Written Answers Nos. 28-35
28. Deputy Billy Kelleher asked the Minister for Health the way his Department can assist the private and voluntary nursing home sector, which is experiencing difficulties in the recruitment and retention of nurses; and if he will make a statement on the matter. [14653/15]
View answerI understand from the HSE that there are two areas under active review in relation to these recruitment and retention issues. Firstly, there is the issue of recruitment of nurses educated and trained in Ireland. The Office of the Nursing and Midwifery Services Director have been supportive in allowing the nursing home sector meet with graduate students in the universities. The Chief Nursing Office in the Department has been engaged with, the nursing home sector in promoting nursing in the older adult as a career choice. The Office has facilitated discussions, spoken at conferences and engaged with 3rd level universities on seeking solutions to this issue. Discussions have involved exploring career pathways within older people services to encourage staff into this area of nursing practice.
The second area under review, relates to the recruitment of global nurses. There are 3 adaptation courses available this year in April, June and August. These courses are 6 weeks in duration and facilitate the integration of global nurses to nursing in an Irish context. Of the 195 places available only 60 places have been taken to date. The nursing home sector are aware of these vacancies.
In addition, options are being explored with an Irish university to offer a one-day programme of assessment through an examination format. The pilot of this programme will be complete and results available in the last quarter of 2015.
29. Deputy Robert Troy asked the Minister for Health the way his Department is addressing the long waiting times and lack of access to community mental health services for children and teenagers. [14474/15]
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 within 15 working days, please contact my Private Office and they will follow up the matter with them.
30. Deputy Bernard J. Durkan asked the Minister for Health the extent to which ready access and back-up support remains available to children seeking assessment or treatment under the child and adolescent mental health services; the extent to which the services need to be enhanced to meet current and future requirements; and if he will make a statement on the matter. [14455/15]
View answerAs this is a service issue this question has been sent to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
31. Deputy Bernard J. Durkan asked the Minister for Health the extent to which an examination and assessment will be carried out into the causes of overcrowding at accident and emergency services throughout the country; if comparisons have been made with the best and worst practices in this regard; if provision will be made to address any issues emerging, with a view to ensuring that, in the future, patients do not have to remain on trolleys in corridors or reception areas, with consequent distress for them and their families and unsatisfactory working conditions for doctors and nurses; if precise identification of bed requirements relative to the population in each catchment area will be undertaken, with a view to addressing any deficiencies in accommodation or staffing levels; if his recent initiative in respect of the provision of extra step-down beds requires any further enhancement; and if he will make a statement on the matter. [14660/15]
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.
32. Deputy Joan Collins asked the Minister for Health his views on the long delays for patients awaiting spinal surgery at Galway University Hospital. [14641/15]
View answerImproving waiting lists for scheduled care is a key priority for me and for the Government. Taking into account current pressures on acute hospital services, I have put in place a target that by mid-year nobody will wait more than 18 months for in-patient, day case treatment or an out-patient appointment, with a further reduction to a wait time of no more than 15 months by year end. The HSE is currently working on an implementation plan to achieve these targets and this will be monitored throughout the year.
I have been assured by the Saolta University Health Care Group that the waiting list for spinal surgery is a priority for the Saolta University Health Care Group. I understand that a number of arrangements are being put in place in order to facilitate the level of complexity involved in relation to this type of surgery. The Group is currently reviewing a number of resources in the context of bed availability, access to diagnostics, purchase of specialist spinal equipment and access to theatre. Plans in this regard are progressing and every effort is being made to facilitate potential surgery dates for this cohort of patients.
In addition, the National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the Health Service Executive, sets out the processes that hospitals are to implement to manage waiting lists.
33. Deputy Paul Murphy asked the Minister for Health if he will report on the expected take-up of health insurance by persons under 34 years of age; and if he will make a statement on the matter. [14709/15]
View answerCommunity rating, reflecting the principle of intergenerational solidarity, is a fundamental cornerstone of the Irish health insurance market. Under community rating, the level of risk that a particular consumer poses to an insurer does not directly affect the premium paid. Premiums for younger or healthier lives are typically higher than their expected claims would require, whereas for older or less healthy lives, premiums are typically lower than the expected claims would require.
Community-rated insurance markets depend on a continuing entry of younger people, to help keep premium prices down for everybody. Lifetime Community Rating (LCR) is being introduced to encourage people to take out private health insurance at a younger age, thereby helping to spread the costs of older and less healthy people across the market, to support affordable community-rated premiums for everyone who wishes to purchase insurance. It is a necessary measure to help support the viability of community rating within our system of private health insurance, as without it there will be a continued deterioration in the age profile of the insured population, which in turn will contribute to claims inflation and higher insurance premiums for all.
