Written Answers Nos. 124-138
124. Deputy Terence Flanagan asked the Minister for Health if he is satisfied with the budget allocated to Beaumont Hospital, Dublin 9 and the level of overcrowding at its emergency department; and if he will make a statement on the matter. [42754/14]
View answerAs this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
125. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his plans to liaise with the Department of the Environment, Community and Local Government in the context of the budget 2015 commitment to reconvene a social housing construction programme in view of the importance of access to housing in the community for persons challenged by mental health issues. [42756/14]
View answerIn July 2012, the Department of Health and the Department of the Environment, Community and Local Government jointly published the National Implementation Framework to support the Government's National Housing Strategy for People with Disability 2011 to 2016. The Strategy sets out a broad framework for the delivery of housing for people with disabilities, and for people with mental health issues, through mainstream housing policy. The development of the Strategy took account of the Government's disability and mental health policies, including the Report of the HSE Working Group on Congregated Settings and A Vision for Change, to progress the options for people with intellectual, physical or mental health disabilities to obtain suitable housing accommodation at community level, with supports appropriate to their needs. It was envisaged that this would be implemented by way of a leasing funding model for social housing. To advance this, €1 million was transferred from the HSE Vote to the Department of the Environment, Community and Local Government Vote to provide for housing options for up to 150 people currently resident in disability or mental health settings, in both 2013 and 2014.
Due to the relatively small numbers of people who were in a position to leave institutional type settings in 2013, the Department of the Environment, Community and Local Government obtained approval from the Department of Public Expenditure and Reform for up to €975,000 of this funding to be used for the purchase of a small number of properties, on a once-off basis, to accommodate up to 15 people for whom a person centred plan with appropriate supports was in place. The remaining €25,000 was targeted at leasing homes in the community for those 'transitioning' before the end of 2013.
Cross-departmental objectives on housing for people leaving institutional or other disability and mental health settings are being advanced through the Housing Strategy for People with a Disability Implementation Monitoring Group, and its associated Housing Sub-Group, which my Department is participating in. This Group is chaired by the Department of the Environment, Community and Local Government, which has the lead role in advancing the Housing Strategy.
Budget 2015 also provided for new Social Housing investment by that Department, which includes provision for 400 new housing units for people with specific needs, and up to 150 new homes in the community for those with disabilities leaving institutional type settings. Some of these homes may be available for people with mental health issues. The Department of Health will continue to work closely with the Department of the Environment, Community and Local Government to maximise the options under all social housing initiatives for those with a mental health disability.
126. Deputy Seán Kyne asked the Minister for Health if Government has a policy of examining the role played and services provided by chemists and pharmacies with a view to maximising the availability of services in the community setting which would draw on the skills set of pharmacies while also reducing pressure on other areas of the health service; and if he will make a statement on the matter. [42784/14]
View answerThe development of primary care services is an essential component of the health reform process. In a developed primary care system up to 95% of people's day to day health and social care needs can be met in the primary care setting. In particular, pharmacy services are well placed within the community to provide essential health advice and to support effective care at the lowest level of complexity and in a cost-effective manner.
As we continue to experience increased pressure and demand on the resources within the health system it is necessary to consider new and innovative ways to provide the services we require. Expanding the role of the community pharmacist to providing a range of new pharmacy services will be an important consideration as we seek to further expand and develop the primary care sector.
The Government recognises the contribution that has been made by community pharmacists in recent years by providing an expanded range of services. Successful engagement with the sector has enabled pharmacists to provide new services such as flu vaccinations, an emergency hormonal contraception service, advice on health eating, support for smoking cessation and participation in a pilot project on a medicines use review service.
We will continue to engage with community pharmacists to consider the feasibility of implementing other new services that may be cost-effective for the health system.
