Written Answers Nos. 524-541
524. Deputy Nicky McFadden asked the Minister for Health the Health Service Executive's position on the provision of community funding for sequential compression biomechanical devices, or art assist devices, to suitable patients; if he will acknowledge the cost-effectiveness of providing the devices for home use and avoiding costly hospital stays; and if he will make a statement on the matter. [44352/13]
View answerThe Health Information and Quality Authority (HIQA) conducted a Health Technology Assessment (HTA) of intermittent pneumatic compression for severe peripheral arterial disease at the request of the Health Service Executive. This HTA was published on the 26th June 2013.
HIQA's advice to the HSE was that, despite some promising results on the effect of intermittent pneumatic compression in people with severe peripheral vascular disease (who are not suitable for revascularisation), further high quality studies are required to reliably demonstrate its effectiveness. They also advised that until such evidence is generated in the context of well designed research studies, this treatment remains unproven.
Within the Irish healthcare system there has been limited use of intermittent pneumatic compression to treat patients with critical limb ischaemia. Following the publication of this Health Technology Assessment report there will be engagement and discussion with prescribing clinicians regarding the findings of this important report. In the meantime, the HSE will not be reimbursing for the use of this product. The HSE is happy to review its position on completion of any clinical trials prompted by the relevant clinicians.
525. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the services provided at the paediatric rheumatology department at Crumlin children's hospital; the number of clinics per week and the number of appointments scheduled; the average waiting time for an outpatient appointment; if he will provide in tabular form the medical staffing levels for the unit and the full-time versus part-time nature of same; if he is satisfied that there is sufficient cover to ensure all patients are seen in a prompt manner; his plans to increase staffing levels there; and if he will make a statement on the matter. [44357/13]
View answerAs the queries raised by the Deputy are service matters, I have asked the HSE to respond directly to the Deputy.
526. Deputy Billy Kelleher asked the Minister for Health if there is an obligation on the part of the State to represent and seek compensation on behalf of the patients who had to have their hips replaced as a result of the faulty DuPuy product; and if he will make a statement on the matter. [44370/13]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
527. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will provide an update on the National European Rare Disease Plan; if glutaric aciduria type 1 will be placed on the list for newborn screening; and if he will make a statement on the matter. [44386/13]
View answerIreland has been supportive of the EU proposals on rare disease which concluded with a Council Recommendation in June 2009. The end point is that countries are recommended to develop plans or strategies preferably by the end of 2013. Ireland is now well advanced in this work.
In January 2011, EUROPLAN, the European Project for Rare Disease National Plan's Development, organised a national conference bringing together patients, patient organisations and healthcare professionals to discuss what might feed into the development of a national strategy for rare diseases.
A National Consultation Day for stakeholders was held in Farmleigh in June 2012. This was followed by an on-line consultation which elicited just under 500 valid responses. A report on both aspects of the consultation is currently being finalised by the Institute of Public Health. The Institute is playing an important support role in the development of the National Plan.
It is expected that the Steering Group will submit a plan to the Minister before the end of the year. It is intended to publish the Report on the Consultation alongside the publication of the Plan.
A proposal to include Glutaric Aciduria Type l in the National Newborn Bloodspot Screening Programme was presented to the Programme's Governance Group by Prof. Philip Mayne, Director of the National Newborn Screening Laboratory, Temple Street Hospital. This proposal is under consideration.
528. Deputy Billy Timmins asked the Minister for Health the position regarding prescriptions (details supplied); and if he will make a statement on the matter. [44406/13]
View answerThe Medical Council's Guide to Professional Conduct and Ethics states that "it is in the best interests of the patient that a general practitioner supervises and guides the overall management of their health".
Medical card holders who are given a prescription by a hospital or clinic must request their GP to transcribe the details onto a GMS prescription form in order for them to receive their medication free of charge, subject to any applicable prescription charges.
There is an arrangement under the GMS Scheme for the emergency supply of medicines for medical card holders on discharge from hospital. Community pharmacists are authorised to dispense a maximum of seven days supply of medicines prescribed for persons who have been in-patients in a hospital or who have attended an Emergency Department and because of the circumstances of their discharge and/or the urgency of the prescribed medication it would not be possible to attend their GP to have the hospital prescription transcribed to a GMS prescription form. This arrangement relieves any difficulties that patients might encounter due to being discharged from hospital late in the evening or at weekends.
I wish to assure the Deputy that it is best clinical practice that a person in need of treatment should regularly attend their GP and that the GP is fully aware of the medications that any patient may be being prescribed. This is entirely consistent with the gatekeeper role played by the GP in the delivery of primary care. As GPs receive an annual capitation fee per GMS patient there are no extra costs incurred by such patients.
529. Deputy Tom Fleming asked the Minister for Health if he will expedite a medical card review in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [44414/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has issued to Oireachtas members.
530. Deputy Patrick Nulty asked the Minister for Health if the renewal of a full medical card will be expedited in respect of a person (details supplied) in Dublin 15; the reason for the delay; and if he will make a statement on the matter. [44418/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has issued to Oireachtas members.
