Written Answers Nos. 460 - 477
460. Deputy Bernard J. Durkan asked the Minister for Health the extent to which services are currently available for children and parents suffering from narcolepsy; and if he will make a statement on the matter. [37139/14]
View answerThe Health Service Executive and the Department of Education and Skills continue to provide a range of services and supports to individuals diagnosed with narcolepsy following pandemic vaccination regardless of age, on an ex gratia basis. These services and supports which are co-ordinated by the HSE National Advocacy Unit are intended to provide that individuals receive tailored assistance to address their specific requirements, where appropriate. It is acknowledged that treatment and individual medical needs may need to be reassessed over time to take account of changes in their condition or circumstances.
The ex gratia health supports include clinical care pathways to ensure access to rapid diagnosis and treatment, multi-disciplinary assessments led by clinical experts, counselling services for both the individuals and their families, discretionary medical cards for those who have been diagnosed have been provided to allow unlimited access to GP care and any prescribed medication, ex gratia reimbursement of vouched expenses incurred in the process of diagnosis and treatment, including travel expenses for attending medical appointments; physiotherapy, occupational therapy assessments, dental assessments and dietary services all on a needs basis. Regional co-ordinators have been appointed to assist individuals to provide advice, information and access to local services.
On the education side, the National Educational Psychological Services (NEPS) engaged with all of the schools being attended by children with narcolepsy to provide guidance and assistance on the condition and the supports available. These include special education home tuition, the provision of supplemental learning support/resource teaching support on a needs basis and the provision of Special Needs Assistants (SNA) support if required. Furthermore, reasonable accommodations, including special examination centres and rest breaks were provided for students who sat state exams in June. Similar arrangements will be available on a needs basis to students sitting state exams in future years. The Department of Education and Skills issued circulars providing information to schools on the nature, likely symptoms, possible effect of the condition of narcolepsy on students and the supports available for students.
With regard to third level, students diagnosed with narcolepsy following pandemic vaccination can access the Disability Access Route to Education (DARE) scheme, which is a college/university scheme which offers enhanced access routes to third level education.
All health and educational services and supports will continue to be provided on an ex gratia basis. Those services and supports will be reassessed on an ongoing basis to take account of the individual's condition and circumstances.
462. Deputy Bernard J. Durkan asked the Minister for Health the current position in regard to achievement of universal health insurance; and if he will make a statement on the matter. [37141/14]
View answerI am committed to a major agenda of health reform, in line with the commitments contained in the Programme for Government and our policy statement, Future Health. I want to push ahead as soon as possible with key reforms in areas such as extending free GP care on a phased basis, improving the management of chronic diseases, implementing key financial reforms including Money Follows the Patient, and establishing hospital groups as a critical enabler of improving patient quality and efficiency.
When I became Minister for Health I reviewed our progress to date and the timescales for implementing very important reforms, including Universal Health Insurance, based on universal entitlement to a single-tier health service, that is based on need, not income.
I remain committed to implementing the important improvements that a UHI system is intended to bring. While I believe that it will not be possible to introduce a full UHI system by 2019, as envisaged in the White Paper on Universal Health Insurance, I want to emphasise my commitment to implementing reforms based on UHI and the White Paper. In order to do this I want to examine some key elements further and then to decide on the best way forward.
The Government published the White Paper on Universal Health Insurance in April of this year and my Department initiated a consultation process on it. An independent analysis of the submissions is underway and I expect to receive this report in the next week.
My Department has also initiated a major costing exercise to estimate the cost of UHI for households and the Exchequer and is working closely with the ESRI and the Health Insurance Authority and initial costings should be available by the end of quarter one in 2015.
The independent thematic analysis of submissions from the consultation process on the White Paper and the results of the major costing exercise on UHI will assist in charting a clear course towards the objective of a universal, single-tier health service.
463. Deputy Bernard J. Durkan asked the Minister for Health the ongoing steps taken to ensure patient safety; and if he will make a statement on the matter. [37142/14]
View answerPatient safety has become both a national and international imperative in recent years, with increased emphasis on patient safety in policy reform, legislative changes and development of standards of care driven by quality improvement initiatives. The Commission on Patient Safety and Quality Assurance was established in Ireland in January 2007 and published its report in August 2008. The Commission's report provides the roadmap to developing a national culture of patient safety and recommends increased leadership and accountability throughout the service through new governance, management and reporting structures. The Commission made a wide range of detailed recommendations in the following areas:
- Involvement of Patients, Carers and Service-Users in the system which covers communications, open disclosure etc.
- Leadership and Accountability in the system which includes governance, management and reporting structures, education, training, research etc.
