Health Services Provision

Questions (805, 806, 858)

Robert Dowds

Question:

805. Deputy Robert Dowds asked the Minister for Health if he will provide a response to the stroke survivors survey launched on 7 April 2014 by the Irish Heart Foundation. [19017/14]

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Robert Dowds

Question:

806. Deputy Robert Dowds asked the Minister for Health his views on the findings of the stroke survivors survey launched by the Irish Heart Foundation on 7 April 2014, that only 11% of the stroke survivors had access to psychological services, just half had access to speech and language therapy and only two thirds had access to physiotherapy; and the Government's response to this issue [19018/14]

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Billy Kelleher

Question:

858. Deputy Billy Kelleher asked the Minister for Health his response to the national survey of stroke survivors recently published by the Irish Heart Foundation which indicated that one third of stroke survivors have no access to physiotherapy, half cannot get any speech and language therapy or occupational therapy and just one in ten can get any psychological help; that more than one in three pay for their own rehabilitation; and that 60% are made financially worse off by their stroke; and if he will make a statement on the matter. [19315/14]

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Written answers (Question to Health)

I propose to take Questions Nos. 805, 806 and 858 together.

My colleague, Minister White, was recently invited by the National Disability Authority to speak at the launch of this Report. This study is welcome as it provides comprehensive information on the impact of stroke for survivors and their carers.

Many developments in cardiac care have been brought about through various means including the National Cardiovascular Health Policy. This policy named “Changing Cardiovascular Health” covers from 2010 to 2019. It provides an integrated and quality assured approach for the prevention, detection and treatment of cardiovascular disease including stroke. Since 2010, significant improvements have been made with regard to access to acute treatments for coronary heart disease as well as the development of stroke units across the country. As Minister for Health, I was pleased to outline these at the launch of the Irish Heart Foundation Stroke day on 11th April last week.

Key elements of Stroke care now available include: New and existing stroke units provided with additional therapy, nursing and consultant posts; The Clinical Programme for Stroke continues its work to develop and disseminate care pathways and clinical protocols; A national 24/7 access to safe stroke thrombolysis through service development, telemedicine and training is already available in many hospitals with access protocols agreed for others; Ambulance access protocols are being developed by the Stroke Programme working in partnership with national ambulance service to agree and implement ambulance access protocols. Thrombolysis is now available to all acute hospitals admitting stroke patients and 9.5% of patients are being thrombolysed. This rate compares well with the best European figures and exceeds our target 7.5%.

The Stroke Programme estimates that the number of people with enduring disabilities as a result of stroke has decreased as the percentage of patients with stroke discharged from acute hospitals to nursing homes has dropped from 17.3% in 2009 to 14.5% in 2012. This is a positive outcome. The rapid increase in access to thrombolysis, from 3.3% in 2008 to 9.5% in 2012, has resulted in better outcomes for patients. The Stroke Foundation Education programme developed by the Stroke Programme and available to all staff caring for stroke patients is leading to improved patient experience of stroke service provision. Patients requiring more intensive rehabilitation are referred to the nearest available rehabilitation service, such as the Stroke Rehabilitation Unit, Baggott Street, Dublin Stroke Rehabilitation Unit, Louth County Hospital, Dundalk Hibernian Stroke Rehabilitation Unit, St. Mary’s Hospital, Phoenix Park Stroke Rehabilitation Unit and St. Finbarr’s Hospital, Cork.

Stroke rehabilitation can be provided in a number of settings, which range from specialised rehabilitation centres and departments in acute hospitals to outpatient and community settings. The establishment of managed clinical rehabilitation networks for neurological and prosthetic rehabilitation services in each of the 4 HSE Regions is proposed to facilitate the development of integrated quality rehabilitation services. The Programme’s Model of Care outlines that 4 regional hubs, which will have clinical and consultant leadership from a designated specialist in rehabilitation medicine, supporting existing neurologists and specialists in medicine for the elderly, be set up. It will include the National Rehabilitation Hospital (NRH) as the national hub and will also incorporate the setting up of Specialist Community-Based Rehabilitation Teams.

