Written Answers Nos. 588 - 604
588. Deputy Mary Mitchell O'Connor asked the Minister for Health if he will extend the age category for free breast check eligibility to include women under 50 and over 64 years; and if he will make a statement on the matter. [54052/13]
View answerThe BreastCheck Programme provides free mammograms to all women aged 50-64. The HSE's National Cancer Screening Service continually reviews new and emerging evidence on screening benefits, including the optimum age range for screening. International evidence does not support the introduction of population-based breast screening below the age of 50. A priority of the BreastCheck Programme at present is to maximise national uptake in the 50-64 year age cohort. It also aims to extend the upper age range to include the 65-69 age cohort as soon as possible.
590. Deputy Thomas P. Broughan asked the Minister for Health the number of temporary employments in the Health Service Executive for which a company (details supplied) has recruited the successful applicants in the years 2011, 2012 and to date in 2013. [54066/13]
View answer592. Deputy Thomas P. Broughan asked the Minister for Health the expenditure incurred by the Health Service Executive in engaging the services of a company (details supplied) in the years 2011, 2012 and to date in 2013. [54069/13]
View answerI propose to take Questions Nos. 590 and 592 together.
As these are operational matters they have been referred to the Health Service Executive for direct reply.
591. Deputy Pat Deering asked the Minister for Health the amount of funding allocated for Alzheimer's care in the past years, in tabular form, showing the breakdown between home care and community care. [54068/13]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
593. Deputy Billy Timmins asked the Minister for Health if he will consider reducing the registration fees payable by pharmacists to the Pharmaceutical Society of Ireland which are very high by international standards; if he will reduce the annual pharmacy premises charge from €2,250 to €500 per annum and take €8 million from the reserve of the PSI to put that money to better use within the HSE as such a large surplus is not necessary; and if he will make a statement on the matter. [54073/13]
View answerThe Pharmaceutical Society of Ireland (PSI) is an independent, self-financing statutory body, established by the Pharmacy Act 2007. It is charged with, and is accountable for, the effective regulation of pharmacists and pharmacies in Ireland, including responsibility for supervising compliance with the Act. Under the Act, the PSI inter alia is responsible for the registration of pharmacists, pharmaceutical assistants and pharmacies, the education, training and continuing professional development of pharmacists, as well as the inspection of pharmacies, enforcement of medicines and pharmacy legislation and the operation of fitness to practise functions. These functions are funded by fees paid by registrants. The setting of fees for the pharmacy profession is governed by the Act which requires the PSI to make an application for ministerial consent to any fees that it proposes to charge. This process allows for the consideration, and examination, of the Society’s fee proposals by my Department.
In 2008, the PSI commissioned an extensive review of its functions arising from the implementation of the Pharmacy Act 2007. The process included a comparative analysis of comparable international pharmacy regulators and consultation with national stakeholders. Arising from that review the fees for registrants were set by the Council of the PSI with the approval of the then Minister for Health. In 2010, following an internal review of fees and the cost of regulation, the PSI Council sought and received ministerial approval for an annual reduction in continued registration fees of 10% -11% for pharmacists, pharmaceutical assistants and pharmacies. The PSI is currently carrying out a review of registration fees and will report to the Minister in early 2014.
594. Deputy Tom Fleming asked the Minister for Health If he will issue a progress report on the new national children's hospital; the facilities that will be provided; when is it envisaged works will commence; the timeframe for completion; the amount of funding spent to date on the project; the total estimated cost; and if he will make a statement on the matter. [54079/13]
View answerThe new children's hospital project is a priority for this Government. The National Paediatric Hospital Development Board (NPHDB) is the body responsible for the capital project. Last August, I announced appointments to this Board to replace the transitional Board which had been in place since January this year. These appointments bring architectural, planning, procurement, engineering and construction expertise to the project. In November, Mr. John Pollock was selected as Programme Director of the NPHDB. Also in August, I announced appointments to the Children's Hospital Group Board which, as client for the project, will play a key role in ensuring the new hospital is optimally designed and completed as swiftly as possible. In November, Ms Eilísh Hardiman took up post as CEO of the Children's Hospital Group, and will play a central role in driving forward the integration of the three hospitals, and the project as a whole.
Prior to the commencement of construction, key elements of the project include design development, decant works for the site and planning permission. The new NPHDB has reviewed the design team procurement process, which had been initiated in July, and decided on a change of approach based on its collective expertise and taking into account changing market conditions. While this means that the design team will be selected in Spring 2014, rather than by the end of this year as originally planned, the Board is confident there will be no delay to the project overall. Pre-application planning discussions have commenced, a master plan for the St. James's Hospital campus is being prepared and St. James's Hospital is working closely with the Development Board and the HSE in relation to the decant phase of the project. Work on the review of urgent care centre configuration is at an advanced stage and I intend to bring proposals in this regard to Government shortly.