- Organisational and Professional Regulatory Framework which includes licensing of healthcare facilities, regulation of healthcare professionals and credentialing;
- Quality Improvement and Learning Systems which includes evidence-based practice, clinical audit, adverse event reporting, medication safety, health information and technology.
Since the publication of the Commission's Report the Department and its Agencies have continued to work towards improving patient safety.
In addition, a number of HIQA Reports and investigations including the HIQA Investigation into UHG (2013) and the CMO's Report on Perinatal Deaths (2006-to date) in Portlaoise Regional Hospital earlier this year have informed policy on patient safety and demonstrate that we still face many challenges to ensure that our health and social care services are truly safe and of the highest quality.
The HSE, in its National Service Plan 2014 has threaded through the Plan a requirement that at a time of further financial contraction, it is especially important to ensure that providing the best level of care for patients and service users, must be at the forefront of planning for and management of services. This commitment is also a central theme of Future Health - A Strategic Framework for Reform of the Health Service 2012-2015. To this end, the HSE has emphasised specific measures focused on quality and patient safety in the Service Plan including HCAIs, Medication Safety and implementation of Early Warning Score Systems. My officials meet with the HSE each month on the Service Plan and patient safety is a standing item on that agenda.
There are many facets to the patient safety agenda and several initiatives underway have the potential to drive significant change throughout health service provision over the coming years. The leadership of this change from a governance and management perspective will be a key dimension of progressing towards this goal.
I will just detail briefly below some of the key initiatives introduced to progress patient safety:
- The establishment of the Health Information and Quality Authority (HIQA) which is the independent authority responsible for driving quality, safety and accountability in residential services for children, older people and people with disabilities in Ireland. HIQA also sets, monitors and inspects against healthcare standards.
- Approval and publication of HIQA's National Standards for Safer Better Healthcare in June 2012.
- Clinical effectiveness is a key component of safe, quality care. To this end the Minister for Health established the National Clinical Effectiveness Committee (NCEC) in 2010 to provide a framework for national endorsement of clinical guidelines and audit to optimise patient care. To date, three National Clinical Guidelines have been launched: the National Early Warning Score for Ireland (NEWS), the Prevention and Control Methicillin-Resistant Staphylococcus aureus (MRSA) and Surveillance, Diagnosis and Management of Clostridium difficile Infection in Ireland. Each guideline has been subject to an economic evaluation and implementation will be monitored through the HSE's monthly Performance Assurance Reports, compliance with HIQA's National Standards for Safer Better Healthcare and increased alignment with the clinical indemnity scheme.
- An additional four guidelines were commissioned by my predecessor, arising out of the HIQA report into the Halappanavar case: Sepsis, Paediatric Early Warning Score (PEWS), Maternal Early Warning Score (MEWS) and Clinical Handover. It is planned to launch the Sepsis and MEWS Guidelines in November.
- A National Patient Safety Advisory Group has been established to support my Department in providing national leadership on patient safety and quality and to advise on the development of policy in the area of patient safety and quality.
- Legislative proposals are at an advanced stage of development by my Department for the introduction of a national licensing system. This will provide for a mandatory system of licensing for public and private health service providers.
- Much of the legislation governing healthcare professionals has been extensively updated and amended in recent years with the publication of a number of relevant Acts including the Medical Practitioners Act 2007 and the Nurses and Midwives Act 2011.
- 'Patient Safety First' is an awareness raising initiative through which healthcare organisations declare their ongoing commitment to patient safety. The overall branding was supported by a new Patient Safety First logo and the launch of anew website (www.patientsafetyfirst.ie).
- The establishment by the HSE of the Directorate of Quality and Patient Safety in order to strengthen the HSE’s internal quality and risk framework.
Establishment of HSE's National Incident Management Team.
- The establishment by the HSE of its Advocacy Unit, the publication of the HSE's Patient Charter 'You and Your Health Service' and the launch of the WHO's Patient Safety Champion's Network .
- A National Policy on Open Disclosure was developed jointly by the HSE and the State Claims Agency and launched in November 2013. Implementation of the policy across all health and social services has now commenced by the HSE.
- The Royal College of Physicians in Ireland and the HSE have jointly set up the Clinical Programmes to provide strategic leadership to develop and roll out models of best practice in clinical care nationally.
- The upgrading by the Clinical Indemnity Scheme of the national confidential web-based clinical incident reporting system, STARSweb to the National Adverse Event Management System (NAEMS).
Many of these patient safety initiatives have made significant progress in terms of legislative, regulatory and structural changes. Changing culture and developing processes for patient safety are critical to delivery of a quality safe healthcare service. A quality and safety culture ensures that quality and safety is seen as fundamental to every person working within that service, including clinical and non-clinical staff, healthcare managers and the Board, or equivalent, of an organisation.