The implementation of the Department of Health’s National Policy and Strategy for the Provision of Neuro-rehabilitation Services in Ireland - in collaboration with the National Clinical Programme for Rehabilitation Medicine and its Model of Care - will provide for improved access to and quality of services for all patients requiring rehabilitation and their families.

Primary Care also plays an important role in stroke rehabilitation. The HSE’s National Service Plan 2013 provided for additional funding of €20m to strengthen primary care services (€18.525m for the recruitment of 264.5 primary care team posts and €1.475m to support Community Intervention Team development). The posts were allocated based on the analysis carried out by the HSE in identifying areas of deprivation and need. The additional primary care posts includes 72 Public Health Nurses, 40.5 Registered General Nurses, 47.5 Physiotherapists, 52.5 Occupational Therapists and 52 Speech and Language Therapists.

As of 6th March 2014, 199.5 posts have been filled or start dates have been agreed. The HSE is striving to have the remainder of the posts filled as soon as possible in 2014. Taken together, all these developments show that we have made significant progress in preventing stroke and its complications.

Nursing Home Services

Questions (807)

Seán Ó Fearghaíl

Question:

807. Deputy Seán Ó Fearghaíl asked the Minister for Health the procedures employed by the Health Service Executive, or his Department, to ensure that registered providers of nursing home care agree a contract with each resident, in accordance with Part 8 of the Health Act 2007; and if he will make a statement on the matter. [19043/14]

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Written answers (Question to Health)

Under the Health Act 2007, statutory responsibility is given to the Health Information and Quality Authority for the independent inspection and registration of certain categories of designated centres including residential care settings for older people. This responsibility is underpinned by a comprehensive quality framework comprising the Health Act 2007, Regulations and the National Quality Standards for Residential Care Settings for Older People in Ireland.

All designated centres, public, voluntary and private nursing homes are subject to the same core standards and regulations in relation to quality and safety in order to ensure the well-being of their residents. In accordance with the Regulations, registered providers must agree a contract with each resident within one month of their admission.

It is a matter for HIQA to determine whether a nursing home is in breach of the Regulations or the quality standards. If a nursing home is found not to be in compliance with the Regulations it may either fail to achieve or lose its registration status. HIQA also has wide discretion in deciding whether to impose conditions of registration on nursing homes.

EU Directives

Questions (808)

Brian Stanley

Question:

808. Deputy Brian Stanley asked the Minister for Health when the cross-border health care directive will be transposed into Irish law. [19044/14]

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Written answers (Question to Health)

The Directive on Patients’ Rights in Cross Border Healthcare provides rules for the reimbursement to patients’ of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State (Member State of Affiliation) and supplements the rights that patients already have at EU level through the legislation on the coordination of social security schemes (regulation 883/04).

The Directive seeks to ensure a clear and transparent framework for the provision of cross-border healthcare within the EU, for those occasions where the care patients seek is provided in another Member State rather than in their home country. However, it should be emphasised that the vast majority of EU patients receive healthcare in their own country and prefer to do so.

The Department of Health is continuing to work on the necessary statutory provisions to fully implement the Directive and will have them in place as soon as possible. Nevertheless, there are arrangements in place in respect of the key provision of the Directive in relation to a national contact point (NCP), which has been set up within the HSE – the email address is crossborderdirective@hse.ie.

The principal function of the NCP is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost, the procedures for accessing and determining those entitlements. The NCP also has a responsibility to ensure that all enquirers are informed of the rights, if any, that they may have through the legislation on the coordination of social security schemes (regulation 883/04) and which may be more beneficial to them. The NCP will be able to inform patients what the cost of their treatments would be in Ireland to allow them make a comparison with the costs they are being quoted for comparable treatment in another Member State.

