Written Answers Nos. 448-468
448. Deputy Finian McGrath asked the Minister for Health the position regarding claims of abuse of service users of the Health Service Executive (details supplied); and if he will make a statement on the matter. [36174/15]
View answerIt is my understanding from the details supplied by the Deputy that this case involves an alleged assault by a resident in an approved centre on a fellow patient. As this incident has been reported to the Gardai, it would be inappropriate for me comment any further at this time. I have, however, requested the HSE to provide me with a report on this matter, including the circumstances around the alleged medication error.
449. Deputy Clare Daly asked the Minister for Health if he will provide justification for a scenario whereby persons are charged the full amount for their hospital stay, even when they are spending that time on a trolley for the entire duration, in many instances with no other facilities. [36184/15]
View answerAll charges for public hospital in-patient and out-patient services are made in accordance with the Health Act 1970, as amended. The charge for public in-patient services is €75 per night, up to a maximum of €750 in a calendar year. The Emergency Department charge is €100 for each episode of care. Exemptions from these statutory charges are extended to certain cohorts including persons with full eligibility (medical card holders).
All persons who opt to be treated on a private basis on admission to hospital are liable for the statutory charges set out in the Fourth Schedule of the Act.
Issues around performance in Emergency Departments (ED) are being addressed by the ED taskforce. It is important to note that patients are being actively cared for during their ED attendance, regardless of where they are accommodated. According to the most recently published HSE Performance Assurance Report (for July 2015), 70.2% of patients attending ED were either admitted or discharged within 6 hours and 83.6% of patients were admitted or discharged within 9 hours. 2.8% of patients were in ED for more than 24 hours. These areas are a particular focus for hospitals and site specific plans are being prepared to improve performance. Each Hospital Group has implemented an escalation protocol for those patients whose wait time in ED is approaching 24 hours as part of the Winter Planning process.
While there is continued focus on reducing the number of patients on trolleys, it is important to note that treatment trolleys are routinely used in day surgery procedures such as colonoscopy and that in the case of a chemotherapy or dialysis patient, best practice is to treat him\her in a seated or reclining position, on a therapy chair or a recliner, rather than on a bed.
450. Deputy Michael McCarthy asked the Minister for Health the funding, in detail, provided to a hospital (details supplied) in County Cork; and if he will make a statement on the matter. [36186/15]
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.
451. Deputy Robert Dowds asked the Minister for Health for an update on the delivery of primary health care centres on the Convent Road in Clondalkin; on the Rowlagh in North Clondalkin; at Ballyowen; and at Lucan, in County Dublin. [36188/15]
View answerThe HSE has responsibility for the provision, maintenance and operation of Primary Care Centres. Therefore, this matter has been referred to the HSE for attention and direct reply to the Deputy. 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.
452. Deputy Terence Flanagan asked the Minister for Health the position regarding the recruitment of nurses at the Mater Hospital in Dublin 7; and if he will make a statement on the matter. [36191/15]
View answerWith a recovering economy, the Health Service Executive is now in a position to offer a wide range of career opportunities for nurses and midwives. There are many initiatives currently underway to improve nursing staff levels throughout the country. These include the retention of 2015 degree programme graduates, offering full time permanent contracts, and an international recruitment campaign. In addition the conversion of agency usage to permanent staffing in line with agreed processes is a key objective of the National Service Plan 2015.
With regard specifically to nursing posts in the Mater Hospital, I have asked the HSE to respond to the Deputy directly on the matter. 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.
453. Deputy Brendan Griffin asked the Minister for Health when a replacement manual wheelchair will be provided to a person (details supplied) in County Kerry; and if he will make a statement on the matter. [36192/15]
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.
454. Deputy Billy Kelleher asked the Minister for Health the reason for the delay in procuring a microscope at Tallaght Hospital in Dublin 24 (details supplied), the lack of which has resulted in the cancellation of procedures for the past number of months; when it will be received; and if he will make a statement on the matter. [36194/15]
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 up the matter.
455. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 192 of 24 June 2015 in relation to the newly-instituted national incident management system, where severity ratings are being assessed by the local health care organisation at time of reporting, the training that has been given to local staff to handle the reporting and rating of the severity of incidents; and the review and oversight mechanisms that are involved in maintaining the quality control of these severity ratings which are filled in locally. [36199/15]
View answerUnder the National Treasury Management Agency (Amendment) Act 2000 there is a statutory requirement for all State authorities including the HSE and its funded agencies to report adverse incidents promptly to the State Claims Agency (SCA) and to facilitate any subsequent investigation. This allows the HSE in conjunction with the SCA to identify and analyse developing trends and patterns and to develop and implement risk mitigation strategies.
Considerable work has been undertaken in the first six months of 2015 in the roll out the new National Incident Management System (NIMS). At the end of June 2015, the former ‘STARsWeb’ system was ‘switched off’. NIMS is now the national (and only mandated) platform for reporting incidents. It provides a powerful reporting tool that supports incident investigation, tracking of recommendations from investigations and analysis of adverse event trends, all of which should inform the risk strategies of each health service organisation.
In terms of the quality of data;
- This is supported by the NIMS intelligent interview entry forms, incorporating specific questioning and picklists, along with mandatory field validations which are designed to standardise reporting across the health sector. This will also lead to improvement in data quality.
- Certain NIMS information is automatically generated by the system through built in algorithms. An example of this is the "severity rating" which is based on the injury outcome. This algorithm follows the Impact table for clinical and non clinical incidents, which is set out in the HSE’s Safety Incident Management Policy, and results in the generation of an objective, system-driven "severity rating".
- NIMS provides the capability for the user to conduct a risk investigation and update the injury outcome as appropriate, allowing for a reclassification of the system generated "severity rating".
- The State Claims Agency, as the host of NIMS, has also established a data services section which monitors the quality of data on NIMS on an ongoing basis.
As part of NIMS, a new taxonomy consistent with the World Health Organisation taxonomy was introduced to facilitate more consistent reporting. The benefits of this will be seen as the system becomes the established reporting tool for both serious and less serious incidents.
As part of the roll out programme for NIMS, almost 700 people have been trained to enter incidents on the system. Further training is currently underway to allow each service produce reports on its own data.
456. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 192 of 24 June 2015, when it is expected that the national incident management system will feed into the development of a comprehensive information base, publicly available for purposes of comparison, similar to the United Kingdom's national child and maternal health intelligence network. [36200/15]
View answerThe new National Incident Management System (NIMS) is an end-to-end risk management tool, the purpose of which is to provide the HSE and HSE-funded services with the information to manage incidents throughout the incident lifecycle, that is from reporting of incidents to management of investigations, to tracking of how the recommendations following such investigations are being implemented. It will be an important management tool for understanding and learning from incidents with a view to improving patient, service user and staff safety, while continuing to fulfil the legal requirement to report incidents to the State Claims Agency.
Phase 1 implementation of NIMS, which deals with the recording of incidents and which replaced the STARsWeb System was completed in June 2015.
Planning for Phase II is well advanced and will provide for management of investigation and the development of a standard suite of reports to support the management of incidents. Also, as part of this Phase II the HSE, in conjunction with the State Claims Agency, will be considering the format and content of information to be published and international practice in this area will be examined, in order to inform those considerations.
457. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 468 of 23 June 2015, and given the acknowledged role that the Health Information and Quality Authority has in carrying out investigations regarding serious shortfalls and shortcomings in maternity units, the reason the Health Service Executive is conducting internal inquiries. [36201/15]
View answer458. Deputy Clare Daly asked the Minister for Health if the Health Information and Quality Authority has been appointed as the external reviewer for the review of Portiuncula Hospital in County Galway; if not, the reason; and if he will make a statement on the matter. [36202/15]
View answerI propose to take Questions Nos. 457 and 458 together.
