Written Answers Nos. 1-30
10. Deputy Clare Daly asked the Minister for Health if he will alter his proposals for a redress scheme for the victims of symphysiotomy to take account of the concerns of their representative organisation SoS and instead that a mechanism for dealing with medical negligence and the lifting of the statute of limitations would be facilitated in order to secure proper compensation. [53985/13]
View answerOn 26 November Government approved the appointment of retired Circuit Court Judge Yvonne Murphy to assist in setting out a possible course of action in relation to women who have undergone surgical symphysiotomies. Judge Murphy has been asked to meet a number of key interested parties, particularly the support groups for the women, and also the State Claims Agency, and the insurers. Together with the Judge, I met the three support groups - Survivors of Symphysiotomy, Patient Focus and Survivors of Symhysiotomy Limited - after the Government meeting on 26 November, to outline this plan to them.
Judge Murphy will complete her work within around 8 working weeks and provide a report to me as early as possible in February. I will then be in a position to revert to Government with detailed proposals, so that a decision can be taken as early as possible on the matter.
The Government has also decided not to pursue amending the Statute of Limitations Act in respect of symphysiotomy claims. This decision is based on strong legal advice that even if the statute bar is lifted, many women will still face long delays and many legal obstacles in pursuing their cases through the courts. A number of women have not been able to access their files and in some cases the persons involved in their surgery are deceased. Analysis of the small number of cases, which have come through the legal process, shows that the legal costs alone in pursuing a case are extremely high.
The actual liability of the State in law in respect of each individual symphysiotomy case is extremely difficult to determine. However, there is a strong cross-party commitment to facilitate closure for the women who have been adversely affected by symphysiotomy, many of whom are now elderly.
My priority continues to be to ensure that the women who have had this procedure have their health needs comprehensively and professionally met. In this regard, the HSE provides a range of services to women who may be experiencing any adverse effects as a result of undergoing this procedure. These services include the provision of medical cards for the women, the availability of independent clinical advice and the organisation of individual pathways of care and the arrangement of appropriate follow-up. All these services are available on request by the women from the HSE nominated Symphysiotomy Liaison Officers.
11. Deputy Colm Keaveney asked the Minister for Health the reason the programme for Government commitment on ringfenced funding of €35 million for community mental health posts is not being honoured in 2014; and if he will make a statement on the matter. [54108/13]
View answer21. Deputy Colm Keaveney asked the Minister for Health the way mental health services will be developed in 2014; and if he will make a statement on the matter. [54109/13]
View answerI propose to take Questions Nos. 11 and 21 together.
This Government has prioritised the reform of our mental health services in line with A Vision for Change and is committed in particular to the delivery of more and better quality care in the community. Towards this end, funding of €70 million and 890 posts have been provided to develop our community mental health services in 2012 and 2013.
In Budget 2014, the Government has again re-committed to the continued development of our mental health services in these extremely challenging times, where the options for additional expenditure generally are very constrained. €20 million is being ringfenced for the further development of our mental health services in 2014. This means that, despite serious resource pressures overall, funding of €90m has been made available since 2012 up to end of 2014, which has been specifically ear-marked for mental health and suicide prevention.
This funding will enable the HSE to continue to develop and modernise our mental health services in line with the recommendations of A Vision for Change and will allow for the recruitment of between 250 and 280 additional staff to further enhance our:
- Adult Community Mental Health Teams;
- Child and Adolescent Mental Health Teams;
- Specialist Mental Health Teams
The recruitment process for these new posts will commence in the first Quarter of 2014, with all posts targeted to be in place by Quarter 4 of 2014.
I can confirm to the Deputy that I have been assured that the remaining €15 million which was due in 2014 for mental health will be restored in 2015. I will also be advocating for an allocation of €35 million in 2015 for mental health.
