Written Answers Nos. 139-153
139. Deputy Seán Ó Fearghaíl asked the Minister for Health to set out his plans to address the ongoing delays in accessing the nursing home support scheme; and if he will make a statement on the matter. [42768/14]
View answerI am aware that waiting times on the Nursing Homes Support Scheme placement list are now at around 15 weeks. This is a matter of concern for me, and my Department and the HSE are working to ensure that the resources that are available deliver the best possible outcomes for older people. This will require an integrated approach across community, residential and other service areas.
The HSE controls the release of funding to manage the funds that are available across the course of the year. Funding is released to approved applicants according to their place, in order of their approval date, on the national placement list. Over the course of the year to date, demand has exceeded what could be funded and the national placement list has grown as a result.
In July this year, the HSE allocated €5 million for an initiative to improve access to appropriate care for older people. To date, this has funded over 300 transitional care beds for patients in acute hospitals from the placement list for the Nursing Homes Support Scheme and over 200 home care packages to assist patients in the acute hospitals who require a home care package to be discharged.
The Government has provided additional funding of €25 million in 2015 to address delayed discharges. This funding will be targeted at hospital and community services which can demonstrate initiatives to address the specific needs of delayed discharge patients most positively and, therefore improve timelines for admissions from Emergency Departments and waiting lists. These will include measures to place patients in more appropriate settings through the use of home care packages and intermediate and long-term care.
The Review of the Nursing Homes Support Scheme which is currently underway will consider the future funding and sustainability of the Scheme as well as how community and residential services are balanced. This Review will be completed in the coming months.
140. Deputy Joan Collins asked the Minister for Health to set down the current location of the medical records, including the birth registers and the maternity theatre registers, for each year from 1950 to 1971, inclusive, relating to maternity and obstetric services formerly provided at St. Kevin's Hospital under arrangements pursuant to maternity services legislation; and if he will make a statement on the matter. [42763/14]
View answerAs the Deputy may be aware, St. James’s Hospital was established in 1971 having formerly been known as St. Kevin’s Hospital. The HSE has advised me that associated maternity records are contained on microfilm in an off-site facility. The HSE has further advised that birth registers which include theatre registers for the years 1950 to 1970 are held by St. James's Hospital with the exception of a 6 month period from May 19th 1965 to December 31st 1965. Unfortunately neither the hospital nor the HSE can provide an explanation as to why registers were not completed during that period.
141. Deputy Robert Troy asked the Minister for Health to explain the way the Health Service Executive will address the funding needs for services for persons with disabilities in Longford-Westmeath, with specific reference to St. Christopher’s Services, Longford and St. Hilda's, Athlone, County Westmeath. [42776/14]
View answerSt. Christopher’s and St. Hilda’s Services are funded under Section 39 of the Health Act and are expected to receive over €8.24m and €4.1m respectively from the HSE in 2014.
St. Christopher's and St. Hilda's are responsible for the management of their resources within their allocated funding. The HSE has been notified by St. Christopher’s of its financial difficulty, particularly in relation to services at Marion Avenue, Ballymahon and Morlea House, Longford. The HSE is working closely with the Board of Directors of St. Christopher’s to assist them in finding efficiencies within their service and a number of measures to reduce their funding deficit have been proposed and meetings are ongoing in this regard.
The HSE has informed me that its priority is to support those adults and children and their families who rely on disability services provided by St. Christopher's and St. Hilda's in the Longford/Westmeath area, and to ensure that a sustainable service will be in place for the future.
In relation to the specific queries raised by the Deputy, as these are service issues, they have been referred to the HSE for direct reply.
If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and they will follow up the matter with the HSE.
142. Deputy John Halligan asked the Minister for Health to set out his views regarding the alarming figures that show an escalation in fair deal waiting lists since the fair deal budget was cut earlier this year; his views on whether the waiting lists for financial approval have increased by 25% since July 2014 compared with 2007; if he will resolve this financial crisis and further commit to providing additional staffing assistance to deal with the backlog that has been created; his views on whether four months is an unacceptable waiting period for the elderly in our communities who are desperately seeking accommodation under the scheme; and if he will make a statement on the matter. [40165/14]
View answerI am aware that waiting times on the Nursing Homes Support Scheme placement list are now at around 15 weeks. This is a matter of concern for me, and my Department and the HSE are working to ensure that the resources that are available deliver the best possible outcomes for older people. This will require an integrated approach across community, residential and other service areas.
