Written Answers Nos. 303 - 320
303. Deputy Michael Lowry asked the Minister for Health if he is aware that the Joint Committee on Health and Children met on 21 November 2013 to discuss the treatment and prevention of Lyme disease; if his Department received any findings, recommendations or reports from the joint committee; and the proposed response to Lyme disease. [16608/15]
View answerLyme disease (also known as Lyme borreliosis) is an infection transmitted to humans by bites from ticks infected with the bacterium Borrelia burgdorferi. The infection is generally mild affecting only the skin, but can occasionally be more severe and debilitating.
Lyme borreliosis is is a notifiable infectious disease, the notifiable entity being the more severe neurological form, Lyme neuroborreliosis. The Health Protection Surveillance Centre (HPSC) collects and collates surveillance data on the condition. 20 cases of of the condition have been provisionally notified in 2014. This number is likely to fall following validation.
Lyme borreliosis can be asymptomatic or have a range of clinical presentations. Current best advice is that diagnosis should be made only after careful examination of the patient's clinical history, physical findings, laboratory evidence and exposure risk evaluation. Exposure to ticks prior to disease manifestations is necessary for the diagnosis of Lyme borreliosis. Since an awareness or recollection of a tick-bite is not always present, however, this should not exclude the diagnosis of Lyme borreliosis. Later stages require the use of antibody detection tests (or advanced DNA detection techniques). Testing for Lyme Disease is undertaken in most of the larger hospitals in Ireland. In undertaking Lyme testing, it is essential that the results are interpreted in the light of the clinical condition of the patient. If the result of this initial screen is equivocal, the patient's samples are referred to the U.K.'s Public Health England Porton Down facility which uses a two-tier system recommended by American and European authorities. This involves a screening serological test followed by a confirmatory serological test. Because of the general availability of initial screening for Lyme disease in Ireland and the provision of a confirmatory testing service in the UK, there is no need for Irish citizens to travel abroad for testing.
Common antibiotics such as doxycycline or amoxicillin are effective at clearing the rash and helping to prevent the development of complications. They are generally given for up to three weeks. If complications develop, intravenous antibiotics may need to be used. Anyone who suspects they may have contracted Lyme Disease should consult their GP who will arrange appropriate testing and treatment.
The Scientific Advisory Committee of the HPSC has established a Lyme Borreliosis Sub-Committee. The aim of this Sub-Committee is to develop strategies to undertake primary prevention in order to minimise the harm caused by Lyme Borreliosis in Ireland. These strategies will be published in a Final Report. In addition to staff from the HPSC, the membership of the Sub-Committee includes specialists in Public Health Medicine, Consultants in Infectious Diseases, Clinical Microbiology, Occupational Health, an Entomologist from the Parks and Wildlife Service, a representative from the Local Government Management Agency and an Environmental Health Officer. A representative from the Patients' Association is also being sought. The Terms of Reference of the Sub-Committee are:
- To raise awareness in Ireland of Lyme Borreliosis amongst clinicians and the general public;
- To identify and highlight best international practice in raising awareness about Lyme Borreliosis for the General Public;
- To develop policies of primary prevention of Lyme Borreliosis in Ireland based on best international evidence;
- To explore ways in which to improve surveillance of neuroborreliosis in Ireland;
- To develop strategies to raise awareness among the public particularly in areas of higher tick populations;
- To produce a Final Report covering all the above areas.
The Sub-Committee will hold its inaugural meeting on May 6.
Each year the HPSC holds a Lyme Awareness Week. This involves raising awareness for clinicians and the general public as to the risks of infected biting ticks, protection against tick bites and identifying the disease. Much use is made of the media to broadcast these messages in addition to the extensive material provided on the HPSC website. This year's Lyme Awareness Week takes place from April 27 - May 1st.
I understand that the Committee did not publish a report on Lyme Disease after the meeting referred to by the Deputy.
304. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the status of the posts required to set up an eating disorder inpatient service for the child and adolescent mental health services, as indicated in the Health Service Executive mental health division operational plan 2015; and if he will make a statement on the matter. [16609/15]
View answerAs this is a service issue this question has been referred to the HSE for direct reply. If the Deputy has not received a reply within 15 working days he should contact my Private Office and they will follow up the matter with them.
305. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide, in tabular form, the number of persons waiting for colonoscopies in each hospital for the month of March, separately in the following categories: less than three months, between three and six months, between six and nine months, between nine and 12 months and greater than 12 months; and if he will make a statement on the matter. [16612/15]
View answerThe National Treatment Purchase Fund is now publishing monthly waiting list reports at the end of each month. The report requested by the Deputy for the numbers of persons waiting for colonoscopies in each hospital, by time category, at March 2015 is now available from the National Treatment Purchase Fund Website: www.ntpf.ie.
306. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide details of the changes to the long-term illness scheme in chapter 47 of Management of the Health Service Executive Vote: Health Service Executive Update June 2012, which outlines that long-term illness patients will be provided with a general practitioner visit card in place of long-term illness cards; the way their medication costs and medical appliances costs will be covered; if those patients with these cards will still be eligible for medication at general medical services level charges; and if he will make a statement on the matter. [16614/15]
View answerThe Government, in the recent Statement of Government Priorities, has reiterated its commitment to the introduction of a universal GP service for the entire population in line with the Programme for Government. This policy constitutes a fundamental element in the Government’s health reform programme. The original intention was to start with those on the long-term illness scheme. The view was then taken that this would entail putting in place a cumbersome legal and administrative infrastructure to deal with what would have been only a temporary first phase on the way to universal GP service to the entire population.
Having considered this matter the Government announced in Budget 2014 its decision to commence the roll-out of a universal GP service for the entire population by initially providing all children under 6 years with access to a GP service without fees. An expert group was subsequently appointed to list illnesses or diseases in order, that is, from those which should be counted first and be provided with coverage to those that would be covered later. The group found it would be unjust, unethical and impractical to create a hierarchy of diseases and a list of illnesses in order stating one was more severe than the next.
The Government chose the under-6s and over-70s as the initial phases for the introduction of a universal GP service simply because they are the youngest and oldest in society and the ones who need to see their GP most often. This service will commence during the summer subject to the passing of the necessary legislation in respect of the over-70s which has now passed Second Stage in this House. These phases are being achieved in parallel with an extension in coverage for chronic disease, starting with asthma among children and diabetes among adults.
The current operation of the Long Term Illness Scheme remains in place for all eligible persons.
307. Deputy Tom Fleming asked the Minister for Health if he will intervene with the Health Service Executive regarding the hundreds of notifications by the executive to elderly, vulnerable recipients of home help in County Kerry; if he will ensure the necessary funding is provided to offset these severe cuts to already diminished services; and if he will make a statement on the matter. [16615/15]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with them.
308. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide the details of the trust system to be introduced; the way this transition will take place; the new roles that these trusts will have; the structure and function that are envisaged; and if he will make a statement on the matter. [16616/15]
View answerHospital Groups have been established on an administrative basis and my priority for 2015 is to get all the Hospital Groups up and running as single cohesive entities.
Primary legislation will be required in due course to give full effect to the introduction of Hospital Trusts. While Future Health sets the broad direction of travel for reforming the system, it was always made clear that an incremental approach to implementation would be taken. Future Health specifically referred to a “reform-learn-reform” approach being taken to the process which would enable us to make changes to the proposed approach while simultaneously making progress towards the final structures and delivering tangible improvements as we go.
Pending the enactment of legislation, the implementation of Hospital Groups will progress in a phased manner, which will provide for devolved decision-making, fostering flexibility, innovation and local responsiveness, while also adhering to prescribed national service objectives and standards. Phase II of the Health Reform Programme, as set out in Future Health, provides for the dissolution and replacement of the HSE with the introduction of a formal purchaser/provider split, the establishment of a Healthcare Commissioning Agency and a range of provider agencies, including Hospital Trusts. This is a complex health reform programme and it is essential that the hospital trust legislation is developed as part of the overall process and that the appropriate structures are in place in advance of formal establishment of trusts.
In the meantime each Group must develop and produce a strategic plan which will describe how they will provide more efficient and effective patient services; how they will reorganise these services to provide optimal care possible to the populations they serve; and how they will achieve maximum integration and synergy with other Groups and all other health services, particularly primary care/community based services.
My Department (with the assistance of the Strategic Advisory Group on the Implementation of Hospital Groups) will progress the significant body of work necessary to facilitate the transition from Hospital Groups to Trusts. It will set down the high level overarching policy to guide overall hospital services reorganisation from a national standpoint to inform and complement the plans of the Hospital Groups and will provide guidance on the definition of a Hospital Trust in an Irish context. The Groups and their respective strategic plans will be rigorously reviewed against criteria to test their suitability to proceed to become Hospital Trusts. The review of Groups should be completed before Trusts are legally established and if changes prove necessary; these will be made with Government approval when Hospital Trusts are being formed.
309. Deputy Fergus O'Dowd asked the Minister for Health if he will order a new independent investigation by a qualified person or persons from outside of the Health Service Executive into the death of a person (details supplied); and if he will make a statement on the matter. [16620/15]
View answerI understand that the person who is the subject of the Deputy's question passed away in 2012.
It is generally best that complaints are dealt with locally when they occur and all efforts made to resolve them with the patient or person who has the complaint. There are a number of options open to individuals or their families to make a complaint about the health services. Part 9 of the Health Act 2004 states that a person has the right to complain about any action of the Health Service Executive (HSE) or a service provider that they believe was not fair or had an adverse effect on them. The HSE has appointed designated Complaints Officers to ensure the effective management of complaints throughout their relevant areas of responsibility.
If an individual is unhappy with the way in which his/her complaint was dealt with at the point of care the National Advocacy Unit of the HSE will appoint an independent officer to review the complaint. The Executive also has a National Safety Incident Management Policy which sets out the steps to be taken in an investigation; when independence from the HSE is required, the HSE policy provides for national and international experts to be part of reviews.