12. Deputy Derek Keating asked the Minister for Health following revelations that the CEO of an organisation (details supplied) is in receipt of bonus payments, if he has responded to this report; if he will confirm that no other bonus payment was made in the past seven years which includes benefit-in-kind such as fees for university, travel expenses, study leave or any other such benefit that a CEO has derived from their boards of management; and if he will make a statement on the matter. [53976/13]
View answer31. Deputy Derek Keating asked the Minister for Health if a CEO of an organisation (details supplied) receives a benefit in kind payment such as university fees, study leave and other costs that may be picked up by the board of the organisation, if this is a payment under the recently reported bonus scheme; and if he will make a statement on the matter. [53975/13]
View answerI propose to take Questions Nos. 12 and 31 together.
As the Deputy is aware, the HSE's internal audit report on remuneration in health service providers funded under Section 38 of the Health Act 2004 has found that there are a variety of unapproved payments being made to senior managers. Staff of these organisations are public servants and are subject to Government pay policy.
The HSE Internal Audit has indicated that the CEO referred to by the Deputy is in receipt of two allowances, one for managing another location and one for assisting with fundraising for the organisation.
The HSE has a team of senior managers following up with all of the disability organisations and hospitals, including the agency referred to in the Deputy's question, to ensure that a clear plan to achieve full compliance with health sector pay policy is developed with each agency.
As set out in the pay policy, if an organisation wishes to make a business case for the continuation of an unapproved allowance, it is open to it to do so and any such cases will be considered by the HSE (with the involvement of my Department and the Department of Public Expenditure and Reform, as necessary).
While this process is underway it would not be appropriate for me to comment on an individual case. As stated previously, these issues are being examined on a case by case basis and it is important that due process is followed.
13. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will confirm that he and the Department of Public Expenditure and Reform approved a salary package for a former CEO of a Dublin hospital which ensured that when the person took up a post as CEO of Health Service Executive hospitals in the west, he was remunerated on the basis of his former CEO salary plus top-up; if this arrangement has been investigated in the internal audit into top-ups ordered by him; if any other such arrangements have been entered into by him and or his colleague; and if he will make a statement on the matter. [54118/13]
View answerIn late 2011 the HSE identified an urgent need to put in place appropriate management arrangements for the Galway and Roscommon hospitals, in view of the need to address critical service difficulties that had been identified in the hospitals concerned. Serious problems of a long standing nature had been identified in managing scheduled and unscheduled care. Similar difficulties had arisen in the Midwestern Regional Hospitals (Limerick/Nenagh/Ennis) and an existing senior HSE manager was assigned to this post. Despite the best efforts of the HSE it had not been possible to attract senior managers with the requisite expertise to run the hospitals. For that reason individual senior managers were identified from within the system to take on new Group CEO roles for a period.
An individual was identified as the most appropriate person to take on the role of Chief Executive of the Galway/Roscommon hospital group, on a secondment basis for three years from his position as Chief Operations Officer of a major Dublin Hospital. Following a request by my Department, the Department of Public Expenditure and Reform approved this secondment on a personal-to-holder basis. The remuneration package reflected the level at which the individual was being remunerated in respect of his duties in the public hospital and additional work undertaken separately for an associated private hospital.
This arrangement was approved as an exceptional matter and did not represent a change in overall public service pay policy.
14. Deputy Billy Kelleher asked the Minister for Health the number of primary care centres that are to be developed under PPP criteria; and if he will make a statement on the matter. [54082/13]
View answerIn relation to the potential Primary Care Centres to be delivered under the Public Private Partnership (PPP) Programme, the National Development Finance Agency (NDFA) published a Prior Information Notice (PIN) on Friday 15th November 2013 in the Official Journal of the European Union ("OJEU") through the eTenders Public Procurement portal which can be viewed on the www.etenders.gov.ie website.
Of the 35 primary care centre locations announced under the Infrastructure Stimulus Package in July 2012, 16 locations have been identified as being suitable for the PPP model. The 16 locations are as follows:
|
HSE West |
HSE South |
HSE Dublin Mid Leinster |
HSE Dublin North East |
|
Ballymote |
Dungarvan |
Kilcock |
Coolock/Darndale |
|
Boyle |
Carrick on Suir |
Knocklyon/Rathfarnham |
Summerhill, Dublin |
|
Westport |
Wexford Town |
Crumlin/Drimnagh |
- |
|
Claremorris |
Waterford City |
- |
- |
|
Tuam |
- |
- |
- |
|
Limerick |
- |
- |
- |
|
Ballinrobe |
- |
- |
- |
The 16 locations are being developed by the HSE to be brought to a preliminary design and statutory planning process. It is expected that 10-14 sites (indicative number 12 based on affordability) from the above list will be delivered as part of a single PPP contract with the remaining centres to be procured by the HSE using other procurement means.
15. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will require the Health Service Executive to urgently revisit its plans for the reconfiguration of mental health services in Galway-Roscommon, in view of the many concerns raised, particularly the need to maintain the services provided at the 22 bed unit at Ballinasloe; and if he will make a statement on the matter. [54117/13]
View answerMental health services in HSE West, including the single administrative unit of Galway/Roscommon, has been resourced to implement A Vision for Change. This requires modernising the service in this particular area, to provide better outcomes for both patients and staff. In this context, existing resources in Galway/Roscommon need to be re-shaped, and the priority is to achieve this in line with similar re-configurations undertaken, or planned, elsewhere nationally.
In light of the above, a detailed assessment was carried out by HSE West, to reconfigure mental health services in Galway/Roscommon. An Expert Group applied an open and transparent scoring system to assess the merits of all locations and the most appropriate skill mix for service delivery. On foot of the conclusions of the Expert Group, I accept the Executive's recommendation to bring about much needed re-configuration of mental health services in this region.
Community mental health services in this area will be enhanced on a transitional and phased basis, bearing in mind that at least some staff from St.Brigid's in Ballinasloe will transfer to new community based provision. Flexibility exists within overall HSE West mental health resources to deliver on this objective.
HSE West has established an Implementation Team, including both patient and staff representation, to engage in appropriate consultation to progress this initiative and to address any outstanding local concerns. The Team has held a number of briefings and meetings to-date, including with the Mental Health Commission, Ballinasloe Town Council, and HSE staff. In conjunction with relevant officials, I also recently met with a delegation of local public representatives, care professional and union representatives concerning re-configuration of services across Galway/Roscommon. I am satisfied that the approach being taken by the HSE to improve future mental health services for this area is the best option, taking account of all relevant policy and resource issues.
16. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he expects costs throughout the health service to be contained within budget for the foreseeable future; and if he will make a statement on the matter. [54080/13]
View answer252. Deputy Bernard J. Durkan asked the Minister for Health the extent to which his Department monitors expenditure throughout the various structures of the health service with particular reference to the need to identify areas incurring over-expenditure habitually, the action taken to address this issue; and if he will make a statement on the matter. [54687/13]
View answer253. Deputy Bernard J. Durkan asked the Minister for Health if he is satisfied that adequate steps have been taken to ensure accountability in relation to spending throughout the entire health service; and if he will make a statement on the matter. [54688/13]
View answerI propose to take Questions Nos. 16, 252 and 253 together.
There is a determination by both my Department and the HSE to ensure budgets and savings are tightly monitored throughout 2014.
The health service is operating in a very challenging environment given the increasing demand due to demographic pressures; the need to ensure patient safety as a priority at all times; and the very challenging targets for service delivery in areas such as waiting times.
The health services continue to experience very significant budgetary challenges alongside increased demands for services. Given the budgetary constraints on the health services in recent years, it remains a priority to focus on improving the way services are organised and delivered, and to reduce costs so as to minimise any negative effect on service provision. In the context of 2014 I have identified key priorities based around the principles of fairness, equity and efficiency. The goal, wherever possible, is to cut the cost of services rather than the level or quality of the services delivered and to accelerate the pace of reform.
There is ongoing and intensive engagement each month between officials of my Department and the HSE in the context of regular monitoring of expenditure. My Department also provides detailed analysis each month on expenditure trends to the Department of Public Expenditure and Reform, and there is regular engagement between officials from that Department, my Department and the HSE.
The Strategic Framework for Reform of the Health Services “Future Health” identified, as one of the key challenges, the need for an integrated financial management system. My Department is working with the HSE to ensure the development and roll out of a comprehensive financial management system as a matter of priority.