The new children's hospital will provide in-patients with their own single room and en-suite bathroom, with overnight in-room accommodation for parents. The new theatres and procedure rooms will have advanced medical technology for patient diagnosis (e.g. x-ray machines) and complex surgeries, which will inevitably improve clinical outcomes for patients. The hospital will have a child-centred design with colourful play areas and external gardens for children (and for their families). Different play areas and recreational facilities will be provided that are appropriate for different age groups. Work on developing a detailed 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 with the transition of services to the new hospital to commence at the end of 2018.
In October, the Minister for Public Expenditure and Reform announced that up to €200m would be made available for the new children’s hospital from the sale of the National Lottery, adding to the existing €450 million Exchequer funding. The level of funding now in place underlines the Government’s commitment to this priority project. Also, philanthropic / non-Exchequer funding will be sought to the maximum and most appropriate degree. Estimated costs will be reviewed and refined at each stage as the project progresses. The total spent on the new children’s hospital to date is €41 million. Of the total spent on the project in its previous location, much of the work that was done for the project on its previous site can be transferred to the new site. However, a proportion of the costs incurred require to be written off. This cannot be avoided, having regard to the fact that the continuing serious planning concerns identified meant that the project could not continue on the original site.
595. Deputy Maureen O'Sullivan asked the Minister for Health if he will include key performance indicators for waiting lists for psychological therapy in the upcoming Health Service Executive Service Plan 2013; if he will include indicators to measure not only the number of mental health service users but also the outcome of the use of these services to monitor and improve the services over time; and if he will make a statement on the matter. [54097/13]
View answerThe Department of Health works on an ongoing collaborative basis with the HSE in developing and refining performance measures across all service areas, including mental health, to ensure that they are as robust and meaningful as possible and reflect key priorities and international best practice as well as being comparable both within the EU and further afield. The National Director for Mental Health indicated that, during 2014, the HSE will develop a metric to collect information in relation to the numbers waiting for psychological therapy in the mental health services, to pilot the collection of the metric, with a view to including it in the 2015 service planning process.
The development of outcome measures in the absence of an ICT system in mental health is more complex. However, it is planned to build on the work currently underway in developing KPI's for General Adult and Psychiatry of Old Age Community Mental Health Teams to focus on developing access and quality metrics during 2014.
596. Deputy Maureen O'Sullivan asked the Minister for Health the care plan, with costs, that has been put in place in respect of a person (details supplied) in Dublin 1. [54098/13]
View answerAs this is a service issue this question has been referred to the HSE for direct reply.
597. Deputy Richard Boyd Barrett asked the Minister for Health the amount consultants with private practice are receiving on top of their Health Service Executive salary in private fees and the measures he is taking to address this. [54101/13]
View answerThe amount consultants receive in respect of private practice reflects the volume of cases and the level of fees charged. Consultant Contract 2008 sets out clear rules on the relative volume of private practice that may be undertaken by consultants, depending on the individual contract held, and the arrangements for measurement and management of this, including the steps to be taken where it the permitted volume exceeded. Depending on contract type, a consultant may have no access to private practice (Type A contract holders), a cap of 20% private activity for newly appointed consultants (Type B) or a cap of up to 30% in the case of certain existing consultants. Arrangements concerning implementation and monitoring of Consultant Contract 2008 are matters for the HSE in the first instance. It is incumbent on publicly-funded hospitals to ensure compliance with the terms of the contract, including the provisions in relation to the ratio of private practice undertaken.
The level of fees charged by a consultant who sees a patient privately is a matter between the consultant and the patient. The fees arising may be met personally by the patient concerned, by the patient's health insurer, or a combination of the two depending on the extent, if any, to which the patient has insurance cover for the service provided. Given these arrangements, the data sought by the Deputy is not available. However, I have impressed on health insurers the need to contain costs, including payments in respect of consultant fees.
598. Deputy Michael Healy-Rae asked the Minister for Health the reason, when there are hundreds of Irish trained nurses moving abroad looking for work, more than 800 front-line nursing posts were lost in hospitals in 2013. [54106/13]
View answer629. Deputy Tom Fleming asked the Minister for Health the number of nursing posts that have been lost in Cork-Kerry region hospitals to date since January 2013; the numbers lost in each hospital; the number of nursing jobs in total that have been left unfilled in these hospitals since 2009; the measures being taken to fill the vacancies of lost posts since January; the medium to long term plan to restore these staffing levels to an acceptable level for staff and patient safety; and if he will make a statement on the matter. [54346/13]
View answerI propose to take Questions Nos. 598 and 629 together.
