Written Answers Nos. 121 - 139
121. Deputy Brian Stanley asked the Minister for Health the timeframe for the introduction of full charges to private health insurers for the use of public hospital beds; and if he will make a statement on the matter. [30410/13]
View answerThe Health (Amendment) Bill 2013 was published on 14 June. The Bill was read a second time in the Seanad on 20 June. It is envisaged that the Bill will be enacted before the end of the Summer session and that the charges would take effect shortly thereafter.
122. Deputy Michael Colreavy asked the Minister for Health the measures he is taking to urgently address the ongoing situation at acute psychiatric services in County Roscommon; and if he will make a statement on the matter. [30405/13]
View answerThe Deputy will appreciate that the Health Service Executive has statutory responsibility for the planning and delivery of services at local level. This includes management of this particular facility as part of a single Mental Health service across Galway and Roscommon, which also encompasses similiar acute units at Ballinasloe and Galway. In circumstances where one of these units reaches maximum operational capacity, for whatever reason, then incoming patients receive treatment in one of the other units. This is normal practice in acute mental health provision nationally.
Roscommon Acute Psychiatric Unit recently experienced a high level of sick leave amongst staff. To address this issue, and above all to maintain a safe environment for both patients and staff, the HSE utilises acute services across the Local Health Office area. This includes adopting and maintaining a clinical plan to manage acute admissions. Staffing levels in Roscommon are reviewed on a daily basis, and are subject to change based on evolving operational requirements.
It should be emphasised that addressing relevant issues at this facility can only be viewed in the context of wider changes in the health service, including in the mental health area, and the need to provide in the future the most appropriate and best possible service at this Unit, in line with agreed Mental Health policy and service norms applicable elsewhere.
Roscommon public representatives and HSE Forum members met with HSE West senior clinicians and managers on Friday last to discuss issues such as Access to services; Staffing levels; and on-going or possible future service initiatives. I understand that the meeting was constructive overall. I will continue to liaise closely with the HSE concerning the matter raised by the Deputy, with a view to ensuring that any difficulties are resolved in the most appropriate manner in the light of evolving service priorities.
123. Deputy Jonathan O'Brien asked the Minister for Health his plans for the introduction of a national strategy for a childhood obesity prevention and intervention service; if he has engaged directly or, if not, will engage with the anchors/providers of the W82GO childhood obesity treatment programme at Temple Street Children’s Hospital, Dublin; and if he will make a statement on the matter. [30413/13]
View answerAs Minister for Health, I have made overweight and obesity a public health priority and have established a Special Action Group on Obesity (SAGO) with whom I meet regularly to progress the obesity agenda. The range of measures being implemented by my Department seek to promote a healthy lifestyle, to encourage adults and children to make healthier food choices and to become more active.
SAGO is working on a combination of priority actions which, taken together, should make a difference in the long term. These measures include:
- Calorie posting in restaurants;
- Healthy Eating Guidelines;
- Marketing of Food and Drink to Children;
- Treatment Algorithms;
- Opportunistic Screening and Monitoring for overweight and obesity;
- Vending Machines in Schools and
- A Physical Activity Plan.
SAGO is also currently looking at ways to promote healthy eating, in accordance with this Department's Healthy Eating Guidelines.
The Health & Well-being Programme in the Department of Health is working with the HSE and Safefood to develop an integrated advertising and promotional campaign (September 2013) with the objective of increasing awareness among the parents of children of the health challenges posed by excess weight of their children;
- Target audience include primary carers of children aged between 1 to 12 and key influencers, health professionals, community development workers and educators;
- Key partners are being identified along with opportunities for them to come on board and deliver some of their existing projects in the context of the broader campaign;
- The core message of the campaign will be broadly focused at families in general and what to do if they recognise unhealthy behaviours as opposed to focusing specifically on weight status. The issues of body image and the ‘stigma’ of being overweight/obese are critical factors to be borne in mind in all aspects of the campaign.
As Minister for Health, I also arranged an EU Informal Ministerial meeting during our Presidency and I am pleased to say that Childhood Overweight and Obesity was a key element of this. The European Union are drafting an Action Plan for Member States to take this work forward.
The HSE has a significant involvement in relation to childhood obesity. This includes 3 intervention programmes and 18 national prevention programmes targeting children. There are also regional obesity intervention and prevention programmes.
