Written Answers Nos. 570-589
570. Deputy Seán Kyne asked the Minister for Health if the Irish Blood Transfusion Board has a specific policy outlining the steps to be taken on receipt of information from a third party regarding the donation of blood by another person; and if he will make a statement on the matter. [12089/14]
View answerI have been informed by the Irish Blood Transfusion Service that it has a comprehensive policy relating to donor acceptance criteria where third party information is received. Details of this policy are available from the Irish Blood Transfusion Service.
571. Deputy Brendan Griffin asked the Minister for Health if he is concerned that general practitioners signing up to the new contract for free GP care for children under six must agree to the Health Service Executive inspecting their records; if he feels this could compromise confidentiality for patients; and if he will make a statement on the matter. [12091/14]
View answer572. Deputy Brendan Griffin asked the Minister for Health if he envisages an increase in the rate of visits to the general practitioner per annum by children under six once free GP care for them is introduced; if so, how GPs will cope with this; and if he will make a statement on the matter. [12092/14]
View answer580. Deputy Seán Ó Fearghaíl asked the Minister for Health if, with regard to the draft agreement for provision of services to under six year olds, he has concerns regarding the fact that the draft agreement seeks to limit the number of each doctor's patients to no more than 2,000; if such a limitation is likely to generate a need for additional general practitioners; if his Department, in its policy making role, has determined the number of doctors in general practice that will be required here; and if he will make a statement on the matter. [12147/14]
View answer581. Deputy Seán Ó Fearghaíl asked the Minister for Health if he has studied the draft agreement for the provision of services to under six year olds which the Health Service Executive has circulated to general practitioners; if there is any particular significance to the fact that the term "doctor" is not used in the draft contract; and if he will make a statement on the matter. [12148/14]
View answer589. Deputy Seán Ó Fearghaíl asked the Minister for Health further to the publication of the draft agreement for the provision of services for under six year olds, if the suggestion of a five year contract is one which may prove disruptive to general practice; if he is satisfied that the formal performance reviews envisaged in the agreement can be carried out with sufficient certainty and regularity as to ensure medical service provision; and if he will make a statement on the matter. [12217/14]
View answerI propose to take Questions Nos. 571, 572, 580, 581 and 589 together.
The Government is committed to introducing, on a phased basis, a universal GP service without fees 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 years and under with access to a GP service without fees. The implementation of this measure will require primary legislation, which I expect to be published shortly. A draft contract for the provision of free GP care to children aged 5 years and under, is currently the subject of a consultation process. I would wish to emphasise that the document is a draft and I have no doubt that there will be changes to the text following the consultation process.
The Deputies' questions raised a number of specific issues, which I will now address.
The obligations set out in the draft contract in respect to the inspection of records by the HSE is a standard feature of most contracts for the provision of health and social services on behalf of the HSE. Among the circumstances in which they might need to be invoked would be where patient safety concerns arise; where concerns exist about the quality of services being provided; in processing complaints from patients/relatives; and for probity assurance purposes. In exercising a provision of this nature, the HSE would be obliged to have due regard to patient confidentiality considerations, the need for patient consent and applicable legislative obligations.
In relation to the limitation on the number of patients on a GPs list, a similar provision is included in the existing General Medical Services (GMS) contract.
Regarding visitation rates, research carried out for the Department in 2013 indicates that fee-paying children under 6 years of age have an annual GP visit rate of 2.7, whereas, medical card/GP visit card holding children in the same age cohort have an annual visitation rate of 3.1.
The term "medical practitioner " rather than "doctor" is used throughout the existing GMS contract and throughout the draft contract for the provision of GP care for children under six years.
I expect that issues such as increased visitation rates, the capacity of the existing number of doctors to deliver the service and the proposed five year contract will be the subject of further discussions with the GP's.
573. Deputy Seán Kyne asked the Minister for Health his views regarding the ruling of Mr. Justice Treacy of the High Court in Northern Ireland regarding the blood donation policy operating in that jurisdiction; his views on whether such a ruling may have a bearing on the policy in operation in this jurisdiction. [12107/14]
View answerI have noted the ruling of Mr Justice Treacy of the High Court in Northern Ireland regarding the blood donation policy operating in that jurisdiction. I understand that this decision is under appeal. While policy decisions in other jurisdictions do not impact directly here, it is normal practice for the Irish Blood Transfusion Service to keep developments in relation to blood donation at an international level under ongoing review.