As part of the process of further strengthening the financial management of the HSE, independent expertise was engaged to evaluate the financial performance management system and a Finance Reform Board has been established, chaired by the Director General, including senior HSE management and representatives from my Department and the Department of Public Expenditure and Reform.
Proposals regarding the development and roll out of an integrated financial management system have been endorsed by the Board, with my full support and approval, and the HSE is now finalising a business case for submission to the Department of Public Expenditure and Reform.
17. Deputy Richard Boyd Barrett asked the Minister for Health after the revelations of top up payments in the Central Remedial Clinic, if he intends to hold an investigation into this practice in all agencies and services under the Health Service Executive; and if he will make a statement on the matter. [54100/13]
View answerI have initiated this process arising from the HIQA report into Tallaght. I requested that the HSE conduct an Internal Audit of all Section 38 funding recipients. As a result of this audit and as has been reported extensively, a considerable number of funding recipients have been found to be in breach of Government pay policy with regard to the remuneration of senior staff.
I have no plans to establish an independent inquiry into the practice of top-up payments to senior executives in all agencies and services under the Health Service Executive.
I have requested urgent action to ensure that every agency is fully compliant with Government pay policy.
The HSE has a team of senior managers following up with individual agencies and the Director General of the HSE met with the Chairpersons and the CEOs of all the Section 38 organisations last Thursday. That meeting focused on the requirement of the Board of each Agency to further strengthen governance standards and set out the new requirement to furnish the HSE with a Compliance Statement from the current financial year and for each year thereafter. This statement will have to be approved by the Board of each Agency on an annual basis, signed by the Chairman and another Director on behalf of the Board and submitted to the HSE together with the organisation’s Annual Audited Accounts. This Annual Compliance Statement will be required in addition to the annual Service Agreement between the Agency and the HSE.
Further and separate meetings are being held by senior HSE managers with all of the disability organisations and hospitals concerned this week to ensure that a clear plan to achieve full compliance with health sector pay policy is developed with each agency.
As indicated above the HSE is urgently meeting individual agencies and it is important that due process is followed.
18. Deputy Mick Wallace asked the Minister for Health his plans to address the fact that it is consistently shown that Travellers have a shorter life span and substantially poorer health than their settled peers; and if he will make a statement on the matter. [54115/13]
View answerHealthy Ireland, A Framework for Improved Health and Wellbeing 2013-2025 is the national framework for action to improve the health and wellbeing of the country over the coming generation. Healthy Ireland includes a high-level goal to reduce the health inequalities experienced by many people in Ireland, including Travellers.
The All Ireland Traveller Health Study (AITHS) found that Travellers experienced higher levels of morbidity and mortality and also reported that access to health services is good, with Travellers stating that their access is at least as good as that of the rest of the population, with almost 97% of all Travellers registered with a GP. The Study identified a number of priority areas for action to improve the health status of Travellers including mental health and suicide; men’s health; addiction/alcohol; diabetes and cardiovascular health. The annual HSE National Service Plan and associated Operational Plans contain a number of specific actions in respect of progressing identified health priorities many of which are delivered in partnership and collaboration with Travellers.
The over-arching principles of Healthy Ireland provide the required and appropriate platform through which the identified issues as they relate to Traveller health will be met. The need for a robust research and data framework to systematically build data systems around Traveller health will be met through the Outcomes Framework and the Research and Data Plan currently in development and which will provide for the systematic monitoring and evaluation of data and indicators relating to health status and the social and environmental determinants of health within robust governance arrangements. The identification, collection and evaluation of key data and indicators relating to health status and the social and environmental determinants of health will be central to the monitoring of Healthy Ireland .
The goal in Healthy Ireland to reduce health inequalities requires not only interventions to target particular health risks but also a focus on addressing these wider social determinants of health. The Framework provides for new arrangements to ensure effective co-operation between the health sector and other areas of Government and public services that are concerned with these broad determinants of health, including those of importance and relevance to all of those persons who experience health inequalities, including Travellers. The new structures established under Healthy Ireland to enable and support its implementation will provide a focus on addressing the health needs of all groups experiencing health inequalities, including Travellers, and provides an opportunity to take a new approach to tackling issues such as health inequalities and the social determinants of health more effectively.