The safety of service users is of paramount importance and steps need to be taken to anticipate and avoid things going wrong and to reduce the impact if they do. Creating a culture of open disclosure and learning from the things that go wrong is the bedrock of making systems safer. It is in this context that the HSE requires all safety incidents to be reported, managed and investigated.
The HSE's National Safety Incident Management Policy 2014 and the Guidelines for Systems Analysis Investigation of Incident and Complaints 2012 were developed by the Executive to protect patients and ensure that robust investigations are carried out. The policy sets out the steps to be taken when an investigation is required and has been developed in line with international best practice in patient/service user safety and risk management.
The HSE recognises that some incidents, due to their seriousness, complexity, or where there are matters of significant public concern, will require investigations to have an additional level of independence. In the acute hospital sector the HSE has formal arrangements in place with the Forum of Postgraduate Training Bodies in Ireland and Royal Colleges in the UK for seeking nominations to Chair or participate in investigation teams. The use of these external experts is the exception rather than the rule.
At the request of the Chief Clinical Director, Saolta University Healthcare Group, the Executive's National Incident Management and Learning Team established a Review of the Maternity Services at Portiuncula Hospital, Ballinasloe with an independent Review Team, chaired by Professor James Walker, Professor of Obstetrics and Gynaecology, University of Leeds and supported by trained investigators. The Review team are working towards the Review being completed by the end of this year.
Under Section 9 of the Health Act 2007 the Health Information and Quality Authority (HIQA) may undertake an investigation as to the safety, quality and standards of services provided by the Health Service Executive if the Authority believes that on reasonable grounds there is a serious risk to the health or welfare of a person receiving those services. I, as Minister, also have powers under the Health Act 2007 to request an investigation in particular circumstances. In the case of the Portiuncula Review I will await the outcome of the HSE Review Team's work before deciding if any further course of action is appropriate.
459. Deputy Billy Kelleher asked the Minister for Health the hospitals that will be providing the additional 440 beds to ease the pressure on emergency departments, in tabular form; the number of beds each hospital will provide; if these beds will all or in part remain permanently in place; if not, when any or all of them will be removed; the number of additional staff needed for this; the number to be provided in each relevant hospital; if he plans to recruit such staff, or if he plans to source them through agencies; and the additional full-year costs of providing the 440 beds and the staff complement required. [36205/15]
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 up the matter.
460. Deputy Gabrielle McFadden asked the Minister for Health if a second palliative care consultant for the midlands region has taken up the post at the Midlands Regional Hospital in Mullingar in County Westmeath; if so, when the consultant commenced the role; what the role specifically entails; and if he will make a statement on the matter. [36226/15]
View answerAs the recruitment of consultants is a matter for Health Service Executive, I have forwarded your question to the HSE 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.
461. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied) regarding dementia; and if he will make a statement on the matter. [36236/15]
View answerThe Irish National Dementia Strategy was launched in December 2014. This Delivers on a commitment in the Programme for Government to develop a national Alzheimer's and other dementias strategy to increase awareness, ensure early diagnosis and intervention and develop enhanced community based services.
The Department of Health and the HSE have agreed a joint initiative with the Atlantic Philanthropies to implement significant elements of the Strategy over the period 2014-2017. This National Dementia Strategy Implementation Programme will represent a combined investment of €27.5m, with Atlantic Philanthropies contributing €12m and the HSE contributing €15.5m.
This Programme will promote a greater focus on timely diagnosis of dementia and on the value of early intervention, along with the long-term objective of making people in Ireland generally more aware and understanding of the needs of people with dementia and of the contribution that those with dementia continue to make to our society.
Key elements of the initiative include:
- the roll-out of a programme of Intensive Home Supports and Home Care Packages for people with dementia;
- the provision of additional dementia-specific resources for GPs, who are the critical and initial point of contact with the health system for those with dementia. The resource material will include training materials and guidance on local services and contact points etc;
- measures to raise public awareness, address stigma and promote the inclusion and involvement in society of those with dementia.
