Thursday, 28 May 2015

Written Answers Nos. 31 - 50

National Carers Strategy Implementation

Questions (31)

Caoimhghín Ó Caoláin

Question:

31. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his views on the reason that of the national carers strategy's 42 objectives, only one objective has been achieved to date, with 19 showing only initial progress, ten showing no progress and, most worryingly, eight having regressed; whether the 19% cut to the respite care grant in budget 2012 will now be reversed; if the halving of funding for housing grant schemes will be reversed and if the current poor discharge planning and lack of consultation with family carers when their loved one moves from hospital to home care will be addressed; and if he will make a statement on the matter. [20774/15]

Written answers

Minister of State at the Department of Health

The National Carers’ Strategy was published in July 2012 and sets the strategic direction for future policies, services and supports provided by Government Departments and agencies for carers.

It sets out a vision to work towards and an ambitious set of National Goals and Objectives to guide policy development and service delivery to ensure that carers feel valued and supported to manage their caring responsibilities with confidence and are empowered to have a life of their own outside of caring.

The Strategy also contains a Roadmap for Implementation with a suite of actions and associated timelines, and identifies the Government Department responsible for their implementation. It is important to note that the actions in the Roadmap for Implementation are those that can be achieved on a cost neutral basis.

The National Carers' Strategy committed to the production of an Annual Report on progress which would be published on the websites of relevant Departments. The first Annual Report on implementation of the Strategy was published in November 2013 and the second in January 2015, both of which are available on my Department's website. These Annual Reports will provide the Deputy with a list of actions that were identified in the Strategy and what progress has been made on each one since the Strategy’s publication.

While The Carers Association's recently published Family Carers Scorecard raises concerns over the pace of implementation, much work has been done and the report acknowledges achievements such as:

- The development of a single assessment tool for older people containing a detailed Carers Needs Assessment;

- The imminent release of one million euro funding from Dormant accounts for training and information provision for family carers;

- The hosting of an Annual Carers Forum by the Department of Social Protection and in particular the positive engagement around the structure of this forum to meet the needs of family carers.

I acknowledge that the pace of implementation of the Carers' Strategy has been slower than we would have wished. At my Department's request, the HSE has set up a multi-disciplinary working group to bring forward implementation of the health aspects of the Strategy.

With regard to discharge planning, in 2014 the HSE published a guide called 'Integrated Care Guidance: A practical guide to discharge and transfer from hospital'. The guide sets out nine steps for effective discharge planning and transfer from hospital to community healthcare settings. Steps 8 and 9 detail the discharge arrangements and the communication process to include the carers/family and relevant personnel in the community to be communicated with during the discharge process.

In relation to the Respite Care Grant and the Housing Grant Schemes, these are a matter for my colleagues the Minister for Social Protection and the Minister for Environment and Local Government respectively.

Hospital Waiting Lists

Questions (32)

Jim Daly

Question:

32. Deputy Jim Daly asked the Minister for Health the steps that have been taken to reduce the waiting lists for operations on children with scoliosis of the spine; and if he will make a statement on the matter. [20545/15]

Written answers

Minister for Health

Spinal conditions, including scoliosis, in children and young people are predominantly managed at Our Lady’s Children’s Hospital, Crumlin (OLCHC). It is acknowledged that the waiting times for spinal surgery services at Our Lady’s Hospital Crumlin are unsatisfactory and must be addressed as a priority. Accordingly, funding was allocated in the HSE Service Plan for 2015 for the appointment of an orthopaedic surgeon, anaesthetist and support staff at Crumlin. This will maximise the use of available theatre sessions in the hospital. The first of these additional staff is now in post, and recruitment for the remaining posts is in process. In addition, capital funding has been agreed for a new theatre on site at Crumlin, which will expand theatre capacity further. As a further measure, available capacity is being identified in other hospitals and some children are being transferred for their surgery, where it is considered clinically appropriate for them.

The Children's Hospital Group, OLCHC and the HSE are working together on an ongoing basis to identify all options to increase capacity further.

