Written Answers Nos. 134-144
134. Deputy Seán Haughey asked the Minister for Children and Youth Affairs his plans to reform the early childhood care and education scheme; if he will make the conditions of the scheme more flexible; and if he will make a statement on the matter. [9013/16]
View answerThe Early Childhood Care and Education (ECCE) programme currently provides one free pre-school year to children who are in the age range 3 years 2 months to 4 years and 7 months in September in the year of enrolment. It was the case that only children who satisfied the age criteria in September could access the programme during the following school year.
In Budget 2016, I announced a significant expansion the pre-school provision under the ECCE programme. This measure, which will be introduced from September 2016, means that children will be eligible to start free pre-school when they reach the age of 3, and continue to avail of free pre-school until they start primary school (once the child is not older than 5½ years at the end of the pre-school year i.e. end June). Following the introduction of the expanded programme there will be three opportunities each year - in September, January and April - for eligible children to enrol for the free pre-school provision. This will ensure that children aged 3 or over have the opportunity to enrol as soon as possible after their third birthday.
This extension of the Programme will increase the number of children availing of free pre-school from about 67,000 p.a to 127,000 in a given programme year.
I was conscious also of the difficulty experienced by some children with a disability in accessing and benefiting fully from the ECCE Programme. To address this issue, I announced in Budget 2016 the necessary funding to implement a new practical, workable model for meeting the needs of children with a disability. The model will deliver seven levels of support to enable the full inclusion and meaningful participation of children with disabilities in the ECCE Programme. These are:-
i. An Inclusive Culture
ii. Information for Parents and Providers
iii. A Qualified and Confident Workforce
iv. Expert Educational Advice & Support
v. Equipment, Appliances and Minor Alterations
vi. Therapeutic Intervention
vii. Additional Assistance (where the supports available at levels 1-6 are not sufficient to meet a child’s needs).
Work on the detailed design and implementation of the new model for meeting the needs of children with a disability is at an advanced stage. The view is to introduce the initiative from September 2016. It is intended that service providers and parents will be able to submit applications for supports under the new model from June 2016 onwards to allow them to plan for pre-school enrolment in September 2016 and to ensure that children will begin to benefit from these measures from that point forward.
The new measures which I am introducing will ensure that all children in Ireland from the age of 3 years will be able to access free education, either in pre-school or in primary school, which is a significant step forward for children and families.
135. Deputy Donnchadh Ó Laoghaire asked the Minister for Children and Youth Affairs the status of the appointment of members to fill the vacancies on the Council of Gaisce, the President’s Award, some of which have existed for over a year; his views regarding the precedent for having a previous award recipient on the council; on youth participation in decision making in this organisation; and if he will make a statement on the matter. [9095/16]
View answerGaisce is a company limited by guarantee with charitable status. Under the Memorandum and Articles of Association of the company, the Minister for Children and Youth Affairs appoints members to the Council of Gaisce.
I am advised that there are six vacancies at this time. A number of reappointments and appointments were made in 2015. Officials of my Department and Gaisce are engaging with the Public Appointments Service in relation to the identification of suitably qualified candidates for appointment to the Council.
In line with the 2014 Guidelines on Appointments to State Boards, Gaisce has identified the competencies and experiences and skills that are most needed on the Council at this time. Gaisce is committed to ensuring that young people have the greatest opportunity possible to apply for appointment, including those who have been award recipients in the past or have experience of the Gaisce programme.
The Public Appointments Service, Gaisce and officials from my Department recently met to discuss this matter. Gaisce restated at this meeting that a priority from their perspective was allowing young people the greatest opportunity possible to apply for appointment to the Council. I welcome Gaisce's commitment to ensuring young people have the opportunity to apply for appointment which is in keeping with the National Strategy on Children and Young People's participation in decision making. The Public Appointments Service are currently working to revise the draft advertisement booklet following that meeting with the expectation that it will be agreed in the coming weeks. Gaisce and the Public Appointments Service will then make a decision as to when the positions should be advertised so as to optimise the number of young people and others who will apply.