574. Deputy Seán Kyne asked the Minister for Health if he will confirm the cost of temporary relocation of a health centre (details supplied) necessitated by a problem with asbestos material which had to be removed; and if he will make a statement on the matter. [12108/14]
View answer575. Deputy Seán Kyne asked the Minister for Health the amount per year for the past ten years that the Health Service Executive has spent on accommodation at a location (details supplied) for the public health nurse; and if he will make a statement on the matter. [12109/14]
View answerI propose to take Questions Nos. 574 and 575 together.
The HSE has responsibility for the provision of Primary Care Centres and the operation and maintenance of existing health centres. Therefore, this matter has been referred to the HSE for attention and direct reply to the Deputy.
576. Deputy Gerry Adams asked the Minister for Health the reason medical card services were withdrawn in respect of a person (details supplied) in County Louth; if he will direct his Department to review the decision; and if he will make a statement on the matter. [12112/14]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has issued to Oireachtas members.
577. Deputy Dominic Hannigan asked the Minister for Health when a person (details supplied) may expect to receive payment from the Health Service Executive for the work they have carried out; and if he will make a statement on the matter. [12136/14]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
578. Deputy Dominic Hannigan asked the Minister for Health if there are regulations in place setting out the number of patients a general practitioner may see in a set timeframe; and if he will make a statement on the matter. [12137/14]
View answerWhile there are no regulations specifying the number of patients that a general practitioner may see in a set time period, the Medical Council’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners states “Doctors must always be guided by their primary responsibility to act in the best interests of their patients” and “Patient safety and quality of patient care should be at the core of the health service delivery that a doctor provides.”
579. Deputy Michael McCarthy asked the Minister for Health the number of paediatric orthopaedic surgeons currently employed in the State; and if he will make a statement on the matter. [12138/14]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply.
582. Deputy Brendan Smith asked the Minister for Health if he will confirm that there will be no change to the status of the Cavan-Monaghan integrated service area in the delivery of health services; and if he will make a statement on the matter. [12151/14]
View answer583. Deputy Brendan Smith asked the Minister for Health if a review of the integrated services area in the delivery of health services has been completed; when this report will be published; and if he will make a statement on the matter. [12153/14]
View answerI propose to take Questions Nos. 582 and 583 together.
The HSE is finalising this review. It is anticipated that the final report will shortly be submitted to the Minister for Health, after which its findings and recommendations will be considered. I am not in a position to comment on specific areas at this stage.
584. Deputy Brendan Smith asked the Minister for Health if there has been a reduction in the staffing complement at a hospital (details supplied); if so, if there are proposals to increase the staffing resources in this particular department of the hospital; and if he will make a statement on the matter. [12155/14]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
585. Deputy Brendan Smith asked the Minister for Health the present position regarding a capital development project (details supplied) in County Cavan; when this project will proceed to the next stage; the likely timescale for construction; and if he will make a statement on the matter. [12158/14]
View answerThere will always be more projects than can be funded by the Exchequer. As with all capital projects, further development of the acute sector infrastructure must be considered within the overall capital envelope available to the health service. There is limited funding available for new projects over the period 2014-2018 given the level of commitments and the costs to completion already in place.
586. Deputy Aengus Ó Snodaigh asked the Minister for Health if his attention has been drawn to the serious concerns of a family (details supplied) in Dublin 8 regarding the treatment of their father, who died on the way home following discharge from St. James's Hospital and his views on this matter. [12159/14]
View answerFirstly, may I offer my deepest sympathies to this family on their loss. I have asked the HSE to respond directly to the Deputy in relation to this case.
With regard to specific complaints in relation to experiences of individuals in our hospitals, I am advised that details of the HSE's formal complaints policy, entitled “Your Service Your Say”, can be found on the HSE website, at http://www.hse.ie/eng/services/yourhealthservice/feedback/complaints/. In accordance with this procedure, a complaint must be made in the first instance to the hospital in which the incident causing the complaint occurred. If an individual is not satisfied with the response from the hospital, a review can be sought from the HSE Director of Advocacy at Oak House, Millennium Park, Naas, County Kildare, tel 1890 424 555, and the Ombudsman at Office of the Ombudsman, 18 Lower Leeson Street, Dublin 2, tel 1890 223 030, email ombudsman@ombudsman.gov.ie.
587. Deputy Seán Ó Fearghaíl asked the Minister for Health if he is concerned about the number of doctors currently entering general practice; the numbers that have entered general practice in each of the years 2010 to 2013, inclusive; the strategies he and his Department are employing to ensure that the numbers entering general practice are sufficient to meet the needs of our growing population; and if he will make a statement on the matter. [12179/14]
View answerThe OECD Health Data 2013 shows the average number of General Practitioners (GPs) per 1,000 population across OECD countries in 2011 was approximately 0.70. It also shows that Ireland had approximately 0.72 GPs per 1,000 population in 2011. It should be noted that figures for some countries exclude trainees, while others (including Ireland) include all registered GPs.