465. Deputy Bernard J. Durkan asked the Minister for Health the costs associated with the employment of agency staff at all levels throughout the health sector, the degree to which savings may be made by the appointment of temporary, part-time or full-time staff in lieu thereof; and if he will make a statement on the matter. [37144/14]
View answerIn the Health Sector which provides 24/7 care 365 days of the year, flexibility is required that allows the use of overtime and agency staff to meet agreed and approved service levels. Recourse to overtime or agency is necessary for a variety of reasons including, for example, over-runs in operating theatres, sudden increases in service demand, to cover for sick leave, annual leave and maternity leave. However, the HSE is focused on reducing current levels of agency usage recognising that the increase in agency spending to date this year, up 42% to the end of July compared with 2013, is unsustainable.
In order to mitigate the impact on frontline services of the reduction in employment numbers that has been required, the priority is to reform how health services are delivered in order to ensure a more productive and cost effective health system. Agency staff cannot be used to substitute for staff losses as a result of the need to reduce health sector employment. The revised working arrangements provided for in the Haddington Road Agreement are a pivotal element in this regard. The Agreement has made a number of measures available to the HSE to reduce agency costs while maintaining existing service levels. These include the Graduate Nurse Initiative, the Support Staff Intern Scheme and the additional employee hours made available to the HSE due to increased working hours.
In addition, while it is necessary to continue to control public sector employment, arrangements are in place in the HSE to allow the recruitment of staff where it has been established that there is an urgent service requirement. The scope for offering temporary contracts to fill posts on a temporary basis where it is established that there is a service need and that savings can be achieved by direct employment compared with agency usage is also under consideration.
The specific data requested by the Deputy will be issued to the HSE for direct reply.
466. Deputy Bernard J. Durkan asked the Minister for Health the areas throughout the health service currently experiencing the greatest pressure/demand in the public health sector; the measures/steps required to address any such issues; and if he will make a statement on the matter. [37145/14]
View answer468. Deputy Bernard J. Durkan asked the Minister for Health the extent to which budgetary provisions for his Department have been adequate to meet requirements to date; and the extent to which such requirements and resources are likely to be compatible in the coming year without loss or reduction in services. [37147/14]
View answer469. Deputy Bernard J. Durkan asked the Minister for Health the extent to which on a monthly basis his Department has monitored expenditure and costs throughout the health service; the areas which have shown to have difficulties staying within budget; the action taken or needed in such circumstances; and if he will make a statement on the matter. [37148/14]
View answerI propose to take Questions Nos. 466, 468 and 469 together.
Officials from my Department continuously monitor expenditure and costs throughout the health service and meet on a monthly basis with officials from the Health Service Executive (HSE) to discuss the monthly Performance Assurance Reports and Management Data Reports produced by the HSE. These monthly reports detail activity and financial performance in the HSE under each of its Divisional Areas and provide an assessment of the key expenditure trends across the health services.
This year is, undoubtedly, proving to be a particularly challenging year for the health services and this is reflected in the overrun to end July of €286 million. The Department of Health has already signalled that the health service is facing a possible financial overrun of around €500 million this year. Areas which are showing particular difficulty staying within budget include the Acute Hospital sector (57% of the overall deficit) and the Primary Care sector (19%).
Much comment has been made about waiting lists following the publication of the latest Performance Assurance Report. The success of the Outpatient waiting list initiative, facilitated in part through appointments during additional working hours, made available through the Haddington Road Agreement, has had the consequence of increasing in-patient and day-case waiting lists, as people who have been seen as out-patients are referred on to such lists for further treatment as required.
Hospitals have endeavoured to respond to these developments, in addition to managing service demands arising from admissions through Emergency Departments; this is evident in higher in-patient and day case discharge activity to date in 2014. Measures to make use of all available capacity and to drive evidence-based best practice health-care for optimum outcomes are being developed by the HSE, in collaboration with acute hospitals, the SDU and the NTPF. These include:
· Strict observation of the National Waiting List Protocol (2014), including strict adherence to chronological scheduling and bi-annual validation of lists for all patients waiting more than 3 months
- Adherence to relevant HSE National Clinical Programme guidelines
- Flexible usage of theatre capacity within specialties
- Prioritising Day-of-surgery admission where clinically appropriate
- Implementation of pre-admission clinics to ensure that patients are fit for surgery
In addition, the availability of acute hospital beds is significantly constrained in that a significant number of patients who are deemed medically fit for discharge are awaiting alternative care arrangements in the community in the form of long term nursing home care, respite care or transitional care. A co-ordinated approach to delayed discharges between Acute and Social Care Divisions of the HSE is underway to reduce the number of people awaiting placements to nursing homes or home, depending on their personal requirements. Despite this initiative, the HSE indicates that the numbers of patients awaiting discharge will continue to increase over the next number of months thus reducing in-patient capacity for winter months.
