Peadar Tóibín
Question:556. Deputy Peadar Tóibín asked the Minister for Health the mechanism being used to appoint each of the members of the new hospital group boards. [49604/14]
View answerHospital Groups
Questions (556, 557)
Peadar Tóibín
Question:557. Deputy Peadar Tóibín asked the Minister for Health his views that the Ireland East hospital group board will have a member appointed to it who has detailed and hands-on knowledge of Our Lady’s Hospital, Navan, County Meath. [49605/14]
View answerWritten answers
I propose to take Questions Nos. 556 and 557 together.
The Hospital Group Boards, which are being established on an administrative basis, will be required to oversee the effective planning, management and implementation of the integration of services across the Group to achieve an optimum, cohesive, high quality and safe service provision. They will also need to establish a process to oversee the development of relationships with all key stakeholders including the academic partners of the group, primary, community and social care providers, local patient representative groups, research institutes, research funding agencies and professional bodies. Given the scale of the change process involved, the Boards must be populated with individuals with the expertise and competencies necessary to deliver on the strategic agenda. The composition of the Hospital Group Boards, is based on the governance recommendations the HIQA Tallaght Hospital Investigation Report (HIQA, 2012) and the Report on Hospital Groups (DoH, 2013). These reports recommended that the Boards should be competency based and comprised of expertise in at least, but not limited to, the following domains: Clinical; Business; Social; Legal; Medical Academic; Patient Advocacy.
My Department, in consultation with the HSE and HIQA, has developed a competency framework to be used in selecting suitable Board members in consultation with the Hospital Group Chairs. Group Board members, including the Ireland East Hospital Group Board, will be selected on the basis of having the necessary competencies to enable them to contribute to and challenge the performance of the hospital groups.
HSE Investigations
Questions (558)
Thomas P. Broughan
Question:558. Deputy Thomas P. Broughan asked the Minister for Health if he will order a public inquiry into the revelations broadcast on RTE (details supplied). [49616/14]
View answerWritten answers
The HSE’s immediate priority since situation arose has been to ensure a safe and caring home for the individuals that reside in Áras Attracta with ongoing communication and meetings with families of the residents involved.
A Garda investigation into allegations of abuse at the centre is ongoing and the Gardaí had requested that a stay be placed on HSE investigations until such time as the Garda investigation is completed. However, the HSE has informed me that Gardaí have now cleared the way for the investigation to commence.
The investigation team is working independently of the HSE and is chaired by Mr Christy Lynch. This process is necessary as it will form an important input into any disciplinary process which the HSE will undertake.
The second process established by the HSE is an assurance review and chaired by Dr Kevin McCoy. This review has two purposes:
- An Assurance review of the services at Áras Attracta. The final report will include an individual plan for improvement in each bungalow within the complex.
- Secondly the review will identify system wide learning and will involve engagement with academia as well as input from staff. Importantly Dr. McCoy will particularly focus on involvement of families and their representatives and will begin meetings with families and other stakeholders.
It is important that these processes should be allowed to complete their work. The matter will be monitored closely by the Department of Health on an ongoing basis.
Drug Treatment Programmes
Questions (559, 560)
Thomas P. Broughan
Question:559. Deputy Thomas P. Broughan asked the Minister for Health the agency or body which has responsibility for calibrating the commercial methadone pumps which are used by pharmacies to dispense methadone; and if there is an operating procedure in his Department to invigilate and determine the standard of methadone pumps used in pharmacies. [49617/14]
View answerThomas P. Broughan
Question:560. Deputy Thomas P. Broughan asked the Minister for Health if his attention has been drawn to discrepancies between the amount of methadone supplied by manufacturers or distributors to dispensing pharmacies and other methadone outlets; the amount of methadone prescribed to persons in receipt of opioid substitute treatment; if there is a record of any excess of methadone which is supplied to pharmacies and other methadone outlets by manufacturers or distributors but is not prescribed to persons in receipt of opioid substitute treatment. [49618/14]
View answerWritten answers
I propose to take Questions Nos. 559 and 560 together.
The Pharmaceutical Society of Ireland (PSI) is the statutory body responsible for the regulation of the practice and profession of pharmacists in Ireland. PSI Guidelines on the Equipment Requirements of a Retail Pharmacy Business issued in draft form in 2012 and will be published in the PSI January 2015 Newsletter. These advise pharmacy practitioners that, “A high standard of equipment maintenance and cleanliness must be consistently applied. Equipment should be maintained, serviced and calibrated in accordance with the manufacturers’ instructions and records of such service and calibration should be kept.”