The census returns for October 2013 showed a fall of 1,482 whole time equivalents in the health sector since the start of the year, 588 of whom were in the nursing category. These falls reflect Government policy that the numbers employed across the public service must be reduced in order to meet fiscal and budgetary targets. The health sector must make its contribution to the necessary reduction. Nonetheless, it is open to the HSE to continue to recruit nurses and midwives in circumstances where it has been established that there is an urgent service requirement and this can be accommodated within the budgetary and staff number limits in place.
Notwithstanding the need to reduce numbers employed in the public service, the Government is wholly committed to the provision of training, work-experience and employment opportunities where possible. Hence the decision to implement a Nurse Graduate Initiate and an Intern Scheme for Health Support Staff. The Nurse Graduate Initiative enables the health services to offer 1,000 graduate nurses positions for two years, at a time when job opportunities in the public service are very limited. Therefore it supports the retention of recently qualified graduate nurses and midwives within the Irish health system and enables them to gain valuable work experience and development opportunities post-graduation. To date 77 staff nurse/midwife graduates have commenced employment in HSE South, 256 nationally.
There is a global demand for nurses and that they are a mobile workforce. A range of factors, including opportunities to gain further experience, the levels of pay available, working conditions generally and other economic factors and social conditions in different countries influence decisions to move abroad. As the recruitment of nurses to specific posts and regions is a matter for the HSE in the first instance, the Deputy's enquiries concerning nursing posts in Cork-Kerry regional hospitals have been referred to the Health Service Executive for direct reply.
599. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he has studied the recent response from the Health Service Executive (details supplied) with particular reference to identification of the primary reasons for the high numbers of young girls and boys reporting at accident and emergency with suspected deliberate self-harm injuries; the extent to which investigations have been carried out as to whether cyber bullying or other causes were contributory factors; the procedures put in place, if any, to address such issues; and if he will make a statement on the matter. [47830/13]
View answerGovernment policy on deliberate self-harm and suicide prevention is guided by our national strategy Reach Out which makes a number of recommendations in relation to fast track referrals to community-based mental health services, effective response to deliberate self-harm, training, reducing stigma and promoting positive mental health, initiatives aimed at helping young men and research. The HSE’s National Office for Suicide Prevention (NOSP) has primary responsibility for the implementation of Reach Out. I would like to assure the Deputy that dealing with the current high levels of suicide and deliberate self harm is a priority for this Government.
The National Suicide Research Foundation (NSRF), which is funded by the NOSP operates the National Registry of Deliberate Self Harm. This is a national system which monitors the occurrence of deliberate self-harm presenting to hospital Emergency Departments. The NSRF compiles and publishes data on the incidence of deliberate self harm an annual basis. Data on the reasons behind the presentation of deliberate self-harm is not collected.
A Child and Adolescent Self-Harm in Europe (CASE) study which was carried out in Ireland and in six other centres in Europe and Australia aimed to establish the prevalence and correlates of self-harm among adolescents aged 15-17 years. The study found that the common factors significantly associated with self-harm among young boys and girls in Ireland were having a friend who engaged in self-harm and drug use. Among girls, having lower self-esteem experiencing problems making friends or keeping friends and conflict with parents were also associated with deliberate self-harm. Having a family member who had engaged in deliberate self-harm and experience of forced sexual activity were also significant for girls.
Deliberate self-harm in boys was significantly associated with higher levels of anxiety and impulsivity, problems with schoolwork and having experienced bullying at school. Among boys who had experienced bullying, other factors increasing the risk of self-harm included worries about sexual orientation, physical abuse, and problems with school work. Risk of lifetime self-harm was four times higher for boys who experienced bullying in school.
Drawing from the CASE study data from the seven countries, Madge at al (2011), found that there was a weak association between being bullied and deliberate self-harm. The researchers concluded that there is no single pattern of self-harm among young people, but both psychological characteristics and stressful life events substantially increase risk. The NOSP is currently funding a literature review to examine the prevalence and impact of cyber bulling on mental health and suicidal behaviour. This literature review addresses Action 11 of the Department of Education and Skills Action Plan on Bullying (2013). The literature seems to suggest that cyber bullying alone does not lead to deliberate self-harm or suicidal ideation, but cyber bullying may increase depression in young people, and thereby exacerbate vulnerabilities which increase the risk of deliberate self-harm and suicidal ideation. Emergency Departments have the expertise in deliberate self-harm, crisis intervention nurses and/or liaison psychiatry services to support anyone who attends after an episode of self-harm.