The funding pressures in primary care are mainly related to local demand led schemes, PCRS and legacy child-care expenditure. However, positive developments include the fact that waiting times for physiotherapists and occupational therapists have decreased and there has also been improvement in end of life care and childhood health surveillance.
There has been understandable focus recently on the challenging resource constraints within which the health services are operating. While the budgetary targets this year are particularly constrained, it is important to recognise that financial and resource constraints have applied in each of the last number of years as a direct consequence of the emergency financial situation the Government has had to address during its period in office. These challenges come at a time when the demand for health services is increasing each year which, in turn, is driving costs upwards. However, despite these resource reductions and increasing service demands the HSE has managed to support growing demand for its services arising from such factors as population growth, increased levels of chronic disease, the ageing of the population, increased demand for prescription drugs, and new cost intensive medical technologies and treatments. The HSE and its staff are to be commended for their ongoing efforts to meet these increased demands on its services since 2008.
I have already stated that I am hopeful that next year things will be improving in regards to HSE waiting times and budget overruns. Any improvements will of course be contingent on getting a realistic budget in place for next year. I will continue to engage with the HSE and the Department of Public Expenditure with a view to putting in place a budget for 2015 which will stabilise the health service.
467. Deputy Bernard J. Durkan asked the Minister for Health the number and location of primary care centres already provided throughout the country; those pending; the extent to which the latter are ready to go; when they will be ready for use; and if he will make a statement on the matter. [37146/14]
View answerThe HSE has responsibility for the provision of Primary Care Centres. The folllowing table sets out the location of Primary Care Centres in operation throughout the country.
The part of the question relating to Primary Care Centres not yet in operation has been referred to the HSE for attention and direct reply to the Deputy.
Primary Care Centres in Operation
|
- |
HSE Region |
County |
Location |
In Operation |
Method of Delivery |
|
1 |
DML |
Dublin |
Irishtown |
Prior to March 2011 |
Direct Build |
|
2 |
DML |
Dublin |
Pearse Street |
Prior to March 2011 |
Direct Build |
|
3 |
DML |
Dublin |
Balally/ Milltown |
Prior to March 2011 |
Existing Health Care Facility |
|
4 |
DML |
Dublin |
Killiney |
Prior to March 2011 |
Existing Health Care Facility |
|
5 |
DML |
Dublin |
Ballogan/Leopardstown |
Prior to March 2011 |
Operational Lease |
|
6 |
DML |
Kildare |
Naas |
Prior to March 2011 |
Operational Lease |
|
7 |
DML |
Laois |
Mountmellick |
Prior to March 2011 |
Operational Lease |
|
8 |
DML |
Offaly |
Banagher/Kilcormac |
Prior to March 2011 |
Existing Health Care Facility |
|
9 |
DML |
Offaly |
Clara |
Prior to March 2011 |
Existing Health Care Facility |
|
10 |
DML |
Offaly |
Daingean |
Prior to March 2011 |
Existing Health Care Facility |
|
11 |
DML |
Offaly |
Moneygall/Shinrone |
Prior to March 2011 |
Existing Health Care Facility |
|
12 |
DML |
Westmeath |
Kinnegad |
Prior to March 2011 |
Operational Lease |
|
13 |
DML |
Wicklow |
Newtownmountkennedy |
Prior to March 2011 |
Operational Lease |
|
14 |
DNE |
Cavan |
Virginia |
Prior to March 2011 |
Direct Build - Existing Health Care Facility Refurbished |
|
15 |
DNE |
Dublin |
Ballymun |
Prior to March 2011 |
Direct Build |
|
16 |
DNE |
Meath |
Dunboyne |
Prior to March 2011 |
Existing Health Care Facility |