531. Deputy John O'Mahony asked the Minister for Health if a community ophthalmologist position will be filled to cover maternity leave (details supplied) in County Mayo; and if he will make a statement on the matter. [44421/13]
View answerCommunity Optometric Services are provided by the Health Service Executive (HSE). The HSE has therefore been asked to examine this matter and to reply to the Deputy as soon as possible.
532. Deputy John O'Mahony asked the Minister for Health when a person (details supplied) in County Mayo will receive an appointment with an ophthalmologist; and if he will make a statement on the matter. [44425/13]
View answerAs the HSE is responsible for providing optical screening services for school age children, the HSE has been asked to examine this matter and respond directly to the Deputy.
533. Deputy Micheál Martin asked the Minister for Health the position regarding the plan to construct a national children's hospital and the necessary steps which must be completed before construction commences; the reason for the delays that have occurred to date; when construction will commence; the timeframe for the entire project; and if he will make a statement on the matter. [44428/13]
View answerThe National Paediatric Hospital Development Board is the body with statutory responsibility for building the new children's hospital. In August I announced appointments to this Board to replace the transitional Board which had been in place since January 2013. These appointments bring architectural, planning, procurement, engineering and construction expertise and experience to the project. 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. Ms Eilísh Hardiman was selected as CEO of the Children's Hospital Group in September following an open recruitment process through the Public Appointments Service and is expected to take up post in November.
Prior to the commencement of construction, key elements of the project include design development, decant works for the site and planning permission. The procurement process for the new design team was initiated in July. Following its appointment, the new Board reviewed that procurement process and have decided on a change of approach based on its collective expertise and experience and taking into account changing market conditions. While this change means that the design team will be selected in Spring 2014, rather than by the end of this year as originally planned, the new Board is confident that there will be no delay to the project overall, as time can now be recovered at contractor tender stage. In tandem, 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. Pre-application planning discussions have commenced while 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.
Work by the new Board on developing a detailed project timeline is continuing, which will reflect the urgency and priority of the project and also its scale and complexity. However, at this stage, the Board is confident that construction can begin in Spring 2015.
534. Deputy John O'Mahony asked the Minister for Health when a child (details supplied) in County Mayo will receive an appointment with an ophthalmologist; and if he will make a statement on the matter. [44431/13]
View answerAs this is a service matter it has been referred to the HSE for direct reply.
535. Deputy Tom Fleming asked the Minister for Health if he will ensure that there are no further cuts to home help hours, if he will further ensure that home helps who are looking after a number of clients are protected and are not penalised by reducing their hours; and if he will make a statement on the matter. [44436/13]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
536. Deputy Joan Collins asked the Minister for Health if a person (details supplied) in Dublin 6 is entitled to funding from the Health Service Executive. [44438/13]
View answerThe general position regarding funding is set out in the Value for Money (VFM) and Policy Review of Disability Services which I published last year. The VFM Review found that HSE funding is based on an incremental determination process with relevant adjustments made to the previous year's baseline allocation. In recent years, the funding of new places has been made at local level on the basis of providing services to named individuals, but, once allocated, the funding does not remain associated with or follow that individual but is absorbed into the agency's base.
The move towards a model of funding which is linked to individual need, and which by definition will follow that individual, is encompassed by the recommendations in the VFM Review. It is intended that the actions recommended in the VFM Review will lay the groundwork for individualised budgeting once sufficient analysis of the benefits is carried out in the Irish context and adequate financial management, resource allocation and governance structures are in place to ensure its long-term viability. The priority is to further improve current services, while expediting the analysis of the benefits to be gained from a person-centred supports model and developing the administrative and governance infrastructure necessary for a more accountable and individualised service.
With regard to the individual query raised by the Deputy, as it relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
537. Deputy Michael Healy-Rae asked the Minister for Health the reason community-based supports for persons with a disability continue to be cut, including personal and home help assistance; and if he will make a statement on the matter. [44445/13]
View answerThis Government currently provides funding of over €1.5 billion to the Disability Services Programme, through the Health Service Executive's (HSE) National Service Plan for 2013 and is committed to protecting frontline services for people with disabilities to the greatest possible extent. In relation to Home Support Services for older people, I would like to reassure the Deputy that the HSE committed in its National Service Plan for 2013 to maintaining the home help and home care package services at levels planned for 2012.
The HSE as a whole has to operate within the parameters of funding available to it and given the current economic environment, this has become a major challenge for all stakeholders, including the HSE, voluntary service providers, service users and their families. I can assure the Deputy that the HSE will continue to ensure that all of the resources available for specialist disability services are used in the most efficient and effective manner possible.
However, pending the completion of the HSE's National Service Plan for 2014, it is not possible to predict the service levels to be provided next year for the disability sector.