127. Deputy Michelle Mulherin asked the Minister for Health if he will create a new statutory entitlement for patients who have a complaint where it relates to the judgment of a clinician in the diagnosis or treatment of a condition to ensure that it be referred for examination and adjudication upon its receipt by the Ombudsman; and if he will make a statement on the matter. [42739/14]
View answerIt is currently the case that if an individual is unhappy with the level of care provided by a health service employee such as a doctor, nurse or other regulated healthcare professional, he/she may make a complaint to that employee's professional regulatory body. However, my Department is aware that the Ombudsman is in favour of extending his remit to examine clinical diagnosis or clinical judgments in complaints made against the HSE. Legislative changes to the statutory remit of the Ombudsman would have to be made by the Minister for Public Expenditure and Reform who has responsibility for the Ombudsman legislation. Drawing up the necessary changes to the legislation would be undertaken in consultation with my Department.
My Department requires ongoing assurance by the HSE that its statutory role in relation to complaints management is operating effectively and is in the best interests of patients. I understand that the HSE is currently in the process of strengthening its capability in Quality Improvement, Complaints Handling and Adverse Incident Management at a national level by allocating responsibility for these functions to a National Director. Improvements in the complaints handling process are expected as a result. My Department will have further engagement with the HSE and the Ombudsman in this regard and these discussions will include consideration of the role and responsibilities of the Ombudsman and his desire to extend his remit to adjudicating on cases relating to the clinical diagnosis or judgement.
128. Deputy Mick Wallace asked the Minister for Health his plans to address the ongoing issues regarding the provision and quality of ambulance services in County Wexford; and if he will make a statement on the matter. [42782/14]
View answerA significant development programme is underway within the National Ambulance Service in an effort to modernise and reconfigure services. I am not aware of any particular issues with the provision of ambulance services in the Wexford area. However, if the Deputy has specific concerns he wishes to raise, I would ask him to forward the details to my office for investigation.
129. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he may anticipate a reduction in the time taken for patients to meet with their respective consultants with a view to early access to hospital and relevant surgical procedures; if he has examined the basic cause or causes for waiting lists for various procedures; if he expects to be in a position to address such issue in the short to medium term; if he will identify the precise measures needed to make a positive impact on the situation; and if he will make a statement on the matter. [42787/14]
View answerAccording to the HSE's most recently published data, the total number of patients on in-patient and day case waiting lists at the end of August 2014 was 53,431. This is an increase of 3,736 or 7.5% on August 2013.
In August 2014 the number of patients waiting in excess of 12 months for an outpatient appointment has decreased from 84,167 to 41,604; a reduction of 51% when comparing the same periods in 2013 and 2014. Furthermore, the percentage of patients waiting more than 12 months has decreased from 22% in August 2013 to 11% in August 2014. Up to the end of August there has been a 3% increase in outpatient attendances compared to 2013; this equates to 64,289 additional patients seen. Although the increased provision and uptake of outpatient appointments is positive, it is likely to result in some additional demand for in-patient and day cases.
The trends indicate that waiting lists are likely to continue to increase in to next year. The capacity to provide services for these patients has been curtailed by increased emergency admissions and delayed discharges. The HSE continues to seek improvements in the provision of elective surgery, medical and outpatient services through reform, facilitation of local level initiatives, strict adherence to the National Waiting List Protocol and relevant HSE Clinical Programme guidelines and networking of services between hospitals in the new Hospital Groups. The Government has provided additional funding of €25 million in 2015 to address delayed discharges and thereby improve timeliness for admissions from Emergency Departments and waiting lists. The plans to address in-patient and day-case waiting lists are being considered in the 2015 Service Planning process which is currently underway and progress in this area will be a priority for hospital groups throughout next year.
130. Deputy Micheál Martin asked the Minister for Health his views on the implementation of the programme for Government particularly in the area of universal health insurance; and if he will make a statement on the matter. [35596/14]
View answerI am committed to the major agenda of health reform set out in the Programme for Government and the policy statement, Future Health. In particular, 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.