The HSE controls the release of funding to manage the funds that are available across the course of the year. Funding is released to approved applicants according to their place, in order of their approval date, on the national placement list. Over the course of the year to date, demand has exceeded what could be funded and the national placement list has grown as a result.
In July this year, the HSE allocated €5 million for an initiative to improve access to appropriate care for older people. To date, this has funded over 300 transitional care beds for patients in acute hospitals from the placement list for the Nursing Homes Support Scheme and over 200 home care packages to assist patients in the acute hospitals who require a home care package to be discharged.
The Government has provided additional funding of €25 million in 2015 to address delayed discharges. This funding will be targeted at hospital and community services which can demonstrate initiatives to address the specific needs of delayed discharge patients most positively and, therefore improve timelines for admissions from Emergency Departments and waiting lists. These will include measures to place patients in more appropriate settings through the use of home care packages and intermediate and long-term care.
The Review of the Nursing Homes Support Scheme which is currently underway will consider the future funding and sustainability of the Scheme as well as how community and residential services are balanced. This Review will be completed in the coming months.
143. Deputy Terence Flanagan asked the Minister for Health if he will provide an update regarding the review of emergency ambulance services in Dublin city; and if he will make a statement on the matter. [42753/14]
View answerAmbulance services in Dublin are provided by Dublin Fire Brigade (DFB) on behalf of the HSE. DFB has 12 emergency ambulances, 11 of which are funded by the HSE at a cost of €9.3 m per annum. They are crewed by paramedic-qualified firefighters. The National Ambulance Service (NAS) provides some emergency capacity in the Dublin area, as well as non-emergency transport.
The Dublin City Manager and the HSE's Chief Operating Officer commissioned an independent review of DFB ambulance services. This review is examining all aspects of DFB ambulance operations earlier this year. The purpose of the review is to determine the best model of ambulance provision for the city, including the coordination of Dublin’s emergency ambulance services with national provision under the NAS’s single national control and dispatch system, due to commence operating in 2015.
The DFB review is being conducted in parallel with the HIQA review of the NAS and the NAS capacity review. In consultation with Dublin City Council, the time scales for completing the review have been revised, to allow the outcome of the NAS capacity review to inform the recommendations of the DFB review. I am advised the DFB review is now expected to be completed in the New Year.
These reviews will allow us to identify the best way to enable our emergency ambulance services to meet the challenges of the future. I look forward to the recommendations of all three reviews, which will help us to ensure that we provide a service capable of delivering the best possible outcomes for the public.
144. Deputy Pat Deering asked the Minister for Health if he will provide a report on the new children's hospital. [42737/14]
View answerThe National Paediatric Hospital Development Board is the statutory body responsible for planning, designing, building and equipping the new children's hospital. The new hospital will be co-located with St James's Hospital, and ultimately tri-located with a maternity hospital to be developed on campus. In addition to the main hospital, the project includes two satellite centres at the campuses of Tallaght and Connolly Hospitals.
The Project Brief has now been completed and approved. The Project Brief sets out details of the specialties to be provided and the planned accommodation. This will include 384 in-patient beds, all in single en-suite rooms with in-room parent accommodation, a further 85 daycare beds and 14 theatres, including three hybrid theatres to facilitate access to imaging during surgery, all in the main hospital. There will be 111 outpatient consulting examination rooms across both the main hospital and the two satellite centres, as well as ED and urgent care facilities.
A design team has been procured and is working on detailed design development, with the aim of submitting a planning application in June 2015. Subject to planning, work will commence at the main site at St. James's, and at satellite centre sites at Connolly and Tallaght, in January 2016.
145. Deputy Clare Daly asked the Minister for Health to set out his views regarding his proposed redress scheme for the survivors of symphysiotomy. [42795/14]
View answerI am pleased to announce that the Surgical Symphysiotomy Payment Scheme commenced yesterday, 10th November 2014. Government has agreed that the Scheme will also include payments for the small number of women who have had a pubiotomy. The Scheme is designed to be simple, straightforward and non-adversarial, and aims to minimise the stress for the women concerned. Many are elderly and may not want to experience the delay, publicity and financial risks that sometimes come with a court case. I met all three support groups representing the women last September and their views have helped to shape the Scheme.