|
17 |
DNE |
Meath |
Trim |
Prior to March 2011 |
Operational Lease |
|
18 |
South |
Carlow |
Carlow Town Shamrock Plaza/South Carlow/Bagnlestown |
Prior to March 2011 |
Operational Lease |
|
19 |
South |
Cork |
Dunmanway/Drimoleague |
Prior to March 2011 |
Existing Health Care Facility |
|
20 |
South |
Cork |
Rosscarbery |
Prior to March 2011 |
Existing Health Care Facility |
|
21 |
South |
Cork |
Skibbereen |
Prior to March 2011 |
Existing Health Care Facility |
|
22 |
South |
Cork |
Mallow |
Prior to March 2011 |
Operational Lease |
|
23 |
South |
Cork |
Mitchelstown |
Prior to March 2011 |
Operational Lease |
|
24 |
South |
Tipperary |
Cashel |
Prior to March 2011 |
Existing Health Care Facility |
|
25 |
South |
Waterford |
Waterford City West |
Prior to March 2011 |
Operational Lease |
|
26 |
South |
Wexford |
Gorey (The Palms) |
Prior to March 2011 |
Operational Lease |
|
27 |
West |
Donegal |
Letterkenny |
Prior to March 2011 |
Operational Lease |
|
28 |
West |
Galway |
Inis Oir |
Prior to March 2011 |
Direct Build |
|
29 |
West |
Galway |
Inis Mór, Aran Islands |
Prior to March 2011 |
Existing Health Care Facility |
|
30 |
West |
Galway |
Ballinasloe |
Prior to March 2011 |
Existing Health Care Facility |
|
31 |
West |
Galway |
Moycullen |
Prior to March 2011 |
Existing Health Care Facility. Expansion Required |
|
32 |
West |
Roscommon |
Strokestown |
Prior to March 2011 |
Direct Build - Existing Health Care Facility Refurbished |
|
33 |
West |
Mayo |
Achill |
Prior to March 2011 |
Existing Health Care Facility |
|
34 |
West |
Mayo |
Charlestown |
Prior to March 2011 |
Existing Health Care Facility |
|
35 |
West |
Limerick |
Ballylanders |
Prior to March 2011 |
Existing Health Care Facility |
|
36 |
West |
Limerick |
Hospital |
Prior to March 2011 |
Existing Health Care Facility |
|
37 |
West |
Limerick |
Limerick City/Ballynanty |
Prior to March 2011 |
Existing Health Care Facility |
|
38 |
West |
Clare |
Limerick City at Westbury |
Prior to March 2011 |
Existing Health Care Facility |
|
39 |
West |
Tipperary |
Nenagh |
Prior to March 2011 |
Existing Health Care Facility |
|
40 |
West |
Roscommon |
Roscommon Town |
Prior to March 2011 |
Operational Lease |
|
41 |
West |
Sligo |
Sligo Town |
Prior to March 2011 |
Existing Health Care Facility |
|
42 |
West |
Sligo |
West Sligo |
Prior to March 2011 |
Existing Health Care Facility |
|
43 |
West |
Donegal |
Fanad/Rosguill |
Prior to March 2011 |
Existing Health Care Facility |
|
44 |
DML |
Dublin |
Inchicore |
Post March 2011 |
Direct Build |
|
45 |
DML |
Dublin |
Ballyfermot |
Post March 2011 |
Direct Build |
|
46 |
DML |
Dublin |
Churchtown |
Post March 2011 |
Operational Lease |
|
47 |
DML |
Dublin |
Dublin City at James Street/Pimlico/Liberties |
Post March 2011 |
Operational Lease |
|
48 |
DML |
Dublin |
Bride St/Liberties (Old Meath Hospital Campus) |
Post March 2011 |
Operational Lease |
|
49 |
DML |
Dublin |
Rathfarnham |
Post March 2011 |
Short Term Lease |
|
50 |
DML |
Kildare |
Newbridge |
Post March 2011 |
Operational Lease |
|
51 |
DML |
Kildare |
Clane |
Post March 2011 |
Operational Lease |
|
52 |
DML |
Laois |
Portarlington |
Post March 2011 |
Operational Lease |
|
53 |
DML |
Longford |
Longford Town |
Post March 2011 |
Operational Lease |
|
54 |
DML |
Westmeath |
Athlone at Clonbrusk |
Post March 2011 |
Operational Lease |
|
55 |
DNE |
Cavan |
Cootehill |
Post March 2011 |
Direct Build |
|
56 |
DNE |
Cavan |
Cavan Town |
Post March 2011 |
Operational Lease |
|
57 |
DNE |
Cavan |
Kingscourt |
Post March 2011 |
Operational Lease |
|
58 |
DNE |
Cavan |
Cavan Town at Connolly Court |
Post March 2011 |
Operational Lease |
|
59 |
DNE |
Dublin |
Blanchardstown/Grove Court/Blakestown/Mountview |
Post March 2011 |
Operational Lease |
|
60 |
DNE |
Louth |
Carlingford |
Post March 2011 |
Direct Build - Existing Health Care Facility Refurbished |
|
61 |
DNE |
Louth |
Ardee |
Post March 2011 |
