Written Answers Nos. 43-64
43. Deputy Helen McEntee asked the Minister for Health for an update on his Department's engagements with the Health Service Executive to address overcrowding challenges at Our Lady of Lourdes Hospital in Drogheda; and if he will make a statement on the matter. [35560/15]
View answerReducing Emergency Department overcrowding is a priority for me and for the Government. I convened the ED Taskforce in December 2014 to provide focus and momentum in dealing with the challenges this issue presents. The Director General of the HSE is co-chairing the ED Taskforce Implementation Group until March 2016. He has taken this decision in order to ensure that all relevant parts of the health services, including acute, social and primary care, are optimising resources in order to deal with the particular challenges associated with the winter months.
Based on the Task Force's Action Plan, additional funding of €74m was provided in April of this year. This funding has supported significant progress to date on reducing delayed discharges and lowering the waiting time for Fair Deal funding, as well as providing additional transitional care beds and home care packages to provide viable supports for those no longer needing acute hospital care. This additional funding came on top of measures already taken in Budget 2015, when the Government provided €25m to support services that provide alternatives to and relieve pressure on acute hospitals. In relation to bed capacity, further additional funding of €18m was provided in July for a winter initiative to include the provision of approximately 300 additional hospital beds. A further 116 hospital beds which have been closed for refurbishment or for infection control purposes during 2015 are also to be re-opened by the end of November.
Following the construction and commissioning of a modular unit at Our Lady of Lourdes Hospital Drogheda, an eight bay Clinical Decision Unit opened on 8 September, with a four bay Surgical Assessment Unit due to open shortly and 12 in-patient beds due to open by the end of November. The Clinical Decision Unit and Surgical Assessment Unit will allow the hospital to facilitate appropriate patient streaming, observation and treatment in a designated space, as well as reducing the pressure on the Emergency Department and the additional in-patient beds will further address the overcrowding challenges.
All of these actions are intended to enable the HSE to deliver my stated objective of reducing the number of delayed discharges by one third to less than 500 and the number of patients on trolleys in EDs waiting for admission for over nine hours to fewer than an average of 70.
44. Deputy John Halligan asked the Minister for Health the number of patients outsourced from University Hospital Waterford to private hospitals for outpatient appointments in 2014 and in 2015 to date; the average cost per consultation for these appointments; the number of such appointments that required follow-up care; the number of these care requirements that will be facilitated at University Hospital Waterford; the number of patients referred to private hospitals for inpatient or day case procedures; the average cost of these procedures; the hospitals the patients were treated at; the number of these outsourced patients who received a full complement of care and have now been returned to University Hospital Waterford; and if he will make a statement on the matter. [36369/15]
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.
45. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he has evaluated the ongoing requirement in respect of hospital beds and accident and emergency accommodation at all general hospitals with a view to minimising waiting lists and the use of trolleys for a long period while patients are awaiting attention; the extent to which he has identified the main contributory factors that have continued to cause problems in recent years; how he hopes to provide the necessary facilities to alleviate the problem in the short to medium term; and if he will make a statement on the matter. [36261/15]
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.
46. Deputy Robert Troy asked the Minister for Health if he will address the lack of rehabilitative services and facilities available in County Westmeath for post-operative patients; and if he will make a statement on the matter. [36563/15]
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.
47. Deputy Caoimhghín Ó Caoláin asked the Minister for Health for a detailed account of the spend to date, at end quarter 3, of the additional €35 million allocated for mental health purposes in 2015; if he will specify each of the headings and subheadings and the sums expended in each case; if the total sum will be fully and appropriately utilised before year end; and if he will make a statement on the matter. [36362/15]
View answerFollowing discussions between the Department of Health and the HSE around the allocation of the €35 million provided for mental health in 2015, the priority areas to be further enhanced and developed for the remainder of the year have been broadly agreed. The priorities for this year include a number of non-pay initiatives including the funding of external providers to supplement HSE service delivery, funding to improve safety and regulatory compliance of services on a once-off basis this year, as well as funding for enhanced service capacity which was funded up to now through the use of time related savings from previous years' allocations. At this point €26.43m has been approved for release to the HSE, with the remainder to be finalised with the HSE as soon as possible.