538. Deputy Michael Healy-Rae asked the Minister for Health the reason there are 763 children who still have not received their needs assessment despite waiting six months or more and 65% of them nine months or more; and if he will make a statement on the matter. [44446/13]
View answerPart 2 of the Disability Act 2005 was commenced on 1 June 2007 in respect of children aged under 5. In 2008, the then Government decided, in the light of financial circumstances, to defer further implementation of the Disability Act 2005 and the Education for Persons with Special Educational Needs Act 2004.
Part 2 of the Disability Act, inter alia, provides for an assessment of the needs of eligible applicants occasioned by their disability to be commenced within three months of receipt of an application and completed within a further three months.
There has been a very significant rise in overall activity around the assessment process in recent years in respect of the children now encompassed by the process. The number of assessment reports received in 2012 was 3,505 which is over 400 applications more than in 2010. It is worth noting that in the period 2010-2012 over 8,200 reports were completed. While the HSE recognises that it faces significant challenges in respect of meeting the statutory time-frames which apply to the assessment of need process given the number and complexity of cases, it is endeavouring to address the issue from available resources.
While any delay in assessment or intervention for any child is not desirable, the assessment process under the Disability Act can take place in parallel with any intervention which is identified as necessary. The HSE has issued guidance to its staff that where there is a delay in the assessment process, this should not affect the delivery of necessary and appropriate interventions identified for a particular child.
In addition, targeted action plans have been put in place since early 2011. Measures have included: prioritising assessments, holding additional clinics, contracting the private sector to conduct assessments and reconfiguring resources to target areas of greatest need. These plans are monitored on a monthly basis by the HSE centrally.
Following the publication of a report commissioned from the National Disability Authority by the Department of Health and the Health Service Executive, a major emphasis is being placed on reconfiguring disability services for children into geographically-based early-intervention and school-aged teams as part of the Progressing Disability Services for Children and Young People Programme which is underway. The NDA report indicated that where integrated teams were operating, the assessment of need process ran more smoothly. It found that there was no one single solution to remove all of the challenges to operating a statutory assessment of need. Officials from my Department are currently engaging with the HSE and the NDA to further consider the findings contained in this Report.
539. Deputy Michael Healy-Rae asked the Minister for Health the reason front-line staff are not being replaced while waiting lists for services are growing, with 34,617 persons, mostly young children, waiting for speech and language therapy, of whom 6,500 are waiting longer than a year; and if he will make a statement on the matter. [44447/13]
View answerAs the Deputy will be aware, the Health Service Executive has operational responsibility for the delivery of health and personal social services within the ambit of its Vote (Vote 39). The level of health services to be delivered within the available funding has been set out in the HSE National Service Plan, which I approved in January.
The Government has decided that the numbers employed across the public service must be reduced in order to meet its fiscal and budgetary targets. The health sector must make its contribution to that reduction. This policy requires the health service to reduce its workforce to 98,938 wholetime equivalent employees by the end of 2013. However, the HSE can make staff appointments once it remains within its overall employment ceiling and has the financial resources to do so.
With regard to the HSE's Speech and Language Therapy Service, I understand that each individual that presents to the Service has an initial assessment to determine their individual need for therapy. The therapist, in conjunction with the parent(s) or carer, will determine the severity of the individual's difficulties and prioritise for therapy accordingly. The level of intervention is in line with clinic policy, age and severity of the diagnosis. The waiting period for intervention is dependent on the nature and severity of the disorder following assessment.
The HSE aims to ensure that the resources available are used to best effect, in order to provide assessment and ongoing therapy to children and adults in line with their prioritised needs. Along with the significant investment in area of speech and language therapists employed in recent years, a range of new approaches have been developed and used in many Speech and Language Therapy services across the country. These include providing structures, training and support to parents /carers so that they can work to help improve the individual's speech and language. In addition, therapy is delivered in group settings where appropriate. The HSE has stated that it is committed to working in partnership with other service providers to achieve maximum benefits for children and adults with speech and language therapy requirements, and aims to ensure that, the speech and language therapy resources available are used in the most effective manner possible.
540. Deputy Patrick O'Donovan asked the Minister for Health when he expects to introduce minimum pricing legislation for alcohol products; and if he will make a statement on the matter. [44451/13]
View answerProposals are currently being finalised on foot of the recommendations in the Steering Group Report on a National Substance Misuse Strategy 2012. These proposals cover all of the areas mentioned in the report, including measures on access and availability of alcohol; controls on alcohol advertising and sponsorship; labelling of alcohol products, and legislation on minimum unit pricing.
The Cabinet Committee on Social Policy has considered these proposals and it is intended to bring forward a finalised package of proposals for consideration by Government shortly.
In the meantime, work on developing a framework for the necessary Department of Health legislation is continuing. A health impact assessment has been commissioned in conjunction with Northern Ireland as part of the process of developing a legislative basis for minimum unit pricing. The health impact assessment will study the impact of different minimum prices on a range of areas such as health, crime and likely economic impact.
541. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he is satisfied, with respect to cancer patients at the Mid-Western Regional Hospital in Limerick, that all data protection legislation is being complied with, both for public and private patients; and if he will make a statement on the matter. [44458/13]
View answerThe Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to him.