19. Deputy Mary Lou McDonald asked the Minister for Health when he will conclude his consideration regarding the provision of medical services to women, eligible under the Magdalen Laundries redress scheme, who reside outside the State. [53979/13]
View answer38. Deputy Maureen O'Sullivan asked the Minister for Health the position regarding the proposed legislation that will deal with the health care needs of Magdalen survivors living outside the State; and if he will make a statement on the matter. [54088/13]
View answerI propose to take Questions Nos. 19 and 38 together.
The Government has accepted in principle the recommendations of Judge Quirke on the establishment of an ex gratia Scheme and related matters for the benefit of those women who were admitted to and worked in the Magdalen Laundries. The Government furthermore decided that the Minister for Justice and Equality would bring forward in one Bill, on behalf of the relevant Departments, measures to deal with the provision of medical and other services, and other matters to women who were admitted to and worked in the Magdalen Laundries. The Minster for Justice has recently forwarded to me initial proposals for inclusion in the Heads of a Bill in connection with the above legislation. I am currently examining these initial proposals with a view to further consultation with the Minister for Justice and Equality in the preparation of the legislation.
20. Deputy Thomas Pringle asked the Minister for Health if he will provide an update on the review of medical cards; the revised target for medical card probity; and if he will make a statement on the matter. [54125/13]
View answerAll medical card and GP visit card holders are subject to a periodic review of eligibility to determine continuing eligibility.
Each month, the HSE analyses the Medical Card Register to identify those medical/GP visit cards which are scheduled for review within three months. A review notification will indicate the card holder should complete a self-assessment or request the card holder to return evidence of household income, assessable outgoings and medical circumstances to enable a full review assessment be conducted by the HSE. The HSE has increased this time line to four months in respect of those clients who were granted eligibility on the basis of discretion to allow an additional month to ensure that all pertinent medical and other data is provided for inclusion in the assessment process. All customers scheduled for review are notified and a balance of either full reviews or self-assessments is conducted.
A reminder letter is issued a month later if the requested review form details have not been returned at that point. If a person does not return the review form within the time specified, continuing eligibility cannot be confirmed and the medical card cannot be reissued. In these circumstances, or where the review process establishes that a person no longer holds eligibility, the eligibility ceases.
Persons are requested to return their completed review forms at least one month in advance of the due expiry date of their existing eligibility, in order to give the HSE sufficient time to carry out the review and/or to get back to the individuals, if the application is incomplete or requires any further details to be furnished.
Where a review form is returned, but not fully completed by the expiry date, it is HSE policy to extend the eligibility of the client for a reasonable period of time until the review is carried out and a final decision made on the person's continuing eligibility, once there is appropriate communication from the client. Medical card holders who genuinely engage with the review of their medical card eligibility will not have their eligibility withdrawn before that review is complete.
GPs are advised three months in advance of the review dates of their patients’ GP visit cards/medical cards and, subsequently, the following month and the month after that, if the patient has not returned the review form by that time.
GPs have full electronic visibility of the medical card panel of patients available to them and have the facility to electronically allow temporary extension of eligibility for expiring cards where a sensitive renewal is appropriate. The temporary extension may also be allowed where they are aware that a person is still availing of services but there may be something that prevents them from carrying out a standard review, e.g. a blind person with little family support. GPs can also add new babies to existing cards. All GPs have appropriate electronic access to the medical card eligibility database and they do not have to confirm medical card details by contacting HSE PCRS.
To ensure the most beneficial, effective and efficient use of resources the HSE also undertakes reviews of medical card/GP visit card eligibility, whereby selected cardholders are asked to confirm that they are ordinarily resident in Ireland. Being ordinarily resident in Ireland is a prerequisite for medical card/GP visit card eligibility. Approximately 10,000 letters are issued each month and the cardholder is asked to sign and return a Declaration of Residency to the HSE. On receipt of this declaration, eligibility to the GMS Scheme continues. If a person does not return the Declaration of Residency form eligibility ceases.