The following table details the funding approved to date. The initiatives listed at 1 - 8 are already under way and broadly consist of existing base cost initiatives which will be funded on an ongoing basis from the 2015 development funding. The €11 million provided for priority works to improve safety and regulatory compliance of Mental Health Services and the €2 million provided for short-term respite, assistance and supports for the Disability Services are being provided on a once-off basis this year, and this funding will be available in full to the Mental Health Services in 2016 for the recruitment of mental health posts and other service developments.
|
Initiative/Project |
€m |
|
|
1 |
National Forensic Services |
2.500 |
|
2 |
Private Placements (Eating Disorders, Challenging Behaviour) |
1.800 |
|
3 |
Acute Unit (Cork University Hospital) Security and Staffing Costs |
1.850 |
|
4 |
Counselling Services (SHIP Waterford) |
0.180 |
|
5 |
Headstrong Jigsaw |
0.750 |
|
6 |
Community Early Intervention Responses |
2.400 |
|
7 |
Stigma Reduction |
0.200 |
|
8 |
Service User Engagement to advance recovery |
1.000 |
|
9 |
Suicide Prevention Initiatives |
2.750 |
|
10 |
Priority Works to enhance safety in mental health facilities (once-off) |
11.000 |
|
11 |
Disability Services (once-off) |
2.000 |
|
Total Allocated to end- September |
26.430 |
48. Deputy Mick Wallace asked the Minister for Health his plans for specific measures to reduce the waiting list for child and adolescent mental health services across the country, which, according to the Irish Hospital Consultants Association, has increased by 24% in a three to six-month period; the measures his Department is taking in this regard in County Wexford; and if he will make a statement on the matter. [36267/15]
View answerThis Government is committed to ensuring that all aspects of Child and Adolescent Mental Health Services (CAMHS) are delivered in a consistent and timely fashion across the country. To this end, the HSE recently introduced a new Standard Operating Procedure for both in-patient and community CAMHS services.
In March last, I asked the HSE to undertake a detailed validation of CAMHS Waiting Lists. This process, which is monitored regularly and in consultation with the HSE, was designed to minimise inappropriate referrals and waiting times and, in particular, to reduce the numbers waiting over 12 months. In this context, the total number of children and adolescents waiting to be seen continues to fall month on month, with a decrease from 2,542 in July to 2,240 in August. The numbers waiting less than 3 months have fallen from 1,045 to 781. There has also been good progress on those waiting over 12 months, which has fallen from 300 in July to 241 (a reduction of 59, this also represents a reduction of 218 on the April figure). There has been a small decrease in the numbers waiting over 3 months from 1,497 in July to 1,459 in August, while bearing in mind that there has been a continued increase overall in demand for CAMHS services over this year.
The position I have outlined above relates to the national approach on CAMHS. In relation to measures which the HSE has put in place in Wexford, as this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
49. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the up-to-date position regarding the establishment of an island of Ireland-based deep brain stimulation service from suitability assessment through to and including the insertion procedure and subsequent aftercare; if access to this service at the Royal Victoria Hospital in Belfast will be open to suitable sufferers of Parkinson's disease and dystonia from across all 32 counties; if active consideration is being given to the establishment of other procedures that are not currently available on this island because of the failure to measure viability on the potential throughput of the all-island population; and if he will make a statement on the matter. [36364/15]
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.
50. Deputy Terence Flanagan asked the Minister for Health his assessment of the progress made to address the overcrowding crisis in the emergency department at Beaumont Hospital in Dublin 9; and if he will make a statement on the matter. [36472/15]
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.
51. Deputy Anthony Lawlor asked the Minister for Health if the Health Service Executive is aware of the overcrowding issue at its health care facility (details supplied) in County Kildare; if he will arrange to have an immediate assessment of the premises undertaken; his plans to provide temporary accommodation to deal with the problem; and if he will make a statement on the matter. [36466/15]
View answerThe HSE has responsibility for the provision, maintenance and operation of Health 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.
52. Deputy Thomas Pringle asked the Minister for Health the amount of funding provided for more community first responder teams and more paramedics that will go directly to County Donegal; and if he will make a statement on the matter. [36467/15]
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.
53. Deputy Joan Collins asked the Minister for Health his views on the waiting list for surgery for scoliosis patients in University Hospital Galway. [36585/15]
View answerImproving waiting times for scheduled care for patients is a priority for the Government. In January, taking into account current pressures on acute hospital services, I put in place maximum permissible waiting times for inpatient and day case treatment and outpatient appointments of 18 months by 30 June and 15 months by year end. In June, the HSE reported a performance against the 18 month maximum waiting time of 99.6% for in-patient/day cases and 92% for out-patients.
