Written Answers Nos. 172-181
172. Deputy Terence Flanagan asked the Minister for Health to outline his assessment regarding the success of the assertive case management team in addressing the problem of persons taking drugs on Dublin city centre streets; and if he will make a statement on the matter. [24137/15]
View answerIn September 2014, the HSE, in partnership with a local voluntary service provider, the Housing First service and An Garda Síochána set up an assertive case management programme to engage with a high-risk cohort who are involved in anti-social behaviour and/or public drug use. The pilot programme aims to provide shared care planning for these individuals, who have complex needs, and address their issues of homelessness and addiction using shared resources.
44 individuals have signed up to case management with the assertive case management team since the programme began. 42 service users who had previously not been engaging with services are continuing to access the services. The team has also engaged with local businesses and initiatives to provide a direct referral route for individuals who may be negatively impacting on business. It also takes on a role in disposing of drug paraphernalia and liaises with Dublin City Council where large quantities need to be disposed of. The next step is to evaluate the programme, and review its effectiveness in light of the overall outcomes of the service for the individuals involved.
173. Deputy Terence Flanagan asked the Minister for Health if he will provide an update regarding the construction of the national children's hospital; and if he will make a statement on the matter. [24138/15]
View answerThe National Paediatric Hospital Development Board is the statutory body responsible for planning, designing, building and equipping the new children's hospital. The new hospital will be co-located with St. James's Hospital, and ultimately tri-located with a maternity hospital to be developed on campus. In addition to the main hospital, the project includes two satellite centres at the campuses of Tallaght and Connolly Hospitals. Design development is ongoing and a planning submission is to be made in the coming weeks. Subject to planning, work is scheduled to commence at the main site at St. James's, and at satellite centre sites at Connolly and Tallaght, in early 2016.
I hope that this update is sufficient for the Deputy.
174. Deputy Terence Flanagan asked the Minister for Health to explain the reason a specialist is not available at a hospital (details supplied) in Dublin 9; and if he will make a statement on the matter. [24139/15]
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.
175. Deputy Terence Flanagan asked the Minister for Health to outline his plans for implementing the recommendations of the World Health Organization's resolution (details supplied); and if he will make a statement on the matter. [24140/15]
View answerThe resolution concerned of the World Health Organisation is largely encompassed in the aims and work of the HSE's National Clinical Programme for Epilepsy (NCPE). This has been in operation since 2010. Its main objective is to provide the best value, safe care for all people with epilepsy in the right place, at the right time by sharing the best available information.
Under the first recommendation of the resolution, the NCPE has a specific remit to describe models of care and formulate guidelines, where necessary, which aim to improve quality, access and value of clinical care. An advisory group of medical, nursing, technical and patient experts was convened with a remit to define a Model of Care for epilepsy. Consensus was rapidly agreed based on best international practice on the need to define centres of expertise nationally, to invest in nurse specialists and electronic communication, and to standardise procedures in epilepsy care. The NCPE has supported the implementation of this policy position with over 30 new Whole Time Equivalents (WTEs) in 6 defined national centres. The Model of Care has been signed off by the National Clinical Lead and Clinical Advisory Group and is being prepared for submission to the HSE Office of the National Director for Clinical Strategy and Programmes.
The NCPE has also developed and supported the implementation of an Electronic Patient Record; this promotes patient safety by supporting the availability of current, accurate patient information to clinicians involved in patient care. In addition, a suite of over 40 guidance documents (SOPs) have been developed by the NCPE. These look at the management of persons with Epilepsy across the care continuum from initial presentation, specialised treatment (including surgery) and to long-term management in primary care.
A detailed SOP has also been developed for the management of women with epilepsy, which includes family planning, pregnancy, delivery right through to menopause. This was completed in conjunction with the National Clinical Programme for Obstetrics and Gynaecology. Three Primary Care SOPs have also been developed in conjunction with the National Clinical Programme for Primary Care to cover the critical areas of managing seizures in the community, the process of referral to specialised services and the intelligent support process for managing Epilepsy in primary care. The NCPE also contributes to the National Medicines Liaison Centre collaborative and GP bulletins with information relating to the management of Epilepsy in the Community.
Under the second recommendation of the WHO resolution, the NCPE's Model of Care for Epilepsy advocates self management. Epilepsy specific self-management programmes, such as Epilepsy Ireland’s STEPS programme (Support & Training in Epilepsy Self-management) and the ‘Training for Success’ initiative run at the Sligo Institute of Technology, address more condition-specific issues such as living with Epilepsy; managing seizure triggers; lifestyle and safety; and understanding the impact of diet, exercise and sleep. The NCPE also supports the development of transitional programmes that support adolescents with epilepsy transition from paediatric services to adult services. Included in successful transition is the development of self-management and self-awareness skills to enable the young adult to take more responsibility for the management of their condition.
For the third recommendation of the WHO resolution, the NCPE has a close working relationship with Epilepsy Ireland. The programme regularly contributes to the Epilepsy Ireland newsletter and various national and regional conferences with updated information on developments within the programme.
Finally, on the question of research as per the fourth recommendation of the resolution, long-standing links with the Royal College of Surgeons in Ireland Genetics group has resulted in senior participation in the International League Against Epilepsy (ILAE) genetics consortium; this has been making important discoveries that will impact on diagnosis and treatment of epilepsy in the future. In this regard, significant advances on epilepsy research capacity have been made in Ireland. Furthermore, clinicians and researchers associated with the NCPE have been regular recipients of Health Research Board sponsored research grants. Other examples of research projects underway in Ireland include:
- Improving our understanding of the gene-based regulation of neuronal cell death and hippocampal remodelling in epilepsy
- European collaborative project called EpimiRNA which aims to understand molecular mechanisms, diagnostics and develop novel therapeutics for epilepsy
- Research group focused on identifying genetic predictors of the development and treatment of epilepsy
- A study on children with undiagnosed early onset epileptic encephalopathy.