It should be noted that each person who has eligibility to a medical card/GP visit card receives a plastic card on which a ’valid to’ date is printed. This is the latest date that a review may be conducted in respect of that person. Notwithstanding the ‘valid to’ date printed on the card, the HSE may also carry out random reviews of continued eligibility, to ensure that people who hold cards are still eligible, based on national guidelines
The HSE's National Service Plan for 2014, which the Cabinet approved yesterday, includes a €23million savings target under medical card probity in 2014.
22. Deputy Denis Naughten asked the Minister for Health the steps he is taking to increase thrombolysis rates for stroke patients; and if he will make a statement on the matter. [53982/13]
View answerImprovements in Stroke services were envisioned in the “Changing Cardiovascular Health: Cardiovascular Health Policy 2010 -2019” which was launched in 2010. The policy establishes a framework for the prevention, detection and treatment of cardiovascular diseases, including stroke, which seeks to ensure an integrated and quality assured approach in their management, so as to reduce the burden of these conditions.
The implementation of the National Stroke Programme, since 2010 to date has resulted in improved services for all stroke programmes. One of the programme's targets was to increase the rate of safe thrombolysis from 1% to 7.5% by the end of 2013. The HSE has recently reported a national stroke thrombolysis rate of 10.5% for the third quarter of this year, which exceeds targets and is comparable to rates internationally.
I am pleased to report that the national 24/7 access to safe stroke thrombolysis is progressing, with 24/7 access available now in 23 hospitals. Ambulance access protocols are in place for other hospitals where acute stroke patients are taken to the nearest hospital providing 24/7 thrombolysis. As mentioned earlier, significant improvements in thrombolysis rates have been noted as high as 10.5% so far this year.
Further developments in training on this matter are ongoing through the Thrombolysis Training programme. The Stroke Foundation Education Programme has been developed and rolled out through the Centres for Nurse Education. The programme empowers all care staff to provide better care and information to stroke patients. TRASNA (Telemedicine Rapid Access for Stroke and Neurological Assessment) is being implemented. Both the Mater and Cavan hospitals' TRASNA are operational since May; AMNCH and Naas will switch to new system in the coming months. The HSE National Ambulance Service has worked in partnership with the Irish Heart Foundation whereby Emergency Ambulance Vehicles double as mobile billboards to improve public awareness of stroke symptoms and boost IHF F.A.S.T. Stroke Campaign.
23. Deputy Anne Ferris asked the Minister for Health the number of submissions received on an opt-out system of consent for organ donation; if he will provide an overview of such submissions; the time-line for proposals on an opt-out system; and if he will make a statement on the matter. [53980/13]
View answerMy Department undertook a public consultation between 19 July and 20 September this year on the practical aspects of introducing an opt-out system of consent for organ donation. A total of 57 submissions were received and an overview of these submissions is available on my Department's website www.doh.ie. My Department, in conjunction with the HSE's National Organ Donation and Transplantation Office, also hosted a consultation event on organ donation and transplantation in Dublin Castle on November 21st.
The outcome of the public consultation and the consultation event will inform the development of the legislative proposals which will give effect to an opt-out system of consent for organ donation. Work on these proposals is currently being progressed.
24. Deputy Billy Kelleher asked the Minister for Health the action being taken to ensure that older persons in residential settings have access to essential therapies; and if he will make a statement on the matter. [54085/13]
View answerUnder the Nursing Homes Support Scheme, services and supports which are common to the vast majority of nursing home residents are included in the cost of care. These are:
- nursing and personal care appropriate to the level of care needs of the person;
- bed and board;
- basic aids and appliances necessary to assist a person with the activities of daily living; and
- laundry service.
Goods and services that are already available to individuals under another existing scheme are not included in the services covered by the Nursing Homes Support Scheme as this would involve effectively paying twice for the same thing. However, older people in residential settings are entitled to be referred and assessed for HSE Primary Care Teams and Network services in the same way as any other eligible person in the community.
The Care and Welfare Regulations for Nursing Homes provide that nursing homes shall ensure that all appropriate health care is facilitated, including access to services provided by HSE Primary Care Teams.
In 2012, the HSE completed an analysis of the distribution of health professionals who provide various therapies and other supports. This analysis revealed considerable variation across the HSE’s 17 Integrated Service Areas. Accordingly, in 2013, Primary Care funding of €20 million is being invested to support the recruitment of prioritised front-line primary care team posts and to enhance the capacity of the primary care sector.