The HSE was provided with additional funding of €51m to ensure that these maximum waiting times are achieved. The funding provided is intended to maximise capacity across public and voluntary hospitals as well as outsourcing activity where the capacity is not available to meet patient needs within the maximum allowable waiting time. It is recognised that issues of complexity and capacity adversely impact a small number of specialties, including spinal surgery for scoliosis.
The Saolta University Healthcare Group has assured my Department that the waiting list for such surgery is a high priority and that Galway University Hospital has been actively working to ensure that the necessary arrangements are in place in order to facilitate the level of complexity involved. In particular, significant progress is being made in relation to ensuring the required resources are in place in the context of bed availability, access to diagnostics, purchase of specialist spinal equipment and access to theatre. My Department is informed that the waiting list for spinal surgery at Galway University Hospital currently comprises thirteen patients, that one scoliosis patient was treated between January and May 2015 and that 3 scoliosis patients have been treated since May 2015.
54. Deputy Seán Kyne asked the Minister for Health when it is envisaged that the specific projects to be funded under the capital plan allocation for health services will be finalised; and if the projects will include plans for a new emergency department at University Hospital Galway. [36469/15]
View answerFollowing the announcement last month of the health capital envelope of €3,061 million for the multi-annual period 2016-2021, the HSE has undertaken preliminary work on the Capital Plan. This Plan, which requires my approval together with the consent of the Minister for Public Expenditure and Reform, will include a schedule of projects to be delivered. This recently announced capital envelope has increased funding available in the later years and therefore scope for additional investment concentrated towards the end of the period. Funding has been made available to begin the development of this large project which incorporates a new ED. However, in advance of the approval of the Plan, it is not possible to indicate with any certainty when projects will be finalised.
55. Deputy John Halligan asked the Minister for Health the number of unfilled consultant positions at University Hospital Waterford by Department; the measures the hospital has taken to fill these posts to date; the average salary being offered; how this compares with similar positions in other hospitals; and if he will make a statement on the matter. [36370/15]
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.
56. Deputy Bobby Aylward asked the Minister for Health the action that will be taken to reduce the waiting times for speech and language therapy in the south east; and if he will make a statement on the matter. [36582/15]
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.
57. Deputy Seán Ó Fearghaíl asked the Minister for Health the proposals being brought forward to upgrade facilities and improve services at Saint Vincent's Hospital in Athy in County Kildare. [36655/15]
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
58. Deputy Dara Calleary asked the Minister for Health how budget 2016 will improve and enhance the National Ambulance Service, especially in the western region; and if he will make a statement on the matter. [36590/15]
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.
59. Deputy John Browne asked the Minister for Health if there will be an increase in home help hours in County Wexford in 2016; and if he will make a statement on the matter. [36566/15]
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.
60. Deputy Colm Keaveney asked the Minister for Health the reason there was no specific 2016 funding commitment of €35 million for mental health on budget day, in line with the programme for Government and with previous budget day announcements; if the €15 million not provided in budget 2014 will now be provided in 2016; and if he will make a statement on the matter. [36578/15]
View answerIn line with the Programme for Government, my priority as Minister has been to modernise our mental health services, and to prioritise new resources to underpin the implementation of A Vision for Change. This Government, despite severe financial pressures overall, has provided additional ring-fenced funding of €125 million since 2012 up to end 2015 for mental health to modernise services in line with Vision and Programme for Government commitments.
The additional €20 million provided for mental health in 2014 must be seen in the context of the overall additional ring-fenced funding for mental health since 2012. This amount was considered appropriate given the challenge in recruiting staff to new posts, which has improved since then. The overall additional ring-fenced funding since 2012 represents a significant investment, facilitating the prioritised development and reconfiguration of Community Mental Health Teams for adults and children and adolescents. The funding is also being used to enhance specialist community mental health services for older people with a mental illness and those with an intellectual disability and mental illness, forensic mental health services, and to enhance access to counselling and psychotherapy in primary care and for suicide prevention measures.
The details of the 2016 Budget will be finalised with the HSE in the context of approval of its 2016 National Service Plan, which will also outline the total amount of funding for all services, including mental health services, in 2016.