National Carers Strategy Implementation

Questions (33)

Billy Kelleher

Question:

33. Deputy Billy Kelleher asked the Minister for Health his views on the recently published "Family Carers Scorecard" of the national carers strategy; and if he will make a statement on the matter. [20779/15]

Written answers

Minister of State at the Department of Health

The National Carers’ Strategy was published in July 2012 and sets the strategic direction for future policies, services and supports provided by Government Departments and agencies for carers.

It sets out a vision to work towards and an ambitious set of National Goals and Objectives to guide policy development and service delivery to ensure that carers feel valued and supported to manage their caring responsibilities with confidence and are empowered to have a life of their own outside of caring.

The Strategy also contains a Roadmap for Implementation with a suite of actions and associated timelines, and identifies the Government Department responsible for their implementation. It is important to note that the actions in the Roadmap for Implementation are those that can be achieved on a cost neutral basis.

The National Carers' Strategy committed to the production of an Annual Report on progress which would be published on the websites of relevant Departments. The first Annual Report on implementation of the Strategy was published in November 2013 and the second in January 2015, both of which are available on my Department's website. These Annual Reports will provide the Deputy with a list of actions that were identified in the Strategy and what progress has been made on each one since the Strategy’s publication.

While The Carers Association's recently published Family Carers Scorecard raises concerns over the pace of implementation, much work has been done and the report acknowledges achievements such as:

- The development of a single assessment tool for older people containing a detailed Carers Needs Assessment;

- The imminent release of one million euro funding from Dormant accounts for training and information provision for family carers;

- The hosting of an Annual Carers Forum by the Department of Social Protection and in particular the positive engagement around the structure of this forum to meet the needs of family carers.

I acknowledge that the pace of implementation of the Carers' Strategy has been slower than we would have wished. At my Department's request, the HSE has set up a multi-disciplinary working group to bring forward implementation of the health aspects of the Strategy.

I am determined that this Strategy will be applied in a way that makes a real and positive difference to the lives of carers, their families, and those they care for.

HIQA Remit

Questions (34)

Patrick O'Donovan

Question:

34. Deputy Patrick O'Donovan asked the Minister for Health his plans to extend the inspection role of the Health Information and Quality Authority to the provision of private care for elderly persons and vulnerable adults in their own homes; and if he will make a statement on the matter. [20546/15]

Written answers

Minister of State at the Department of Health

Government for National Recovery, 2011-2016 commits to developing and implementing national standards for home support services which will be subject to HIQA inspection. Primary legislation and resources will be required for the introduction of a statutory regulation system for home care services. This will be considered by Government on a prioritised and phased basis as resources, legislative and planning processes allow. In the meantime the HSE is progressing a range of measures to improve Home Care provision overall, to standardise services nationally and to promote quality and safety.

Mental Health Services Provision

Questions (35)

Colm Keaveney

Question:

35. Deputy Colm Keaveney asked the Minister for Health the position regarding the deterioration in the relationship between staff and management in the psychiatric unit of University Hospital Galway, resulting from serious concerns over the physical condition of the unit, staffing levels, and the effect of both on the welfare of patients in the unit [20767/15]

Written answers

Minister of State at the Department of Health

As this is a service issue this question has been referred to the HSE for direct reply. If a reply has not been issued within 15 working days, please contact my Private Office and they will follow up the matter with them.

Hospitals Inspections

Questions (36)

Bernard Durkan

Question:

36. Deputy Bernard J. Durkan asked the Minister for Health if he is satisfied that adequate health and safety guidelines and precautions apply in all hospitals throughout the country without exception, including maternity hospitals and nursing homes in the public and the private sectors; the extent to which such guidelines are updated on a regular basis; the issues that have been brought to the attention of his Department which might impact on the well-being of patients or staff; the steps taken to address these issues; and if he will make a statement on the matter. [20758/15]

Written answers

Minister for Health

Since 2009 all nursing homes - public, voluntary and private - have been registered and inspected by the Health Information and Quality Authority.

The Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations, 2013 (SI 415/2013) contain comprehensive provisions for the purpose of ensuring that proper standards are in place in designated centres for older people. Schedule 5 to these Regulations lists the policies and procedures that a registered provider must have in place including, for example, health and safety (to include infection control and food safety); risk management; prevention, detection and response to abuse; staff training; responding to emergencies; fire safety management; handling of complaints; medications management.