Judge Maureen Harding Clark, a retired High Court Judge, will undertake the role of independent Assessor to the Scheme. Judge Clark, from her previous work on the Lourdes Hospital Redress Scheme, brings valuable experience to the role of determining the appropriate level of award for each individual.
The Symphysiotomy Scheme is open to women who are still living and who underwent a surgical symphysiotomy or pubiotomy in the State between the years 1940 and 1990. Awards of €50,000, €100,000 and €150,000 will be offered. Women who have had a surgical symphysiotomy may accept an award of €50,000. For women who have had a symphysiotomy and have suffered significant disability a higher award of €100,000 will be offered. Where a woman has had a symphysiotomy immediately following Caesarean section an award of €100,000 will be offered and where she has suffered significant disability following these procedures €150,000 will be offered. For a woman who underwent a pubiotomy an award of €100,000 will be offered and for women who have suffered significant disability following this procedure, €150,000 will be offered. Details of the Terms of the Scheme and how to access application forms have been widely advertised.
Awards will be exempt from tax and legislation is being put in place as a matter of urgency to ensure they are also exempt from being taken into consideration for means tested welfare schemes. The Judge expects to make payments to some women before Christmas.
It is not a requirement for a woman to retain a Solicitor to make an application. However, the Scheme makes provision for applicants to have legal and other advice available to them in preparing to submit an application if they wish. Judge Clark has assured me that if women have questions on any aspect of the Scheme, her staff will be available to assist in any way possible.
I would like to emphasise that women will not waive their rights to take their cases to court as a precondition to participating in the Scheme. Women may opt out of the Scheme at any stage in the process, up to the time of accepting their award. It is only on accepting the offer of an award that a woman must agree to discontinue her legal proceedings against any party arising out of a symphysiotomy or pubiotomy.
Applications must be made within 20 working days of the Commencement Date. The Closing Date for receipt of applications is therefore Friday 5 December 2014. In exceptional circumstances, Judge Clark has discretion to extend the time for receipt of applications by an additional 20 working days, that is, to Wednesday, 14 January 2015.
I hope the implementation of this Scheme will be of benefit to the women concerned and their families.
146. Deputy Dara Calleary asked the Minister for Health to set out his views on whether the off-trade market for the sale of alcohol is being distorted by anti-competitive practices; if he is considering new regulations to prevent below-cost selling of alcohol; and if he will make a statement on the matter. [39378/14]
View answerAddressing the price of alcohol is an important component of any long-term strategic approach to tackling alcohol misuse. There is a link between consumption and harm and evidence that affordability is one of the drivers of increased consumption. The Government has approved an extensive package of measures to deal with alcohol misuse, to be incorporated in a Public Health (Alcohol) Bill, including minimum unit pricing.
The Government has decided that minimum unit pricing is the most effective policy measure to deal with the sale of alcohol at cheap prices. Minimum unit pricing is a mechanism of imposing a statutory floor in price levels per gram of alcohol that must be legally observed by retailers in both the on and off trade sector. This is a targeted measure, designed to prevent the sale of alcohol at very cheap prices. It is mainly aimed at those who are higher risk, such as adolescents and people who have a harmful and hazardous alcohol consumption pattern. It should therefore only have a marginal effect on moderate drinkers. It is not expected that minimum unit pricing will affect the price of alcohol in the on-trade sector or the majority of alcohol products sold in the off-trade sector.
Work on developing a framework for the necessary Department of Health legislation is continuing and it is hoped to publish a General Scheme of a Bill shortly.
147. Deputy Colm Keaveney asked the Minister for Health to set out the position regarding the continuing practice of admitting children to adult mental health units; the child welfare issues arising from the practice; the rights to education of children admitted to such units; and if he will make a statement on the matter. [42764/14]
View answerOver the period January to September 2014, there were 211 child and adolescent admissions to mental health inpatient units of which 69 were to approved adult in-patient units. The majority were voluntary admissions with parental consent, and most of these admissions were aged 16 to 17 years. A third were discharged within two days and the remainder within a week of admission. Admissions to adult inpatient units take place only in a situation of extreme urgency or in a crisis situation. Admissions would arise where no adolescent bed is immediately available, or where the requirement for immediate assessment and treatment may justify this, and where the nearest suitable and available Child and Adolescent Mental Health Services (CAMHS) in-patient unit is a considerable distance away. In individual cases, the presenting needs of the young person who may be nearly eighteen would be a factor in terms of assessment or admission.