136. Deputy John Brassil asked the Minister for Health to fully reinstate the rural general practitioner allowance as a matter of urgency to ensure that rural areas are adequately provided with local general practitioner care; and if he will make a statement on the matter. [8831/16]
View answerThe Government is committed to ensuring that patients throughout the country continue to have access to GP services, especially in remote, rural areas and also in certain urban areas, and that general practice is sustainable in such areas into the future. There has been a positive engagement between the HSE, the Department and the IMO on a set of proposals for enhanced rural GP practice support and an updated list of special items of service. These proposals arise from the current phase of discussions on the modernisation of the GMS GP contract.
The Department is currently preparing a Statutory Instrument which would give effect to the proposed arrangements. Under the legislation, the Statutory Instrument also requires the consent of the Minister for Public Expenditure and Reform to give effect to the above proposals.
137. Deputy Bernard J. Durkan asked the Minister for Health the extent to which child psychiatric services remain adequate to meet modern challenges; and if he will make a statement on the matter. [8917/16]
View answerThe HSE National Service Plan 2016 aims to improve placement of children in age appropriate mental health settings. A 95% target of appropriate placements in Child and Adolescent Units is indicated in the Plan, to allow for some operational flexibility surrounding emergency placements in Adult Units. While it remains challenging for the HSE to meet this ambitious target progress on this important area has been significant despite increasing demands generally on CAMHS service. This is underscored by the fact that there were 247 such admissions to adult units in 2008, and 95 admissions in 2015. It is a priority for the HSE to keep such admissions to a minimum, and this is kept under constant review.
I have prioritised developing all aspects of CAMHS, including timely access to appropriate services, early intervention and an integrated service approach. Additional resources and facilities means that we now have 67 CAMHS Teams, and 3 Paediatric Liaison Teams, supported by 66 operational CAMHS beds across the country. This includes the extra 8 CAMHS beds recently opened in the new Linn Dara Unit in Dublin, which is helping to decrease pressures on CAMHS admissions to adult units. Further CAMHS beds are scheduled to open in the system.
The HSE is committed to ensuring that all aspects of CAMHS services are delivered in a consistent and timely fashion, including improved access to age appropriate units. Last year, the Executive introduced a new Standard Operating Procedure for both in-patient and community CAMHS services. This has contributed to improving services overall, including reducing inappropriate admissions of adolescents to adult units. It is designed also to reduce CAMHS Waiting Lists, particularly for those waiting over 12 months.
Bearing in mind all the circumstances, I am satisfied that the HSE is making real progress in relation to the issues raised by the Deputy, while taking account of the wishes of each young person, their parents or guardians, and the complexities of each case. In many instances, a multi-disciplinary or inter-agency approach is required. The Department will continue to closely monitor this issue, in conjunction with the HSE, to ensure that the various new initiatives now underway, will contribute to improving CAMHS services, including the rate of age appropriate admissions across all regions.
138. Deputy Peter Fitzpatrick asked the Minister for Health the number of unfilled job vacancies which exist in Our Lady of Lourdes Hospital in Drogheda, County Louth; and if he will make a statement on the matter. [8810/16]
View answerI have asked the HSE to respond to the Deputy directly on this 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 on the matter with them.
139. Deputy Peter Fitzpatrick asked the Minister for Health the number of patients treated in Louth County Hospital, Dundalk, County Louth in 2015; the services available in the hospital; his plans to increase the number of services available there; and if he will make a statement on the matter. [8811/16]
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.
140. Deputy Pat Casey asked the Minister for Health if the pigmented lesions clinic at St. Vincent’s University Hospital in County Dublin is closing to new referrals between May and September 2016 due to staffing shortages; the locations suspected skin cancer sufferers, especially those with malignant melanoma, will be referred to during this period; and if he will make a statement on the matter. [8825/16]
View answerThe Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to him.
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 with them.
