Billy Kelleher
Question:70. Deputy Billy Kelleher asked the Minister for Health his views that the €25 million funding to address delayed discharges is insufficient; and if he will make a statement on the matter. [2393/15]
View answerHospital Accommodation Provision
Questions (70)
Written answers
Delayed discharges arise when a patient has been clinically discharged from an acute hospital but remains in an acute hospital bed, thus rendering that bed unavailable for patients who need admission. In Budget 2015 the Government allocated €25m to tackle the problem of delayed discharges and this additional funding is being applied across residential and community services to reflect the varying needs of patients.
Of this €25m:
- €10m has been allocated to the Nursing Homes Support Scheme which has resulted in 300 extra approvals and shortening the waiting time for approval from 17 weeks to 11 weeks,
- €8m is being used to augment short-term residential care capacity and has provided for 50 additional short stay beds which have been sourced from the private sector. An additional 65 are to come on stream on a phased basis from March 2015,
- €5m is being used for home care services which will provide 400 additional Home Care Packages to benefit 600 discharges across targeted hospitals, and
- €2m is being used to strengthen Community Intervention Teams which to date has facilitated 571 people to be seen in their own home.
The HSE is looking at every possible option for alternative accommodation, including vacant beds in private nursing homes to address delayed discharges. Since January 5th 2015, the HSE has been working to match patients whose acute care has been completed but who require ongoing residential care with suitable placements. This will see a potential movement of 250 patients across the country from acute hospitals to other suitable facilities.
Accident and Emergency Departments
Questions (71)
Joan Collins
Question:71. Deputy Joan Collins asked the Minister for Health his views on the report from the emergency task force on the crises in emergency departments here; the measures that will be put in place to resolve the crises in the short and long term; and if he will make a statement on the matter. [2359/15]
View answerWritten answers
ED overcrowding is a priority issue for me and for the Government and I acknowledge the difficulties which the current surge in ED activity is causing for patients, their families and the staff who are doing their utmost to provide safe, quality care in very challenging circumstances.
I convened the Emergency Department Taskforce last month to develop long term solutions to overcrowding by providing additional focus and momentum in dealing with the challenges presented by the current trolley waits. The Taskforce comprises senior doctors, lead hospital consultants, HSE National Directors, union representatives and senior officials from the HSE Acute Hospitals Directorate and the Department of Health.
The taskforce will provide additional focus and momentum in dealing with the challenges, complementing the ongoing work of the Special Delivery Unit and taking a service-wide approach including social care, primary care and acute care. The aim is to develop effective measures that will achieve sustainable, integrated and effective improvements across all services related to the ED trolley waits. Following a second meeting of the taskforce last week, the HSE is working on an action plan to be finalised by the end of the month to specifically address ED issues with a view to a significant reduction in trolley waits over the course of 2015.
In the interim, all hospitals have escalation plans to manage not only patient flow but also patient safety in a responsive, controlled and planned way that supports and ensures the delivery of optimum patient care. These plans include the opening of additional overflow areas, reopening of closed beds, provision of additional diagnostic scans and Consultants doing additional ward rounds to improve the appropriate flow of patients through the hospital system. The Government has provided additional funding of €3 million in 2014 and €25 million in 2015 to address delayed discharges and actions being taken include the provision of additional home care packages, additional transition beds in nursing homes, 300 additional Fair Deal places and an extension in Community Intervention Teams.
Medical Card Applications
Questions (72)
Robert Dowds
Question:72. Deputy Robert Dowds asked the Minister for Health the position regarding a medical card application in respect of a person (details supplied); and the reason there has been an unacceptable delay in the processing of this application. [2348/15]
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, he should contact my Private Office, who will follow up the matter with the Executive.
Departmental Expenditure
Questions (73)
Lucinda Creighton
Question:73. Deputy Lucinda Creighton asked the Minister for Health if he will provide a detailed outline as to the way the additional €3 million which he allocated to alleviate overcrowding in hospital emergency departments will be spent; and if he will make a statement on the matter. [2341/15]
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.
Medical Card Administration
Questions (74)
Billy Kelleher
Question:74. Deputy Billy Kelleher asked the Minister for Health the progress made with regard to the implementation of medical card proposals announced late in 2014; and if he will make a statement on the matter. [2390/15]
View answerWritten answers
In the light of the conclusions of the Expert Panel on Medical Need and Medical Card Eligibility and the external review of the Medical Card Process, a range of actions have been identified to improve the operation of the medical card system, particularly for people with significant medical needs.
The HSE is putting arrangements in place for a more integrated and sensitive processing of medical card applications involving significant medical conditions to ensure greater interaction between the central office regarding the assessment of a person’s eligibility and the local health office regarding the person’s medical condition and the services that they may require. The HSE has appointed a senior manager to lead the reform of the systems for handling medical card application and reviews.
The HSE is developing a single, integrated process for people to apply for a medical card, a GP visit card, the Long-Term Illness Scheme and the Drugs Payment Scheme. Access points will be established around the country in health offices to support and assist people to make applications.
The HSE is taking steps to establish a clinical advisory group to develop a methodology and guidance for the assessment of applications involving significant medical conditions so as to take account of the burden involved and the needs arising from the condition and to ensure that appropriate services are provided to people who need them.