National Quality Standards for Residential Care Settings for Older People are also in place. These standards outline what is expected of a provider of services and what a person, his or her family, and the public can expect to receive from residential care services.

In June 2012 the HIQA National Standards for Safer Better Healthcare were approved by the previous Minister for Health. The National Standards are aimed at protecting patients and they provide a strategic approach to improving safety, quality and reliability in our health services. They describe high quality safe healthcare services. Such services deliver care which is safe, effective, person centred and which promotes better health for service users. The National Standards also describe what capacity and capability factors service providers require to implement these standards. Service providers, including the private (independent) service providers, can use the National Standards as a framework to organise, manage and deliver their services safely. It is envisaged that the proposals being developed for the licensing of healthcare providers will be based on key concepts within the National Standards.

HIQA continues to monitor the quality and safety of healthcare services with the National Standards through the delivery of a programme of thematic monitoring reviews based on identified priorities and consultation with stakeholders. HIQA also carries out a programme of announced and unannounced infection prevention and hygiene inspections in hospitals in line with the National Standards for the Prevention and Control of Healthcare Associated Infections.

The National Clinical Effectiveness Committee (NCEC) was established in 2010. Clinical effectiveness is a key component of patient safety and quality. The integration of national and international best available evidence in service provision through utilisation of clinical effectiveness processes promotes healthcare that is up to date, effective and consistent.

Clinical effectiveness incorporates the utilisation of quality assured National Clinical Guidelines, National Clinical Audit and general clinical practice guidance. This is a quality improvement approach which promotes cost-effective healthcare that is evidence-based, with subsequent improved clinical decision-making and clinical outcomes. Clinical effectiveness will underpin the models of care for the HSE's national clinical programmes.

To date, the NCEC has quality assured 6 National Clinical Guidelines which have been endorsed by respective Ministers and mandated for implementation in the Irish health system. These include:

1. National Early Warning Score (NEWS);

2. Prevention and Control of MRSA;

3. Clostridium difficile;

4. Irish Maternity Early Warning System ( IMEWS);

5. Clinical Handover in Maternity Service; and

6. Sepsis Management.

Their implementation will be monitored through the HSE Assurance Reports, compliance with HIQA's National Standards for Safer Better Healthcare and increased alignment with the Clinical Indemnity Scheme.

National Drugs Strategy Implementation

Questions (37)

Maureen O'Sullivan

Question:

37. Deputy Maureen O'Sullivan asked the Minister for Health the role of the national drug rehabilitation implementation committee in the drugs strategy; and if he will make a statement on the matter. [20537/15]

Written answers

Minister of State at the Department of Health

The National Drugs Strategy 2009-2016 is a cross cutting area of public policy and service delivery. A core objective of the National Drugs Strategy is the development of a national integrated treatment and rehabilitation service that provides drug free and harm reduction approaches for problem substance users.

The National Drug Rehabilitation Implementation Committee (NDRIC) is chaired by the HSE and includes representation from relevant Government departments and agencies and the community and voluntary sectors. Its role includes overseeing and monitoring the implementation of the recommendations of the 2007 Report of the Working Group on Drugs Rehabilitation, developing national protocols to facilitate the level of inter-agency cooperation needed to implement shared care plans, and overseeing case management and care planning processes.

The committee has developed a National Drugs Rehabilitation Framework to provide a 'continuum of care' for the recovering drug user through promoting a more integrated and client-centred approach based on shared care planning and inter-agency working. The rollout of the framework is currently being advanced through the HSE's Addiction Services and the Local and Regional Drug and Alcohol Task Forces. As part of this rollout, NDRIC is developing competency based training to be provided to all treatment providers and relevant agencies in Drug & Alcohol Task Force areas.

The Department of Health has commenced work on the development of a new National Drugs Strategy for the period after 2016. Extensive consultation with key stakeholders and the public will take place as part of this process.

Mental Health Services Provision

Questions (38)

Mick Wallace

Question:

38. Deputy Mick Wallace asked the Minister for Health if he is satisfied that the current mental health provision in County Wexford is adequate, particularly in view of the county's relatively high suicide rates which according to the last census were almost twice the national rate; and if he will make a statement on the matter. [20548/15]

Written answers

Minister of State at the Department of Health

As this is a service issue this question has been referred to the HSE for direct reply. If a reply has not been issued within 15 working days, please contact my Private Office and they will follow up the matter with them.

