and demanding targets and timescales have been issued to hospital managers and clinical directors and progress on a site-by-site basis will be assessed against these. The HSE has recently established a national group chaired by a senior executive to bring a clear and urgent focus to: implementation of the Directive, assessment of performance and site-by-site accountability for change. The HSE is also conscious of the need to implement other measures to improve the working conditions of NCHDs, including protection of training time, the implementation of formal bleep policies and the transfer of tasks often inappropriately undertaken by NCHDs to more appropriate staff.

I am satisfied that the HSE is making every effort to improve the working hours of NCHDs and to implement other measures to improve their working conditions which will in turn facilitate the provision of improved and safer delivery of services to patients.

Hospital Staff

Questions (129)

Catherine Murphy

Question:

129. Deputy Catherine Murphy asked the Minister for Health if he will consider requesting the Health Information and Quality Authority to immediately conduct an assessment of staffing levels at all acute hospitals in the State to determine if there are sub-optimal levels of care being provided and significant risk to patient outcomes; if he has determined a basic staffing-patient ratio below which patient care would be severely compromised; and if so, if he will publish this information; and if he will make a statement on the matter. [22630/13]

Written answers

Minister for Health

Under the Health Act 2007 the Health Information and Quality Authority (HIQA) is responsible for monitoring the quality and safety of health and personal social care services and investigating as necessary serious concerns about the health and welfare of people who use these services. In cases where HIQA believes that there is a serious risk to the health and welfare of healthcare service users, then HIQA may undertake an investigation into the safety, quality and standards of healthcare services.

In June 2012 HIQA published the National Standards for Safer Better Healthcare. These national standards provide the building blocks for quality and safety throughout the healthcare system, creating a common understanding of what is required with regard to the quality and safety of services provided. The HSE is continuing to work with hospitals in preparation for the monitoring process against the National Standards which will be commenced by HIQA later this year.

Effective service delivery requires processes to ensure that there will be sufficient staff available at the right time and with the right skills to deliver high-quality care. The focus of health service management is on ensuring that all critical and essential services are protected and are provided in a safe manner.

The Government has determined that, in line with its commitment to reduce the size of the public service, health sector employment numbers must be reduced substantially in 2013 and 2014. Spending on health services will also have to be very tightly controlled. However, the HSE can make critical staff appointments when necessary.

The Public Service Agreement has been crucial to the health service’s ability to manage through the very difficult circumstances of recent years. The flexibility and adaptability shown by staff has meant that even with reducing staff numbers, service levels have largely been maintained and indeed performance in relation to Emergency Departments and hospital waiting lists has markedly improved.

Primary Care Centres Provision

Questions (130, 629)

Caoimhghín Ó Caoláin

Question:

130. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide a progress report on the proposal to develop a primary care centre at Carrickmacross, County Monaghan; and if he will make a statement on the matter. [22556/13]

Caoimhghín Ó Caoláin

Question:

629. Deputy Caoimhghín Ó Caoláin asked the Minister for Health further to Parliamentary Question No. 235 of 2 May 2013, if he will provide a progress report on the proposal to develop a primary care centre at Carrickmacross, County Monaghan; and if he will make a statement on the matter. [22412/13]

Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 130 and 629 together.

The delivery of primary care infrastructure is a dynamic process and must take account of changing circumstances including the feasibility of implementing the delivery of the centres by means of lease, direct- build or PPP. GP engagement and agreement to deliver primary care services from primary care centres is central to delivery of the necessary infrastructure. Regardless of the method of delivery or deprivation ranking, locations cannot be progressed unless there is committed GP engagement. Carrickmacross is one of the 35 potential locations for primary care centres to be developed by means of the Public Private Partnership (PPP) project as announced in the July 2012 Infrastructure Stimulus Package. Of the 35, approximately 20 will be offered to the market subject to a) agreement between the local GPs and the HSE on active local GP involvement in the centres and b) site suitability and availability.

Delivery of health care infrastructure is a service matter. Therefore the Deputy's question has been referred to the HSE for direct reply.

Question No. 131 answered with Question No. 116.

