Written Answers Nos. 42-54
43. Deputy Aengus Ó Snodaigh asked the Minister for Health the additional measures or resources that will be provided to assist organ donation and transplant services here; and if he will make a statement on the matter. [40044/13]
View answerThe HSE, through its National Organ Donation and Transplantation Office, in conjunction with my Department, has identified further priority areas for action to enhance the organ donation and transplantation system. These are being considered in the context of the current Estimates process.
Meanwhile, approval has been given for 30 wholetime equivalent posts at various levels for the expansion of kidney transplantation services at Beaumont Hospital and for the development of urology services at Connolly Hospital Blanchardstown. 8 of these 30 wholetime equivalents are in post and the remaining are in the final stages of the recruitment process. A capital allocation of €5m has been approved for phase 1 of the Kidney Transplant Expansion Programme in Beaumont. An additional operating theatre will be equipped by the beginning of October and the refurbishment and fit out of St Damien’s Ward and the expansion and fit out of the Histocompatibility and Immunogenetics Laboratory will follow in 2014.
44. Deputy Aengus Ó Snodaigh asked the Minister for Health the measures he will take to reduce the number of persons waiting for initial appointments with hospital consultants; the current number of people waiting for such appointments at present; the number waiting for a year or more; if he has a target for reduction; and if he will make a statement on the matter. [40043/13]
View answerUnder this Government, clear data on outpatient waiting lists is being published for the first time following a national project undertaken by the National Treatment Purchase Fund (NTPF). The waiting list for outpatients is updated monthly and includes numbers waiting by hospital, by timeframe and by specialty.
In August 2013, there were 374,104 people overall on outpatient waiting lists. 84,167 were waiting more than one year. This compares with 384,632 people waiting on outpatient appointments in March 2013 (when electronic data collection was introduced). A maximum waiting time target of 12 months for a first-time outpatient appointment has now been set, as shown in the HSE Service Plan 2013. Hospitals are working closely with the HSE Special Delivery Unit and the NTPF, and have developed and commenced necessary action plans to achieve the national target by December 2013.
The availability now of clear data allows resources to be targeted appropriately , including tackling long waits, while the delivery of outpatient services is being reformed through the Outpatient (OP) Service Performance Improvement Programme. The overall aim of the Programme is to ensure timely, appropriate access to OP services.
45. Deputy Seán Crowe asked the Minister for Health if funding for day services for young persons with severe disabilities who have completed school in 2013 will be fully restored; and if he will make a statement on the matter. [40039/13]
View answerI recognise the importance of life-skills training and day support services to young people with disabilities who have left the education system and and its importance to their future progression. It is not a question of funding being withdrawn as funding through the formal education route ceases once a person's education comes to an end. The Department of Education and Skills is responsible for making educational provision for young people with disabilities up to age eighteen. In relation to young adults over eighteen years of age with special needs the Health Service Executive (HSE) has the lead role for the provision of specialised disability support services.
This year the HSE’s National Service Plan includes an additional €4m in demographic funding to help to provide training places and day services for school-leavers and Rehabilitative Training (RT) graduates. The HSE indicate there are 850 young people this year who are making the transition to HSE services compared to 695 school-leavers who required places last year. The provision of services to these young people with support needs is extremely challenging in all regions of the country and the HSE and service providers are making every effort to provide day services to people with disabilities over the age of 18 who require continuing supports. This has always been dependent on the availability and location of appropriate places coupled with the needs of the individual school-leaver and the available resources. Each person is assessed on an individual basis to plan for their services and to identify the most suitable training place or day service placement depending on their particular needs and abilities.
Places have now been provided for 831 school-leavers. Currently 19 school-leavers and 8 RT graduates still require a place and 163 individuals have been provided with a partial placement and require additional hours to fully address their assessed need. Work is underway in each region to address the needs of those individuals who have not been provided with placements or those placements requiring additional hours.
From within the existing disability allocation, resources are being made available by the HSE to enable these remaining places to be provided. The HSE in collaboration with voluntary service providers and umbrella representative groups will put in place the necessary monitoring and oversight arrangements to ensure that these remaining places are in place as speedily as possible.
46. Deputy Lucinda Creighton asked the Minister for Health his health priorities for the Dáil Éireann term ahead; and if he will make a statement on the matter. [39928/13]
View answerI remain committed to a wide series of health reform as outlined in the document Future Health. Those areas of reform that I have prioritised for this Dáil term are:
To publish a White Paper on Universal Health Insurance.
To establish a new Patient Safety Agency on an administrative basis.
In conjunction with the HSE and the State Claims Agency to rollout the National Adverse Management System to develop a risk based approach for the provision of indemnity to services and professionals.
To conduct with the HSE a review of the Integrated Service Areas.