The Government published the White Paper on Universal Health Insurance in April. This set out the Government's proposals for a universal, single-tier health service for Ireland. A public consultation on the White Paper on UHI was undertaken. Last month I received the report of the independent analysis of the main themes outlined in the responses received and I intend to publish it shortly. My Department has also initiated a major costing exercise for UHI, led by the ESRI. I expect to have initial costings by the end of the first quarter of 2015.
When I became Minister for Health, I reviewed our progress to date and the timescales for implementing very important reforms, including UHI. I came to the conclusion that it will not be possible to introduce a full UHI system by 2019, as envisaged in the White Paper. However, I want to emphasise my commitment to implementing reforms, and in order to do this I want to examine some key elements further. I will then decide on the best way forward in consultation with my colleagues in Government. When I receive the results of the ESRI costing exercise next year, I will be in a position to set out in more detail the next steps and I will bring proposals to Government.
131. Deputy Joe Higgins asked the Minister for Health if he will report on his discussions on the extension of free general practitioner visits to those under six years of age and over 70 years of age; and if he will make a statement on the matter. [42789/14]
View answerThe Government 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. The Government has commenced this process in respect of all children under 6 years. The Health (General Practitioner Service) Act 2014, which provides an entitlement for all children aged under 6 to a GP service without fees, was enacted on 25th July 2014. Under a Framework Agreement, the Department of Health, the HSE and the IMO are engaged intensively on the introduction of GP services without fees for children aged under 6.
The Government's aim is to have universal GP care without fees for children under 6 years implemented early next year, subject to the conclusion of the present discussions and the completion of a fee-setting process.
In July 2014, the Government approved the drafting of a Bill to amend the Health Act 1970 to provide a GP service, without fees, for all persons aged 70 years and over. Drafting of the Bill by the Department and the Attorney-General’s Office is nearing completion and this will allow for the introduction of access to GP care without fees for persons aged 70 and over, which will be facilitated under the existing General Medical Services contract.
132. Deputy Billy Kelleher asked the Minister for Health if proposed free general practitioner care will be subject to a fee; and if he will make a statement on the matter. [42774/14]
View answerThe Government 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. The Government has commenced this process in respect of all children under 6 years. The Health (General Practitioner Service) Act 2014, which provides an entitlement for all children aged under 6 to a GP service without fees, was enacted on 25th July 2014. Under a Framework Agreement, the Department of Health, the HSE and the IMO are engaged intensively on the introduction of GP services without fees for children aged under 6.
In July 2014, the Government approved the drafting of a Bill to amend the Health Act 1970 to provide a GP service, without fees, for all persons aged 70 years and over. Drafting of the Bill by the Department and the Attorney-General’s Office is nearing completion and this will allow for the introduction of access to GP care without fees for persons aged 70 and over.
The Government's aim is to have the first two phases for the under-6s and over-70s implemented early next year subject to the conclusion of the present discussions and the completion of a fee-setting process. By the end of next year, approximately half of the population will have access to GP services, without charges. That’s a major step on the way to universal health care.
Some GPs have raised concerns that there could be a high level of inappropriate or unnecessary attendances at GP practices when a service is free and have suggested that there could be an option for a GP to apply a nominal fee to deter such unnecessary visits to a GP, and free up GP time for genuine patients. However, the Minister for Health is currently implementing the phased introduction of a universal GP service without charges in line with existing and planned legislation.
133. Deputy Richard Boyd Barrett asked the Minister for Health if he will investigate the circumstances in which a person (details supplied) in Dublin 12, and who acquired hepatitis C following a blood transfusion during an operation for a burst appendix carried out in St. James's Hospital on 11 November 1982, but for which the medical records for the operation have now disappeared, denying this person the documentary evidence required to verify that he contracted hepatitis as a consequence of a transfusion of infected blood; and if he will make a statement on the matter. [42791/14]
View answerThe Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to him.