Hospital Services

Questions (132)

Denis Naughten

Question:

132. Deputy Denis Naughten asked the Minister for Health the position regarding plans for the development of rehabilitation services at Roscommon County Hospital; and if he will make a statement on the matter. [22387/13]

Written answers

Minister for Health

In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the Health Service Executive for direct reply.

Health Services Expenditure

Questions (133)

Pearse Doherty

Question:

133. Deputy Pearse Doherty asked the Minister for Health if he will outline the scope of the cuts he proposes to impose on health services, other than staff pay cuts, during 2014 and 2015; if he has carried out an impact analysis of such cuts to date since 2008; and if he will make a statement on the matter. [22561/13]

Written answers

Minister for Health

The level of funding available for the health budget for 2014 has not yet been determined, and the extent of any savings required will be considered as part of the Estimates and budgetary process later this year. Deliberations by the Government on the expenditure allocations for next year and 2015 are likely to continue up until Budget time. As with previous Budgets, the difficult financial position facing the Exchequer will obviously require very careful management across all areas of expenditure.

There has been a significant reduction in the cost base of the health services over the last few years, and yet the level of service has either been maintained or increased. We are cutting the cost of services, not the services. This has been, and will continue to be, achieved through efficiencies and re-configuration under the existing Croke Park Agreement. Significant savings have been achieved to date in relation to the cost of pharmaceuticals and professional fees, thereby reducing the cost of the PCRS without affecting the clients. The agreement reached with the Irish Pharmaceutical Healthcare Association (IPHA) will provide savings in excess of €400m over the next three years. This will mean significant reductions for patients in the cost of drugs, as well as a reduction in the drugs bill to the State.

The reductions in the cost base over the last number of years have largely been required to meet unavoidable pressures within the health system, along with Programme for Government commitments, for which no additional funding was available from the Central Exchequer. Within the overall expenditure reduction, additional funding was made available to address key policy priorities in services for older people, disability, cancer, child protection and suicide. Furthermore, additional numbers of medical cards as a result of the economic crisis along with the development of primary care and mental health services all had to be met from the reduced level of funding available for the health sector. Achieving this, whilst maintaining the level of services provided is evidence of the significant progress in reducing the cost of services in the health sector.

My Department and the HSE will continue to work on the Health Reform Programme, which is a central element of the Programme for Government and critical to providing a health service which is fair to patients, gives them access when they need it and delivers value for money for the taxpayer.

Question No. 134 answered with Question No. 89.

Question No. 135 answered with Question No. 83.

National Children's Hospital Status

Questions (136)

Thomas P. Broughan

Question:

136. Deputy Thomas P. Broughan asked the Minister for Health if he will report on the current status of the new National Children's Hospital project; the current indicative timetable for the project including when the tendering process and construction phases will begin; and if he will make a statement on the matter. [22188/13]

Written answers

Minister for Health

The new children’s hospital is a key commitment in the Programme for Government and the largest project within the current Capital Plan. The National Paediatric Hospital Development Board (NPHDB) is the body charged with building the hospital. Following detailed consideration of the project management and governance structures required to deliver the project as quickly as possible and to the highest quality, I intend to restructure the NPHDB so that its sole focus is on planning, designing, building and equipping the new hospital. I am currently considering the necessary appointments to the NPHDB to ensure that it has the expertise needed to deal with this very large and complex capital project.

In the interim, senior officials from my Department and the HSE were appointed to the NPHDB in January 2013. The priorities for this transitional Board has been on reconciling the brief with the new site, site preparation, close-out of existing contracts and new procurement processes. A joint group involving the HSE and St James's Hospital are meeting regularly to progress the enabling and decant work required; a shared services group is in place focusing on identifying the facilities which can be shared so as to optimise the build; and a review of urgent care centre(s) configuration is underway and is expected to be complete within the coming weeks. The latter is key to finalising the scale of the facilities required on the St James's campus and informing the design.