176. Deputy Finian McGrath asked the Minister for Health whether he is aware of the significant potential loss of nurses in our nursing homes and senior citizens services; the action he will take on this urgent matter; and if he will make a statement on the matter. [24153/15]
View answerI wish to thank the Deputy for raising this issue. The nursing home public and private sectors are collaborating with the Department of Health and the HSE in sourcing several solutions to meeting the issues arising in relation to nurse recruitment and retention.
Currently, 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 HSE Office of the Nursing and Midwifery Services Director has been supportive in allowing the nursing home sector meet with graduate students in the universities, to discuss employment opportunities. In addition, the Chief Nursing Office in the Department has been engaged with, the public and private nursing home sector in promoting nursing in the older adult as a career choice. The Office has facilitated ongoing discussions, spoken at conferences and engaged with 3rd level universities on seeking solutions to the recruitment and retention issue. These discussions have involved exploring and reviewing career pathways within older people services to encourage more staff into this area of nursing practice.
The second area under review relates to the undertaking of initiatives for the recruitment of global nurses. The background to this issue is that nurses who trained in a country outside of Ireland and wish to work in Ireland are required to apply to register as a nurse with the Nursing and Midwifery Board of Ireland. The Nursing and Midwifery Board of Ireland, following assessment of qualifications by an applicant, may require an applicant to undertake a six to twelve week period of adaptation and assessment. A period of adaptation is designed to make up for differences in education and ensure competence for working in the Irish health service. If this adaptation is required it must be successfully completed as a pre-requisite to registration.
A collaborative group including Department of Health, HSE and Nursing Homes Ireland (NHI) representatives continue to explore options to facilitate adaptation. In this regard some hospitals will respond to local need from local nursing homes, and this has been encouraged within the hospital group structures; some hospitals will continue to support placements pending funding from NHI though not at peak undergraduate student times; and, some are withdrawing from the provision of clinical placements to facilitate their own internal international recruitment initiatives.
In addition, options are being explored with an Irish university to offer a one-day programme of assessment through an examination format. It is hoped that the pilot of this programme will be complete and results available in the last quarter of 2015.
177. Deputy Finian McGrath asked the Minister for Health if he will support a matter (details supplied) regarding the Donnycarney centre for senior citizens in Dublin 5; and if he will make a statement on the matter. [24154/15]
View answerAs 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.
178. Deputy Finian McGrath asked the Minister for Health if he will provide support in respect of a person (details supplied) in Dublin 5 in view of the circumstances; and if he will make a statement on the matter. [24155/15]
View answerAs 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.
179. Deputy Finian McGrath asked the Minister for Health if he will provide support in respect of a person (details supplied) in Dublin 5 who requires taxis to get to hospital appointments; and if he will make a statement on the matter. [24156/15]
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.
180. Deputy Thomas P. Broughan asked the Minister for Health to outline his plans to inform citizens of their right to receive treatment abroad under the cross-border Directive 2011/24/EU with only the requirement of a general practitioner referral letter; and if he will make a statement on the matter. [24189/15]
View answer181. Deputy Thomas P. Broughan asked the Minister for Health to outline his plans to inform persons on waiting lists of their rights to obtain care outside Ireland and to be reimbursed, fully or partially, in case of non-medical card holders for same; and if he will make a statement on the matter. [24190/15]
View answerI propose to take Questions Nos. 180 and 181 together.
The EU Directive on the application of patient’s rights in cross-border healthcare seeks to ensure a clear and transparent framework for the provision of cross-border healthcare within the EU and is designed to clarify patients' rights to access safe and good quality treatment across EU/EEA Member States.
The Health Service Executive operates the EU Directive on Patients’ Rights in Cross Border Healthcare in Ireland. In line with practice in other EU Member States, the HSE, through the National Contact Point (NCP) office, provides information for patients on the Cross-Border Directive on its website - http://www.hse.ie/eng/services/list/1/schemes/cbd/ - and also by phone. The principal function of the NCP (which is the mechanism specified under the Directive for the dissemination of information on the Directive by Member States) is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost and the procedures for accessing and determining those entitlements. The NCP also has a responsibility to ensure that all enquirers are informed of the right to healthcare, if any, that they may have through the European legislation on the coordination of social security schemes (EU Regulation 883/04) and which may be more beneficial to them. The NCP is able to inform patients what the cost of their treatments would be in Ireland to allow them make a comparison with the costs they are being quoted for comparable treatment in another Member State.
The healthcare being sought under the CBD can only be healthcare that a person would be entitled to within the public health system in Ireland, which is not contrary to Irish legislation. Referral for care under the CBD can be made by a GP, a hospital consultant and certain other HSE clinicians. It will be a matter for the patient and his/her referring doctor to identify the clinician abroad and satisfy him/herself in relation to the qualifications, quality and safety of the services being availed of in the other jurisdiction.
Prior authorisation may be required from the HSE for certain healthcare. This requires completion of an application process; consequently patients intending to access care under the CBD should check with the HSE in advance of travelling. The costs must be borne by the individual and he/she then will seek reimbursement for the cost of the healthcare upon return to Ireland. The HSE will reimburse the patient for care which meets the terms of the CBD in line with the Directive. Costs will only be reimbursed up to the level that would have been arisen if the healthcare had been provided in Ireland or the actual cost of the healthcare in the other member state, whichever is the lesser. All other costs associated with accessing care abroad under the CBD are a matter for the patient and will not be reimbursable by the HSE.
