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Wednesday, 27 Nov 2013

Written Answers Nos. 181-187

Ombudsman for Children Remit

Questions (181)

Thomas P. Broughan

Question:

181. Deputy Thomas P. Broughan asked the Minister for Children and Youth Affairs if the Ombudsman for Children will be given additional powers to conduct statutory reviews once the death of a child known to the Health Service Executive’s children and family services, soon to become the Child and Family Agency, has occurred. [51065/13]

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Written answers

It is my view that the powers of investigation currently held by the Ombudsman for Children’s Office (OCO) as they relate to HSE Children and Family Services should extend to the Child and Family Agency following its establishment. In this connection my Department will be consulting with the OCO in accordance with Section 10(7)(a) of the Ombudsman for Children Act, 2002. This will be with a view to the making of an order to amend Schedule 1 of the Act to include the Child and Family Agency as a public body which will be subject to the OCO powers of investigation.

I should point out that there currently exists a very effective mechanism to investigate deaths and serious incidents involving children in care and known to the HSE. That is the National Review Panel, which is chaired by Dr. Helen Buckley and which has over the past number of years published a series of important, comprehensive reports. I recently indicated my intention to strengthen the operation of the National Review Panel by asking HIQA to undertake an audit/oversight role in relation to the processes of the Panel and discussions are ongoing in relation to the detail of this role.

Hospital Consultants Contract Issues

Questions (182)

Billy Kelleher

Question:

182. Deputy Billy Kelleher asked the Minister for Health if public hospitals currently have in place any arrangements allowing Category A consultants to carry out private work within public hospitals, or any arrangements to allow Category B consultants to carry out private work outside of the public hospital; and if he will make a statement on the matter. [50871/13]

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Written answers

A key objective of the consultant contract 2008 is to improve access for public patients to public hospital care. The contract sets out clear rules on the level of private practice that may be undertaken by consultants, depending on the individual contract held, and the arrangements for measurement and management of the public/private mix.

Consultants holding a Type A contract are not permitted to engage in privately remunerated professional practice. Consultants holding a Type B contract may undertake private practice on-site, up to a limit of 20% of activity on a casemix-adjusted basis, and limited off-site private practice in cases where the individual consultant held a category I or Category II contract under Consultant Contract 1997.

It is incumbent on publicly-funded hospitals to ensure compliance with the terms of the contract, including the provisions in relation to private practice. In particular, my Department has requested that the HSE satisfy itself that no consultant with a Type B Contract is engaged, or will be permitted to engage, in off-site private practice beyond the level, if any, provided for in their contract.

HSE Investigations

Questions (183, 184)

Terence Flanagan

Question:

183. Deputy Terence Flanagan asked the Minister for Health if the Health Service Executive investigation into the death of a person (details supplied) under the national incident protocol addressed in its recommendations the fact, established during the inquest, that a previous abortion was a significant factor in her death; if these recommendations included measures to ensure that women are warned of the serious physical risks to themselves of undergoing an abortion; and if he will make a statement on the matter. [50878/13]

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Terence Flanagan

Question:

184. Deputy Terence Flanagan asked the Minister for Health his views on the Health Service Executive investigation into the death of a person (details supplied) under the national incident protocol; if he will list its full recommendations; and if he will make a statement on the matter. [50880/13]

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Written answers

I propose to take Questions Nos. 183 and 184 together.

As I have said in previous replies to Parliamentary Questions on this issue I have been advised that the circumstances surrounding this very unfortunate case were investigated by the Health Service Executive (HSE) under the National Incident Protocol following which 11 actions were recommended. The recommendations are as follows:

1. The need to identify clinical pathways relating to management of women with an intrauterine death in third trimester to complement existing medical management policy.

2. The Guidelines for Medical Management of Intrauterine Death should be revised in line with a review of the medical literature.

3. Details of all patients for Induction of Labour, regardless of place of induction should be centrally documented.

4. This recommendation cannot be disclosed as it contains personal, private, sensitive and confidential information relating to the individual patient.

5. Develop a brief operational outline of the Gynaecology Department to assist staff who are sent there on an occasional/intermittent basis.

6. Due to the complexity of work, there is a need for an updated training needs analysis of all midwifery and nursing staff on the gynaecology ward.

