Written Answers Nos. 574-591
574. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the details of the 24-7 crisis intervention within specialist mental health services; when this is to be provided; and if he will make a statement on the matter. [49690/14]
View answerAcute mental health services are delivered on a 24/7 basis. A Vision for Change recommends that, as part of community secondary care provision, there should be a crisis house available in each catchment area. A number of mental health services have provided crisis houses as part of their community residential provision and, as the mental health services move away from the provision of low and medium support community residences, opportunities to provide the crisis house model will be explored. In other areas, respite arrangements are in place to address the emergency needs of service users.
As part of the investment in mental health in 2013, 35 posts were identified to provide for the implementation of the Clinical Programme to address self-harm presentations in emergency departments. Currently 23 of these posts are in place and the remainder are in the recruitment process.
The focus continues to be on building the capacity of community mental health teams across Child and Adolescent, General Adult and Psychiatry of Old Age to provide a comprehensive community-based secondary care response. The investment in mental health in 2012 and 2013 meant that almost 900 new mental health professionals are taking their places on community mental health teams and working to introduce the new clinical programmes.
The Suicide Crisis Assessment Nursing Service (SCAN) provides a skilled mental health nursing service to Primary Care that is
- available, accessible and speedy in providing a response to GP requests for a timely assessment of those in suicide/self harm distress
- Carries out a comprehensive (bio-psycho-social) needs and risk assessment of the client within the GP surgery
- Works collaboratively in partnership with the GP (and the wider specialist mental and local community services, as appropriate) to institute a health/social care plan to meet the risk and care needs of the client.
Initially piloted by the National Office for Suicide Prevention (NOSP) in South Dublin Cluain Mhuire Mental Health Services and Wexford Mental Health services, the service is currently under development in Waterford, Donegal, Sligo/Leitrim, Dublin North, Dublin South Central, Cork North, Galway/Roscommon and Laois/Offaly.
The NOSP also funds over 42 services within the statutory and voluntary sector such as Samaritans, Pieta House, Console - many of whom provide direct support to individuals in crisis. In 2014, the Samaritans free-call Connect number 116 123 was launched.
The HSE National Mental Health Division Operational Plan 2015 which was published on 18th December, 2014 identifies specific actions to ensure access to mental health services for individuals accessing community mental health services. This includes building the capacity in 2015 to respond on a 24/7 basis to service users engaged with the community mental health services and, as an initial step, to put in place weekend cover for identified service users of the community mental health services.
575. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the details of recruitment of child and adolescent psychiatrists; figures on waiting lists for CAMHS; and if he will make a statement on the matter. [49691/14]
View answerAs this is a service issue this question has been referred to the HSE for direct response. 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.
576. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the number of children who continue to be admitted to adult psychiatric wards; and if he will make a statement on the matter. [49692/14]
View answerDraft figures for 2014 indicate that there were 89 admissions of children to adult psychiatric units. It is important to note that the number of admissions does not necessarily equate to the number of children admitted, as a child may be admitted on one or more occasions in any given year.
The reduction in the numbers of children admitted to adult psychiatric units has been a focus for the HSE Mental Health Services over recent years. Progress in this area has been significant, as evidenced by the fact that the number of such admissions to adult units in 2008 was 247, and that the number of such admissions has been declining annually since. The issue raised by the Deputy is a key priority action for improvement in the HSE Service Plan for 2015.
577. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the details of the new counselling and primary care service initiated in July 2013; and if he will make a statement on the matter. [49693/14]
View answerThe Counselling in Primary Care (CIPC) initiative is a national service provided under the governance framework of the National Counselling Service (NCS) of the HSE. Short term counselling (up to eight sessions) is provided for adults with non-complex psychological problems aged 18 and over and who hold a valid medical card. Referral into the service is by the person's GP or other member of the Primary Care Team.
The establishment of the CIPC initiative is aimed at providing a more immediate response to wider community for persons in need of counselling and advice. If deemed necessary, persons presenting with more serious crisis issues can be referred on to the appropriate HSE community mental health services.
