Health Services Expenditure

Questions (207)

Bernard Durkan

Question:

207. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he and his Department have curtailed expenditure overruns throughout the service; and if he will make a statement on the matter. [21785/14]

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Written answers (Question to Health)

The Revised Estimate for 2014 for the Health group of Votes provides for gross expenditure of €13.164 billion comprising €12.774 billion in current expenditure and €390m in capital expenditure. 2014 will be another extremely challenging year for the health services. Significant cost extraction is required with €619m in savings to be achieved. In Net Vote terms, the April Returns indicate a cumulative deficit of €89m.

There is ongoing and intensive engagement each month between officials of my Department, DPER and the HSE in the context of regular monitoring of expenditure. The HSE's Performance Assurance Report and the more detailed Management Data Report are published monthly on the HSE's website - www.hse.ie - and provide an overall analysis of key performance data from Finance, HR, Hospital and Primary & Community Services.

The HSE is pro-actively engaged in internal efforts to maximise savings and cost containment plans and to ensure that additional measures are identified and safely implemented to mitigate any projected deficits which are within HSE direct control, while engaging on an ongoing basis with my Department. The HSE will continue to engage with the acute hospital sector in relation to the 2014 savings measures and cost containment initiatives.

Hospital Acquired Infections

Questions (208)

Bernard Durkan

Question:

208. Deputy Bernard J. Durkan asked the Minister for Health the total number of reports of various infections arising from MRSA or other hospital bugs on a monthly basis in each of the past three years to date; the action taken arising therefrom; and if he will make a statement on the matter. [21786/14]

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Written answers (Question to Health)

As I have stated in the House on previous occasions, the prevention of Healthcare Associated Infections (HCAIs) and colonisation/infection of patients with antimicrobial-resistant organisms (AMR) such as MRSA is one of my priorities in protecting patient safety. HCAIs represent a major cause of preventable harm and increased health care costs.

The prevalence of MRSA has dropped considerably in recent years. There has been a decrease of 62.5% in reported cases of MRSA from 2006 to 2013. However, there are concerns about the rates of resistance of other organisms as detailed in the EARS- Net Report referred to below.

The Health Protection Surveillance Centre (HPSC) collates information from hospitals on health care associated infections and antimicrobial resistant organisms such as MRSA, Clostridium difficile etc. The most recent European Antimicrobial Surveillance System Report (EARS - Net) for Quarter 4, 2013 was published on March 27th. The full Report is available at http://www.hpsc.ie/hpsc/A-Z/MicrobiologyAntimicrobialResistance/EuropeanAntimicrobialResistanceSurveillanceSystemEARSS/EARSSSurveillanceReports/2013Reports/.

The HSE has implemented a number of national initiatives in the control and prevention of HCAIs for many years, including:

- SARI 2001-2010 (The Strategy for the Control of Antimicrobial Resistance in Ireland) which specifically outlined the national strategy for prevention of AMR and was launched by the Minister of Health in 2001.

- HSE ‘Say No to Infection’ which focused on both HCAIs and AMR, launched in 2007

- The RCPI & HSE National Clinical Programme for the prevention and control of HCAIs and AMR which commenced in late 2010.

- Public reporting of HCAIs and AMR in Irish acute hospitals:

- HCAIs Prevalence Study 2006 and 2012

- S. aureus bloodstream infection (reported quarterly since 2007) – this includes public reporting of MRSA rates per hospital

- Alcohol hand rub consumption (reported bi-annually since 2007)

- Antibiotic consumption (reported bi-annually since 2007)

- Hand hygiene compliance (reported bi-annually since 2011)

The overall aim of the National Clinical Programme for the prevention and control of HCAIs and AMR is that every health care worker and all parts of the health care system recognise that the prevention and control of HCAIs and AMR is a key element of clinical and non-clinical governance. Our health care systems have processes in place to ensure safe health care is reliably delivered irrespective of the health care setting. The programme focuses on getting three basic practices right every time we care for our patients, these are hand hygiene, using antimicrobials appropriately (antimicrobial stewardship) & preventing medical device-related infections i.e., IV lines/drips, urinary catheters. If the above three measures are applied consistently and reliably every time health care workers care for their patients/residents/client then a significant proportion of HCAIs, including that caused by AMR, will be prevented.