There are currently 46 child and adolescent beds operational nationally - 14 in Dublin, 12 in Cork and 20 in Galway, with more planned. Difficulties in recruiting Consultant Psychiatrists have impacted on bed availability in recent months in both Cork and Dublin, resulting in a reduction from 56 beds to the current 46. However, a further 10 beds are due to open in Dublin over the coming weeks.
If there is no public bed available and a bed is required, private in-patient beds are purchased by the HSE in either St. Patrick's or St John of Gods.
In regard to the specific education and welfare issues raised by the Deputy, in the first instance these are the statutory operational responsibility of the HSE, and have been referred to the Executive for direct reply. If he has not received a reply from the HSE within 15 working days, I would ask him to please contact my Private Office and they will follow up the matter with them.
148. Deputy Caoimhghín Ó Caoláin asked the Minister for Health to set out the membership and commencement date of the second investigation into the tragic outcome at Cavan General Hospital maternity unit in November 2012; the terms of reference that will apply; and if he will make a statement on the matter. [42760/14]
View answerMy Department is aware of the High Court Order in respect of a HSE Report of an investigation into an incident at Cavan General Hospital in November 2012. I understand that it is the intention of the HSE to undertake a further investigation and I have asked the HSE to write directly to you to provide you with the information you have requested. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow up on the matter.
149. Deputy Thomas P. Broughan asked the Minister for Health to outline the actions being taken by his Department in conjunction with the Health Service Executive to ensure community mental health teams and inpatient psychiatric services are fully staffed, particularly in the Dublin north-east region, where there have been crises in recent months with the lack of inpatient capacity. [42728/14]
View answerThis Government has prioritised the reform of our mental health services in line with A Vision for Change and is committed in particular to the delivery of more and better quality care in the community. Additional funding totalling €90 million and some 1,100 new posts have been provided as part of the 2012, 2013 and 2014 Budgets, with a further €35 million to be provided next year.
Subject to approval by senior managers, 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. In addition, the HSE continues to fill a significant number of development posts in line with service priorities identified by Government.
To date, the appointment of new staff to Community Mental Health Teams has been slower than we would have liked and was due to a number of factors, including budgetary pressures within the HSE and the need to establish the type and number of posts required by each Community Mental Health Team. In addition, there were a number of posts for which there were difficulties in identifying suitable candidates due to factors including availability of qualified candidates and geographic location. To help address these issues, the HSE Service Plan 2014 committed to the streamlining of the recruitment process to allow for more local control and specialisation in respect of future appointments. In addition a comprehensive workforce analysis was carried out, together with priorities identified by Area Mental Health Management Teams, to inform decisions as to how best to target the 2014 investment posts.
In relation to the particular staffing issue in Dublin North East, as this is a service issue this question has been referred to the HSE for direct reply to the Deputy. 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 the Executive.
150. Deputy Billy Kelleher asked the Minister for Health to set out his plans to address the ongoing delays in accessing the fair deal scheme; and if he will make a statement on the matter. [42770/14]
View answerI am aware that waiting times on the Nursing Homes Support Scheme placement list are now at around 15 weeks. This is a matter of concern for me, and my Department and the HSE are working to ensure that the resources that are available deliver the best possible outcomes for older people. This will require an integrated approach across community, residential and other service areas.
The HSE controls the release of funding to manage the funds that are available across the course of the year. Funding is released to approved applicants according to their place, in order of their approval date, on the national placement list. Over the course of the year to date, demand has exceeded what could be funded and the national placement list has grown as a result.
In July this year, the HSE allocated €5 million for an initiative to improve access to appropriate care for older people. To date, this has funded over 300 transitional care beds for patients in acute hospitals from the placement list for the Nursing Homes Support Scheme and over 200 home care packages to assist patients in the acute hospitals who require a home care package to be discharged.
The Government has provided additional funding of €25 million in 2015 to address delayed discharges. This funding will be targeted at hospital and community services which can demonstrate initiatives to address the specific needs of delayed discharge patients most positively and, therefore improve timelines for admissions from Emergency Departments and waiting lists. These will include measures to place patients in more appropriate settings through the use of home care packages and intermediate and long-term care.
The Review of the Nursing Homes Support Scheme which is currently underway will consider the future funding and sustainability of the Scheme as well as how community and residential services are balanced. This Review will be completed in the coming months.