As funding for the health service will be provided from the Vote of the Office of the Minister for Health from 2014 the Department will work closely with the HSE and the Department of Public Expenditure and Reform on the detailed arrangements required to bring about this change and will work with the HSE to implement the recommendations in the 2012 Reviews of Financial Management Systems in the Health Service.
To pursue cost control in the private health insurance market throughout 2013 and address the regulatory status of the VHI by the end of the year.
To work with the HSE to increase the number of health care professional working in primary care and implement a programme of investment in primary care centres.
To continue to work with the HSE to implement programmes aimed at reducing waiting times for scheduled and unscheduled care and to oversee the establishment of administrative hospital groups as a first step to the establishment of hospital trusts by December 2015.
To support the HSE in rolling out a Single Assessment tool for older people services in 2013. To extend the HIQA regulatory scheme to residential services for people with disabilities and will review the applicability of the Fair Deal Scheme to other sectors. The Department will work with the HSE to move toward a person centred model of service and supports for disability services and to complete a prospective funding model for palliative care.
Develop an eHealth strategy and work with the HSE to establish an Information and ICT Strategy Unit.
In relation to legislation I will bring forward a number of Bills as outlined in the Governments Legislative Programme published last week.
47. Deputy Clare Daly asked the Minister for Health if he will ensure that there are no funding cuts to St. Michael's House, in order to reduce the harsh impact on services such as residential and respite care. [39921/13]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services, including disability services. The HSE either directly provides or contracts disability agencies such as St. Michael House to provide a range of disability services through service level arrangements.
St. Michael’s House received over €70 million in 2012 in funding from the HSE to provide a range of services to approximately 1,660 children and adults with an intellectual disability in over 170 centres in the Greater Dublin Area and Navan, Co. Meath.
The HSE and St. Michael's House work in close collaboration with regard to the funding and delivery of services to people with an intellectual disability. As a voluntary agency, St. Michael’s House are obliged to work within the resources available to them and in that regard have introduced significant efficiencies over recent years to remain within budget. The HSE has advised that these changes to date have not resulted in service contraction.
The Haddington Road Agreement (HRA) sets out measures relating to productivity, cost extraction and reform which together intends to achieve a required pay bill reduction of €150m identified in the HSE Service Plan 2013. The agreement provides a framework and opportunities for managers within the health services, including agencies such as St. Michael's House, to reduce their costs associated with agency and overtime and a wide range of other pay costs, particularly through measures such as additional working hours and revised rates in respect of overtime.
The HSE has advised the Department of Health that the recent application of additional budget cuts under the HRA has presented a significant challenge to St. Michael's House. A process is now underway between the HSE and St. Michael’s House to identify the impact of these budget reductions on services. The Department of Health has received assurances from the HSE that both organisations are committed to working within the terms of the HRA to ensure that services are impacted upon only as a measure of last resort.
48. Deputy Mick Wallace asked the Minister for Health the strategy the Health Service Executive has in place to improve the protection of those who fall victim to domestic violence; and if he will make a statement on the matter. [40060/13]
View answerIn 2010 the National Strategy on Domestic, Sexual and Gender-based Violence was published. It aims to provide a framework for sustainable intervention to prevent and effectively respond to domestic, sexual and gender-based violence and is lead by Cosc which is the National Office for the Prevention of Domestic, Sexual and Gender-based Violence.
The HSE subsequently published its own Policy on Domestic, Sexual and Gender-based Violence. The principal actions are in line with the National Strategy. The HSE’s policy states that a health-focused analysis of violence is crucial, not only because the consequences of such violence require a significant amount of healthcare system resources, but most importantly because the health care system is often the first route through which victims seek to access supports.
The Children and Family Agency within the forthcoming new Chid and Family Agency Bill (1)(c) has responsibility for providing care and protection for victims of domestic, sexual and gender-based violence whether in the context of the family or otherwise. Going forward this will ensure that there is an integrated care pathway for identifying, referring and providing a range of supports for families who are experiencing or have experienced domestic violence including referral pathways to services funded by the Children and Family Agency through service level or grant aid agreements.
49. Deputy Pádraig Mac Lochlainn asked the Minister for Health the additional resources he will make available to assist the rebuilding of Letterkenny General Hospital following flood damage; and if he will make a statement on the matter. [40041/13]
View answerFollowing the flooding in Letterkenny General Hospital a major emergency plan was put into operation. As part of this plan a Rebuild Steering Group was established and is supported by a design team.
The Group identified the Scope of Works (11 projects), indicative timescales and costs to restore services to the hospital. Emergency capital funding has been made available to fund the projects which include, inter alia;
- Gynae Department restored;
- Temporary cardiac investigations area completed;
- Interim kitchens/Staff canteen are in place and in operation;
- Interim Emergency Department and Radiology Department including two mobile DR (X Ray) trailers are in place and providing service;
- Planning permission submitted for culvert works;
- Option appraisal and detailed design completed for temporary outpatients.
