Thursday, 6 Feb 2014

Written Answers Nos. 208-218

Hospital Staff Data

Questions (208)

Gerry Adams

Question:

208. Deputy Gerry Adams asked the Minister for Health if he will provide in tabular form a breakdown of staff numbers employed in Louth County Hospital, Dundalk, from 2007-14. [5992/14]

Written answers

Minister for Health

The detailed information sought by the Deputy in relation to health service staff is a matter for the HSE and, accordingly, I have asked the HSE to respond directly to him.

HSE Agency Staff Data

Questions (209)

Gerry Adams

Question:

209. Deputy Gerry Adams asked the Minister for Health if he will provide a full breakdown in tabular form of all money spend on agency staff at Louth County Hospital, Dundalk, from 2007-14. [5993/14]

Written answers

Minister for Health

The detailed information sought by the Deputy in relation to agency staff is a matter for the HSE and, accordingly, I have asked the HSE to respond directly to him.

HSE Expenditure

Questions (210)

Gerry Adams

Question:

210. Deputy Gerry Adams asked the Minister for Health if he will provide a breakdown of all public money used by Louth County Hospital, Dundalk, or his Department to treat patients in private hospitals. [5994/14]

Written answers

Minister for Health

As this is a service matter, I have asked the HSE to respond directly to the Deputy.

Hospital Waiting Lists

Questions (211)

Gerry Adams

Question:

211. Deputy Gerry Adams asked the Minister for Health if he will provide a separate breakdown of inpatient and outpatient waiting times across all specialties at Louth County Hospital, Dundalk. [5995/14]

Written answers

Minister for Health

As this is a service matter, I have asked the HSE to respond directly to the Deputy.

Hospital Procedures

Questions (212)

Gerry Adams

Question:

212. Deputy Gerry Adams asked the Minister for Health the number of elective procedures and surgeries cancelled at the Louth County Hospital, Dundalk from 2008-2014 [5996/14]

Written answers

Minister for Health

As this is a service matter, I have asked the HSE to respond directly to the Deputy.

Health Services Provision

Questions (213)

Caoimhghín Ó Caoláin

Question:

213. Deputy Caoimhghín Ó Caoláin asked the Minister for Health when services will be provided for a person (details supplied) in County Kildare. [5997/14]

Written answers

Minister for Health

As the particular issue raised by the Deputy relates to an individual case, this is a service matter for the Health Service Executive. Accordingly, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.

Medical Records

Questions (214)

Olivia Mitchell

Question:

214. Deputy Olivia Mitchell asked the Minister for Health what will happen to patients' medical records due to the closure of Mount Carmel Hospital; and if he will make a statement on the matter. [5998/14]

Written answers

Minister for Health

The HSE is working with the staff of Mount Carmel Hospital to ensure that the needs of patients are met in the short term. In order to ensure as seamless a transition as possible for patients, arrangements are being made to transfer their care to alternative hospitals of their choice. In this regard, active maternity notes are transferring with maternity patients to their designated maternity facility. The HSE is conscious of the necessity for appropriate storage and accessibility of historic medical records, and will continue to work with the hospital to ensure that an appropriate storage solution is developed. In the meantime, I have been advised that historic records are being retained on site at Mount Carmel.

Orthodontic Services Provision

Questions (215)

Charles Flanagan

Question:

215. Deputy Charles Flanagan asked the Minister for Health when orthodontic treatment will be approved in respect of a person (details supplied) in County Laois; and if he will make a statement on the matter. [6000/14]

Written answers

Minister of State at the Department of Health (Deputy Alex White)

The 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.

Substance Abuse Prevention Education

Questions (216)

Thomas P. Broughan

Question:

216. Deputy Thomas P. Broughan asked the Minister for Health the amount of Health Service Executive expenditure for the purposes of preventing and treating alcohol addiction; if he will provide details of the various programmes and initiatives in place across the country for preventing and treating alcohol addiction in the years 2012 and 2013; and the projected allocation for 2014. [6003/14]

Written answers

Minister for Health

The Government recently approved an extensive package of measures to deal with alcohol misuse to be incorporated in a Public Health (Alcohol) Bill. These measures are based on the recommendations contained in the Steering Group Report on a National Substance Misuse Strategy, 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.

The other measures (eg for the HSE, professional bodies etc) set out in the Steering Group Report on a National Substance Misuse Strategy, were endorsed by Government and are to be progressed by the relevant departments and organisations. The HSE has responsibility for implementing a number of recommendations and this is reflected in the HSE Service Plan for 2014.

The provision of services to prevent and treat addiction to alcohol is the responsibility of the Health Service Executive and as such, I have referred this question to the Health Service Executive for attention and direct reply.

HIQA Inspections

Questions (217)

Brendan Griffin

Question:

217. Deputy Brendan Griffin asked the Minister for Health the warnings issued by the Health Information and Quality Authority to Kerry General Hospital in the past two years following hygiene inspections; the dates of these visits and warnings; the action that was taken by the hospital subsequently to ensure optimum levels of patient safety; and if he will make a statement on the matter. [6009/14]

Written answers

Minister for Health

Established as an independent statutory body under the Health Act 2007, the Health Information and Quality Authority's (HIQA) mandate extends across the quality and safety of the public, private and voluntary sectors. Since late 2012 HIQA has been carrying out a monitoring programme against the National Standards for the Prevention and Control of Healthcare Associated Infections (NSPCHCAI). Both I and my Department welcome the publication of HIQA's reports and note the concerns raised in them about hand hygiene practices particularly among medical staff.