25. Deputy Billy Kelleher asked the Minister for Health the strategies in place to enhance palliative care; and if he will make a statement on the matter. [54084/13]
View answerNational policy on Palliative Care is contained in the Report of the National Advisory Committee on Palliative Care(2001) and the HSE 5 year / Medium Term Framework for Palliative Care Services (2009 – 2013) and (in relation to children) Palliative Care for Children with Life-limiting Conditions in Ireland - A National Policy. Palliative Care is moving beyond the traditional life limiting area of cancer to address other non-malignant or chronic conditions. Although there is regional variation, in 2012 approximately 35,738 people received specialist home care palliative services and 4,274 people received specialist in-patient care. There are currently 157 specialist in-patient palliative care beds in 9 locations across the country. In 2012, there were 2,808 admissions to this service, a 4.4% improvement on 2011 figures. The HSE Service Plan target of providing 92% of patients with a specialist inpatient bed within 7 days will be met in 2013.
There are 38 acute hospital specialist palliative care teams , though again there is some variability across locations.
The HSE National Service Plan 2013 provides funding of €72m for Palliative Care (circa 75-80% of this is provided to the main voluntary organisations). Palliative care is also funded through acute, disability and community services (in an exercise undertaken in 2012, the HSE identified that spending on home nursing care for children with life-limiting conditions amounted to an additional €8.58m ). The HSE is engaging with voluntary groups where deficits in service provision have been identified, for example in Waterford, Kerry, the Midlands, Wicklow and Mayo / Roscommon.
With regard to children, Palliative Care for Children with Life-limiting Conditions in Ireland - A National Policy (2009), provides the framework for the development of services for children with life-limiting conditions and their families. A programme of care for children with life-limiting conditions is being jointly funded by the HSE and the Irish Hospice Foundation, including the appointment in 2011 of the first Paediatric Consultant with a Special Interest in Palliative Care based in Crumlin Children’s Hospital and eight Children’s Outreach Nurses to support children being cared for at home by their families.
26. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if it is the case that there are currently four operating theatres closed in Cappagh Hospital; the waiting times, by procedure, at Cappagh in October 2011, 2012 and to date in 2013; and if he will make a statement on the matter. [54120/13]
View answerCappagh National Orthopaedic Hospital has a total of seven operating theatres. The number of theatres in use on any given day varies depending on the number of consultants available and the clinical case load mix on the day. Staffing restricts the maximum number of concurrent theatres in use at any given time to five. It should be noted that, as set out in the published HSE September 2013 Performance Report, Cappagh Hospital has treated more in-patients and day case patients overall in 2013, compared to 2012. Up to September 2013 the number of in-patients discharged from Cappagh Hospital exceeded the numbers targeted in the HSE Service Plan by 22.5 % and the number of day case treatments exceeded target by 14.3%.
In relation to waiting lists, the number of patients on the waiting list in October 2011, 2012 and 2013 is detailed in the table.
Cappagh Hospital Waiting List
|
Date |
Day Case |
In-Patient |
Total |
|
30 October 2013 |
958 |
1,569 |
2,527 |
|
31 October 2012 |
705 |
1,527 |
2,232 |
|
1 November 2011 |
763 |
1,665 |
2,428 |
I have asked the Health Service Executive to provide the detailed information on the waiting times by procedure directly to the Deputy.
27. Deputy Patrick O'Donovan asked the Minister for Health in view of recent controversies regarding the use of proceeds from shops and other facilities in institutions covered by section 39 of the Health Act, if he will consider examining the legislation covering such organisations with a view to ensuring that pay, salaries and conditions for senior officials in these organisations that are funded by the Exchequer can be scrutinised and revised accordingly; and if he will make a statement on the matter. [53977/13]
View answerAs the Deputy is aware, the HSE's internal audit report on remuneration in health service providers funded under Section 38 of the Health Act 2004 has found that there are a variety of unapproved payments being made to senior managers. 2004. Staff of these organisations are public servants and are subject to Government pay policy.