On 31st December 2013, 2,840 medical practitioners held registration as trained Specialists in the specialty of General Practice on the Specialist Division of the Medical Council's Register of Medical Practitioners. This compares with 2,731 at 31st December 2012; 2,562 at 31st December 2011; and 2,270 at 31st December 2010. Holding registration does not necessarily mean that the medical practitioner is in active practice. On 31 December 2013, there were 2,413 GPs contracted to provide services under the General Medical Services Scheme. This compares with 2,368 on 31 December 2012; 2,277 on 31 December 2011; and 2,258 on 31 December 2010.
There are currently 157 GP training places per year. The HSE and the Irish College of General Practitioners are currently in discussions about the potential to increase this number.
In July last year, my colleague Dr James Reilly, Minister for Health, established a Working Group, chaired by Professor Brian MacCraith, President of DCU, to carry out a Strategic Review of Medical Training and Career Structure. The Working Group will examine and make high-level recommendations relating to training and career pathways for doctors with a view to improving graduate retention in the public health system, planning for future service needs, and realising maximum benefit from investment in medical education and training. Professor MacCraith has been asked to furnish the Group's final report by the end of June 2014.
The HSE is currently engaged in a medical workforce planning project, which will include a workforce plan for GPs. When this work has been completed, it will assist in identifying GP requirements.
588. Deputy Dan Neville asked the Minister for Health the policy of his Department and the Health Service Executive in providing necessary information to family carers of patients who require after-care following medical or psychiatric treatment. [12196/14]
View answerThe issue raised by the Deputy potentially spans a wide range of care facilities, care recipients, and individual case circumstances. Patients, family caregivers and health care providers all play vital roles in maintaining a patient's health after discharge, from whatever type of care facility. Effective discharge planning is designed to help recovery, ensure that medications are properly prescribed and correctly given, assist in responsibility for caring, and reduce the chances that a relative is re-admitted to care. Every effort is made by the Department and the HSE to ensure that these principles are reflected in relevant health legislation, policies and operational guidance documents, and carried through in the type of care provided by individual facilities to each patient. Regulated health professionals adhere to codes of conduct which set out frameworks and guidelines of professional and ethical standards across a range of practices, including communicating with patients and their families on all aspects of treatment. These codes are revised at regular intervals.
In relation to acute care, the HSE National Integrated Care Guidance (2014) has been developed by the National Integrated Care Advisory Group under the auspices of the Quality and Patient Safety Division. The guidance is based on feedback received following extensive national and targeted consultation with service providers in both the acute and community healthcare settings, and on review of the HSE Integrated Discharge Planning Code of Practice (2008). This practical guide to integrated care is designed to support healthcare providers to improve their discharge and transfer processes from the acute hospital setting back into the community. This guide will support service providers in demonstrating how they are meeting the National Standards for Safer Better Healthcare, and outlines nine key steps in effective discharge and transfer of care which will facilitate faster, safer discharges for patients.
In relation to psychiatric services, in 2009 the Mental Health Commission published a Code of Practice on Admission, Transfer and Discharge to and from an Approved Centre, pursuant to Section 33(3) (e) of the Mental Health Act 2001. The code of practice is relevant to all partners involved in the delivery of mental health care and treatment. The Commission has also developed a similar guide for service users, carers and advocates. A primary aim of Mental Health Commission publications is to create a more positive approach to recovery for service users through in-patient mental health services, by improving the continuity and co-ordination of care and treatment provided.
The national policy document, 'A Vision for Change ', recognises the vital role played by family members in the recovery process, which is accepted and supported by mental health professionals. It is acknowledged that patient outcomes are better where families and/or carers are involved, and healthcare professionals should actively encourage patients at all stages to involve their family and/or carer in the development of the patients care and treatment plan. However, it is also acknowledged that patient confidentiality should not be compromised and, in some cases, patients specifically request that contact is not made with families. If this confidence was breached, it could damage the health professional/patient relationship. The Medical Council's Ethical Guide does, however, allow a doctor to ethically breach confidentiality if, for example, he/she believes that the patient is at-risk of harming himself/herself or others.
I have asked the Expert Group, which is currently reviewing the Mental Health Act 2001, to specifically consider the broader issue of whether mental health legislation should be amended to require health professionals to consult with the family of persons with mental health problems. The Expert Group is also expected to report on a range of other issues, including discharge planning from approved centres. The Group are coming towards the end of their deliberations, and I expect to receive its Report in the coming months.