The HSE is also involved with the W82GO programme and has recently agreed that the programme will be expanded in Dublin. The HSE has also advised me that it will be training a further 12 people across the country and may extend the programme further next year.
125. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will confirm his already signalled intent to provide funding in the health budget for the introduction of a bilateral cochlear implantation programme in 2014; his plans to meet the parents of the children affected; and if he will make a statement on the matter. [30386/13]
View answerThe HSE has advised that it is working closely with Beaumont Hospital to progress plans for both simultaneous and sequential bilateral cochlear implantation. The development of the service will require additional resources for Beaumont and a business case is currently being prepared, with guidance from two UK independent experts, which will be submitted for consideration in the HSE 2014 Estimates process. Confirmation of any funding must await the outcome of this process.
I am pleased to say that I have arranged to meet with Happy New Ear in early July and I look forward to hearing their views. Minister Kathleen Lynch, with officials from the Department of Health and the HSE, also met with Happy New Ear on 22 May last. She outlined to them the progress being made in regard to the provision of bilateral cochlear implantation and I understand that it was a very positive meeting.
126. Deputy Catherine Murphy asked the Minister for Health if his attention has been drawn to incidences where medication deemed to be available under the long-term illness scheme is not being prescribed by pharmacists in certain locations; if he will confirm that all medicines covered by the scheme are available universally across the State; and if he will make a statement on the matter. [30266/13]
View answerPersons suffering from prescribed conditions, who are not already medical card holders, can get free drugs, medicines and medical and surgical appliances for the treatment of that condition under the Long Term Illness (LTI) Scheme.
The HSE Local Health Office is responsible for approving medication to be supplied to a patient under the scheme. A patient who has been prescribed new medication relating to their long-term illness must apply to their Local Health Office to have that medication included on the list of medication covered by their LTI book.
The list of medications provided for illnesses under the LTI Scheme differs depending on the individual and their illness and is reviewed on a case by case basis.
127. Deputy Dessie Ellis asked the Minister for Health the mental health services in the Health Service Executive Dublin North East area for 16-18 year olds; and if he will make a statement on the matter. [30398/13]
View answerAs this is a service matter this question has been referred to the HSE for direct reply.
128. Deputy Pearse Doherty asked the Minister for Health if there is a cost-benefit analysis of overseas training and development courses provided to staff of his Department and the Health Service Executive, and funded by the State, for the years 2011 and 2012; and if he will make a statement on the matter. [30393/13]
View answerThe only courses approved in 2011 and 2012 were relatively short-term intensive and low cost relative to benefit and therefore did not require a formal cost-benefit analysis.
It is essential that senior Officials in my Department take part in training courses and programmes so they can manage more effectively the numerous challenges which face my Department and our Health System now and into the future. Senior managers who attend such programmes are positioned in important areas where it is necessary to be equipped with the skills and knowledge required for high level leadership, negotiation, policy making and decision making. This modest investment pays dividends in the medium and long term, with the main beneficiary being our Health System.
The Health Service Executive has been asked to reply directly to the Deputy.
129. Deputy Sandra McLellan asked the Minister for Health the position regarding the reconfiguration of ambulance and emergency services here; and if he will make a statement on the matter. [30401/13]
View answerA significant reform programme is under way in the HSE to reconfigure the management and delivery of pre-hospital emergency care services. Under Future Health: A Strategic Framework for Health Reform in Ireland 2012-2015, this will ensure a clinically driven, nationally coordinated system to support all pre-hospital emergency care activity in the State. The programme involves a number of measures, including the Performance Improvement Action Plan, development of the intermediate care service (ICS), the trial emergency aeromedical service (EAS), and the National Ambulance Service (NAS) Control Centre Reconfiguration Project.
The NAS is taking steps to improve response times where possible, by addressing challenges such as reliance on on-call rostering, geography, resourcing and the use of emergency ambulances for routine patient transport.
The NAS is moving its emergency ambulance services from on-call to on-duty rostering. This means highly trained paramedic crews are in their stations or vehicles to respond immediately to 112/999 dispatches, and they can move to optimal locations at any time during a shift. The NAS is also developing a non-emergency transport fleet, the national intermediate care service (ICS), for routine clinical transfers of patients, freeing up emergency ambulances for emergency responses.