600. Deputy Joan Collins asked the Minister for Health if he will provide an up to date report of the Health Service Executive service plan. [54042/13]
View answerThe Health Service Executive's National Service Plan for 2014, setting out the type and volume of health and social services the HSE will provide during the course of next year, was adopted by the Directorate of the HSE on Monday of this week and submitted to me. I have now considered and approved the Service Plan. The approved Service Plan was submitted to Government for its consideration this morning. The HSE will publish the Plan tomorrow, Wednesday, 18 December.
601. Deputy Brendan Griffin asked the Minister for Health the current waiting lists for the five migraine clinics in Counties Cork and Galway, Dublin's Mater Hospital, St. Vincent's Hospital and Beaumont Hospital; and if he will make a statement on the matter. [54143/13]
View answerIn relation to the detailed information requested by the Deputy, I have asked the Health Service Executive to respond to him directly.
602. Deputy Michael Lowry asked the Minister for Health further to parliamentary Questions Nos. 499 and 522 of 10 December, if he will address the specific issues raised with regard to the lack of supports available for teenagers who have suffered a brain injury; if his attention has been drawn to the lack of a dedicated adolescent rehabilitation unit for teenagers who have suffered an acquired brain injury; if his attention has been drawn to the lack of support group or organisation for affected teenagers; if his attention has been drawn to the devastation caused to teenagers as a result of these injuries; if his attention has been drawn to the fact that a teenage brain can recover swifter and better if the correct supports are put in place; if he is aware that the organisations referred to in the reply do not cater for teenagers as was erroneously stated; if he will take immediate action to tackle this issue and provide for an adolescent support unit; and if he will make a statement on the matter. [54149/13]
View answerThe Health Service Executive (HSE) has recognised the need to increase the level of consistency and standardisation in the way both early intervention services and services for school-aged children with disabilities are delivered. The HSE is currently engaged in a reconfiguration of existing therapy resources to geographic based teams for children (0 - 18 years). A number of national and regional implementation groups have been set up to progress this plan over the coming years. This measure will have a positive impact on the provision of clinical services for all children and young adults requiring access to health related supports.
As I indicated to the Deputy in my reply of the 10th December, within Disability Services, the two main organisations that are funded to meet the needs of people with acquired brain injury nationally are Acquired Brain Injury Ireland and Headway Ireland. Some other organisations such as Cheshire Ireland and the Irish Wheelchair Association also provide services for people with acquired brain injury.
Acquired Brain Injury Ireland (ABII) works mainly with adults (18-65 years) whose main disability is acquired brain injury, although ABII is also involved in pilot projects developing services for children and runs parenting programmes for parents of children with acquired brain injury in Dublin. ABII provides a range of flexible and tailor-made services, including assisted living services, home and community services, home and community rehabilitation services, day resource services, rehabilitation support, case management, education programmes and individual development supports. Headway provides a range of services to people with acquired brain injury (16 - 65 years), including day services, a psychology and social work service, community integration programmes, supported employment, family support and rehabilitation training programmes.
Neuro-rehabilitation services for children are provided by the HSE or by the non-statutory sector acting in partnership with the HSE. These services are provided primarily through the tertiary services offered by the National Rehabilitation Hospital (NRH), Enable Ireland and the Central Remedial Clinic. The NRH currently has 8 dedicated beds for children who have a requirement for rehabilitation.
Within the HSE primary and community services, neuro-rehabilitation services are provided through the Early Intervention and Children's Therapy Teams, which provide assessment and intervention services to children with a wide range of disabilities. The HSE is committed to the implementation of the recommendations contained in the Report - National Policy & Strategy for the Provision of Neuro-rehabilitation Services in Ireland 2011 - 2015 and to the development of the Rehabilitation Medicine Programme. In this regard, both clinical and executive leads have been assigned and a national working group drawn from the various stakeholders has been established and is currently developing an implementation plan.
In relation to services specifically for children and teenagers with acquired brain injury, the Report concludes that the best interests of children with neurological presentations and associated needs are best served by including such children within a children's framework and recommends that children's needs be included in the work being done through the reconfiguration of paediatric services. HSE Disability Services managers work with service users and their families to provide an appropriate level of service during the transition phase to adult services, according to eligibility for specific services and within available resources.
603. Deputy John O'Mahony asked the Minister for Health when a person (details supplied) in County Mayo will receive an appointment for orthodontic treatment; and if he will make a statement on the matter. [54151/13]
View answerThe HSE provides orthodontic treatment to patients based on their level of clinical need. An individual's access to orthodontic treatment is determined against a set of clinical guidelines and priority is given to patients with greatest needs. The HSE has been asked to examine the specific query raised by the Deputy and to reply to him as soon as possible.
604. Deputy Brendan Griffin asked the Minister for Health if he will provide an update on the neurology programme for headaches and migraine (details supplied); and if he will make a statement on the matter. [54152/13]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