In parallel there is an ongoing process regarding settling the insurance claim to cover the extensive damage. This claim will fund a significant part of the identified costs but is very much work in process. Any deficit in costs, not covered by the insurance claim will be met (subject to the normal scrutiny) by the Health Service Executive.
I am satisfied that every possible resource has been made available and will continue to be made available to Letterkenny General Hospital to implement the scope of works identified by the Rebuild Steering Group.
50. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the mechanisms that are in place to assess the impact budget 2014 will have on the health, safety, quality of care and provision of services for patients in our public health system; and if he acknowledges the need to healthcare-proof this and all future budgets. [40029/13]
View answerThe health care system has, over recent years, had to deal with a number of major challenges, including reduced overall levels of funding and employment levels, demographic pressures, and increased numbers of people with chronic illnesses.
Despite this, major improvements in mortality and morbidity rates have been achieved in certain core areas, including diseases of the circulatory system, where the death rate per 100,000 has fallen by almost 36% since 2002, and overall cancer rates, which have witnessed an 8% overall reduction in the same period. This has been achieved during a period when the average length of stay in acute hospitals has also reduced and the number of patients receiving the treatment they require without having to stay in hospital (that is day case patients) has increased as a percentage of total discharges by over 50%.
The 2013 Service Plan required the HSE to continue to focus its delivery of services on the dual challenge of protecting patient outcomes while, at the same time, reducing costs. 2014 will be no different in this regard and any measures impacting on the health system as a result of Budget 2014 will also be assessed against these criteria – with the outcomes of this consideration set out in the HSE’s National Service Plan for 2014, which will be submitted to me for approval within a matter of weeks of the Budget.
The National Service Plan, in setting out the operating framework for the delivery of HSE services throughout 2014, will look to deliver the maximum level of safe services possible, with prioritisation, where necessary, of certain services to meet the most urgent needs. The Plan will also set out targets in respect of each programme area to ensure that performance can be evaluated throughout the year in order to identify any emerging areas of concern, and, should any such concerns arise, implement necessary remedial measures without delay.
51. Deputy Dessie Ellis asked the Minister for Health if he will ensure that all children diagnosed with cancer are granted, or allowed to retain, medical cards; and if he will make a statement on the matter. [40038/13]
View answerUnder the provisions of the Health Act 1970, the assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependants. There is no automatic entitlement to a medical card for persons of any age with a specific illness, such as cancer.
However, under the legislation, there is provision for discretion by the HSE to grant a medical card where a person's income exceeds the income guidelines. The HSE takes a person's social and medical issues into account in determining whether or not "undue hardship" exists for a person in providing a health service for themselves or his or her dependents.
The HSE has an effective system in place for the provision of emergency medical cards for patients who are terminally ill, or who are seriously ill and in urgent need of medical care that they cannot afford. They are issued within twenty-four hours of receipt of the required patient details and the letter of confirmation of the condition from a doctor or a medical consultant. With the exception of terminally ill patients, the HSE issues all emergency cards on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and that the applicant will follow up with a full application within a number of weeks of receiving the emergency card. As a result, emergency medical cards are issued to a named individual, with a limited eligibility period of six months.
For persons with a terminal illness, no means test applies. Once the terminal illness is verified, patients are given an emergency medical card for six months. Given the nature and urgency of the issue, the HSE has appropriate escalation routes to ensure that the person gets the card as quickly as possible.
52. Deputy Mary Lou McDonald asked the Minister for Health if he will provide a progress report on the development of the new National Children’s Hospital [40049/13]
View answerThe National Paediatric Hospital Development Board is the body with statutory responsibility for building the new children's hospital. Last month I announced appointments to this Board to replace the transitional Board which had been in place since January 2013. These appointments ensure appropriate professional membership with the necessary capital development expertise and experience in complex healthcare capital projects. Also in August I announced the appointment of members to the Children’s Hospital Group Board. This Board will oversee the operational integration of the three existing paediatric hospitals in advance of the move to the new hospital and is also the client for the new hospital, and hence is critically important for the project as a whole. Earlier this month, Ms Eilísh Hardiman was selected as CEO of the Children's Hospital Group following an open recruitment process through the Public Appointments Service.
With regard to the progress of the capital project, the tender process for the procurement of a new design team is well underway, and the aim is to have the new design team in place by the end of 2013. Pre-application planning discussions have commenced and the aim is to secure planning permission by December 2014. A review of urgent care centre(s) configuration is almost complete; the number and location of these satellite centres in the Dublin area is a key decision, as the size, activity and infrastructure of these satellite centre(s) has implications for the main hospital brief. In parallel, St. James's Hospital is working closely with HSE Estates and the National Paediatric Development Board in regard to the decant phase of the project.
The new children’s hospital is a priority for me and for this Government. I am confident that the appointments made to the two Boards will ensure the new hospital is completed as swiftly as possible, with optimal design and value for money.