If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
134. Deputy Finian McGrath asked the Minister for Health if he will provide an update on the medical card issue; and if he will make a statement on the matter. [42748/14]
View answerI understand the Deputy is referring to the Keane report - The Report of the Expert Panel on Medical Need for Medical Card Eligibility. Eligibility for health services in Ireland, as set out in the Health Act 1970 as amended, is based primarily on ordinary residence and means. All people ordinarily resident in the State are eligible for publicly-funded hospital services. In addition, about two-fifths of the population are eligible for publicly-funded primary care services.
The Deputy will be aware that the Director-General of the HSE established an Expert Panel to examine and recommend the range of medical conditions that would be considered as a basis of eligibility for health services. The Expert Panel was chaired by Prof Frank Keane, Past President of the Royal College of Surgeons Ireland and Clinical Lead, National Clinical Programme for Surgery. The panel included a range of 23 clinical experts from primary care, specialist services and therapies. It also included a patient representative. The work of the Expert Panel was also informed by on-line public consultation and the convening of a patient representative forum to consider the issues.
The Keane report was received by my Department last month and I am considering its findings. The Keane report acknowledged that eligibility is a complex and challenging issue. It is widely known that the report concluded that it is neither feasible nor desirable to list conditions for medical card eligibility.
This is a very detailed report and when I have finished considering its conclusions, discussed them with the HSE and consulted as necessary with the Minister for Public Expenditure and the Attorney General, I will be reporting to Government on the matter.
135. Deputy Brendan Smith asked the Minister for Health if he will provide in tabular form for the years 2011, 2012 and 2013 for Letterkenny General Hospital, Sligo Regional Hospital and Cavan General Hospital, the number of medical staff per 1,000 inpatient discharges; the number of nursing staff per 1,000 inpatient discharges; the number of agency staff per 1,000 inpatient discharges; the national average in each of the above three categories across all hospitals in each year; and if he will make a statement on the matter. [42779/14]
View answerI have asked the HSE to respond to the Deputy directly on this matter. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
136. Deputy Sean Fleming asked the Minister for Health his plans to deal with spending overruns in his Department; and if he will make a statement on the matter. [42049/14]
View answerThe total net budget for my Department (Vote 38) for 2014 is almost €202m comprising €186m Revenue and €16m Capital. This funding is for the salaries and expenses of the Office of the Minister for Health and certain other services administered by that Office, including grants to research, consultative and advisory bodies. The October Returns, produced five working days after month end, shows net current expenditure for my Department at €15 million under profile. I am confident that my Office will operate within budget and I do not anticipate any expenditure overruns on the Vote.
137. Deputy Billy Kelleher asked the Minister for Health when the 2015 Health Service Executive service plan will be published; and if he will make a statement on the matter. [42772/14]
View answerAs required under legislation (Health Act 2004 as amended), I have written to the Health Service Executive to notify the Executive of its allocation for 2015. I understand that considerable work has already been undertaken by the HSE on the preparation of the 2015 National Service Plan and I expect that the Executive will submit its Plan for my consideration and approval within the next two weeks.
When approved the Plan will be laid before the Houses of the Oireachtas and published within the timeframes set down in the relevant legislation.
It is intended to complete the service planning process as early as possible to facilitate the monitoring of monthly expenditure from the start of next year.
138. Deputy Seán Kyne asked the Minister for Health if his Department provides supports, financial or otherwise, to businesses, employers and community organisations to acquire training in first aid to equip staff or volunteers with first aid skills, particularly CPR and use of defibrillators, which are vital in saving lives in emergency situations and in particular in rural areas where ambulance waiting times are longer by reason of distance; and if he will make a statement on the matter. [42778/14]
View answerMy Department administers a National Lottery Discretionary Fund. From this fund, once-off grants are available to community and voluntary organisations providing a range of health-related services. If an organisation wishes to make an application for funding in 2015, it should submit a formal application. Detailed procedures along with the application form will be available in January 2015 on my Department's website at www.health.gov.ie.
I have asked the Health Service Executive to respond to you directly regarding what assistance it may be able to provide to organisations providing first aid response within the community. If you have not received a reply from the HSE within 15 working days, please contact my Private Office and they will follow up the matter with them.