Employees of Section 39 organisations are not public servants. They are not included in the HSE employment control ceiling, are not bound by the Department of Health Consolidated Salary Scales and are not members of a public service pension scheme. The Government, however is determined to ensure that public pay policy is respected across the health service and to that end, at my request, the Director General of the HSE has written to 353 Section 39 funded agencies in receipt of HSE funding of more than €250,000, requesting that they have due regard to public pay policy particularly in respect of senior managers.
28. Deputy Billy Kelleher asked the Minister for Health the average increase in general practitioner workload he anticipates from the introduction of free GP care for children aged under six years; and if he will make a statement on the matter. [54083/13]
View answerThe Government is committed to introducing, on a phased basis, a universal GP service within its term of office, as set out in the Programme for Government and the Future Health strategy framework.
As announced in the Budget, it has been decided to commence the roll-out of a universal GP service by providing all children aged 5 and under with access to a GP service without fees. The implementation of this measure will require primary legislation. The necessary administrative arrangements will be made during the course of 2014 when the specifics of the legislation are known. It is not possible to be definitive about the average increase in workload resulting from the introduction of this measure. However, the increase in the total number of GP visits arising from the introduction of a GP service without fees is expected to be low as this age group represents a relatively small proportion of the overall population and parents already bring their children to their GP, as necessary, regardless of whether they have to pay.
29. Deputy Patrick O'Donovan asked the Minister for Health in view of the recent revelations into the use of voluntary contributions and proceeds from shops and other facilities to top up the pay of chief executive officers and other officials within organisations covered by sections 38 and 39, if he will consider legislative or other measures to insist on capping of salary grades for persons within organisations as part of future funding arrangements from the State for such organisations; and if he will make a statement on the matter. [53974/13]
View answerAs the Deputy is aware, the HSE's internal audit report on remuneration in health service providers funded under Section 38 of the Health Act 2004 has found that there are a variety of unapproved payments being made to senior managers. 2004. Staff of these organisations are public servants and are subject to Government pay policy.
The HSE has a team of senior managers following up with individual agencies and the Director General of the HSE met with the Chairpersons and the CEOs of all the Section 38 organisations last Thursday. That meeting focused on the requirement of the Board of each Agency to further strengthen governance standards and set out the new requirement to furnish the HSE with a Compliance Statement from the current financial year and for each year thereafter. This statement will have to be approved by the Board of each Agency on an annual basis, signed by the Chairman and another Director on behalf of the Board and submitted to the HSE together with the organisation’s Annual Audited Accounts. This Annual Compliance Statement will be required in addition to the annual Service Agreement between the Agency and the HSE.
Further and separate meetings are being held by senior HSE managers with all of the disability organisations and hospitals concerned this week to ensure that a clear plan to achieve full compliance with health sector pay policy is developed with each agency.
Employees of Section 39 organisations are not public servants. They are not included in the HSE employment control ceiling, are not bound by the Department of Health Consolidated Salary Scales and are not members of a public service pension scheme. The Government, however is determined to ensure that public pay policy is respected across the health service and to that end, at my request, the Director General of the HSE has written to 353 Section 39 funded agencies in receipt of HSE funding of more than €250,000, requesting that they have due regard to public pay policy particularly in respect of senior managers .
30. Deputy Thomas P. Broughan asked the Minister for Health further to Parliamentary Question No. 178 of 13 November 2013, the actions being taken and that will be taken to ensure that citizens requiring long-term residential care are provided with appropriate care and supports as expediently as possible. [53983/13]
View answerThe HSE makes every effort to ensure that individuals who qualify for financial support under the Nursing Homes Support Scheme are provided with such support as expediently as possible. However, there is a set budget for the Nursing Homes Support Scheme each year and the HSE must operate within it. The budget for the Nursing Homes Support Scheme in 2013 is €974m.
As outlined in my previous reply, the HSE operates a national placement list to enable it to remain within budget and to ensure equity of access to finding nationally. In addition, it tries to match the funding available for the Scheme to the level of demand by releasing funding on a weekly basis. At 3rd December there were a total of 123 applicants awaiting funding approval which represents a waiting period of less than 1 week.