There are a number of weeks remaining before the introduction of Lifetime Community Rating. All residents in this State during the grace period, who choose to wait until after 30 April 2015 to purchase private health insurance, will be subject to the provisions of the LCR regulations. I would encourage anybody who is considering purchasing health insurance to do so in advance of the new rules coming into force. Any increase in the number of younger insured persons will have a positive impact on the market as a whole as it will help to make health insurance more affordable for all.
34. Deputy Clare Daly asked the Minister for Health the action he has taken in relation to the fact that, rather than referring the suspension of a person (details supplied) for investigation by the regulator of midwifery, the Nursing and Midwifery Board of Ireland, as per the terms of the contract between the Health Service Executive and self-employed midwives, the area manager of the executive for Dublin Mid-Leinster instead opted to commission and chair a high-cost, resource-intense systems analysis investigation into the person's practice. [14706/15]
View answerI wish to thank the Deputy for the matter raised.
The HSE is legally obliged to actively promote the well-being and to protect the welfare of the public. Decisions in this regard are made on a bona fide basis, based on information available to the HSE at a particular point in time. In relation to the matters raised by the Deputy, the proceedings are ongoing and as such it is not appropriate to comment on a matter currently before the courts.
In regard to the ongoing HSE investigations, which are due to conclude within the next few weeks, the outcome will determine the necessity or otherwise for the HSE to refer the matter to the Nursing and Midwifery Board of Ireland.
35. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his plans for increased chronic care management in general practice; the form this will take; the increased funding that will be provided for this; when new contracts with general practitioners will be negotiated; and if he will make a statement on the matter. [14713/15]
View answerFollowing intensive engagement, the Department of Health, the HSE and the Irish Medical Organisation have reached agreement on a package of measures, including terms for the delivery of free GP care for all children aged under 6 years; the provision of GP care without fees to all persons aged 70 years and over under the existing GMS contract; and the introduction of a Diabetes Cycle of Care for medical card or GP visit card holders who have Type 2 Diabetes. The aim is to commence the GP service for under 6s and over 70s in the summer, with the Diabetes Cycle of Care commencing in Quarter 4 of this year.
Under the new arrangements, an additional 270,000 children under 6 will benefit from GP care free at the point of service. All children under 6 will benefit from the new enhanced service under the proposed GP contract. This will involve age-based preventive checks focused on health and wellbeing and the prevention of disease. These assessments will be carried out when a child is aged 2 and again at age 5, in accordance with an agreed protocol.
The contract will also include an agreed cycle of care for children diagnosed with asthma, under which GPs will carry out an annual review of each child where the doctor has diagnosed asthma. The asthma cycle of care will provide the key elements of best practice in the care of asthma with structured visits including education of child and parents, medicine and inhaler technique review and an individualised asthma plan for parents. It will result in better quality of life for children, with resulting better health and wellbeing and less need to visit hospital. The new expanded GP service will apply to all children aged under 6, including those who already have a medical card.
The extension of GP care free at the point of service to everyone aged 70 or over and who does not currently qualify for this benefit will take effect at the same time as the under-6 service, subject to the enactment of the necessary legislation. This service will benefit about 36,000 new patients.
The Diabetes Cycle of Care will enable patients with a medical card or GP visit card and who have Type 2 Diabetes to avail of two annual visits to their GP practice for a structured review of their condition. This initiative will help to integrate care across the continuum of care, will improve clinical outcomes for patients and reduce complications often experienced with this condition.
In addition to the above, the HSE's 2015 National Service Plan has committed to a number of Chronic Disease Management initiatives as follows:
- It is planning to align the existing 10 primary care diabetes initiatives to the Diabetes Model of Care with the support of the Clinical Programme and augment existing podiatry services to deliver the model of care.
- It is also planning to undertake Chronic Disease Integration and Self Care Demonstrator Projects to provide proof of concept of integrating chronic disease services for Asthma, COPD and heart failure between Primary and Secondary Care, with particular focus on the education of practice nurses and local GPs.
Furthermore, a Memorandum of Understanding signed in February 2015 committed the Department of Health, the HSE and the IMO to substantive negotiations on a new comprehensive GP contract. A priority of these discussions, which have commenced, will be the inclusion of chronic disease management for patients over and above the initiatives outlined above.