Direct Build - Existing Health Care Facility Refurbished |
|
62 |
DNE |
Meath |
Dunshaughlin |
Post March 2011 |
Direct Build - Existing Health Care Facility Refurbished |
|
63 |
DNE |
Meath |
Ashbourne |
Post March 2011 |
Operational Lease |
|
64 |
DNE |
Meath |
Summerhill |
Post March 2011 |
Operational Lease |
|
65 |
DNE |
Meath |
Enfield |
Post March 2011 |
Refurbishment to existing Health Care Facility |
|
66 |
DNE |
Cavan |
Bailieborough |
Post March 2011 |
Direct Build - Existing Health Care Facility Refurbished |
|
67 |
South |
Kerry |
Kenmare/Sneem |
Post March 2011 |
Operational Lease |
|
68 |
South |
Kerry |
Dingle/West Kerry |
Post March 2011 |
Direct Build - Existing Health Care Facility Refurbished |
|
69 |
South |
Kilkenny |
Callan |
Post March 2011 |
Operational Lease |
|
70 |
South |
Kilkenny |
Kilkenny at Grange's Road/Ayrfield |
Post March 2011 |
Operational Lease |
|
71 |
South |
Cork |
Macroom (North Lee) |
Post March 2011 |
Operational Lease |
|
72 |
South |
Cork |
Cork City at Mahon/Blackrock (South Lee) |
Post March 2011 |
Operational Lease |
|
73 |
South |
Cork |
Kinsale |
Post March 2011 |
Operational Lease |
|
74 |
South |
West Cork |
Schull/Mizen |
Post March 2011 |
Operational Lease |
|
75 |
South |
Waterford |
Tramore |
Post March 2011 |
Operational Lease |
|
76 |
South |
Wexford |
Gorey (Gorey Medical Centre) |
Post March 2011 |
Operational Lease |
|
77 |
West |
Donegal |
Glenties |
Post March 2011 |
Direct Build |
|
78 |
West |
Galway |
Galway City East/Ballybane |
Post March 2011 |
Operational Lease |
|
79 |
West |
Galway |
Athenry |
Post March 2011 |
Operational Lease |
|
80 |
West |
Galway |
Loughrea |
Post March 2011 |
Direct Build |
|
81 |
West |
Leitrim |
North Leitrim/West Cavan at Manorhamilton |
Post March 2011 |
Direct Build |
|
82 |
West |
Limerick |
Limerick City - Abbey/St Mary's/King's Island |
Post March 2011 |
Operational Lease |
|
83 |
West |
Mayo |
Ballina |
Post March 2011 |
Operational Lease |
|
84 |
West |
Roscommon |
Castlerea |
Post March 2011 |
Operational Lease |
|
85 |
West |
Roscommon |
Monksland/South Roscommon |
Post March 2011 |
Operational Lease |
470. Deputy Bernard J. Durkan asked the Minister for Health the steps taken or needed to be taken to prevent hospital bugs and infections throughout the public health sector; the extent to which comparisons have been made with the private sector in this regard; and if he will make a statement on the matter. [37149/14]
View answerThe prevention of Healthcare Associated Infections (HCAIs) and colonisation/infection of patients with antimicrobial-resistant organisms (AMR) is one of my Department's priorities in protecting patient safety. HCAIs represent a major cause of preventable harm and increased healthcare costs.
As the Deputy will be aware, 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; first-quarter returns for 2014 see a minor rise compared to quarter 1 of 2013 but it must be stressed that these figures are provisional. There are, however, concerns about the rates of resistance of other organisms as detailed in the EARS- Net Report referenced below. While the reducing trend in reported rates of MRSA in Ireland is welcome, MRSA rates are comparably high with other countries and we must systematically build our actions and processes to continue to reduce the prevalence of MRSA in this country.
The Health Protection Surveillance Centre (HPSC) collates information from acute public and private hospitals on healthcare associated infections and antimicrobial resistant organisms such as MRSA, Clostridium difficile etc. The most recent European Antimicrobial Surveillance System Report (EARS - Net) for Quarter 1, 2014 was published on June 17th. The full Report is available at http://www.hpsc.ie/hpsc/A-Z/MicrobiologyAntimicrobialResistance/EuropeanAntimicrobialResistanceSurveillanceSystemEARSS/EARSSSurveillanceReports/2014Reports/.
