Billy Kelleher
Question:30. Deputy Billy Kelleher asked the Minister for Health his plans to reduce waiting times for inpatient and day cases; and if he will make a statement on the matter. [2391/15]
View answerHospital Waiting Lists
Questions (30)
Written answers
Improving waiting lists for in patient and day case treatment is a key priority for me and for the Government. My Department is working with the HSE to put in place a plan to eliminate very long waiters by the end of the year. This will involve both productivity improvement and rigorous waiting list management. Further increasing day case surgery rates for specific procedures will be important in improving elective access within available capacity. Priority will be given to adherence to the guidelines in relation to the scheduling of patients for surgery, including chronological scheduling, and this will be monitored by the HSE throughout the year.
The management of competing demands for emergency and scheduled care requires changes in how and where patients are treated. The movement of care and treatment from in-patient to day case and from day case to Outpatient Departments is most important, as is ensuring the appropriate ratio of new to return appointments, reducing unnecessary return appointments. Limiting elective surgery in preparation for, or as a response to, increased Emergency Department attendances is intended to help manage the need for immediate emergency or trauma care. Where it is necessary to prioritise cancer and other complex cases, the HSE assures me that this is being done. Inevitably this will affect waiting lists. The challenge is to minimise the need for cancellation at short notice and to manage the impact of such cancellations effectively, within the hospital and in collaboration with other hospitals.
As I have stated publicly in the context of significant emergency pressures currently being experienced by hospitals, realistically I do not envisage significant improvement in elective waiting times in the early part of the year. However based upon the high priority attached to this area in the HSE Service Plan and the first overall increase in the HSE budget in 7 years, it is expected that improvement will occur later in the year.
Hospital Staff
Questions (31)
Robert Troy
Question:31. Deputy Robert Troy asked the Minister for Health if he is satisfied that the number of front-line medical staff at Mullingar Regional Hospital, County Westmeath, is adequate to meet the demands being placed on them; the number of permanent front-line medical staff in the hospital in 2012, 2013 and 2014; the number of agency staff employed in each of those years; the timeframe for any recruitment process, and if this is too long. [2395/15]
View answerWritten answers
The HSE has advised that the current complement of NCHD and Consultants in Mullingar Regional Hospital is 106. This compares to 99 posts in July 2014, 102 posts in July 2013, and 99 posts in July 2012. Of these, 26 are Consultant posts and it is worth noting that there has been no reduction in the number of Consultant posts at the hospital since July 2012. Furthermore, the HSE has advised that new Consultant posts are anticipated in 2015. In this regard, the HSE has advised that there is a need to develop a new Consultant Geriatrician model that would assist in lowering nursing home referrals to the Emergency Department, given that approximately 2,500 bed days at the hospital are used by patients from nursing homes.
The number of NCHD and Consultant agency staff employed in the hospital is as follows: 5 WTEs in January 2015, 2 WTEs in July 2014 and 0.5 WTEs in July 2012. In relation to the timeframe for recruitment processes, the Consultant recruitment is a structured robust process, which may take some months to complete. There is also a new intake of NCHDs every 6 months.
HSE Investigations
Questions (32)
Colm Keaveney
Question:32. Deputy Colm Keaveney asked the Minister for Health the action being taken in response to events at Áras Attracta; and if he will make a statement on the matter. [2375/15]
View answerWritten answers
I welcome this opportunity to outline the progress being made by the HSE in relation to this very serious matter.
Like others, I was shocked and distressed by the revelations of extremely poor and unacceptable standards of care and mistreatment of vulnerable adults in Áras Attracta. Every person who uses our disability services is entitled to expect and receive supports of the highest standard and to live in an atmosphere of safety and care.
The safeguarding and protection of vulnerable people in the care of the health service is of paramount importance and the Director General of the HSE has written to all staff instructing them to take personal responsibility for ensuring that individuals supported by the HSE in any setting are treated with dignity and respect.
In December 2014 the HSE initiated both an expert investigation chaired by Mr Christy Lynch, and an independently chaired review of services at this facility led by Dr Kevin McCoy.
Mr Lynch’s investigation team is working independently of the HSE and will form an important input into any disciplinary process which the HSE will undertake.
Dr McCoy is undertaking an Assurance Review of the services at Áras Attracta and the final report will include an individual plan for improvement in each bungalow within the complex. The review will identify system wide learning involving engagement with relevant expertise as well as input from staff.
I welcome the fact that the Gardaí have now cleared the way so that Mr. Lynch’s investigation can commence. I have asked the HSE to keep me informed of progress.
The HSE has undertaken a number of additional initiatives to ensure that quality and safe care in residential services for people with disabilities is appropriately implemented and monitored.
A six-step plan will address this in a systematic way. These steps are:
- The establishment of a National Implementation Taskforce, including a series of National Summits to improve client safety, dignity, respect and culture;
- Implementation of the National Policy & Procedures on Safeguarding Vulnerable Persons at Risk of Abuse;
- Development of an Advocacy programme;
- Implementation of an evaluation and quality improvement programme in disability residential centres;
- Development of an implementation plan for any recommendations arising from the McCoy review of residential services in Áras Attracta when complete, and,
- Development of long term sustainable & evidence-based safeguarding practices and training programmes specific to residential settings.