Most recent figures available from 9 of the 10 CIPC services indicate that between the period January to end September 2014 there were 10,601 referrals to the service, 31,232 sessions were offered with 1,683 individuals in counselling at end September 2014 and approximately 285 days of counselling being offered every day across 143 locations.
578. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the numbers of staff that have been recruited into mental health services since 2011; the actual increase in numbers of positions in view of natural wastage, redundancy and retirement; and if he will make a statement on the matter. [49694/14]
View answerIn 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 provided an additional €90 million and some 1,150 posts for mental health, between 2012 and 2014, comprising €35 million with 416 posts in 2012, €35 million with 477 posts in 2013, and €20 million for the recruitment of approximately 260 posts in 2014. A further €35 million has been provided for 2015, bringing the total allocated to this area by this Government to €125 million. 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 to counselling and psychotherapy in primary care and investment in suicide prevention measures.
As at end November 2014, 397 or 95% of the 2012 posts and 362 or 77% of the 2013 posts have been filled, with a further 4 WTEs with agreed start dates after 30th November 2014. The remainder of the posts are at various stages of recruitment, however there are some difficulties in identifying some outstanding candidates for geographic and qualification reasons.
With regard to the 2014 posts, some 220 posts have been identified following a comprehensive workforce analysis and recruitment of these posts has commenced. Services are targeting recruitment of all posts as early as possible in 2015.
During the period between in question, the number of staff has fluctuated due to departures for various reasons, including redundancy, retirement or staff moving to take up employment elsewhere. At the end of November 2014, the total number of whole time equivalent staff (WTEs) in the HSE Mental Health Services was 8,953. This compares with 9,207 WTEs listed in the HSE National Service Plan at the end of 2011, which represents a net loss of 254 WTEs over the period to end 2014. However, it is important to note that recruitment of posts under the new allocation did not commence until the end of 2012, at which time there were 8,909 WTEs in place. The recruitment of new posts, while challenging in the current environment, has enabled the gradual decline in posts to be arrested, resulting in a slight drop of 3 posts at the end of 2013 (8,906), compared to the end of 2012, but in an increase of 47 WTEs at the end of November 2014 (8,953), compared to start of that year.
The additional funding provided since 2012 is enabling the HSE to recruit staff who are more suited to the development of a community-focussed mental health service and has provided for a required change in the mix of staff, in particular Allied Health Professionals, across Community Mental Health Teams, in line with A Vision for Change. The targeted actions now relate to addressing the skills shortages, largely in nursing and psychology, which are being considered in terms of how we can attract and source these professionals and how incentivised schemes are affecting decisions of experienced staff to leave the service.
The key priorities in the HSE's 2015 National Service Plan include:
- devising a funded Workforce Plan and Workforce Development Strategy to ensure an adequate level of trained and skilled staff;
- developing and implementing a process to maximise the allocation of resources on an equitable basis aligned to population and deprivation, and
- addressing the infrastructure and support deficits for staff to work effectively within their professions.
These priority actions will build on the significant foundational reform of our Mental Health Services, initiated in the HSE NSP 2014, which included initial work on workforce planning, training and development and improved recruitment services.
579. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the progress on provision of high-quality acute inpatient units based at major general hospitals; and if he will make a statement on the matter. [49695/14]
View answerThe HSE national Clinical Strategy and Programmes (CSPD) will commence the development of Integrated Care Programmes (ICPs) in 2015 to provide a framework to substantially improve and standardise patient care across the country. This framework for the management and delivery of health services will ensure that patients and clients receive high quality, evidence based care, delivered in a co-ordinated manner which feels seamless to the user.
The full implementation of these programmes will deliver significant benefits to the care of the acutely ill medical patient within our health care system. The HSE has identified additional resources to support the development of the Acute Medicine Programme in the 2015 National Service Plan. Furthermore, it has provided for an increase in the opening hours of Acute Medical Assessment Units (AMAUs) from five to seven days per week in St. Vincent's University Hospital, Mater Misericordiae University Hospital and Cork University Hospital.