The HSE has implemented a number of national initiatives in the control and prevention of HCAIs over many years, more recently the HSE's National Clinical Programme for the prevention and control of HCAIs and AMR which commenced in late 2010 and is supported by the national RCPI/HSE Clinical Advisory Group on HCAIs which provides expert guidance and leadership to the health system. The overall aim of the National Clinical Programme is that every healthcare worker and all parts of the healthcare system recognise that the prevention and control of HCAIs and AMR is a key element of clinical and non-clinical governance. The programme focuses on getting three basic practices right every time patients are cared for; these are hand hygiene, using antimicrobials appropriately (antimicrobial stewardship) and preventing medical device-related infections i.e., IV lines/drips, urinary catheters. If the above three measures are applied consistently and reliably every time healthcare workers care for their patients/residents/client then a significant proportion of HCAIs, including that caused by AMR will be prevented.
Public reporting of HCAIs and AMR in Irish acute hospitals includes:
- HCAIs Prevalence Study 2006 and 2012
- S. aureus bloodstream infection (reported quarterly since 2007) – this includes public reporting of MRSA rates per hospital. Arrangements have now been made for monthly collection of new cases of C. Difficile and - Staphylococcus bloodstream infection rates which will inform future HSE Service Plans
- Alcohol hand rub consumption (reported bi-annually since 2007)
- Antibiotic consumption (reported bi-annually since 2007)
- Hand hygiene compliance (reported bi-annually since 2011)
In December last my predecessor 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 healthcare costs. The guideline has been developed for all healthcare 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.
The Department is ensuring that Patient Safety remains 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.
There are no comparative statistics for the private sector regarding initiatives to prevent hospital infections; reporting of HCAIs to the HPSC covers all acute hospitals, both public and private, in Ireland.
471. Deputy Brendan Smith asked the Minister for Health if his Department, along with the Health Service Executive, are putting in place systems to enable health professionals to work on a short-term basis in west Africa to assist in the efforts to deal with the Ebola outbreak; if similar arrangements will be put in place to those established by the NHS in Britain; and if he will make a statement on the matter. [37158/14]
View answerIreland is very supportive of measures to fight the Ebola outbreak in West Africa. My colleague the Minister for Foreign Affairs and Trade has provided significant additional resources through Irish Aid to help the measures to control the outbreak. To date a number of Health Service Executive staff have spent periods of time working with Aid Agencies such as Médecins Sans Frontières and the World Health Organisation (WHO) in a number of West African countries during this outbreak. The exact arrangements to allow them to undertake this work is a matter for the individuals concerned and the Health Service Executive. I support any initiatives to facilitate these and others to work in the affected countries.
472. Deputy Billy Timmins asked the Minister for Health the number of registered gynaecologists and registered psychiatrists here; the number of these that have indicated that they wish to be available under the terms of the Protection of Life in Pregnancy Act; the numbers that have indicated that they wish to be excluded on the grounds of conscientious objector or other grounds; and if he will make a statement on the matter. [37164/14]
View answerAs the Deputy is aware, the Protection During Pregnancy Act was enacted in July 2013 and commenced in January 2014. This is the law that now regulates access to lawful termination of pregnancy in Ireland and, as such, it is expected that all medical professionals will comply with it.
The registration of medical professional is a matter for the Medical Council. I have been advised that in the Specialist Division of the Register of Medical Practitioners there are 257 doctors in the speciality of Obstetrics and Gynaecology and 704 doctors in the specialty of Psychiatry. There is no requirement for medical professionals to issue notifications to me or my officials of the kind the Deputy has referred to.
In the case of conscientious objection, medical professionals can refer to Section 17 of the Act. Section 17 provides that medical practitioners, nurses and midwives will not be obliged to carry out, or to assist in carrying out medical procedures under the Act if they have a conscientious objection. A doctor who has a conscientious objection shall arrange for the transfer of care of the pregnant woman concerned as may be necessary to enable the woman to avail of the medical procedure concerned.
473. Deputy Jonathan O'Brien asked the Minister for Health if his attention has been drawn to the National Positive Ageing Strategy launched on 25 April 2013 with a guarantee that an implementation plan would follow within six months; the date on which the implementation plan will be completed; the date on which the implementation plan will be published; and if he will make a statement on the matter. [37167/14]
View answerThe National Positive Ageing Strategy provides a vision for an age-friendly society and includes four National Goals and underpinning Objectives to provide direction on the issues that need to be addressed to promote positive ageing. The Strategy commits to the preparation of an Implementation Plan to facilitate the translation of the Goals and Objectives of the Strategy into action on the ground. Preparation of this Plan involves a wide range of Departments and agencies all of which must operate within the resources available to them. Progress is being made and the objectives of the Strategy will be progressed as soon as possible.