Hospital Services

Questions (809, 810)

Ciara Conway

Question:

809. Deputy Ciara Conway asked the Minister for Health if he will provide an update in relation to dermatology services in Waterford Regional Hospital, including the current staffing position in relation to consultants, recruitment and retirement of consultants; and if he will make a statement on the matter. [19048/14]

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Ciara Conway

Question:

810. Deputy Ciara Conway asked the Minister for Health if he will provide an update in relation to waiting lists for dermatology services at Waterford Regional Hospital; and if he will make a statement on the matter. [19049/14]

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Written answers (Question to Health)

I propose to take Questions Nos. 809 and 810 together.

In relation to the detailed queries raised by the Deputy, as these are service matters, I have asked the Health Service Executive to respond to her directly.

Hospital Staff

Questions (811)

Ciara Conway

Question:

811. Deputy Ciara Conway asked the Minister for Health if he will commit to ensuring that full teams of support staff are available in the dermatology unit in Waterford Regional Hospital, including details on the number required and the number of vacancies that exist in roles such as SHOs, NCHDs, nursing and administrative staff; the measures being taken to provide a full service in the face of pending retirements; and if he will make a statement on the matter. [19050/14]

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Written answers (Question to Health)

As this is an operational matter it has been referred to the Health Service Executive for direct reply.

Hospital Services

Questions (812)

Ciaran Lynch

Question:

812. Deputy Ciarán Lynch asked the Minister for Health the reason a scheduled procedure was cancelled in respect of a person (details supplied) in County Cork at very short notice; when an alternative date will be provided; and if he will make a statement on the matter. [19051/14]

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Written answers (Question to Health)

In relation to the particular patient query raised by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond to him directly.

Health Services Provision

Questions (813)

Clare Daly

Question:

813. Deputy Clare Daly asked the Minister for Health the basis upon which he deems that hospitals need business plans and his further views that this promotes an ethos of treating health as a commodity. [19052/14]

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Written answers (Question to Health)

The HSE National Service Plan sets out the type and volume of services the HSE will provide for the monies allocated under its Vote during 2014. Hospitals are included in the service planning process, like all services directly provided or funded by the HSE.

The Service Plan was prepared in the context of the challenges faced by the health service this year in terms of reduced staffing levels, and a reduced budget, combined with increasing demand for services. The delivery of this year's Service Plan and hospital plans is focussed on the dual challenge of protecting patient outcomes, while, at the same time, reducing costs. This requires increasing emphasis on models of care that treat patients at the lowest level of complexity and provide safe, quality services at the least possible cost.

The HSE has management systems in place to monitor service delivery throughout the course of the year. The service planning process does not promote an ethos of treating health as a commodity. On the contrary, it underlines the commitment of the Government, the Department of Health and the HSE to health service reform and to the maintenance of high quality services to the greatest extent possible within the resources available.

Hospital Services

Questions (814)

Clare Daly

Question:

814. Deputy Clare Daly asked the Minister for Health if he will provide the Rotunda Hospital's business plan. [19053/14]

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Written answers (Question to Health)

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

National Lottery Funding Applications

Questions (815)

Dan Neville

Question:

815. Deputy Dan Neville asked the Minister for Health if he will provide an update on an application for national lottery funds from his Department in relation to application which was submitted in September 2013 on behalf of Newcastle West Rovers for grant aid to provide clubhouse facilities at the team's newly developed playing pitches at Killeline, Newcastle West, County Limerick. [19055/14]

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Written answers (Question to Health)

My Department administers a National Lottery Discretionary Fund from which once-off grants are paid to community and voluntary organisations providing a range of health related services. The application from Newcastle West Rovers was considered to be more appropriate to the Department of Transport, Tourism and Sport. Accordingly, my Department wrote to them on the 25th September 2013 advising that they should apply for funding from the Sports Capita Programme.