Currently, there are thirty-three hospitals in Ireland with Acute Medical Assessment or Medical Assessment; a list of these is presented below.
Acute Inpatient Units
|
RCSI Hospital Group |
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Beaumont Hospital |
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Cavan General Hospital |
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Connolly Hospital - Blanchardstown |
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Monaghan Hospital |
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Our Lady of Lourdes Hospital Drogheda |
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Saolta Group |
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Galway University Hospitals |
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Mayo General Hospital |
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Letterkenny General Hospital |
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Portiuncula Hospital General & Maternity Ballinasloe |
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Roscommon County Hospital |
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Sligo General Hospital |
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Dublin Midlands |
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St. James's Hospital |
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Tallaght Hospital |
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Naas General Hospital |
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Midland Regional Hospital - Portlaoise |
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Midland Regional Hospital - Tullamore |
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Ireland East Hospital Group |
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Mater Misericordiae University Hospital |
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St. Vincent's University Hospital Elm Park |
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Midland Regional Hospital Mullingar |
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Wexford General Hospital |
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Our Lady's Hospital - Navan |
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St. Luke's Hospital Kilkenny |
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South South West |
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Bantry General Hospital |
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Cork University Hospital |
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Mallow General Hospital |
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South Tipperary General Hospital |
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Kerry General Hospital |
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Mercy University Hospital Cork |
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Waterford Regional Hospital |
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University of Limerick Hospital Group |
|
Nenagh Hospital |
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Ennis Hospital |
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St John's Hospital |
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University Hospital, Limerick |
580. Deputy Sandra McLellan asked the Minister for Health the reason a person (details supplied) in County Cork is not entitled to a medical card; and if he will make a statement on the matter. [49696/14]
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.
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.
581. Deputy Aengus Ó Snodaigh asked the Minister for Health if and when bowel screening will be made available to the over-70s; and the reason persons under 70 are not screened. [49698/14]
View answerBowelScreen, the National Bowel Screening Programme, commenced offering free bowel screening nationwide to men and women aged 60 to 69 years in late 2012. The first round of screening will have been offered to the full cohort in this age group by the end of 2015. The programme is focusing on those aged 60-69 years in the initial phase because this cohort stands to benefit most from bowel screening.
The programme is being implemented on a phased basis and will be expanded over time to the full 55 to 74 years of age target population.
BowelScreen encourages everybody, regardless of age, to become more bowel aware and to contact their GP if they have any concerns.
582. Deputy Billy Kelleher asked the Minister for Health if he will sanction the use of Erivedge in respect of a person (details supplied) in County Cork who cannot afford to pay the cost of this drug and cannot afford to wait until it becomes available through the Health Service Executive; and if he will make a statement on the matter. [49701/14]
View answerDecisions on which medicines are reimbursed by the taxpayer, are not political or ministerial decisions. These are made on objective, scientific and economic grounds by the HSE and often on the advice of the National Centre for Pharmacoeconomics (NCPE).
I understand that the HSE received an application for the inclusion of Erivedge® on the Reimbursement List. The application was considered in line with the procedures and timescales agreed by the Department of Health and the HSE with the NCPE for the assessment of new medicines. In accordance with these procedures, the NCPE conducted a pharmacoeconomic evaluation of Erivedge®. The report is available on the NCPE's website.
As the manufacturer was unable to demonstrate the cost-effectiveness of Erivedge® in the Irish health care setting, the NCPE was unable to recommend reimbursement of the drug under the community drug schemes at the current price.
The NCPE report is an important input to assist decision making and helps inform the next stage of the process which involves further discussions with the manufacturer of the drug, in accordance with the aforementioned procedures agreed with the pharmaceutical industry.
The HSE assessment process is intended to arrive at a decision on the funding of new medicines that is clinically appropriate, fair, consistent and sustainable. As the decision making process is still ongoing it is not possible to comment further.