Home Help Service Provision

Questions (39)

Billy Kelleher

Question:

39. Deputy Billy Kelleher asked the Minister for Health if the target for the provision of home helps in 2015 is being met specifically in CHO4; and if he will make a statement on the matter. [20783/15]

Written answers

Minister of State at the Department of Health

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.

Pharmacy Services

Questions (40)

Ruth Coppinger

Question:

40. Deputy Ruth Coppinger asked the Minister for Health his views on removing the right of pharmacists to have a conscientious objection to providing Norlevo or the morning after pill; if he believes this is a barrier to access; if his attention has been drawn to the number of the pharmacists that do not sell Norlevo; and if he will make a statement on the matter. [20778/15]

Written answers

Minister of State at the Department of Health

Since 2011, a number of levonorgestrel products, including Norlevo, have been reclassified from ‘prescription only’ to ‘pharmacy only’ supply for use as emergency contraception.

The Pharmaceutical Society of Ireland is the statutory body responsible for the regulation of the practice and profession of pharmacists, and the operation of pharmacies, in Ireland in the interest of the health, safety and welfare of patients and the public.

As healthcare professionals, practising pharmacists are required to display full technical competence in their chosen profession, behave with probity and integrity and to be accountable in this regard for their actions. These qualities of competence, probity, integrity and accountability, which a pharmacist must demonstrate, are underwritten by a statutory Code of Conduct. All pharmacists must subscribe to this Code.

The Code states that the practice by a pharmacist of his/her profession must be directed toward maintaining and improving the health, well-being, care and safety of the patient. The Code also requires pharmacists to ensure that, in instances where they are unable to provide services to a patient (e.g. in situations where they have a conscientious objection to such a provision), they take reasonable action to ensure those medicines/services are provided and that the patient’s care is not jeopardised. In practice, this means facilitating the patient in accessing the information or service required to meet their needs from another pharmacist/pharmacy.

In addition to the Code, the PSI issued a guidance document to pharmacists ‘PSI Guidance for Pharmacists on the Safe Supply of Non-Prescription Medicinal Products Containing Levonorgestrel 1500mcg for Emergency Hormonal Contraception’, which provides guidance in fulfilling their professional responsibilities in the supply of these medicines. The guidance document was reviewed, updated and circulated to the profession in February 2015 and is available on the PSI website www.thepsi.ie.

No statistics are available on the number of pharmacists/pharmacies that supply/do not supply Norlevo.

Medical Aids and Appliances Provision

Questions (41)

Seán Kyne

Question:

41. Deputy Seán Kyne asked the Minister for Health the position regarding a medical device, Medtronic’s i-port advance injection device, and the primary care reimbursement scheme; if the substantially less invasive nature of the device and the easier method of treatment for young persons with diabetes has been taken into account regarding its introduction; and if he will make a statement on the matter. [20763/15]

Written answers

Minister of State at the Department of Health

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. The decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE on the advice of the National Centre for Pharmacoeconomics. They are not political or ministerial decisions.

The HSE received an application for the inclusion of the product, i-port Advance™, to be added to the List of Reimbursable Items in the GMS and community drugs schemes. The application was considered in line with the procedures and timescales agreed by the Department of Health and the HSE with the Irish Pharmaceutical Healthcare Association for the assessment of new medicines.

An Expert Group, chaired by the Clinical Lead of the HSE Diabetes Programme, was convened by the HSE to (i) assess the clinical evidence to support the use of the product, (ii) consider whether the product is appropriate for reimbursement status under Schemes and (iii) assist in the determination of the ‘value’ that the innovation presents. The Group also considered the quality of life dimension from using the product.

The Expert Group did not find that the product was either clinically effective or cost effective, and therefore did not recommend that the product should be reimbursed. The Director of Primary Care accepted the recommendation of the Expert Group and the company was informed of the HSE's decision on the 20 April 2015.

