Question No. 191 answered with Question No. 13.

Question No. 192 answered with Question No. 189.

Hospitals Data

Questions (193)

Bernard Durkan

Question:

193. Deputy Bernard J. Durkan asked the Minister for Health how the number of consultants in various disciplines in this jurisdiction compares with best practice in other jurisdictions; and if he will make a statement on the matter. [21771/14]

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Written answers (Question to Health)

The ratio of consultants per head of population in Ireland is lower than in other jurisdictions. However, it is Government policy to move to a consultant delivered service and there has been a significant increase in the number of consultants (Whole Time Equivalents) over the past decade. Under section 57 of the Health Act 2004, the procedure for the approval of consultant posts in the public system and the determination of the number and type of appointments, are matters for the HSE. Since the establishment of the HSE, the number increased by 723 from 1,947 in January 2005 to 2,670 in December 2013. However there are some specialties in which there is an international shortage and which have been traditionally difficult to fill, regardless of the salary scale. There are also some hospitals to which it has historically been difficult to attract applicants.

Though the HSE has the capacity to recruit where it is necessary to do so in order to ensure patient safety and to support service delivery, there is evidence that there are, at present, difficulties in recruiting consultants. The ability of the public service to attract and retain consultants shapes the extent to which the HSE can maintain and develop the range of health services required.

I am currently progressing measures to ensure that we will have an adequate supply of highly skilled consultants and NCHDs. Last July I set up a group under the chairmanship of Professor Brian MacCraith to carry out a strategic review of medical training and career structures. The Group will make recommendations aimed at improving the retention of medical graduates in the public health system and planning for future service needs. It provided an Interim Report in December 2013 focused on training. In April 2014 the Group submitted its second report to me and this dealt with medical career structures and pathways following completion of specialist training. The final report of the Group will deal with workforce planning and this is due to be submitted by the end of June 2014. The work of the Group is fundamental to ensuring that positions within the public health service are attractive to consultants and doctors in training, NCHDs, in the years ahead.

Hospitals Data

Questions Nos. 195 to 197, inclusive, answered with Question No. 186.

Questions (194)

Bernard Durkan

Question:

194. Deputy Bernard J. Durkan asked the Minister for Health how the cost of delivery of various segments of the health service in this jurisdiction compares with that in adjoining or other EU countries; his proposals to encourage the development of best practice in this regard in this country; and if he will make a statement on the matter. [21772/14]

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Written answers (Question to Health)

International data on health service expenditure is compiled by a number of organisations including the Organisation for Economic Cooperation and Development (OECD), the World Health Organisation (WHO) and the EU’s statistical service (EUROSTAT). At a high level, data on national health expenditure can be compared and expressed as per capita expenditure, public versus private expenditure, as a percentage of GDP/GNP, or in terms of purchasing power parities (PPPs). At the lower level of specific service areas, it is much more difficult to arrive at valid comparisons between countries. The reason for this is that health systems differ widely in terms of structure, models of service delivery, and definitions of functions. For example, what constitutes an outpatient service in one country may not have a direct comparison in another country.

Recognising these difficulties, the international organisations, led by the OECD, have in recent years developed a new international standard for health accounting called the System of Health Accounts (SHA). The SHA is designed to provide detailed and standardised information on expenditure according to a three way cross-classification. The three axes are health service functions, health service providers, and health service funders. The resulting data will cover both public and private expenditure and will be a valuable source for health service evaluation, planning and international benchmarking.

Ireland is currently engaged in a major project to compile and submit national SHA data. The project is jointly led by the Department of Health and the Central Statistics Office and will submit SHA data for 2013 by March, 2016. An EU implementing regulation is in the process of being finalised which will make annual compilation of the SHA compulsory for all member states from 2016 onwards.

Questions Nos. 195 to 197, inclusive, answered with Question No. 186.

Mental Health Services Provision

Questions (198)

Bernard Durkan

Question:

198. Deputy Bernard J. Durkan asked the Minister for Health the extent to which adequate financial provision remains available to his Department to meet the requirements of the mental health services with particular reference to the need to ensure the maintenance of the necessary supportive structures; and if he will make a statement on the matter. [21776/14]

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Written answers (Question to Health)

The Government is committed to the continued reform of the mental health services, notwithstanding the substantial overall reduction in resources available to the health service in recent years. Some €90 million in development funding has been provided since 2012 for a range of new posts and other specific initiatives relating to mental health and suicide prevention. Areas being funded this year include specialised secondary care services for children and adolescents, adults, older persons, those with an intellectual disability and a mental illness and forensic services.