Currently within the HSE Addiction Treatment Centres the pumps that are used are calibrated by the company contracted to provide methadone to the services. The pumps are calibrated every six months to ISO standards by an external calibration agency. Each of the centres has Standard Operating Procedures for calibration and maintenance of the pumps.
In community pharmacy, pumps are not universally used for the measurement of methadone. Many community pharmacies use CE marked graduated cylinders in general and decant from 500 ml bottles, with the exception of some high volume dispensaries that may use a pump system.
The Misuse of Drugs Regulations 1988 (S.I. No 328 of 1988) requires pharmacies to maintain a Controlled Drugs (CD) Register in respect of all drugs, including methadone, listed in Schedule 2, with a running balance. Inspections are carried out by the PSI, under Section 67 of the Pharmacy Act 2007. The sale and supply of all Schedule 2 controlled drugs and the manner in which the CD Register is maintained are checked as part of these inspections. The register is reviewed to see if running balances are properly maintained.
Manufacturers’ bottles of methadone liquid contain a small ‘overage’ in some cases. The volume declared would be the nominal volume. In other words, if the label states 500 ml then at least 500 ml must be available for administration. That is the standard for medicines, and this means that a slight excess is included to allow the correct volume to be withdrawn. There is no upper limit in the pharmacopoeias (standards).
The extra liquid can result in a pharmacy having more methadone than expected in certain circumstances, and this should be accounted for through the regular balance checks and reconciliation. To assist pharmacists in maintaining the CD register for methadone products, PSI Inspectors have provided advice that is now available on the PSI website - www.thepsi.ie/. This advice states that the CD register must be regularly reviewed to ensure the pharmacist can satisfy themselves that the register has been completed correctly for all controlled drugs, including methadone. Excess methadone is always accounted for with the CD register per the guidance that has been issued to account for ‘overage’.
If there is excess stock compared to the expected balance and the pharmacist is satisfied that this is due to ‘overage’ from manufacturers’ bottles, the running balance may be adjusted to reflect the current stock level. This entry should be signed by the pharmacist and annotated to show that the adjustment is the result of ‘overage' and their calculations documented in the CD register.
The latest figures available show that a total quantity of 142,119,673 mls of methadone was dispensed through community pharmacies in 2013 for palliative care and for the treatment of opiate dependency. The total quantity of methadone dispensed through the HSE addiction centres for the treatment of opioid dependency was 73,530,249 mls of methadone.
Health Services Provision
Questions (561)
Pat Deering
Question:561. Deputy Pat Deering asked the Minister for Health when a person (details supplied) in County Carlow will receive her physiotherapy. [49629/14]
View answerWritten answers
As this is a service matter, it has been referred to the Health Service Executive (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 it will follow up the matter with it.
Maternity Services Provision
Questions (562)
Joe Carey
Question:562. Deputy Joe Carey asked the Minister for Health the current location of the medical records, including the birth registers and the maternity theatre registers, for each year from 1950 to 1989, inclusive, relating to maternity and obstetric services formerly provided at Tullamore hospital, County Offaly, under arrangements pursuant to maternity services legislation; and if he will make a statement on the matter. [49637/14]
View answerWritten answers
As 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 my officials will follow the matter up.
Hospital Waiting Lists
Questions (563, 564, 565)
Joan Collins
Question:563. Deputy Joan Collins asked the Minister for Health if he will confirm of the 79 patients waiting more than nine months for various procedures including spinal assessment, cast change, full spinal surgery, insertion of growing rods and lengthening of growing rods, the number who have undergone their procedures; and the number of the 103 patients waiting more than six months who have had their procedures. [49645/14]
View answerJoan Collins
Question:564. Deputy Joan Collins asked the Minister for Health the number of the 31 patients who had planned dates, as of 20 November 2014, for procedures including spinal assessment, cast change, full spinal surgery, and insertion of growing and lengthening rods, who have had their procedures. [49646/14]
View answerJoan Collins
Question:565. Deputy Joan Collins asked the Minister for Health the number of spinal cases, that is, scoliosis it has been agreed to carry out in Our Lady's Children's Hospital, Dublin 12 as part of its service level agreement for 2015; and if the agreed SLA includes patients waiting more than nine and six months as of 20 November 2014. [49647/14]
View answerWritten answers
I propose to take Questions Nos. 563 to 565, inclusive, together.
Scoliosis in children and young people is predominantly managed at Our Lady’s Children’s Hospital, Crumlin (OLCHC). I am advised that at the end of last year, there were over 160 children in total waiting for spinal procedures. 104 children were waiting longer than 20 weeks and, of these, 51 were waiting longer than a year. It is acknowledged by all that these waiting times are unacceptable and the Children's Hospital Group, OLCHC and the HSE are actively working to address them as quickly as possible and exploring all short, medium and long-term options to increase capacity. I am pleased to say that funding has been allocated in the 2015 Service Plan to facilitate the appointment of an orthopaedic surgeon, anaesthetist and support staff to maximise utilisation of available theatre sessions in OLCHC.