Work on developing a detailed project timeline is continuing, recognising the urgency and priority attached to the project, as well as its scale and complexity. In the short-term, the contract notice for the procurement of a new design team is expected to be published in the coming weeks. The aim is to have the new design team in place as soon as possible, while complying in the tendering process with EU directives and national guidelines on procurement. The aim is to secure planning permission by December 2014.

In addition to a new building, the new children's hospital entails the coming together of three existing paediatric hospitals (Temple Street, Crumlin and Tallaght). An important step in this regard is the establishment of a Children's Hospital Group, involving the three hospitals. The Group will have a non-statutory Board of Direction which will oversee the integration of services across the three hospitals. The Children's Hospital Group will also act as client for the capital project, and will lead on service transfer planning, human resource planning, philanthropy etc., functions which were previously within the remit of the NPHDB. Dr Jim Browne has been appointed as its Chair, and will work closely with the Chairs of the three existing hospitals, who have welcomed his appointment.

This project is of huge importance for the provision of acute paediatric services for all children in Ireland and is a priority for me and for this Government. No effort will be spared in ensuring the swiftest possible completion, with optimal design and value for money.

Nursing Home Accommodation

Questions (137, 709)

Bernard Durkan

Question:

137. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he continues to monitor the retention and development of nursing homes in the public sector; if his attention has been drawn to the suggestions that upgrading and refurbishments are sometimes excessively costly leading to a danger of closure; if he will ensure that the maximisation of available accommodation is achieved and continues to be a central mission objective; if he will further ensure that all works undertaken are necessary and in the long-term interest of the institution and the care and welfare of its patients; if he will ensure that piecemeal stripping out of elements of service in a self-serving way is not allowed to continue in any public nursing homes; and if he will make a statement on the matter. [22500/13]

Bernard Durkan

Question:

709. Deputy Bernard J. Durkan asked the Minister for Health the degree to which he will continue to support public sector nursing homes and hospitals caring for older persons in view of the high quality of service available to the public sector, notwithstanding competition from the private sector; if he will ensure that the application of standards by Health Information Quality Authority are not used as a means to increase the costs in the public sector over the private sector; and if he will make a statement on the matter. [23025/13]

Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 137 and 709 together.

These are challenging times for the Health Service Executive in respect of all services. In the case of Community Nursing Units, these include challenges regarding staffing, funding and the age and structure of its units. For 2013 the quantum and type of health services to be delivered within the available funding has been set out in the HSE National Service Plan. Minister Reilly approved and laid a copy of the Plan before both Houses of the Oireachtas earlier this year.

If it becomes necessary for an older person to move to a nursing home, their safety and well–being is of paramount concern. We have to ensure that the highest standards of care are provided to all residents in a safe and secure environment, and that we meet the needs of those who require our services in the very best way possible. I believe that patient safety and quality assurance in nursing homes is secured by setting quality standards, reinforced by Regulations that specify how the best services possible can be delivered in an effective and appropriate way. The National Quality Standards referred to by the Deputy apply to all nursing homes, both public and private.

Recent capital investment has brought about a significant improvement in the standard of facilities across all care programmes including Services for Older People. Between 2006 and 2012 approximately €508m capital funding was invested in infrastructure, including CNUs, which supports the delivery of Services for Older People. In order to comply on an on-going basis with regulatory requirements, the HSE is now concentrating on the refurbishment and upgrade of existing accommodation. Accommodation which requires the least investment to comply with the regulatory requirements will be refurbished first. This will achieve the greatest number of compliant beds for the available funding.

Any capital development must be considered in the context of the multi-annual HSE capital programme which is developed over a rolling five year period. In drawing up its capital programme, the HSE is required to prioritise capital infrastructure within its overall capital funding allocation, taking into account the programme’s capital commitments and costs of completion over the multi-annual period. It is essential to assess all projects, other than those where existing contractual commitments are in place, on their merits to ensure that the limited capital funding available goes to those developments which are of highest national importance.

Both myself and my colleague, Minister Reilly are committed to the provision of a quality public nursing home service. Our overall objective is to protect the viability of as many units as possible, within the funding and staffing resources available. The Department is working closely with the HSE to develop an overall plan regarding future public provision for the Minister’s consideration. The plan will reflect regional need and have regard to the current severe financial constraints, restrictions on public sector staffing and recruitment and the on-going need to meet service and safety standards; all of which pose challenges for community nursing units across the country.