If an individual is still unhappy with the outcome of this process he/she can request an independent review of the complaint from the Office of the Ombudsman. In addition, Healthcomplaints.ie is an on-line information service which was developed by the Office of the Ombudsman in cooperation with a number of organisations including my Department and the HSE. This service provides information on how to make a complaint or give feedback about health and social care services in Ireland. This website has been developed for people who use health and social care services in Ireland, as well as for their families, care-givers and advocates.
Furthermore if an individual is unhappy with the level of care provided by a regulated health service professional such as a doctor, nurse or other healthcare professional, he/she may make a complaint to that employee's professional regulatory body.
310. Deputy Aengus Ó Snodaigh asked the Minister for Health if he is aware of cuts made by the Health Service Executive to funding for the transport provided for families of children with special needs to bring those children to and from their homes to centres; the number of families that are affected; the total budget savings; and if consideration will be given to reversing this cut. [16624/15]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply. If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and they will follow the matter up with the HSE.
311. Deputy Dara Calleary asked the Minister for Health the number of persons who have been approved under the fair deal scheme in County Mayo and County Sligo, in 2015 to date. [16626/15]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with them.
312. Deputy Dara Calleary asked the Minister for Health the number of persons who have been approved payments under the fair deal scheme in counties Mayo and Sligo, in 2015 to date. [16627/15]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with them.
313. Deputy Dara Calleary asked the Minister for Health the number of persons who were awaiting determinations on their fair deal applications submitted for approval at the end of November and December 2014 and end of January and February 2015 in counties Mayo and Sligo, and also the current numbers awaiting determination. [16628/15]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with them.
314. Deputy Dara Calleary asked the Minister for Health if the Health Service Executive transitional care initiative is being implemented in counties Mayo and Sligo to ensure persons requiring nursing home care may avail of it in a timely manner, and the numbers supported in counties Mayo and Sligo since the beginning of the year. [16629/15]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with them.
315. Deputy Pat Deering asked the Minister for Health when funding will be sanctioned in respect of a person (details supplied) in County Carlow who has been approved for essential orthotic equipment through the National Rehabilitation Hospital. [16632/15]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy. If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and they will follow the matter up with the HSE.
316. Deputy Billy Kelleher asked the Minister for Health his views on claims by the former director of the national pancreas transplant programme that Beaumont Hospital, Dublin 9, is abandoning patients on the waiting list and that the hospital and the Health Service Executive are taking an unethical and callous approach by seeking to wind up the transplant programme without telling patients; his views that it is unconscionable that four months after the retirement of the director no plan has been made for seriously ill patients; and if he will make a statement on the matter. [16644/15]
View answerAt the end of 2014, two consultant transplant surgeons left the renal and pancreas transplant programme at Beaumont Hospital, one on retirement and the second on leave of absence for professional development purposes. Given the limited number of surgeons who specialise in transplantation, the filling of any vacancies poses a challenge. Every effort is currently being made to fill these vacancies.
Beaumont Hospital is collaborating with St Vincent’s University Hospital in relation to a combined approach to kidney/pancreas transplants, as well as the development of an intra-abdominal organ retrieval service. It is proposed that pancreatic transplants, of which 6 were performed in 2014, will move to St Vincent’s University Hospital this year. While the transfer of such transplants to St Vincent’s has been agreed in principle, it will take some time to make the detailed arrangements to facilitate the commencement of this work. Most pancreas transplants are combined with a kidney transplant. The arrangements being put in place for such cases will involve transplant surgeons from both St Vincent’s Hospital and Beaumont Hospital working together on the St Vincent’s campus.
The nine patients who are on the waiting list for a pancreas transplant are being contacted to reassure them that the pancreatic transplantation programme will continue.
317. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he is aware of the cuts made by the Health Service Executive to funding for the transport provided for families of children with special needs to bring those children to and from their homes to centres; the number of families affected; the total budget saving; and if consideration will be given to reversing this cut. [16645/15]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy. If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and they will follow the matter up with the HSE.
318. Deputy Billy Kelleher asked the Minister for Health the reason for the undershoot of 13.85% against target in the provision of home help hours in counties Cork and Kerry, community health care organisation area 4, in January 2015; and if he will make a statement on the matter. [16646/15]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with them.
319. Deputy Billy Kelleher asked the Minister for Health if he will provide, in tabular form, the number of home help hours allocated in each local health office area; and the way this compared to the targeted allocation as a percentage. [16647/15]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with them.
320. Deputy Billy Kelleher asked the Minister for Health when he will publish the international evidence review on independent hospital trusts undertaken by the Health Research Board at his Department's request; and if he will make a statement on the matter. [16650/15]
View answerA literature review of Independent Hospital Trusts was requested from the Health Research Board by my Department in 2011, to inform policy development. It is regarded as best practice that academic articles and reviews undergo peer review prior to publication. The Health Research Board advised my Department that the peer review undertaken identified a requirement for some further work on this literature review.
In this regard, it was agreed that the original literature review should be supplemented by additional case studies. The case studies have been completed, with appropriate material for integration into the literature review identified. This work has also been peer reviewed and is now being finalised by the Health Research Board for submission to its board, in the first instance, and then for formal submission to my Department. It is expected that the Health Research Board will publish the review in July.