7. There should be a designated individual with responsibility for coordinating, monitoring and auditing the Basic Life Support attendance and Advanced Life Support Skills attendance, ideally a designated Resuscitation Training Officer.

8. An Obstetric Early Warning System should be introduced and evaluated.

9. Install additional phone lines in the ward.

10. A review of the possibility of emergency call bells or designated phones for emergencies in each room should be carried out and measures taken to address this.

11. Hospital wide analysis of all doorways in clinical areas to establish the feasibility of moving a bed in a critical event.

I have been informed by the HSE that the Rotunda Hospital has implemented all 11 recommendations.

It is my expectation that patients should be informed of all the risks to themselves arising from any medical procedure to which they give informed consent.

Health Promotion

Questions (185)

Terence Flanagan

Question:

185. Deputy Terence Flanagan asked the Minister for Health if his Department will be investing more in prevention measures in an attempt to cut our high levels of smoking and drinking following publication of the latest figures from the OECD in the report Health at a Glance, which shows that Ireland is among the top global smokers and drinkers; and if he will make a statement on the matter. [50885/13]

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Written answers

My Department has received Government approval for policy actions aimed at reducing the levels of smoking and drinking in Ireland. I would like to note at the outset that the figure of 29% of the population smoking, quoted by the OECD in their report, was sourced from the 2007 SLAN study. However, the latest figures from the National Tobacco Control Office in the HSE (collected in June 2012), show that 22% of the Irish population now smoke.

Tobacco Free Ireland, which I launched on 3 October 2013, sets a target for Ireland to be tobacco free (i.e. with a prevalence rate of less than 5%) by 2025. Tobacco Free Ireland sets out over 60 recommendations with the overall aims of denormalising smoking in our society, protecting children from the harms of tobacco, enforcing, regulating and legislating for tobacco activities and products, educating about the dangers of tobacco and assisting those who smoke in stopping.

An extensive package of measures to deal with alcohol misuse to be incorporated in a Public Health (Alcohol) Bill was approved by Government on the 24th October 2013. The aim is to reduce our per capita consumption of alcohol to the OECD average (9.1 litres of pure alcohol per capita) by 2020. These measures are based on the recommendations contained in the National Substance Misuse Strategy report 2012. The package of measures to be implemented will include provision for:

- minimum unit pricing for alcohol products;

- the regulation of advertising and marketing of alcohol;

- structural separation of alcohol from other products in mixed trading outlets;

- health labelling of alcohol products; and

- regulation of sports sponsorship.

Work is continuing in my Department on the implementation of the recommendations in Tobacco Free Ireland and the drafting of the Public Health (Alcohol) Bill. These measures have been developed under the Healthy Ireland framework. Healthy Ireland is a government framework, which sets out a vision that will improve the health and wellbeing of all the population of Ireland over the next 12 years. It puts forward a “whole of society” approach and new arrangements to ensure more effective co-operation to achieve better outcomes for all.

Prescriptions Data

Questions (186)

Terence Flanagan

Question:

186. Deputy Terence Flanagan asked the Minister for Health if he has concerns regarding the new study undertaken by NUI Maynooth that shows there has been a 60% increase in the prescription of drugs for children with attention deficit hyperactivity disorder in the past six years; and if he will make a statement on the matter. [50887/13]

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Written answers

I am aware of the study referred to by the Deputy concerning children with Attention Deficit Hypertension Disorder (ADHD), recently undertaken by NUI Maynooth and launched by the children's charity Archways. This report, including the specific issue highlighted by the Deputy, will be considered in detail by my Department and the HSE, in the context of developing policies and services on ADHD.

Health Strategies

Questions (187)

Róisín Shortall

Question:

187. Deputy Róisín Shortall asked the Minister for Health if he will report on the status of the national AIDS strategy committee; the dates on which it has met in the past 18 months; the role it has had in the drawing up of the sexual health strategy; and if he will make a statement on the matter. [50898/13]

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Written answers

The National AIDS Strategy Committee last met on the 29th May 2012. The majority of the members/representative bodies of the National AIDS Strategy Committee were also members of the Steering Group and working Groups established to develop the Sexual Health Strategy. The development of a National Sexual Health Strategy is nearing completion. I intend to submit the Strategy to Government for approval as soon as possible.

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