In parallel to the development of an implementation plan, a number of initiatives are in train to implement components of the Strategy under all four National Goals. In the area of older people’s services and supports, for example, the Review of the Nursing Homes Support Scheme is under way, the Single Assessment Tool has been developed and will be rolled out, measures are being taken to ensure integrated care for older patients, and palliative care services are being improved.
As part of the implementation process, a Healthy and Positive Ageing Outcomes Initiative has been established as a joint initiative of the Department of Health, the HSE’s Health and Wellbeing Programme and the Atlantic Philanthropies. The Initiative will run from October 2014 to December 2017, and will include the development of indicators to monitor changes in older people’s health and wellbeing at national and local level associated with the implementation of the National Positive Ageing Strategy and the Healthy Ireland Framework.
474. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in the determination of an application for a medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [37171/14]
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.
475. Deputy Thomas P. Broughan asked the Minister for Health if he will report on the pilot scheme in the area of orthodontics currently in place in Dublin north east which involves using orthodontic therapists; and the number of patients who will be treated under this pilot scheme in 2014 and in 2015. [37172/14]
View answerThe HSE Dublin North East (DNE) Orthodontic Service has been chosen as the pilot area for this new training programme. One member of the dental hygienist staff and one member of the dental nursing staff have commenced training in September 2014. This course is being accredited by Dublin Dental Hospital, Trinity College and is one year in duration.
In the course of training these students will work under the direct supervision of specialist orthodontists currently working in HSE units in the treatment of a number of children eligible for HSE-funded orthodontic treatment. It is only when the students have successfully completed their course in September 2015 that they may be allocated patients to themselves, working under a treatment plan as designed by a specialist or consultant orthodontist. The programme is on a pilot basis only and not considered a routine part of the service.
476. Deputy Thomas P. Broughan asked the Minister for Health the number of patients waiting for an assessment and the number of children waiting for treatment with the orthodontics service of the Health Service Executive with a breakdown based on each HSE region, including Dublin north east; and if he will report on the average waiting times for patients seeking referrals and treatment with the orthodontics service. [37173/14]
View answerThe HSE provides orthodontic treatment to those who have been assessed and referred for treatment before their 16th birthday. It should be noted that the nature of orthodontic care means that immediate treatment is not always desirable. It is estimated that in up to 5% of cases it is necessary to wait for further growth to take place before treatment commences. Patients are assessed by the HSE Orthodontic Service under the modified Index of Treatment Need. Patients with the greatest level of need i.e. Grade 5 or Grade 4 are provided with treatment by the HSE. Information on waiting times is collated by the HSE by region and for the intervals as shown below. The most recent information on assessment and treatment waiting lists relates to the second quarter of 2014.
|
Waiting time for assessment |
1 - 6 months |
7 - 12 months |
13 - 24 months |
>24 months |
TOTAL |
|
HSE Dublin Mid-Leinster |
2,030 |
1 |
0 |
0 |
2,031 |
|
HSE Dublin North East |
397 |
556 |
0 |
0 |
953 |
|
HSE South |
1,203 |
396 |
109 |
12 |
1,720 |
|
HSE West |
1,606 |
268 |
62 |
18 |
1,954 |
|
TOTAL |
5,236 |
1,221 |
171 |
30 |
6,658 |
|
Waiting time from assessment to commencement of treatment |
1 - 6 months |
7 - 12 months |
13 - 24 months |
25-48 months |
Over 48 months |
TOTAL |
|
HSE Dublin Mid-Leinster |
1,133 |
779 |
1,060 |
1,261 |
87 |
4,320 |
|
HSE Dublin North East |
163 |
626 |
997 |
1,252 |
748 |
3,786 |
|
HSE South |
650 |
439 |
946 |
1,333 |
9 |
3,377 |
|
HSE West |
1,257 |
1,220 |
1,496 |
1,010 |
52 |
5,035 |
|
TOTAL |
3,203 |
3,064 |
4,499 |
4,856 |
896 |
16,518 |
477. Deputy Seán Kyne asked the Minister for Health if he will provide in tabular form all of the State agencies, bodies, organisations and working groups under his Department's remit; the core duties and functions of same; the number of staff at same; the budget of each for 2013 and proposed budget for 2014; the date of establishment of the agencies or organisations; and the legislation, primary or otherwise, from which they derive their powers. [37207/14]
View answerThere are eighteen agencies and bodies which operate under the aegis of the Department which have a role in delivering health services. Some are involved in delivering services while others are regulatory or advisory. This information is available on the Department’s website http://health.gov.ie/about-us/agencies-health-bodies/.
The name, function, establishing legislation, date of establishment, employment control ceiling and funding status for these agencies and other groups under the remit of the Department, is being collated and will be forwarded to the Deputy when it is available.