A Monitoring Group, chaired by the Department of Health, has been established to assist with and advise on implementation of the National Dementia Strategy, including the National Dementia Strategy Implementation Programme. This Group also includes health professionals, administrators, researchers and advocates. The Group also includes a person living with dementia and a representative of those who care for people with dementia. The most recent meeting of this Monitoring Group was held on 24th September 2015.
As the delivery of dementia services 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.
462. Deputy Pearse Doherty asked the Minister for Health for details of general practitioner deployment, including rotas, assigned to the NowDoc out-of-hours general practitioner service at one of its centres (details supplied) in County Donegal for the period 1 September 2015 to 12 October 2015; any disruptions to service provision at this centre, including the reason; and if he will make a statement on the matter. [36239/15]
View answerAs this is a service issue, it has been referred to the Health Service Executive for direct reply to the Deputy. 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 the executive.
463. Deputy Peadar Tóibín asked the Minister for Health the pathway for all categories of patients, most especially trauma patients, when Our Lady of Lourdes Hospital in County Louth is off-call. [36250/15]
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 up the matter.
464. Deputy Clare Daly asked the Minister for Health why the fatal foetal anomaly in initial drafts of a policy in relation to drawing up national care standards for pregnancy bereavements was subsequently altered to the life limiting foetal anomaly; the action taken in relation to the staff member involved; and if he will make a statement on the matter. [36269/15]
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 up the matter.
465. Deputy Clare Daly asked the Minister for Health if he will consider repealing the Regulation of Information (Services Outside the State for Terminations of Pregnancy) Act 1995, given that it places serious limits on getting information from reliable sources regarding accessing an abortion. [36270/15]
View answerThere are currently no plans to repeal the Regulation of Information (Services Outside of the State for Terminations of Pregnancy) Act 1995.
The HSE Crisis Pregnancy Programme funds the availability of free-of-charge crisis pregnancy and post abortion counselling services through a range of service delivery models nationally to support equity of access and client choice. This service is provided in 50 centres nationwide. Crisis pregnancy counselling services are also offered by other providers not funded by the CPP: such as hospitals, general practitioners, and private counselling services. Post abortion medical checkups are also provided free-of-charge through some of these centres.
If a woman is seeking information on abortion services outside of the state she can access this information in the context of a counselling session with a crisis pregnancy counsellor. A list of nationwide counselling services is available at www.positiveoptions.ie. Positive Options is promoted through a public awareness campaign of national radio advertising alongside washroom and GP posters. Where a woman requests this information the counsellor must provide information advice and counselling on all options available to her in relation to her particular circumstances. This information must be truthful and objective and fully inform the woman of all courses of action that are available to her.
The crisis pregnancy counsellor can provide verbal and written information on abortion services and procedures in countries where abortion is lawfully available. The woman is supported through her decision by the crisis pregnancy counsellor and counselling is offered at any stage including after the abortion in terms of post abortion counselling www.abortionaftercare.ie.
466. Deputy Ciarán Lynch asked the Minister for Health when a decision on an application for respite care by a person (details supplied) in County Cork will be made; the availability of respite in the Cork city region; and if he will make a statement on the matter. [36280/15]
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.
467. Deputy Billy Kelleher asked the Minister for Health when a person (details supplied) in County Cork will resume duty as an administration officer, following a career break. [36283/15]
View answerI have asked the HSE to respond to the Deputy directly on the matter. 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.
468. Deputy Eric Byrne asked the Minister for Health his views on correspondence (details supplied) regarding the nursing home support scheme, fair deal; and if he will make a statement on the matter. [36294/15]
View answerUnder the Nursing Homes Support Scheme Act 2009, the HSE has statutory responsibility to operate and administer the Scheme. Therefore, the Deputy's question has been referred to the HSE 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.