HSE Waiting Lists

Questions (42)

Colm Keaveney

Question:

42. Deputy Colm Keaveney asked the Minister for Health his proposals to reduce waiting lists for a range of disability-specific services; and if he will make a statement on the matter. [20766/15]

Written answers

Minister of State at the Department of Health

The Government currently provides funding of approximately €1.5 billion to the Disability Services Programme through the Health Service Executive's National Service Plan for 2015. The HSE aims to ensure that the resources available are used to best effect, in order to provide assessment and ongoing therapy to children and adults in line with their prioritised needs. However, it is acknowledged that current waiting lists for some therapeutic supports are high.

In 2013, additional funding of €20m was provided to strengthen primary care services. This comprised of €18.5m for the recruitment of over 260 primary care team posts and over €1.4m to support community intervention team development.

In 2014, the roll out of the Progressing Disability Services for Children and Young People Programme entailed targeted investment of €4m and the provision of 80 additional therapy staff to improve services for children with all disabilities. At 30th April 2015, 47 of the 2014 posts have been filled, a further 20 are at the stage of 'post accepted' and the process is on-going for the remaining posts. A further €4m allocation was announced in 2015 to continue work on this Programme.

I am confident that the additional resources being invested into both primary care and disability services will have a positive impact on the provision of clinical services to all children with disabilities, including those who may currently be on waiting lists to access therapy inputs.

Ambulance Service Response Times

Questions (43)

Timmy Dooley

Question:

43. Deputy Timmy Dooley asked the Minister for Health if he is satisfied with the proportion of patient carrying vehicles that are answering Echo and Delta calls on target; and if he will make a statement on the matter. [20771/15]

Written answers

Minister for Health

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.

Hospital Services

Questions (44)

Robert Troy

Question:

44. Deputy Robert Troy asked the Minister for Health his plans to enhance long stay facilities in St. Joseph’s Hospital, County Longford and in St. Mary’s Hospital, Mullingar, County Westmeath. [20760/15]

Written answers

Minister of State at the Department of Health

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.

Treatment Abroad Scheme

Questions (45)

Caoimhghín Ó Caoláin

Question:

45. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his views on the case of an Irish citizen (details supplied), a cancer victim whose surgery here was not a success and who has opted for alternative treatment in a medical centre overseas; if he will, in recognition of the serious situation applying for this person and of the great generosity of this person's adopted community (details supplied) in County Cavan, seek to secure some level of financial assistance towards the overall cost of the treatment and any other practical supports that he may identify; and if he will make a statement on the matter. [20775/15]

Written answers

Minister for Health

The HSE operates the Treatment Abroad Scheme (TAS) for persons entitled to treatment in another EU/EEA member state or Switzerland under EU Regulation (EC) No. 883/2004, as per the procedures set out in EU Regulations (EC) No. 987/2009, and in accordance with Department of Health Guidelines. Patients have the ability to apply to the HSE TAS seeking access to public healthcare outside the state through model form E112. The application requires the patient's Irish based public referring hospital consultant, following clinical assessment, to certify, among other things, that the treatment is medically necessary and will meet the patient’s needs. The treatment must not be available within the State or not available within a time normally necessary for obtaining it.

There is no statutory framework for referral of patients outside the EU/EEA member states. In the instance that a consultant wishes to refer a patient to a non-EU/EEA country, the HSE TAS applies the TAS administrative process and documentation for the purposes of such applications. Such applications for treatment in non-EU/EEA countries are required to provide evidence that the treatment is not available within the EU/EEA.

National Positive Ageing Strategy Implementation

Questions (46)

Caoimhghín Ó Caoláin

Question:

46. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the progress on the implementation of the national positive ageing strategy which was published on 24 April 2013, but on which there has been little sign of progress since, given that work on developing the original strategy began in 2007 and older persons have been waiting more than eight years for progress on this issue; whether an implementation plan to deliver the Government’s commitments on positive ageing will be introduced and when; and if he will make a statement on the matter. [20773/15]

Written answers

Minister of State at the Department of Health

The 2011-2016 Programme for Government committed to completing and implementing the National Positive Ageing Strategy (NPAS) so that older people are recognised, supported and enabled to live independent full lives. In our statement of Health priorities for 2015, the Minister for Health and I have reiterated our commitment to implementing the Strategy.