In regard to the specific questions raised, as these are service matters I have asked the HSE to respond directly to you. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
Disability Services Provision
Questions (566)
Fergus O'Dowd
Question:566. Deputy Fergus O'Dowd asked the Minister for Health if he will instruct that the Health Service Executive will ensure that the service level agreements signed with disability providers for 2015 will allocate 5% to 8% of their block grant to individualised, person-centered, community-based models of support; and if he will make a statement on the matter. [49657/14]
View answerWritten answers
In line with Government policy, disability providers are delivering an increasing proportion of services and supports which are individualised, person-centred and community-based from the block grants allocated to them by the HSE. The HSE is actively working with disability providers towards the migration of more services in 2015 to this person-centred supports model.
The Government’s policy is this area is set out in the Report of the Value for Money and Policy Review of Disability Services in Ireland (VFM Review), which recommends migration from an approach which is predominantly organised around group-based service delivery towards a model of person-centred and individually chosen community-based supports underpinned by a more effective method of assessing need, allocating resources and monitoring resource use.
The implementation of the recommendations in the VFM Review has been given priority in the HSE’s National Service Plan for 2015. A number of HSE working groups established to support the reform process will continue their work during 2015 on a range of inter-connected and challenging projects which will support and drive the move to a more personalised and socially inclusive service.
Key priorities for the HSE in 2015 which will progress the move towards greater individualisation of service delivery include:
- Progress on the reconfiguration of residential services, which will support people to move from institutional settings to the community in line with their person-centred plans and in full consultation with the individuals and their families;
- Provision of new day services and supports to approximately 1,400 young people with continuing support needs who are due to leave school and rehabilitative (life-skills) programmes in 2015 and measures to ensure that these new placements are individualised and person-centred. €6m additional funding has been allocated in 2015 (at a full year cost of €12m) for these new placements;
- Progress on the reconfiguration of adult day services towards a model of person-centred supports.
Long-Term Illness Scheme Applications
Questions (567)
Willie O'Dea
Question:567. Deputy Willie O'Dea asked the Minister for Health when a person (details supplied) in County Limerick will receive back payment for ADHD medication as applied for under the long-term illness scheme; and if he will make a statement on the matter. [49663/14]
View answerWritten answers
Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the primary care schemes, including the Long Term Illness Scheme, therefore the matter has been referred to the HSE for attention and direct reply to you. 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.
Health Services Provision
Questions (568)
Sandra McLellan
Question:568. Deputy Sandra McLellan asked the Minister for Health if he will ensure that a child (details supplied) in County Cavan receives the therapies that he urgently requires without further delay; and if he will make a statement on the matter. [49669/14]
View answerWritten answers
As the particular issue raised by the Deputy relates to an individual case, this is a service matter for the Health Service Executive. Accordingly, I have arranged for the question to be 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 them.
Home Help Service Provision
Questions (569)
Aengus Ó Snodaigh
Question:569. Deputy Aengus Ó Snodaigh asked the Minister for Health if he will increase home care hours from 90 minutes a day to three hours a day in respect of a person (details supplied) in Dublin 10. [49672/14]
View answerWritten answers
As this is a service matter it has been referred to the Health Service Executive 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.
General Medical Services Scheme Administration
Questions (570)
James Bannon
Question:570. Deputy James Bannon asked the Minister for Health the position in respect of a person (details supplied) in County Longford; and if he will make a statement on the matter. [49678/14]
View answerWritten answers
The 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.
If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them.
Departmental Correspondence
Questions (571)
Finian McGrath
Question:571. Deputy Finian McGrath asked the Minister for Health his views on correspondence (details supplied) regarding issues raised by persons with intellectual disabilities; and if he will make a statement on the matter. [49680/14]
View answerWritten answers
I note that the issues in question were raised by people with intellectual disabilities at a workshop on how the Irish Government works, run by the National Anti-Bullying Advocacy Group in the National Institute for Intellectual Disability at Trinity College. I want to commend the participants for taking the time to discuss this very important topic and for summarising their views for me. I would like to assure the participants that I have read their submission very carefully and have taken on board the points made, which are clustered around the following issues:
- the cost of having an intellectual disability in Ireland;
- bullying;
- having more choice and control over services; and
- housing and respite services.