583. Deputy Finian McGrath asked the Minister for Health if he will support a matter (details supplied) regarding persons with disabilities; and if he will make a statement on the matter. [49706/14]
View answerThe Health Service 'Procedures on Protected Disclosures of Information in the Workplace' were devised to give effect to the legislation on protected disclosures of information as provided for in the Health Act 2004 (as amended by the Health Act 2007). The purpose is to facilitate employees to make protected disclosures in good faith where they have reasonable grounds for believing that the health or welfare of patients, service users or the public may be put at risk, or where there is waste of public funds or legal obligations are not being met, so that the matter can be investigated.
The legislation also provides statutory protection for health service employees from penalisation as a result of making a protected disclosure in good faith in accordance with this procedure.
In this context, I understand that a protected disclosure was raised by two health sector employees in March 2013, with regard to concerns about an organisation that provides services to people with a disability.
As a result of that disclosure, the Health Service Executive (HSE) has been carrying out an investigation into the issues. I understand that the Investigation Team sent a final draft report to the two disclosers in October 2014 on a private and confidential basis in order for them to review it to ensure that there were no factual inaccuracies and to give them an opportunity to provide comment. The report has not yet been finalised.
As the majority of issues raised relate to the investigation of issues raised in a protected disclosure which is not yet complete, it is not appropriate for me to comment further at this point.
584. Deputy Finian McGrath asked the Minister for Health if he will support a matter (details supplied) regarding methadone deaths here; and if he will make a statement on the matter. [49708/14]
View answerThe National Drug Related Deaths index is an epidemiological database administered by the Health Research Board which records cases of death by drug and/or alcohol poisoning and death among drug users and those who are alcohol dependent.
The Health Research Board published a report on the National Drug-Related Deaths Index on 15 December 2014 which shows deaths up to 2012, the latest year for which data is available. These figures indicate that there was a decrease in the number of deaths where methadone was implicated, with 86 such deaths reported in 2012 compared to 118 in 2011. The majority of these deaths (87%) involved poly-substance poisonings. There is clear evidence that having access to drug treatment is one of the main factors in reducing drug-related deaths.
Methadone maintenance treatment is a critical stabilising treatment that enables people to counter their problem drug use. The HSE provides methadone maintenance in a number of treatment settings to meet the needs of individual drug users. According to the European Monitoring Centre for Drugs and Drug Addiction, methadone is the most commonly prescribed substitution treatment for problem opiate use in Europe. In conjunction with other services and supports such as counselling, after-care and training, methadone maintenance treatment provides a pathway to recovery for the individual affected by problem substance use.
The HSE Service Plan for 2015 includes an additional €2.1m for addiction services targeting vulnerable problem drug users. These measures include enhanced provision for residential detoxification and rehabilitation facilities and the mainstreaming of needle exchange facilities outside the Dublin area. This funding will also support a pilot demonstration project by the HSE, which is designed to increase access to naloxone for opioid users. Naloxone is an opioid antagonist which is used to reverse the effects of overdose of opioids such as heroin, morphine and methadone and has been proven to be an effective way of reducing the number of opioid overdose deaths.
585. Deputy Billy Kelleher asked the Minister for Health when a bone marrow transplant consultant will be appointed to Our Lady's Children's Hospital, Crumlin, Dublin 12. [49717/14]
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 my officials will follow the matter up.
586. Deputy Billy Kelleher asked the Minister for Health in view of the recent investigation into abuse in care facilities, if he will provide in tabular form a breakdown of the number of complaints that have been received by the Health Service Executive since 2011 to date in the various regions around the country regarding home care support, regardless of the type: home help, home support, home care package, personal assistants and so on; and if he will make a statement on the matter. [49720/14]
View answerAs 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.