The National Positive Ageing Strategy provides a vision for an age-friendly society and includes four National Goals and underpinning Objectives to provide direction on the issues that need to be addressed to promote positive ageing. As Minister of State with responsibility for older people, I am driving implementation at the political level. The Strategy is a cross-Departmental one and my Department has an overall coordinating and collating role and a more direct role for the health-related objectives.

A key objective of this Strategy is to change the mindsets of decision makers across Government agencies and to raise the priority that is given to the concerns of older people. The first step in doing this is to establish a system of regular reporting on actions and initiatives that impact on older people, and these reports are regularly sought and collated by my Department. The fact that such reports are already and will continue to be required will in itself increase the focus that is given to older persons' issues, and these reports will be submitted for consideration by the Cabinet Committee on Social Policy and Public Sector Reform chaired by An Taoiseach. Implementation is accordingly an ongoing process.

It is important to point out the many initiatives already in train which contribute to the Strategy's goals. For example, in the health sector, in the area of older people’s services and supports, the Review of the Nursing Homes Support Scheme will be completed shortly. The Single Assessment Tool, which will allow for a systematic assessment of need and allocation of services to older people, is being developed by the HSE; measures are being taken to ensure integrated care for older patients, and palliative care services are being improved. The Deputy will also be aware that €25m was allocated in Budget 2015 to support services that provide alternatives to, and relieve pressures on acute hospitals. In April 2015, an additional €74m was allocated to further tackle the ongoing issue of delayed discharges in acute hospitals. The majority of these patients are older people, and these funds are being applied across both long term and short term residential services and at community level. As a result the waiting time for funding of approved patients under the Nursing Home Support scheme has fallen to four weeks now from eleven weeks in March.

A Healthy and Positive Ageing Initiative (HaPAI) has also been established to implement the research objective of the National Positive Ageing Strategy. It is a joint initiative between the Department of Health, the HSE’s Health and Wellbeing Programme and the Atlantic Philanthropies and will run from October 2014 to December 2017, with a commitment to Department of Health funding for a further two years. The Initiative will monitor changes in older people’s health and wellbeing linked to the Goals and Objectives of the Positive Ageing Strategy. This will be done primarily through the development of positive ageing indicators to be published every two years. A preliminary positive ageing report will be published shortly. The HSE will also develop a physical activity communications campaign under the Initiative.

Disability Services Provision

Questions (47)

Brian Stanley

Question:

47. Deputy Brian Stanley asked the Minister for Health the steps being taken by the Health Service Executive and his Department to ensure that children in counties Laois and Offaly who may be autistic will receive an early diagnosis and assessment; if he will provide a timeframe in which this will take place; and the likely waiting times for occupational therapy and speech and language therapy for children who are assessed as being autistic. [20585/15]

Written answers

Minister of State at the Department of Health

The HSE is currently engaged in a major reconfiguration of existing therapy resources for children with disabilities, including those with autism, into multi-disciplinary geographically based teams. The key objective of the Progressing Disabilities Programme is to bring about equity of access to disability services and consistency of service delivery across the country. This involves the creation of a clear pathway to services for children with disabilities, regardless of where they live, what school they go to or the nature of the individual child's difficulties.

A number of HSE Community Healthcare Organisations across the country are successfully implementing the programme which requires significant preparatory work in engaging with families, schools, voluntary providers and local communities and the development of new procedures and protocols in respect of multidisciplinary and multiagency working. Once this preparatory work has been completed additional posts are being provided to support the implementation of the new model of service.

In the Laois/Offaly area considerable work has been done to put in place the required governance structure which will allow for additional posts to be provided in 2015. A total of 120 new therapy posts will be provided across the country from an additional €4 million allocated this year (equating to €6 million in a full year). The HSE is currently finalising details of the allocation of additional therapy posts and it has informed me that Laois/Offaly will be prioritised.

The allocation of additional resources to Laois/Offaly to support the implementation of the Progressing Disabilities Programme will help address waiting times under the statutory Assessment of Need in the area. Research done by the National Disability Authority has demonstrated that where the Progressing Disabilities Programme has been successively implemented it has had a very positive impact on reducing waiting times for the Assessment of Need.