151. Deputy Regina Doherty asked the Minister for Health to set out his plans to address the issue of delayed discharge; and if he will make a statement on the matter. [42730/14]
View answerThere has been a continuing upward trend in delayed discharges since the beginning of the year. "Delayed Discharges" arise when patients in acute hospitals have finished the acute stage of their treatment but require alternative arrangements to facilitate their discharge. The occupancy of in-patient acute hospital beds by patients who no longer require acute care also has a significant impact on people awaiting emergency or other in-patient or day case treatment.
While there will always be delayed discharges, current levels are resulting in more people on trolleys and more people having their elective admissions or surgery cancelled. As at 4th November 2014, there were 785 Delayed Discharges in acute hospitals nationally, 437 being in the Dublin Academic Teaching Hospitals. The occupancy of in-patient acute hospital beds by patients who no longer require acute care has a significant impact on others awaiting emergency or other in-patient or day case treatment.
The Government has provided additional funding of €25 million in 2015 to address delayed discharges. This funding will be targeted at hospital and community services which can demonstrate initiatives to address the specific needs of delayed discharge patients most positively, and therefore improve timelines for admissions from Emergency Departments and waiting lists. These will include measures to place patients in more appropriate settings through the use of home care packages and intermediate and long-term care. It will include provision for an increased allocation to the Nursing Homes Support Scheme. Planning for this initiative is well advanced. Details will be finalised in the HSE's Service Plan later this month, with a view to their early implementation.
152. Deputy Richard Boyd Barrett asked the Minister for Health further to Parliamentary Question No. 111 of 30 September 2014 if he will report on the multidisciplinary group established to progress the project to improve access to inpatient child and adolescent mental health service beds for children and adolescents in mental health services and, in particular, to ask if the aim of having 58 beds by year end is still a target, as well as his views on whether this is a sufficient number of beds for this service; and if he will make a statement on the matter. [42792/14]
View answerAs this is a service issue this question has been referred to the HSE for direct reply. 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.
153. Deputy Peadar Tóibín asked the Taoiseach if he will provide in tabular form the annual number of new jobs created in the social enterprise sector from 2010 to date in 2014 in each of the Dublin postcodes and in County Dublin. [42905/14]
View answerThe exact information requested by the Deputy is not available.
The Quarterly National Household Survey (QNHS) is the official source of estimates of employment, unemployment and the labour force in the State.
The CSO's statistics on employment do not provide information at the level of detail requested by the Deputy (i.e. details of social enterprise or of postcode areas). The latest figures available from the QNHS are for Quarter 2 of 2014.
The following table 1a shows the number of persons employed, unemployed and in the labour force in the Dublin NUTS3 region in quarter 2 of each year from 2010 to 2014. Regional data is based on the location of the respondent's usual address. Table 1b shows the annual change in these numbers. As Table 1a shows the overall stock of persons employed at given points in time, the annual changes which are calculated using these stock figures measure the number of extra jobs year-on-year. The number of new jobs created will, in general, be larger than this but they are offset in part by the number of jobs lost year-on-year. The QNHS does not record whether a job is newly created.
Table 1a Persons aged 15 years and over in employment, unemployment and in the labour force in the Dublin NUTS3 region Q2 2010 - Q2 2014
'000
|
- |
Q2 10 |
Q2 11 |
Q2 12 |
Q2 13 |
Q2 14 |
|
In employment |
562.1 |
555.2 |
547.4 |
555.1 |
576.4 |
|
Unemployed |
74.8 |
77.9 |
76.9 |
75.4 |
64.1 |
|
In labour force |
636.9 |
633.1 |
624.3 |
630.5 |
640.5 |
Table 1b Persons aged 15 years and over in employment, unemployment and in the labour force in the Dublin NUTS3 region Q2 2011 - Q2 2014 - Annual Change
'000
|
- |
Q2 11 |
Q2 12 |
Q2 13 |
Q2 14 |
|
In employment |
-6.9 |
-7.8 |
7.7 |
21.3 |
|
Unemployed |
3.1 |
-1.0 |
-1.5 |
-11.3 |
|
In labour force |
-3.8 |
-8.8 |
6.2 |
10.0 |
Data may be subject to sampling or other survey errors, which are greater in respect of smaller values or estimates of change.
Source: Quarterly National Household Survey, Central Statistics Office.