The national control centre reconfiguration project will produce one national control and dispatching system. With improved technology, this will allow the NAS to deploy emergency resources more effectively and efficiently, on a regional and national basis rather than within small geographic areas. This project, endorsed by HIQA, is a key element of Future Health.
130. Deputy Martin Ferris asked the Minister for Health the number of children being treated for depression, anxiety and stress; if he will provide information on the direction that is taken for treatment when these diagnoses are made; if he will provide the same information for patients between 18 and 25 years old; if he will outline the guidelines pertaining to the management of these patients; and if he will make a statement on the matter. [30397/13]
View answerAs this is a service matter this question has been referred to the HSE for direct reply.
132. Deputy Pádraig Mac Lochlainn asked the Minister for Health the action he will take on private health insurers passing on to customers the cost of over-charging for hospital treatments; and if he will make a statement on the matter. [30409/13]
View answerI do not have a role in the day to day operations of any private health insurance company. However, it is my understanding that each of the private health insurance companies has its own procedures in place to investigate instances where over-charging of customers for hospital treatments is identified and notified to the insurer.
In the case of the VHI, the Deputy may wish to note that VHI Healthcare has a Special Investigations Unit which specifically deals with this matter. Where an error in charging has been identified, VHI Healthcare notifies the provider in question and deducts the monies involved directly from the provider. The provider is also asked to ensure that their processes are amended to prevent any recurrence. If there are a number of queries or repeat occurrences of anomalies with a particular hospital or service provider, an audit is conducted to identify the extent of this practice, the level of monies to be repaid to VHI Healthcare, and the redesign of processes to prevent any reoccurrence of inappropriate billing.
Customers of private health insurers should contact their insurance company in the first instance if they are not satisfied with their statements or if their insurer has been charged for accommodation or treatments not received. It is then a matter for each individual insurer to ensure that necessary steps are taken to investigate and deal appropriately with the issues identified.
134. Deputy Martin Ferris asked the Minister for Health if he will detail the supports in place for patients with Huntington's disease; if his attention has been drawn to proposals to develop specialist clinics at Beaumont Hospital, Dublin and University Hospital, Galway; if he will outline his plans to develop and implement these proposals; and if he will make a statement on the matter. [30396/13]
View answerAs the Deputy's question relates to operational matters in the HSE, I have asked the HSE to reply directly to the Deputy on these matters.
135. Deputy Charlie McConalogue asked the Minister for Health when the six closed beds in Carndonagh Community Hospital, County Donegal, will be re-opened, returning the hospital to its 30 bed capacity; and if he will make a statement on the matter. [30018/13]
View answerAs this is a service matter it has again been referred to the Health Service Executive for direct reply.
136. Deputy Thomas P. Broughan asked the Minister for Health the current level of expenditure on agency staff both in hospitals and care institutions; the way his Department is working with the Health Service Executive to reduce the expenditure on agency staff and to offer more permanent employment positions to nursing and other care staff with the Health Service Executive; and if he will make a statement on the matter. [30361/13]
View answerI have requested the HSE to reply directly to the Deputy on the current level of expenditure on agency staff in hospitals and care institutions.
The recruitment of permanent staff in the health service is subject to compliance with the terms of the general moratorium on recruitment and the requirement to achieve substantial net reductions in staff numbers in the course of 2013.
The Public Service Stability Agreement 2013- 2016 (Haddington Road Agreement) contains provisions which will increase the working hours of staff in the public service. Within the health service, these additional working hours will be focused to the maximum extent on reduction in the usage of agency staff and overtime working.
The Agreement also provides for revised remuneration arrangements in respect of the Graduate Nurse Initiative, which will support the retention of recently qualified graduate nurses and midwives within the Irish health system, will enable these health professionals to gain valuable work experience and development opportunities post-graduation and will also facilitate a reduction in expenditure on agency nurse staffing. In addition, the Agreement commits the health service employers and SIPTU to the establishment in the health sector of an intern scheme for support staff, under which 1,000 intern places will be created. These interns will be supported in attaining an appropriate qualification to FETAC level 5. The employment of these interns will allow the health service to substantially reduce the use of health support agency staff.