An additional €35 million will be provided in 2016 in line with the commitment in the Programme for Government to accelerate the pace of change to develop a modern, patient-centred, and recovery-orientated mental health service. This means that, despite serious resource pressures overall, this Government will provide funding of €160 million up to end of 2016 which has been specifically ear-marked for new developments in mental health and suicide prevention. This will enable the HSE to continue to develop and modernise our mental health services in line with the recommendations of A Vision for Change.
61. Deputy Catherine Murphy asked the Minister for Health if he is aware of the pressure being exerted on nursing homes in terms of a shortage of nursing staff at present; that extreme delays in the registration process at the Nursing and Midwifery Board of Ireland is exacerbating the problem, in addition to the flight of domestically qualified nurses from Ireland and the aggressive recruitment by larger hospitals of nurses working in nursing homes; the measures he will take to address the immediate shortage and encourage domestically qualified nurses to stay here; and if he will make a statement on the matter. [36268/15]
View answerI am pleased to report that progress has been made in relation to the registration delays in the NMBI. To 13 October 2015, 1,495 applicants have been registered this year, the highest in many years, of which 758 were Irish-trained applicants. The number of applications received to 13 October this year is up 139% on the same period in 2014. I would like to advise the Deputy that, to 13 October, the number of people registered in 2015 was 1,495 and when this is compared to the same period in 2014, the number of people registered is 967 - this represents an increase of 55%.
The latest figures from the NMBI indicate that they have 1,980 open applications, of which:
- 1,348 have documentation outstanding (61%);
- 81 have been approved and a fee is awaited by the NMBI; and
- 168 further cases are waiting review.
The Department has approved the filling of 16 posts and temporary measures have been put in place to ensure all applications received are dealt with in a timely manner. NMBI informed the Department on the 24 September that there are currently no backlogs in processing the post.
Seven adaptation programmes have been held for the nursing home sector since 2014 in order to allow overseas nurses to register in Ireland. One adaptation programme has commenced and a further programme is scheduled later in the year. I understand that five adaptation programmes will be held in 2016. At 23 September 2015, some 405 places have been made available so far on these courses.
The NMBI has approved, on a pilot basis, a new aptitude test with RCSI as an alternative method to assess candidates for registration. Nurses are currently being advised of the availability of this test and all who have a letter for adaptation are being contacted to advise them of this development. This test will be provided in November 2015 when a minimum cohort of 25 nurses is secured. Successful candidates will be recommended for registration to NMBI by RCSI.
On 8 October 2015, a new overseas call centre service was launched by NMBI in response to the significant increase in applications for registration from overseas nurses and midwives. NHI and other key stakeholders were informed of the new overseas call centre service on 7 October. The website has been updated to inform the wider audience. On 16 October 2015, 684 calls were received by this call centre.
With a recovering economy, the Health Service Executive is now in a position to offer full-time jobs to nurses and midwives. There are many initiatives currently underway to improve nursing staff levels throughout the country. These include offering full-time permanent contracts to the 2015 degree programme graduates. 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.
In July, the HSE launched an International Staff Nurse Recruitment Campaign which focused on the UK to attract Staff Nurses to jobs in Ireland. In this campaign, there was a particular emphasis on targeting Irish Nurses who have left Ireland in recent years and want to return home. The HSE is currently in the process of expanding this recruitment initiative outside the UK and Europe in order to fill service vacancies.
62. Deputy Niall Collins asked the Minister for Health when negotiations will open on a new general practitioner contract; and if he will make a statement on the matter. [36576/15]
View answerFollowing the signing of a Memorandum of Understanding by the HSE, the Department of Health and the Irish Medical Organisation in February 2015, the parties commenced talks on a new GP contract and the talks are ongoing.
A priority of these discussions is the inclusion of chronic disease management for patients. As a first step in this process, agreement was reached on the introduction of a Diabetes Cycle of Care for adult patients with Type 2 Diabetes who hold a Medical Card or GP Visit Card. This service commenced on 1st October 2015.
63. Deputy Ruth Coppinger asked the Minister for Health his views on current waiting list times for speech and language therapy, given the Health Service Executive reports that the number of applications for assessments has been rising year on year since 2010; and if he will make a statement on the matter. [36666/15]
View answerThe Disability Act 2005 provides for an assessment of the needs of eligible applicants occasioned by their disability. It was partly commenced in 2007 in respect of children up to the age of five. However, arising from a High Court ruling in 2009, all children born on or after 1st June 2002 have been deemed as being eligible to apply for an assessment of need under the Act.