While I welcome the reducing trend in reported rates of MRSA in Ireland, MRSA rates are comparably high with other countries. We must systematically build our actions and processes to continue to reduce the prevalence of MRSA in Ireland.

In December last I launched and endorsed the second National Clinical Guideline, Prevention and Control Methicillin-Resistant Staphylococcus aureus (MRSA). This National Clinical Guideline provides practical guidance on prevention and control measures for MRSA to improve patient care, minimise patient morbidity and mortality and to help contain health care costs. The guideline has been developed for all health care staff involved in the care of patients, residents or clients who may be at risk of or may have MRSA in acute hospitals, obstetrics and neonates, nursing homes/long stay residential units and the community.

I might add that I have ensured that Patient Safety has been made a priority within the HSE's Annual Service Plan through specific measures focused on quality and patient safety including HCAIs, Medication safety and implementation of Early Warning Score systems. My officials meet the HSE each month on the Service Plan and patient safety is a standing item on that agenda.

Medical Card Reviews

Questions (209)

Terence Flanagan

Question:

209. Deputy Terence Flanagan asked the Minister for Health the reason that persons with Down's syndrome, which is a lifelong condition, who have medical cards are written to every year for review and not every three years; and if he will make a statement on the matter. [21802/14]

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Written answers (Question to Health)

All medical cards, including those granted on a discretionary basis, are subject to a periodic review of eligibility to determine continuing eligibility.

Cards are selected for review in advance of the expiration of their eligibility period, i.e. when the "valid to" date on the card is approaching.In addition, cards are selected on a random basis, where the HSE carries out, on an on-going basis, audits of eligibility to ensure that the medical card register is as accurate as possible and that its voted budget is being spent appropriately in the medical card scheme.

The HSE does not have any indicator on its clients’ registers that would identify people with Down's syndrome.

The HSE has a very structured protocol in place for the review process and makes every effort to ensure on-going engagement with clients during this process. If the HSE is made aware that a person has special needs, whether at application or review stage, assistance will be afforded to help that person complete the application whether at application stage or at review stage. The local health office can be contacted on LoCall 1890 252 919 to request this assistance.

Health Services

Questions (210)

Finian McGrath

Question:

210. Deputy Finian McGrath asked the Minister for Health the position regarding a care package in respect of a person (details supplied) in Dublin 5; and if he will make a statement on the matter. [21803/14]

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Written answers (Question to Health)

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

Health Services

Questions (211)

Finian McGrath

Question:

211. Deputy Finian McGrath asked the Minister for Health the position regarding a long-term care package in respect of a person (details supplied) in Dublin 9; and if he will make a statement on the matter. [21804/14]

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Written answers (Question to Health)

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

Emigration Data

Questions (212)

Finian McGrath

Question:

212. Deputy Finian McGrath asked the Minister for Health the number of young qualified nurses leaving Ireland each year, especially in 2013 and 2014, or any statistical information he may have regarding qualified nurses emigrating; and if he will make a statement on the matter. [21805/14]

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Written answers (Question to Health)

While the information sought by the Deputy is not routinely collated by my Department, I understand that this information is gathered annually by the Health Education Authority, and as such, the question should be directed to the Department of Education and Skills.

Accident and Emergency Services Provision

Questions (213)

Terence Flanagan

Question:

213. Deputy Terence Flanagan asked the Minister for Health the position regarding accident and emergency services at Beaumont Hospital (details supplied); and if he will make a statement on the matter. [21814/14]

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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.

Hospital Services

Questions (214)

Dan Neville

Question:

214. Deputy Dan Neville asked the Minister for Health if he will expedite a surgical appointment in respect of a person (details supplied) in County Limerick; and if he will make a statement on the matter. [21815/14]

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Written answers (Question to Health)

The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the Health Service Executive, sets out the processes that hospitals are to implement to manage waiting lists.

In relation to the particular query raised by the Deputy, I have asked the HSE to respond directly to him on this matter.