Accident and Emergency Departments Closures

Questions (138)

Aengus Ó Snodaigh

Question:

138. Deputy Aengus Ó Snodaigh asked the Minister for Health if he will intervene to reverse the decision to close the Emergency Department at Loughlinstown Hospital, County Dublin; and if he will make a statement on the matter. [22579/13]

Written answers

Minister for Health

St. Columcille’s provides joint acute hospital services with St. Vincent’s and St Michael’s, Dun Laoghaire. Together, they provide a range of services for the catchment of Dublin South-East and Wicklow, across three sites in a collaborative arrangement. Smaller hospitals, such as St Columcille’s hospital, need to be supported within a hospital group, for the safe management of patients who present with varying levels of complexity, for education and training, continuous professional development and the sustainable recruitment of high quality clinical staff. The establishment of hospital groups will ensure that St Columcille’s is guaranteed a central role in the future delivery of good quality care for patients.

Securing the Future of Smaller Hospitals: A Framework for Development offers clear information about the role of our smaller hospitals and what they will do in the future. While the Framework focusses in particular on the role of nine smaller hospitals, including St Colmcille's, which have been the subject of particular attention from the Health Information and Quality Authority, the principles behind it will apply to all smaller hospitals. In developing the Framework, the Government is clear that (i) there is an important future role for smaller hospitals, in which they will provide services for more patients, not fewer; (ii) no acute hospital will close, and (iii) safety issues in all acute hospitals, large or small, must be fully addressed, by providing the right type of service, for the right patient in the right setting. This framework will demonstrate clearly that the future of smaller hospitals is secure. It outlines the need for smaller hospitals and larger hospitals to operate together and therefore is intrinsically linked to the on-going work regarding the development of hospital groups.

We know that the traditional practice of providing as many services as possible in every hospital is neither sustainable nor safe. Professor John Higgins chaired a strategic board on the establishment of hospital groups and I have received his report, which is based on a comprehensive consultation process and contains almost 60 recommendations on the formation, management and governance of hospital groups, all of which are strongly endorsed by the Strategic Board. The formation of Irish acute hospitals into a small number of groups, each with its own governance and management, will provide opportunity for hospital services to be configured to deliver high-quality, safe patient care in a cost-effective manner.

I appreciate that both of the reports and the related government decision are anxiously awaited. However, this is the most radical and most fundamental modernisation of our acute health system infrastructure since the State’s foundation and I took very seriously my obligation to consider the reports closely, to assure myself and my Cabinet colleagues that they provide a robust basis to enable timely access to a high quality and sustainable hospital service for those who need it.

The Deputy will be pleased to learn that I submitted the reports to Government this morning for its consideration and decision and the reports have been accepted. Officials in my department are now in the process of making suitable arrangements for the publication of these reports as soon as possible.

Hospital Facilities

Questions (139)

Gerry Adams

Question:

139. Deputy Gerry Adams asked the Minister for Health if he will report on the progress made to date in the provision of enhanced hospital facilities and other essential services for patients with cystic fibrosis [22563/13]

Written answers

Minister for Health

I am fully aware of the challenges facing cystic fibrosis patients in managing their condition and of the need to support these patients and their families. I am committed to providing the best possible health service and will continue to work with the HSE to ensure the best possible outcomes for these patients.

There has been significant investment in services for people with Cystic Fibrosis in the last few years, the most recent development being the opening of a new dedicated Cystic Fibrosis unit in July 2012 at St Vincent’s Hospital. This unit contains single en suite rooms which are dedicated for inpatient CF patients and reflects best practice in terms of infection control.

The new Nutley Wing (opened summer 2012) at St Vincent’s University Hospital (SVUH) is a seven-storey development of which two floors contain a dedicated Cystic Fibrosis unit.Under a protocol for the treatment of CF patients at SVUH, signed off in July 2012 with the hospital, the HSE, Department of Health and CFA, up to 34 isolation beds will be made available in the new wing and the 10-bed day unit will be used effectively to help ensure that patients are treated in the optimum setting.