Medical Card Reviews

Questions (816)

Sandra McLellan

Question:

816. Deputy Sandra McLellan asked the Minister for Health the reason for a review of a medical card in respect of a person (details supplied); and if he will make a statement on the matter. [19065/14]

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Written answers (Question to Health)

The 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.

Disability Support Services Provision

Questions (817)

David Stanton

Question:

817. Deputy David Stanton asked the Minister for Health in relation to section 13 of Part 2 of the Disability Act 2005, if he will since the introduction of the Act provide a list of the aggregate needs identified in assessment reports which have not been included in service statements as per section 13(1)(c); the total number of assessments made and number completed per section 13(1)(d); the total number of persons to whom services have not been provided to date, including ages and categories of disability as per section 13(1)(d); and if he will make a statement on the matter. [19075/14]

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Written answers (Question to Health)

As this question concerns detailed operational matters, it has been referred to the HSE for direct response to the Deputy, insofar as this information is available.

Disability Support Services Provision

Questions (818)

David Stanton

Question:

818. Deputy David Stanton asked the Minister for Health in relation to section 13 of Part 2 of the Disability Act 2005, the total number of reports he has received from the Health Service Executive under section 13(2), regarding the aggregate needs identified in assessment reports, including an indication of the time periods required for the provision of same, sequence of provision and estimated cost; if he will provide details of same each year since the introduction of the Act; and if he will make a statement on the matter. [19076/14]

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Written answers (Question to Health)

Three reports under Section 13 of the Disability Act 2005, covering the years 2007, 2008 -2009 and 2010, have been received by my Department and subsequently published by the HSE, since this provision was commenced in mid 2007. The focus of these reports was on capturing core management data, including reporting on the number of applications for statutory assessments of need, the number of assessments conducted and on the most frequently required services highlighted in the assessment of need reports.

While improved management information systems were implemented by the HSE in 2011, following discussions with my Department, to collect additional data in relation to the assessment of need process, the Executive continues to face difficulties in reporting on aggregate need. For example, to meet this requirement, in the case of any individual child, clinicians involved in the assessment process and service delivery could be asked to try and work out the ideal service provision for the child. However, my Department and the HSE share the view that such an intensive process in relation to record keeping and reporting in a time of reduced resources, would risk diverting the attention of clinicians away from service intervention, to administrative duties, with no beneficial outcomes for children with disabilities.

It should also be noted that since 2007, there have been a number of significant developments in the delivery of disability services and the overall policy framework. Work is proceeding on reorganising services for children and young people into integrated, geographically-based multidisciplinary teams under the HSE’s Progressing Disability Services for Children and Young People aged 0 -18 Programme. This will significantly improve the ability of the HSE to target resources to where they are most needed, in keeping with the spirit of Section 13 of the Disability Act. Under this new model, the focus is shifting from measuring inputs/outputs to measuring outcomes for the children involved.

The HSE is currently in the process of preparing a combined report under Section 13 for the years 2011 and 2012, which is at an advanced stage of drafting. This is due to be submitted to my Department in the near future. I also understand that the report based on activity in 2013 is at an advanced stage and will be submitted in the near future. My Department and the HSE will continue to work together to identify the most suitable recording and reporting arrangements to work towards meeting statutory obligations, but in such a way that is not overly bureaucratic or burdensome and reflects advances made in the sector.

Respite Care Services

Questions (819, 820)

Robert Dowds

Question:

819. Deputy Robert Dowds asked the Minister for Health if he will provide details of the respite services that are available in south County Dublin. [19087/14]

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Robert Dowds

Question:

820. Deputy Robert Dowds asked the Minister for Health his plans for new or increased respite services in south County Dublin; and if he will make a statement on the matter. [19088/14]

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Written answers (Question to Health)

I propose to take Questions Nos. 819 and 820 together.

As the Deputy's questions relate to service matters, I have arranged for the questions to be referred to the Health Service Executive for direct reply to the Deputy.