In addition the HSE is planning a waiting list initiative in Laois/Offaly shortly utilising spare capacity across public, voluntary and private providers to seek to reduce waiting times for the assessment and treatment of children pending the allocation and filling of the additional posts.

HSE Funding

Questions (48)

Seán Fleming

Question:

48. Deputy Sean Fleming asked the Minister for Health his views on the recent assertion that the Health Service Executive received none of the funding it sought from the Government to develop services in the Midland Regional Hospital, Portlaoise, County Laois, at the time that its senior doctors were warning about safety risks in the hospital; and if he will make a statement on the matter. [20765/15]

Written answers

Minister for Health

Requests for additional posts and funding are considered by the HSE as part of the annual estimates process. Requests for additional resources made in 2011 had to be considered in the context of competing demands for funding, and against the backdrop of the worst financial crisis ever to fall on the State. In 2010 and 2011 the HSE had total budget reductions of €1.75bn and staff levels were further reducing. The reality is that all services were under pressure and there were frequent requests for additional funding.

The Clinical Programmes were in their infancy and a lot of issues and services, which were in need of development, were being identified. Many meetings were held with clinicians, all of whom were, understandably, very vocal about perceived funding and resource needs in their own facilities and specialties. The priority at the time was to deliver the maximum level of safe services possible with the reduced funding and staffing levels. The budgetary challenges continued in 2012. However, I am advised that in applying the cost reduction measures required, the then Dublin Midlands Region afforded a level of protection to paediatric and maternity services.

Following the publication of the HIQA report earlier this month, I will, together with my Department, engage with the HSE to ensure that the report's very serious findings are addressed, and that the recommendations are fully implemented and all other issues arising are dealt with appropriately.

Since the Chief Medical Officer's report on Portlaoise last year, much has been done to strengthen services in the hospital. New management is in place, there is significantly improved clinical governance and additional key clinical staff have been appointed. Portlaoise is now part of the Dublin Midlands Hospital Group. The hospital will be supported to ensure that patients receive their treatment and care in the most appropriate setting within the Group.

Accident and Emergency Departments Waiting Times

Questions (49)

John Halligan

Question:

49. Deputy John Halligan asked the Minister for Health the reason one in four patients requiring emergency hip fracture surgery at University Hospital Waterford in February 2015 had their procedure delayed for more than 48 hours; if he will provide specific details of the levels of trolley and waiting times in UHW's emergency department in February 2015; if he acknowledges that these patients were mainly elderly persons; and if he will make a statement on the matter. [20786/15]

Written answers

Minister for Health

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.

Primary Care Centres

Questions (50)

Thomas Pringle

Question:

50. Deputy Thomas Pringle asked the Minister for Health his proposals in instances where general practitioners have invested heavily in providing their own accommodation and cannot afford to move to a centre to provide primary health care centres; if consideration will be given to providing centres for the support team of a primary care team without a GP; and if he will make a statement on the matter. [20757/15]

Written answers

Minister of State at the Department of Health

International research indicates that shared premises are a key enabler for successful team working in the primary care setting. Primary Care Centres (PCCs) create an environment for improved access, facilitating structured approaches to chronic disease management, enhanced multidisciplinary team working, improved diagnostic capabilities in Primary Care and the integration of services between primary and secondary care.

To-date, there are 87 PCCs in operation, 44 of which have opened since March 2011. There are currently 54 locations where primary care infrastructure is under construction or at an advanced planning stage under three methods of delivery, where completion is expected by Q2, 2017:

- 15 Direct Build;

- 14 Public Private Partnership; and

- 25 Operational Lease.

In November 2014, the HSE advertised an additional 73 locations for delivery of Primary Care Centres by Operational Lease. The HSE is reviewing all Expressions of Interest received to determine which are suitable for more detailed consideration and progression to the next stage of the process.

The HSE continues to provide appropriate accommodation for Primary Care Team staff, taking into account the existing infrastructure from which GPs operate. GPs, not co-located with Primary Care Teams, continue to link and work with the Team through structured team meetings or direct contact with individuals.

A research project has been commissioned by my Department to identify and assess the various options available to Government to encourage the provision, including the upgrading and refurbishment, of primary care centres in areas where they are needed. External consultants have been engaged to carry out this work and I expect to receive a report on the matter later this year.