Beaumont Hospital is one of the 6 specialist centres and provides services to adults with cystic fibrosis. In the 2008 Budget, a special allocation of €2.5m capital funding was provided to enable the hospital to provide facilities for ambulatory care of people with cystic fibrosis.

This enabled the provision of the new dedicated Outpatient facility for patients with CF and will facilitate a comprehensive range of services from the multidisciplinary teams; these include outpatient clinics, a drop in centre / base for clinical assessments with medical consultants and nurses, and the provision of treatments that otherwise have required hospitalization. This facility opened on 26 October 2010.

St Paul's Ward is the specialist respiratory ward in the hospital, on which the single rooms are for elective admissions of patients with CF for prophylactic antibiotic therapy (or other treatment as required). With priority access to a number of en-suite inpatient rooms, the need for an adult with CF being admitted as an inpatient via the Emergency Department is now a rare occurrence.

Services in Dublin for children with Cystic Fibrosis are provided at Crumlin, Tallaght and Temple Street Hospitals. A new dedicated Respiratory and CF unit was opened in Temple Street in June 2010 providing state of the art facilities for children with respiratory disorders, their families and staff. It includes a lung function laboratory with the most up to date equipment, spacious patient treatment rooms and outpatient clinic rooms. The National Newborn Bloodspot Screening Laboratory is also located in Temple Street and newborn screening for Cystic Fibrosis, introduced in July 2011, is an integral component of the National Newborn Bloodspot Screening Programme.

On a regional basis services for children with CF are also provided at specialist centres in Cork, Galway, Limerick, Waterford and Drogheda. The majority of services for children cystic fibrosis care are delivered on an ambulatory care basis.

As the provision of facilities and services for persons with cystic fibrosis is an operational matter for the HSE, I have also asked the HSE to reply directly to the deputy on this matter.

Non-Consultant Hospital Doctors Recruitment

Questions (140, 145)

Pádraig MacLochlainn

Question:

140. Deputy Pádraig Mac Lochlainn asked the Minister for Health if his attention has been drawn to the concerns of Letterkenny General Hospital, County Donegal, that the hospital will not have sufficient non-consultant hospital doctors following the termination of the contracts of its current complement; the action that will be taken to address this issue at this and other hospitals; and if he will make a statement on the matter. [22558/13]

Pearse Doherty

Question:

145. Deputy Pearse Doherty asked the Minister for Health if he has addressed with the Health Service Executive the concern that there will not be sufficient junior doctors at Letterkenny General Hospital, County Donegal; the action, if any, he proposes to take; and if he will make a statement on the matter. [22560/13]

Written answers

Minister for Health

I propose to take Questions Nos. 140 and 145 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 this matter.

Cochlear Implants

Questions (141)

Sandra McLellan

Question:

141. Deputy Sandra McLellan asked the Minister for Health when a bilateral cochlear implant programme will be implemented; and if he will make a statement on the matter. [22581/13]

Written answers

Minister for Health

Since the national cochlear implant programme commenced seventeen years ago, over 700 patients have received cochlear implants. I am advised that, in 2012, ninety cochlear implants were carried out with 42 children receiving implants and 48 adults. In addition to providing the surgical services, the programme provides a comprehensive assessment service to potential candidates and a rehabilitative service to those actually implanted.

The report of the National Audiology Review Group, published by the HSE in 2011, provides the blueprint for the planning, development and delivery of HSE audiology services, including cochlear implantation. It includes 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. It is estimated that there are approximately 200 children in Ireland today who may be suitable for a second implant.

The HSE has advised that it is working closely with Beaumont Hospital to progress plans for both simultaneous and sequential bilateral implantation, and that it has obtained the services of an international expert in the implementation of cochlear implant programmes to advise on how best to progress the proposal. The development of the service will require additional resources for Beaumont and these plans will be progressed through the HSE 2014 Estimates Process.

Question No. 142 answered with Question No. 113.