Many of the points made in the correspondence touch on the responsibilities of a number of my colleagues as well as myself, and I will make sure that my colleagues are made aware of these views. This is a time of major change in the delivery of health-funded disability services in this country, as described in the Value for Money and Policy Review of Disability Services in Ireland, and will result in shifting choice and control from professionals and administrators and giving it back to the individual with a disability, and his or her family.
One of the working groups established by the Health Service Executive to drive this change is examining how best to ensure that service users have a meaningful voice and role in service design and delivery – this working group is chaired by the Chief Executive of Inclusion Ireland. Other working groups are addressing issues such as the transformation of day and residential services from services which were mostly delivered in segregated group-based settings into individualised and person-centred services, delivered in the community.
By working in partnership we will achieve maximum independence, choice and inclusion for people with disabilities and we will realize the vision of a more equitable service for everyone, where services and supports will be tailored to meet individual need while at the same time being provided in an accountable and cost effective manner.
Mental Health Services Funding
Questions (572)
Caoimhghín Ó Caoláin
Question:572. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide details of mental health funding including the commitment to €35 million of ring-fenced mental health funding per year since 2011; the amount and length of time the €35 million that was allocated in 2012 and 2013 was delayed; the proportion of the €20 million that was provided for mental health services in 2014 that was spent on these services; and if he will make a statement on the matter. [49688/14]
View answerWritten answers
In line with the Programme for Government, my priority as Minister has been to modernise our mental health services, notwithstanding the severe resource constraints overall in recent years, and to prioritise new resources to underpin implementation of A Vision for Change. In that regard, the Government has provided an additional €125 million and some 1,100 posts for mental health comprising €35m with 416 posts in 2012, €35m with 477 posts in 2013, €20m for the recruitment of approximately 200 - 250 posts in 2014 and a further €35 million in 2015. The funding is being used to continue to strengthen Community Mental Health Teams for both adults and children, to enhance specialist community mental health services for older people with a mental illness, those with an intellectual disability and mental illness, forensic mental health services, and to enhance access counselling and psychotherapy in primary care and investment in suicide prevention measures.
Details of the overall gross non-capital mental health budget are published annually in the Revised Book of Estimates. Based on that information, the table below details the mental health budget for each of the years 2011 - 2014 inclusive:
|
2011 |
2012 |
2013 |
2014 |
|
€712 million |
€711 million |
€737 million |
€766 million |
The estimated provision for mental health in 2015 is €791.8 million.
Budgetary and other pressures within the HSE delayed the full utilisation of the €35 million allocated in both 2012 and 2013. The underspend in planned Mental Health expenditure and the timing of the recruitment of staff developments was also due to the time needed to get various programmes up and running, such as Counselling in Primary Care, Enhanced Teamworking, Mental Health Information System, Clinical Programmes and the opening of additional in-patient beds.
In relation to the €20 million provided in Budget 2014, the HSE National Service Plan provided for the phasing-in of the expenditure, in order for the HSE to live within its overall available resource across its service areas. It was planned that recruitment of 2014 posts would be started in order to provide for posts to come on stream during Quarter 4 and to this end, an amount of €5 million was expected to be spent in 2014 from the 2014 allocation. The HSE has informed me that a detailed analysis took place during 2014 of all 9,000 staff in Mental Health Services to inform the decision making process on the prioritised allocation of approximately 250 new posts. Although full recruitment did not takes place during Quarter 4 2014, the posts appointed required €0.250m with the remainder of the €5 million largely expended on the opening of unfunded but approved capacity in the National Forensic Service in order to provide sufficient extra capacity to meet the requirements of the Criminal Law Insanity Act. This €20 million is also now available to spend in full on mental health services in 2015, along with the new additional funding of €35m provided in Budget 2015.
Health Services Staff Recruitment
Questions (573)
Caoimhghín Ó Caoláin
Question:573. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the number of mental health posts that had been approved in 2012 and still remain unfilled; and if he will make a statement on the matter. [49689/14]
View answerWritten answers
In 2012, a special allocation of €35m and 416 additional posts were provided for mental health to be used primarily to further strengthen Community Mental Health Teams in both adult and children's mental health services, to advance activities in the area of suicide prevention, to initiate the provision of psychological and counselling services in primary care, specifically for people with mental health problems and to facilitate the re-location of mental health service users from institutional care to more independent living arrangements in their communities, in line with A Vision for Change.
The recruitment process for the posts approved in 2012 is near completion with 397 or 95% of the posts filled as at end November 2014. There are, however, a number of posts for which there are difficulties in identifying suitable candidates due to factors including availability of qualified candidates and geographic location. The HSE's National Recruitment Service is currently working to ensure that the remaining posts will be filled as soon as possible, from existing panels or through competition in the absence of panels.