The HSE is considering plans to monitor practices in social care facilities through the use of surveillance cameras, undercover persons and /or other means. However, it is very conscious of potential difficulties that could arise in relation to privacy and data protection, and given the complex issues involved, has decided to engage expert consultants to advise it on the best way to proceed. A Prior Information Notice under EU procurement rules was published in mid-December in this regard.
I can assure the Deputy that my Department will monitor progress on the initiatives and processes commissioned by the HSE in relation to Áras Attracta, to ensure that the learning from this incident is promulgated throughout our health system.
Hospital Accommodation Provision
Questions (33)
Brendan Griffin
Question:33. Deputy Brendan Griffin asked the Minister for Health the position regarding the provision of extra beds at West Kerry Community Hospital; and if he will make a statement on the matter. [2358/15]
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.
Medicinal Products Availability
Questions (34)
Jerry Buttimer
Question:34. Deputy Jerry Buttimer asked the Minister for Health his plans to make EpiPens more widely available; and if he will make a statement on the matter. [2344/15]
View answerWritten answers
Adrenaline pens, as injectable medicines, may only be supplied on foot of a valid prescription. However, there is provision in the Medicinal Products (Prescription and Control of Supply) Regulations 2003 (as amended) which permits pharmacists, advanced paramedics, paramedics and emergency medical technicians, in emergency circumstances, to supply certain prescription only medicines including adrenaline injections without a prescription.
My Department is currently reviewing policy in this area and will shortly carry out a consultation process on wider availability of a number of prescription only medicines used in emergency situations including adrenaline auto-injectors. This review will explore, among other things the use of guidelines or protocols by means of which non-health professionals may supply and administer adrenaline auto-injectors without a prescription.
Community Care Provision
Questions (35)
Brian Stanley
Question:35. Deputy Brian Stanley asked the Minister for Health when a decision will be made on Abbeyleix and Shaen hospitals. [2352/15]
View answerWritten answers
The Department awaits the HSE's recommendations in respect of both facilities and an announcement will be made as soon as possible once the Minister receives the HSE’s definitive position.
Hospital Waiting Lists
Questions (36)
Charlie McConalogue
Question:36. Deputy Charlie McConalogue asked the Minister for Health further to Parliamentary Question No. 105 of 11 November 2014, when follow-up funding will be provided for the 550 adults who require general surgery, the 953 patients who require diagnostic testing and the 110 patients who require an outpatient review and who were outsourced under the 2013 outpatients initiative to have their treatment; if this treatment will be provided by the hospital to which they were referred; and if he will make a statement on the matter. [2379/15]
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.
Ambulance Service Response Times
Questions (37)
Caoimhghín Ó Caoláin
Question:37. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the details of ambulance call-out target times; his plans to extend or to remove same; the actions he will take to ensure that rural communities are guaranteed appropriate and adequate emergency services; and if he will make a statement on the matter. [2412/15]
View answerWritten answers
Ambulance response time targets for the National Ambulance Service are set out in the HSE National Service Plan. For ECHO and DELTA calls (life threatening conditions), the 2015 response time target is for 80% of calls to get a patient-carrying vehicle on scene within 19 minutes. The latest published data shows that, in October, the volume of ECHO calls rose by 5% compared to the same period in 2013, with DELTA calls up 10%. The response time was met for 76% of ECHO and 67% of DELTA calls. This is an improvement of 3.3% and 4% respectively on 2013.
Response time targets only measure one aspect of ambulance performance and should be part of a suite of assessments. Internationally, many services are moving to patient outcomes as a better indicator of performance. The National Ambulance Service introduced a patient outcome target for out-of-hospital cardiac arrests in 2014, and more are being developed.
Achieving response time targets in rural settings is a difficult task for any ambulance service. HIQA has acknowledged, in its own report, our geographic challenges and has recommended different rural and urban response time targets. While that issue is under consideration, we are adapting ambulance services for the needs of rural populations through, for example, the use of rapid response vehicles and the Emergency Aeromedical Support Service (EAS). The EAS has been very successful and has provided rapid access to appropriate treatment for very high acuity patients, where this may be have been difficult to achieve by road.
I can assure the Deputy that we will continue to strive to improve rural response times. A €5.4 million budget increase in 2015 will help address service gaps, particularly in the west, by reforming rostering and staffing additional stations. We will also expand the number of Community First Response teams, especially in rural and sparsely populated areas. The Intermediate Care Service, for non-emergency clinical transport, continues to free up frontline ambulances, and their highly paramedic staff for emergencies.
The Deputy will be aware that, as well as the recent HIQA report, two other major reports on ambulance services, on national capacity and Dublin services, will be published shortly. All three reports, when taken together, will provide us with very good information which will help drive service improvement. I have therefore asked the HSE to prepare an action plan on completion of the three reports, with timelines to realise a new vision for our ambulance services.