Written Answers Nos. 182-189
182. Deputy Billy Kelleher asked the Minister for Health if his Department has drawn up a report on mortality rates in hospitals; the status of this document; his plans to publish a report on mortality; and if he will make a statement on the matter. [4412/14]
View answerThe CMOs Office of my Department has been developing a report entitled "Healthcare Quality Indicators in the Irish Health System: Examining the Potential of Hospital Discharge Data using the Hospital In-Patient Enquiry System". This work demonstrates the value of using the Hospital In-Patient Enquiry (HIPE) system to derive quality measure that will support a greater knowledge and understanding of health care quality. A number of quality measures derived from HIPE were assessed for feasibility including 30 day in-hospital mortality rates associated with specific conditions.
Following consultation and analysis this report is currently being finalised with a view to publication in the near future.
183. Deputy Billy Kelleher asked the Minister for Health the number of claims for compensation after cancer misdiagnosis that have been taken against the Health Service Executive, its officers or public voluntary hospitals in each of the past ten years; the nature of the claims; the date and the hospitals involved; the number of cases that were settled; the amount in total paid out in settlement for each claim; the number of claims that are outstanding; the specific budget set aside for dealing with any such outstanding claims; and if he will make a statement on the matter. [4413/14]
View answerThe Deputy's questions relate to service delivery matters and accordingly I have asked the HSE to respond directly to him.
184. Deputy John Lyons asked the Minister for Health if he will provide an update on the roll-out of primary health care centres around the country; and if he will clarify which centres have been completed and are operational, which are at planning stage and which have not moved on to the planning stage. [4423/14]
View answer185. Deputy John Lyons asked the Minister for Health if his Department is planning a further roll-out of primary care centres following the completion of the current programme. [4424/14]
View answerI propose to take Questions Nos. 184 and 185 together.
The development of primary care is central to the Government's objective to deliver a high quality, integrated and cost effective health care system. Supporting infrastructure, procured through a combination of public and private investment, will facilitate the delivery of multi-disciplinary primary health care. The location prioritisation exercise initiated by the HSE in 2012 is a dynamic process, constantly evolving to take account of changing circumstances including the feasibility of implementation using the following delivery mechanisms:
- direct/own-build (by HSE);
- by way of the operational lease with the private sector; or
- through the Public Private Partnership (PPP) project.
In addition to the infrastructure already in place thirty four primary care centres have been delivered between March 2011 and December 2013. These locations are set out in the following table. The Heath Service National Service Plan 2014 (Appendix 5 Capital Infrastructure Pages 68, 69) advises that an additional 21 primary care centres are expected to open over 2014/Q12015; 19 by way of operational lease and two by direct/own-build. Significant progress has been achieved using the operational lease mechanism. The HSE continues to work with the private sector to deliver primary care centres by means of operational lease. In addition, a further 13 are to be delivered by direct/own-build. These are St Mary's Orthopaedic Hospital campus, Cork city; Finglas; Grangegorman; Monaghan town; Ballinamore; Sligo town; Manorhamilton; Erris; Ballyshannon; Edgesworthtown; Tullow/Rathvilly/Hacketstown; Loughrea and Dungloe.
In relation to the potential Primary Care Centres to be delivered under the Public Private Partnership (PPP) Project, 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, 15 locations have been identified as being suitable for the PPP model. These are Ballymote; Boyle; Westport; Claremorris; Tuam; Limerick City; Dungarvan; Carrick-on-Suir; Wexford Town; Waterford City; Kilcock; Knocklyon/Rathfarnham; Crumlin/Drimnagh; Coolock/Darndale; and Summerhill, north inner city Dublin. In addition, the HSE has progressed Ballinrobe, which was not one of the original 35, as a suitable substitute.
By year end 2013 the HSE had lodged 14 planning applications, details of which will be available on the relevant planning websites. The submission of Limerick City and Ballinrobe planning applications are to follow as soon as possible. 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 delivered by the HSE using other procurement means. As with all other capital projects the further expansion of the primary care infrastructure programme (including locations that have not moved to planning stage) must be considered within the overall capital envelope available to the health service.
Your question has been referred to the HSE for direct reply in relation to following:
- The schedule of suitable primary care infrastructure delivered before March 2011; and
- Locations at planning stage (other than the locations set out above).