The following table shows that there has been significant year on year increases in the number of children applying for an assessment of need. The full year figures for 2014 show that the numbers have almost doubled since 2008.
|
- |
2007 |
2008 |
2009 |
2010 |
2011 |
2012 |
2013 |
2014 |
2015 – Q1+Q2 |
|
Number of Completed Applications Received |
1,137 |
2,535 |
2,525 |
3,100 |
3,349 |
3,505 |
4,261 |
4,908 |
3,001 |
During the 18 month period from 1st January 2014 to 30th June 2015, 4,473 children deemed to have a disability under the Disability Act received completed Assessment Reports from the HSE. A total of 76% of these children (3,395) were assessed as requiring speech and language therapy services.
Each individual that presents to the HSE's Speech and Language Therapy Service has an initial assessment to determine their individual need for therapy. The therapist in conjunction with the parent(s) or carer will determine the severity of the individual's difficulties and prioritise for therapy accordingly. The level of intervention is in line with clinical policy, age and severity of the diagnosis. The waiting period for intervention is dependent on the nature and severity of the disorder following assessment.
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. Along with the significant investment in the area of speech and language therapists employed in recent years, a range of new approaches has been developed and used in many Speech and Language Therapy services across the country. These include providing structures, training and support to parents/carers so that they can work to help improve the individual's speech and language. In addition, therapy is delivered in group settings where appropriate.
Therapy services for adults and children are generally delivered through Primary Care Teams or community therapy services; through specialist disability providers or Early Intervention and Children's Teams for 0-18 years, which are continually being developed under Progressing Disability Services for Children and Young People (0-18yrs) Programme. Additional funding of €20m was allocated in 2013 to strengthen Primary Care services and to support the recruitment of prioritised front-line posts. As part of this initiative, the HSE commenced recruitment last year of over 260 additional posts for Primary Care Teams, which included 52 Speech and Language Therapists. All of these Speech and Language Therapy posts have been filled. This will help to significantly address waiting times for such services.
The HSE has commenced the reconfiguration of children's disability services into geographically-based early-intervention and school-aged teams as part of the Progressing Disability Services for Children and Young People Programme. The objective of the Programme is to provide one clear referral pathway for all children (0-18s), irrespective of their disability, where they live or the school they attend. The transition to this service delivery model is governed by a consultation and engagement process with all stakeholders, including service users and their families, and is being implemented on a phased basis, with full implementation of the model scheduled for the end of 2015.
In 2014, the roll out of the Progressing Disability Services for Children and Young People (0-18s) Programme entailed targeted investment of €4m and the provision of 80 additional therapy staff (including 31 Speech and Language Therapists), to increase services for children with all disabilities.
A further €6m allocation was announced in 2015 for the reconfiguration of children's disability services, which will enable us to drive implementation of the Progressing Disability Services for Children and Young People Programme through 120 new staff appointments to reconfigured multi-disciplinary, geographic-based teams, and through using innovative approaches, involving public, voluntary and private providers, to achieve targeted reduction of waiting lists.
Improving access to therapy services for children in primary care and in disability services is a particular priority for the Government. Within this context, funding is being provided in 2016 to expand the provision of Speech and Language Therapy in primary care and to support the reorganisation and expansion of Speech and Language and other therapies under the Progressing Disability Services Programme for Children and Young People.
These measures will have a positive impact on the provision of clinical services for all children requiring access to health related supports.
Currently, total waiting lists across all services for each discipline, e.g. Disability, Older Persons, Primary Care, Mental Health, are gathered monthly by the HSE but not in a format where waiting list figures can be extrapolated for children's disability services specifically. The HSE Social Care, Disability services has commenced the undertaking of a baseline analysis of individual discipline waiting lists for children's disability therapy services across the country and current practices in relation to how waiting lists are managed. The objective is to ensure that the Division of Social Care/HSE has full oversight of the budget/expenditure on 0-18 disability services, has confidence in its waiting list data, and has access to relevant and reliable data to properly account for resources and on which to base its management decisions in relation to allocation and use of resources taking account of demand and equity of access.
64. Deputy Brian Stanley asked the Minister for Health the cost per hour of employing home helps directly by the Health Service Executive; and the cost per hour of home helps provided by private companies [35555/15]
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.