587. Deputy Sean Fleming asked the Minister for Health the number of persons on the waiting list for kidney transplants; the number of transplants that were carried out here in 2014; the hospitals these transplants were carried out in; and the number in each hospital; and if he will make a statement on the matter. [49726/14]
View answerThe national renal transplant team in Beaumont Hospital carry out all the kidney transplants in Ireland. The transplants are carried out by the Beaumont team at two locations - Beaumont Hospital for adults and the Children’s University Hospital, Temple Street for paediatric patients up to the age of 19.
152 kidney transplants took place in Ireland in 2014, 40 of which involved living donors. Of these 133 took place in Beaumont Hospital and 19 were carried out in Temple Street.
The number of potential kidney transplant cases as of 7 January 2015 was 544.
588. Deputy Thomas P. Broughan asked the Minister for Health the actions he is taking to deal with hidden waiting lists; and the up-to-date figures of waiting times for potentially life-saving diagnostic tests and procedures, including MRI scans, X-rays, CT scans and PET scans. [49739/14]
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 my officials will follow the matter up.
589. Deputy Joe Carey asked the Minister for Health when a decision on a medical card application will be reached in respect of a person (details supplied) in County Clare; and if he will make a statement on the matter. [49756/14]
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.
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.
590. Deputy Brendan Griffin asked the Minister for Health if he will initiate a full review of the diagnostic approach to Lyme disease in view of numerous examples of unsatisfactory patient experience; and if he will make a statement on the matter. [49758/14]
View answer591. Deputy Brendan Griffin asked the Minister for Health if he will initiate a public information campaign regarding the causes, symptoms and treatment of Lyme disease; and if he will make a statement on the matter. [49759/14]
View answerI propose to take Questions Nos. 590 and 591 together.
Lyme Disease (also known as Lyme borelliosis) is an infection caused by a spiral-shaped bacterium called Borella burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. The infection is generally mild affecting only the skin, but can occasionally be more severe and highly debilitating. The commonest noticeable evidence of infection is a rash called erythema migrans that is seen in about 80-90% of patients.
Lyme borelliosis is diagnosed by a medical history and physical examination and can be difficult if there has been no erythema migrans rash. The infection is confirmed by blood tests which look for antibodies to B. burgdorferi produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease. The standard approach to Lyme diagnostics is a two-stage approach and involves using a sensitive enzyme immunoassay (EIA) as an initial, screening step. Screening EIA's can be insufficiently specific, giving false-positive reactions in the presence of other spirochaete infections including syphilis, and certain viral infections including glandular fever. In addition, sera from patients with autoimmune disorders and other inflammatory conditions can also lead to false-positive results. Samples giving reactive or equivocal tests in screening tests are further investigated in a second-stage immunoblot (Western blot) tests. Use of immunoblot testing greatly increases specificity. Using this outlined two stage approach will give a great degree of certainty around the diagnosis of Lyme Disease. Testing for Lyme borelliosis is currently undertaken in most of the larger hospitals in Ireland.
There is an ongoing publicity campaign regarding Lyme Disease. The Health Protection Surveillance Centre (HPSC) of the HSE is establishing a Lyme Borelliosis Sub-Committee with the primary aim to examine best practice in prevention and surveillance of Lyme Disease and to develop strategies to undertake primary prevention in order to minimise harm caused by Lyme borelliosis in Ireland. This will involve raising awareness among clinicians and the general public. It will explore ways to ensure these messages are brought to the general public with the frequency and in forms in which they can be most effective.
Each year, as part of its ongoing awareness raising regarding prevention and treatment of Lyme Disease, the HPSC holds a Lyme Disease Awareness Week in which media releases are sent out with the intention that media outlets would take up the important Lyme prevention messages. As part of last year's Awareness Week, a supply of information was made available to the public and attention was drawn to a "Tickborne Disease Toolkit", developed by the European Centre for Disease Control (ECDC). This toolkit was modified for use in Ireland and posted on the HPSC website. Indeed, the ECDC informed the HPSC that Ireland was the first European Member State to make such extensive use of this material. Following the Awareness Week, a 100% increase of web traffic to the various Lyme Disease sections of the HPSC website was noted.