|
Count |
HSE Region |
County / Area |
PCT Name / Location |
Delivery Method |
Open |
|
1 |
DML |
Dublin |
Inchicore |
Direct Build |
2011 Q4 |
|
2 |
DML |
Dublin |
Ballyfermot |
Direct Build |
2012 Q3 |
|
3 |
DML |
Dublin |
Rathfarnham |
Lease |
2012 Q4 |
|
4 |
DML |
Dublin |
Churchtown |
Operational Lease |
2012 Q4 |
|
5 |
DML |
Dublin |
Dublin City at James's St /Pimlico /Liberties |
Operational Lease |
2012 Q4 |
|
6 |
DML |
Kildare |
Newbridge |
Operational Lease |
2013 Q2 |
|
7 |
DML |
Laois |
Portarlington |
Operational Lease |
2011 Q3 |
|
8 |
DML |
Longford |
Longford Town |
Operational Lease |
2013 Q2 |
|
9 |
DNE |
Dublin |
Blanchardstown |
Operational Lease |
2013 Q4 |
|
10 |
DNE |
Meath |
Dunshaughlin |
Direct Build |
2012 |
|
11 |
DNE |
Meath |
Ashbourne |
Operational Lease |
2013 Q1 |
|
12 |
DNE |
Louth |
Carlingford |
Direct Build |
2012 |
|
13 |
DNE |
Louth |
Ardee |
Direct Build |
2012 |
|
14 |
DNE |
Cavan |
Cootehill |
Direct Build |
2012 |
|
15 |
DNE |
Cavan |
Bailieborough |
Direct Build |
2012 Q4 |
|
16 |
DNE |
Cavan |
Cavan Town |
Operational Lease |
2012 Q1 |
|
17 |
DNE |
Cavan |
Kingscourt |
Operational Lease |
2012 Q3 |
|
18 |
DNE |
Cavan |
Cavan Town 2 (Connolly Court) |
Operational Lease |
2013 Q2 |
|
19 |
South |
Wexford |
Gorey |
Operational Lease |
2012 Q3 |
|
20 |
South |
Kilkenny |
Kilkenny (at Grange's Road) |
Operational Lease |
2011 Q3 |
|
21 |
South |
Kilkenny |
Callan |
Operational Lease |
2011 Q3 |
|
22 |
South |
Waterford |
Tramore |
Operational Lease |
2011 Q4 |
|
23 |
South |
Cork / South Lee |
Cork City at Mahon |
Operational Lease |
2011 Q4 |
|
24 |
South |
Cork / North Lee |
Macroom |
Operational Lease |
2012 Q1 |
|
25 |
South |
Cork |
Schull |
Operational Lease |
2013 Q4 |
|
26 |
South |
Kerry |
Kenmare |
Operational Lease |
2012 Q3 |
|
27 |
South |
Kerry |
West Kerry (Dingle) |
Direct Build |
2013 |
|
28 |
West |
Limerick |
Limerick City at Abbey St Mary's |
Operational Lease |
2012 Q1 |
|
29 |
West |
Galway |
Galway City East |
Operational Lease |
2011 Q2 |
|
30 |
West |
Galway |
Athenry |
Operational Lease |
2013 Q3 |
|
31 |
West |
Mayo |
Ballina |
Operational Lease |
2011 Q2 |
|
32 |
West |
Roscommon |
Castlerea |
Operational Lease |
2012 Q3 |
|
33 |
West |
Roscommon |
Monksland South Roscommon |
Operational Lease |
2012 Q4 |
|
34 |
West |
Donegal |
Glenties |
Direct Build |
2012 Q3 |
186. Deputy Billy Kelleher asked the Minister for Health the reason general practitioners receive €700 per annum for each medical card patient on their list aged over 70 with no visit required; and if he will make a statement on the matter. [4427/14]
View answerUnder the General Medical Services contract, GPs receive a range of fees and allowances in respect of each medical card and GP visit card patient on their GMS list. The current annual capitation payments in respect of persons 70 years or more are as follows:
- €434.15 - Patient aged 70 years or more residing in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks.
- €271.62 - Patient aged 70 years or more residing in the community.
Annual capitation payments are made to GPs regardless of how many times a patient visits their doctor during the year. However, it is widely acknowledged that the annual visitation rates in respect of GMS patients in the over 70 age cohort would on average exceed those of patients under 70 years of age and those who are not medical card or GP visit card holders.
187. Deputy Billy Kelleher asked the Minister for Health the reason hospitals cannot write prescriptions for medical card patients on discharge; the reason ill patients are required to attend their general practitioner for prescriptions after leaving hospital; the annual cost to the State of this regulation; if it is his intention to remove this requirement; and if he will make a statement on the matter. [4428/14]
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 medication that is prescribed to any patient. 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.
188. Deputy Billy Kelleher asked the Minister for Health his plans to make Anapens publicly available, like defibrillators; and if he will make a statement on the matter. [4429/14]
View answer189. Deputy Billy Kelleher asked the Minister for Health the action his Department and the Health Service Executive have taken to raise awareness of anaphylaxis; if he will provide support to persons at risk and their families; his plans to step up these support measures; if any legislation is planned; if any other agencies under the aegis of his Department are pursuing measures in this regard; and if he will make a statement on the matter. [4430/14]
View answerI propose to take Questions Nos. 188 and 189 together.
Anaphylaxis may arise from a wide variety of causes, including insect stings, food allergies and reaction to certain medications. It affects individuals in many different ways. General practitioners are in the best position to offer advice to sufferers and, where necessary, to refer them to hospital consultants. While it is not possible to be prescriptive with regard to the precautions that should be taken in individual cases, generally speaking, persons at known risk of anaphylaxis would be well advised to carry an adrenaline pen and, in the case of children, carers and teachers should be made aware of the child's condition and have access to, and be shown how to use an adrenaline pen in an emergency.
Adrenaline pens, as injectable medicines, may only be supplied on foot of a prescription. However, there is provision in the Medicinal Products (Prescription and Control of Supply) Regulations which permits pharmacists, in emergency circumstances, to supply certain prescription-only medicines, including adrenaline pens, without a prescription. My Department is currently examining the possibility of amending the Regulations to facilitate the wider availability of adrenaline pens without prescription in emergency situations.
