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Thursday, 26 Sep 2013

Written Answers Nos. 1-15

Departmental Estimates

Questions (11)

Michael Moynihan

Question:

11. Deputy Michael Moynihan asked the Minister for Health if he anticipates bringing forward a supplementary estimate for his Department and the Health Service Executive in 2013; and if he will make a statement on the matter. [39989/13]

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Written answers

It is too early to say whether a supplementary budget will be required in 2013.

Significant savings have been required of the health services since the downturn in the economy. The budget provision for health has reduced by some €1.5bn on the 2008 provision and, taking into account the need to provide for increases in demand, the underlying reduction in health spend is over €3bn since 2008. At the half year position, the budget overrun in the HSE was just 1% of budget.

The health budget has been reduced by 20% in real terms. The number of staff within the health service has reduced by 10%. The population has increased by 8%. Despite this we are still managing to reform and improve the service.

There are a number of measures in place to mitigate deficits including the targeting of significant savings on the cost of drugs and medicines; regulations to reduce fees to doctors and pharmacists; savings under the Haddington Road Agreement, and a focus by HSE senior management on key hospitals where significant deficits are emerging. Detailed regular reporting, including comprehensive cash monitoring, is on-going. Work is also underway in the HSE to reform the financial management systems.

Mental Health Services Funding

Questions (12, 22)

Michael Colreavy

Question:

12. Deputy Michael Colreavy asked the Minister for Health if he will reverse the decision to close the 22-bed mental health unit at St. Brigid’s, Ballinasloe, County Galway; and if he will make a statement on the matter. [40034/13]

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Denis Naughten

Question:

22. Deputy Denis Naughten asked the Minister for Health if he will undertake an independent review of the acute mental health services in counties Roscommon and Galway; the implications of any reconfiguration on the operation of emergency departments/urgent care centres in the region; and if he will make a statement on the matter. [39923/13]

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Written answers

I propose to take Questions Nos. 12 and 22 together.

Galway and Roscommon Mental Health Services, which operates as one administrative unit, has been resourced to implement A Vision for Change, to modernise the service and give better outcomes for both patients and staff. Existing resources therefore need to be reshaped, and the priority now is to achieve this in this instance, in line with similar initiatives elsewhere.

At present, there are 35 acute psychiatric beds in Galway city, and 22 acute psychiatric beds in both Ballinasloe and Roscommon. This gives a total of 79 beds, serving a population of around 315,000. A Vision for Change recommends 50 beds for a catchment population of 300,000. It is clear therefore, in line with policy and operational norms nationally, that the provision of 22 beds in both Ballinasloe and Roscommon means that the current overall stock of 79 in HSE West is too high in relative terms, allied to a corresponding under-development of community based mental health services.

To address this situation, a purpose built 50 bed acute mental health unit will be completed in Galway University Hospital in 2015, to replace the existing smaller unit. This Unit will consist of 35 general adult mental health beds, with the remaining 15 beds relating to psychiatry of later life, eating disorders, and mental health and intellectual disability. The acute unit in Roscommon will continue to provide 22 general adult mental health beds.

The re-organisation of services by HSE West will provide a total of 57 general adult mental health beds. This will be a sufficient number of acute psychiatric beds, in line with A Vision for Change, while allowing the Executive to enhance much needed community based services through re-deployment of some staff from acute services. It is intended that staff from St. Brigid’s, Ballinasloe will be redeployed on a phased basis, to both community mental health teams locally and to the acute units in Galway and Roscommon. I wish to stress that this initiative will not give rise to any job losses, and there will be no negative impact for the existing patients in Ballinasloe.

I am satisfied that the approach adopted by the HSE in this matter is in line with the requirements to deliver A Vision for Change in the Galway/Roscommon area, and is fully consistent with similiar initiatives taken elsewhere in the country to modernise our mental health services. This includes taking account of all related services and skill mix availability in the region, as well as other relevant criteria such as geographic and transport considerations, to realise the best options available within available resources.