137. Deputy Pearse Doherty asked the Minister for Health if it is the case that persons appointed at senior executive or advisory level in the special delivery unit are paid through overseas companies; his views on whether this is a method of avoiding paying income tax in this jurisdiction; if this method of payment has been or is being used elsewhere in his Department; and if he will make a statement on the matter. [30392/13]
View answerThe decisions to employ both individuals concerned in the Special Delivery Unit were based on specific requirements for the provision of specialised expertise to address significant health service reform, as committed to in the Programme for Government. The Department of Health fully cooperates with the Revenue Commissioners in the exercise of their duties and is vigilant with regard to compliance with its tax obligations. As the Department has already stated, it would not be appropriate for it to comment on any tax matter relating to any individual case which may arise.
138. Deputy Catherine Murphy asked the Minister for Health if his attention has been drawn to the delays being experienced by children with ear, nose and throat conditions to get a basic assessment by a consultant, often up to two years; his views on whether such waits can have adverse effects on a child's overall health, social development and scholastic development; the steps he proposes to tackle this problem in a swift manner; and if he will make a statement on the matter. [30265/13]
View answerImproving access to outpatient services across all specialties, including ear, nose and throat, is a key priority for the Government. Collaborating with individual hospitals, the SDU, together with NTPF and HSE has developed the outpatient waiting list minimum dataset. This allows data to be submitted to the NTPF from hospitals on a weekly basis so that, for the first time, outpatient data is available on www.ntpf.ie. The data currently show numbers waiting over the various time-bands for a first appointment at a consultant-led clinic. Future enhancements will include numbers reported by specialty in addition to the breakdown by hospital.
For 2013, a maximum waiting time target has been set of 12 months for a first time consultant-led outpatient appointment and this is reflected in the HSE Service Plan. In working towards the maximum wait times, the SDU and NTPF are working closely with hospitals to analyse performance and to agree action plans for 2013 and extra support as necessary. In parallel, reforming the structure and organisation and delivery of outpatient services is continuing through the Outpatient (OPD) Service Performance Improvement Programme. This national programme, being implemented between 2012 and 2015, encompasses the HSE, SDU, the NTPF and all hospitals providing outpatient services. Key elements include on-going validation and management of waiting lists, the systematic and standardised management of referrals from primary care, a reduction in unacceptably high “do not attend” rates, standardising productivity rates within specialties, appropriate discharging from OP services when clinically appropriate to do so.
139. Deputy Thomas Pringle asked the Minister for Health if he will make a commitment that medical card holders who have undergone breast cancer treatment in hospital will not have to pay the cost of their general practitioner cancer care follow-up; and if he will make a statement on the matter. [30380/13]
View answer621. Deputy Terence Flanagan asked the Minister for Health if he has held any discussions with the Health Service Executive regarding plans to charge breast cancer patients with medical cards for the cost of their general practitioner follow-up care; and if he will make a statement on the matter. [30728/13]
View answerI propose to take Questions Nos. 139 and 621 together.
Breast cancer is the most commonly diagnosed cancer in women in Ireland, but outcomes are good and improving. There is a growing body of evidence internationally that long term hospital based clinical follow up of well women with a history of breast cancer is not required and confers no additional benefit to the women.
Under the General Medical Services (GMS) contract, a general practitioner (GP) is expected to provide his/her patients who hold a medical card or GP visit card with all proper and necessary treatment of a kind generally undertaken by a GP free of charge. Under this contract, GPs already accept clinical responsibility for their patients who have been discharged from consultant care back into the community. The National Cancer Control Programme (NCCP) has developed a follow-up care plan for women who have been discharged from out patient clinics following their treatment from breast cancer. This follow-up care plan is evidence-based and follows best international practice. The plan is aimed at patients who have completed their treatment, who are well, have had no recurrence after five years and continue to have a good outcome. It is a plan for well women to enable them to remain healthy and is not an active cancer care plan.
This plan involves women receiving an annual mammogram which will be undertaken and assessed by the expert team in the designated cancer centre. Each woman will also receive a general health check up carried out by their GP and if the GP has any concerns the woman can be referred into the specialist services in the usual manner. Any woman who needs to be treated on an acute basis is cared for appropriately and timely under the management of her consultant team.