HIQA carried out an unannounced inspection on Kerry General Hospital on 22nd August, 2013. This assessment focussed on gathering information about compliance with two of the NSPCHCAI Standards, namely

- Standard 3: Environment and Facilities Management, Criterion 3.6

- Standard 6: Hand Hygiene, Criterion 6.1.

Overall, the HIQA inspection of Kerry General Hospital found that the areas assessed were generally clean, with some need for improvement. In relation to hand hygiene, the Authority found that hand hygiene practices were inconsistent with the National Standards. The Authority requested Kerry General Hospital to develop a quality improvement plan (QIP) to prioritise the improvements necessary to fully comply with the NSPCHCAI. This QIP was to be approved by an identified individual in Kerry General Hospital who has overall executive accountability, responsibility and authority for the delivery of high quality, safe and reliable services. The QIP was to be published on the Hospital's website within 6 weeks of the date of publication of HIQA's report. HIQA intend to continue with unannounced monitoring activity this year.

Ultimate responsibility for adherence to national standards lies with the HSE. It is the Executive's responsibility to implement and review the hospital's QIP. I have asked the HSE to respond directly to the Deputy with details of the actions taken by Kerry General Hospital to meet the requirements of the HIQA inspection.

Hospital Staff

Questions (218, 220, 226, 227, 228, 229)

Pádraig MacLochlainn

Question:

218. Deputy Pádraig Mac Lochlainn asked the Minister for Health if he will confirm that the European working time directive is being fully implemented in Letterkenny General Hospital. [6011/14]

Pádraig MacLochlainn

Question:

220. Deputy Pádraig Mac Lochlainn asked the Minister for Health his plans to ensure that Letterkenny General Hospital has the necessary numbers of medical registrars in line with the European working time directive. [6013/14]

Pádraig MacLochlainn

Question:

226. Deputy Pádraig Mac Lochlainn asked the Minister for Health his views that there is a crisis in the recruitment of NCHDs in our public hospitals. [6019/14]

Pádraig MacLochlainn

Question:

227. Deputy Pádraig Mac Lochlainn asked the Minister for Health his views that there is a crisis in the recruitment of consultants in our public hospitals [6020/14]

Pádraig MacLochlainn

Question:

228. Deputy Pádraig Mac Lochlainn asked the Minister for Health the percentage of consultant posts advertised by the Health Service Executive in 2013 that remain unfilled due to a lack of applicants [6021/14]

Pádraig MacLochlainn

Question:

229. Deputy Pádraig Mac Lochlainn asked the Minister for Health the likely impact on hospital services of a simultaneous crisis in the recruitment of both NCHDS and consultants [6022/14]

Written answers

Minister for Health

I propose to take Questions Nos. 218, 220, and 226 to 229, inclusive, together.

As they relate to service issues, I have asked the HSE to reply directly to the Deputy on his questions concerning implementation of EWTD and, related to this, the number of Registrars employed at Letterkenny Hospital. I have also asked the HSE to reply directly in relation to the data sought on consultant posts advertised in 2013.

I do not accept that there is a crisis in the recruitment of consultants or in the recruitment of NCHDs. There has been a significant increase in the number of consultants (Whole Time Equivalents) over the past 5 years. The number increased from 2,260 in December 2008 to 2,555 in December 2013. The great majority of almost 5,000 NCHD posts in the system are filled at present and were last year. I recognise, however, that recruitment of consultants and NCHDS is a significant challenge at the present time and needs to be facilitated.

It is appreciated that the 30% reduction decided in September 2012 for future ‘new entrant’ appointments represented a substantial reduction in the rate of pay for consultants. However, it was a necessary measure, given the challenging economic circumstances. If the health services are to continue to provide consultant-level opportunities for doctors to replace consultants who retire and eventually to expand overall capacity, this can only happen on the basis of a lower-cost model. I have asked the HSE and my Department to examine the application of the 30% reduction to serving consultants who move posts and to highly qualified consultants with considerable experience in Ireland or elsewhere taking up new posts.

I have emphasised on a number of occasions that there are a number of factors that need to be addressed to support NCHD recruitment and more importantly retention. NCHDs must be respected, be treated with dignity and have a clear training and career path. Given the need to address NCHDs working conditions, intensive work is underway in all hospitals, involving hospital management and the IMO, to pursue compliance with the European Working Time Directive on junior doctors’ working-hours.

In July last year, I set up a working group chaired by Professor Brian MacCraith, President of DCU, to carry out a strategic review of the medical training and career structure of NCHDs. I received the interim report of the Group in December which dealt primarily with training issues. The Group is now focusing on career structures and pathways following training and is due to report by the end of March on these issues. The final report of the Group is to be submitted to me by end June 2014. I am confident that this strategic review will, in future years, support the retention of sufficient numbers of doctors trained in Ireland within the system.

It should be noted that there are some specialties, at consultant and NCHD level, in which there are international shortages and which have been traditionally difficult to fill. Filling these posts represents a significant challenge given that there is a competitive market. There are also some hospitals to which it has historically been difficult to attract applicants, in particular smaller hospitals that have onerous rosters. The planned establishment of hospital groups should help to address this issue, as this will allow doctors to be appointed as group resources - instead of to just one hospital. Where posts are vacant and suitable candidates cannot be sourced, locums are retained or alternative arrangements are made to ensure service delivery.