I and HSE management recently met with local and union representatives and listened to the concerns of all involved. As agreed at that meeting, the HSE will continue to engage with all parties around service re-organisation in the Galway/Roscommon area. I am satisfied that this is the most appropriate approach to ensure the continued implementation of A Vision for Change in that region.

HSE Staff Remuneration

Questions (13)

Gerry Adams

Question:

13. Deputy Gerry Adams asked the Minister for Health the number of executives in the Health Service Executive on salaries of over €100,000 as of September 2013 and the comparable figure for January 2012; the salaries and other payments received in each case; and if he will make a statement on the matter. [40032/13]

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Written answers

The health service is the most complex sector of the Irish public service and employs approximately one-third of all public service staff. Despite the substantial reductions in financial and staff resources which have been necessary in recent years, the health budget accounts for approximately €13 billion annually. In addition, the health service is the subject of an ongoing major programme of reform in line with the Programme for Government. It is essential therefore that the health service is led by senior managers with the requisite skills and expertise to ensure safe and effective provision of services to the public during a period of major change. The number of executives in the HSE earning over €100,000 represents a very small proportion of overall staff numbers and the posts occupied by these staff are necessary for the safe and effective functioning of the the service.

In 2012, 121 HSE executives earned in excess of €100,000 and between them, total remuneration, including allowances and arrears, amounted to €14.6m. A high-level analysis of annualised payroll data from May 2013 indicates that at that time the number of executives on annual remuneration in excess of €100,000 was 129. In the short time available, it has not been possible to provide the detailed information requested by the Deputy; however the HSE has been asked to provide this information directly to him.

Cochlear Implants

Questions (14)

John McGuinness

Question:

14. Deputy John McGuinness asked the Minister for Health if he will provide an update on the Health Service Executive’s plans to provide cochlear implants to children who need them. [39986/13]

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Written answers

Beaumont Hospital is the centre for delivering Ireland’s national cochlear implant programme, with surgical provision for patients under six (6) years being carried out in the Children’s University Hospital Temple Street.

Since the programme commenced seventeen years ago (in 1995), over 700 patients have received cochlear implants. Beaumont Hospital carried out ninety cochlear implants in 2012 (42 children and 48 adults).

The HSE has developed a proposal, in liaison with Beaumont Hospital, to introduce a bilateral cochlear implant programme in Ireland. It is planned that the programme will be located in Beaumont Hospital. This is a complex development and the HSE has engaged with many stakeholders in the proposed development.

The programme will involve additional staff, equipment and capital works and will be dependent on additional funding being made available to support its commencement. The proposal is being considered as part of the 2014 estimates process.

Hospital Waiting Lists

Questions (15)

Charlie McConalogue

Question:

15. Deputy Charlie McConalogue asked the Minister for Health the reasons for the substantial increase in inpatient and day case waiting lists since the start of 2013; and if he will make a statement on the matter. [40016/13]

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Written answers

Improving access for patients to inpatient and daycase treatment is a priority for this Government and significant progress was made in 2012 towards maximum waiting time targets. However, 2013 has been very challenging. While waiting list numbers tend to increase in the first few months of any year, the increase in 2013 was much greater than expected, associated with the unusual wintry conditions and increase in emergency admissions.

Hence, the SDU / HSE have put in place a National Intervention Strategy aimed at meeting this year's maximum waiting time targets (eight months for adults awaiting an inpatient or daycase procedure, 20 weeks for children, 13 weeks for anyone awaiting a routine GI endoscopy and 12 months for a first-time outpatient appointment). They have advised that all hospitals have now developed and commenced necessary action plans to achieve the national targets for maximum waiting times this year. It is welcome that the latest available figures show a 2% reduction in the overall number of patients waiting for an inpatient or daycase procedure in August compared with July and a 6% reduction in the number of patients waiting longer than 12 months.

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