The Minister and I have asked the HSE to examine, with the Department of Health, the best way to meet the needs of people with significant medical conditions who need the support of the public health system. This work includes considering the best way to make medical aids and appliances available to persons who do not hold a medical card, the provision of services to children with severe disabilities, and to enable people with particular needs to have these met on an individual basis rather than awarding a medical card to all family members.
Services for People with Disabilities
Questions (75)
Caoimhghín Ó Caoláin
Question:75. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the details of the new Health Service Executive guidelines on providing accessible services to patients with disabilities; if a right to health care was considered in these guidelines; if any additional funding will be provided to ensure that these guidelines can be exercised; and if he will make a statement on the matter. [2413/15]
View answerWritten answers
Each member of staff working in health and social care services has a responsibility, relevant to their own role, to ensure that services are accessible to people with disabilities, and that their interactions and communication with people with disabilities are appropriate, respectful, and are delivered in ways that people with disabilities can receive and understand.
The National Guidelines on Accessible Health and Social Care Services were developed to provide practical guidance to all health and social care staff about how they can provide accessible services. While these guidelines refer to specific disabilities, if we take steps to routinely provide accessible services for all, we will positively influence the experience of everybody who uses our services. The guidelines, developed in conjunction with the National Disability Authority, will help all staff to build on their existing knowledge and to recognise that people with disabilities are often experts in what they need. The key message reinforced throughout the guidelines is Ask, Listen, Learn, Plan and Do.
The issue in accessible health services is not a requirement for additional funding or a right to services. It is part of a wider universal access agenda across all public services. The appointment of access officers throughout the country will embed improvements in the quality of our health services. Given that health and social services are provided in hundreds of locations throughout the country, access officers are necessary where there are service users, patients and clients e.g. in hospitals, primary care centres, health and social care clinics or other locations where health and social care is delivered. A plan for the appointment and training of access officers is underway for 2015.
The first challenge is to acknowledge that access is everyone’s responsibility. The second challenge is to help staff understand that access is about more than wheelchair ramps and automated doors - it is about the big and the small things - how consent is obtained, how medication is explained, how appointments are managed and assigned, how bad news is broken - whether a person is blind, deaf or hard of hearing, has autism, an intellectual disability or any other condition.
Hospital Services
Questions (76)
Brendan Smith
Question:76. Deputy Brendan Smith asked the Minister for Health the way waiting times for children inpatient day cases at Cavan General Hospital may be improved; and if he will make a statement on the matter. [2401/15]
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.
Health Services Staff
Questions (77)
Thomas P. Broughan
Question:77. Deputy Thomas P. Broughan asked the Minister for Health if he will report on the performance appraisal methods that are in place to assess the performance of consultants and top management levels in the Health Service Executive; the procedures in place for consultants and hospital management teams that are not meeting their targets; and his Department’s timeframe for supporting the recruitment of necessary health staff at all levels of the health service. [2343/15]
View answerWritten answers
As set out in Performance Management in the HSE - Guidance Document 2012, it is the policy of the HSE to "implement, maintain and monitor a Performance Management System that develops the capacity and capability of its employees, improves the performance of the organisation and addresses the underperformance in a timely and constructive manner". The performance management system applying to all HSE staff can be found within the Staff and Benefits section of the HSE website. It should be noted that top-level management in the HSE (National Directors) are line-managed personally by the Director General.
The Consultant Contract 2008 provides for a structured work planning and performance management mechanism at Appendix III ‘Clinical Directorate Service Plan’. In addition, the Contract requires that consultants:
- “co-operate in giving effect to such arrangements as are put into place to verify the delivery of the Consultant’s contractual commitments.
- “are subject to statutory and regulatory requirements and corporate policies and procedures.”
- “participate in development of and undertake all duties and functions pertinent to the Consultant’s area of competence, as set out within the Clinical Directorate Service Plan
- “ensure that duties and functions are undertaken in a manner that minimises delays for patients and possible disruption of services.”
- “work within the framework of the hospital / agency’s service plan and/or levels of service (volume, types etc.) as determined by the Employer.
- "the contract also provides that service planning for individual clinical services will be progressed through the Clinical Directorate structure or other arrangements as apply.”
- “formally review the execution of the Clinical Directorate Service Plan with the Clinical Director / Employer periodically.
In addition, the agreement between health service management, the Irish Hospital Consultants Association and the Irish Medical Organisation under the Public Service Agreement entitled ‘Consultants Implementing the Public Service Agreement – 17th September 2012’ introduced strengthened working arrangements for consultants.
The Minister for Public Expenditure and Reform announced in Budget 2014 that he intends to delegate greater autonomy to Departments and Agencies to manage their own staffing levels. The change from the application of a rigid employment control framework, with its particular focus on a moratorium on recruitment and compliance with employment ceilings and targets, to a system where the HSE must manage their staffing within an overall pay budget framework will allow for recruitment where it is determined that this can achieve more economical service delivery.
In this regard the Department of Public Expenditure and Reform has requested that the HSE and Department of Health submit a 2015 Pay and Numbers Strategy to support the move to the new framework. Following approval of the strategy by DPER, a letter of delegated sanction for staffing will be issued.