141. Deputy John Brassil asked the Minister for Health his plans to address the issue of young persons being treated in adult facilities for mental health issues; and if he will make a statement on the matter. [8827/16]
View answerThe HSE National Service Plan 2016 aims to improve placement of children in age appropriate mental health settings. A 95% target of appropriate placements in Child and Adolescent Units is indicated in the Plan to allow for some operational flexibility surrounding emergency placements in Adult Units. While it remains challenging for the HSE to meet this ambitious target progress on this important area has been significant despite increasing demands generally on CAMHS service. This is underscored by the fact that there were 247 such admissions to adult units in 2008, and 95 admissions in 2015. It is a priority for the HSE to keep such admissions to a minimum, and this is kept under constant review.
I have prioritised developing all aspects of CAMHS, including timely access to appropriate services, early intervention and an integrated service approach. Additional resources and facilities means that we now have 67 CAMHS Teams, and 3 Paediatric Liaison Teams, supported by 66 operational CAMHS beds across the country. This includes the extra 8 CAMHS beds recently opened in the new Linn Dara Unit in Dublin, which is helping to decrease pressures on CAMHS admissions to adult units. Further CAMHS beds are scheduled to open in the system.
The HSE is committed to ensuring that all aspects of CAMHS services are delivered in a consistent and timely fashion, including improved access to age appropriate units. Last year, the Executive introduced a new Standard Operating Procedure for both in-patient and community CAMHS services. This has contributed to improving services overall, including reducing inappropriate admissions of adolescents to adult units. It is designed also to reduce CAMHS Waiting Lists, particularly for those waiting over 12 months.
Bearing in mind all the circumstances, I am satisfied that the HSE is making real progress in relation to the issues raised by the Deputy, while taking account of the wishes of each young person, their parents or guardians, and the complexities of each case. In many instances, a multi-disciplinary or inter-agency approach is required. The Department will continue to closely monitor this issue, in conjunction with the HSE, to ensure that the various new initiatives now underway, will contribute to improving CAMHS services, including the rate of age appropriate admissions across all regions.
142. Deputy Kate O'Connell asked the Minister for Health the reason for the delay in establishing a primary care centre in the Royal Hospital in Donnybrook, County Dublin; the steps he is taking to address this delay; and if he will make a statement on the matter. [8828/16]
View answerThe HSE has responsibility for the provision and operation of Primary Care Centres. Therefore, I have asked the HSE to respond directly to the Deputy on this issue. 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.
143. Deputy Kate O'Connell asked the Minister for Health the savings made since the withdrawal of medical cards from adults following a diagnosis of cancer, in tabular form; if the cost of processing and rejecting applicants now outstrips the cost of removing that automatic entitlement; and if he will make a statement on the matter. [8829/16]
View answerUnder the provisions of the Health Act 1970, as amended, the assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependants. I can clarify to the Deputy that the health legislation does not have a provision for the HSE to award a medical card to persons by virtue of an illness or a medical condition. However, where an applicant’s means are above the qualifying financial thresholds, the HSE routinely examines for indications of medical or social circumstances which might result in undue financial hardship in arranging medical services and, exercising discretion, may grant eligibility for a medical card on this basis.
The Deputy may be aware of the "Keane" Report of the Expert Panel on Medical Need for Medical Card Eligibility, which made a recommendation that a person’s means should remain the main qualifier for a medical card. It also recommended that it is neither feasible nor desirable to list conditions in priority order for medical card eligibility.
I would like to advise the Deputy that it is important to note that where a medical card is withdrawn - irrespective of its having been awarded based solely on means or where the HSE has exercised discretion - it is not withdrawn due on the cost implications for the HSE. In accordance with the Health Acts, a medical card can only be withdrawn due to eligibility not having been established.
As the medical condition of the applicant is not a factor in the assessment process for medical cards under the National Assessment Guidelines, the HSE does not record data on the GMS Database of this nature.
144. Deputy John Brassil asked the Minister for Health to re-evaluate the way in which the ambulance service is co-ordinated, with a view to delivering the control from a central national centre to regional centres; and if he will make a statement on the matter. [8834/16]
View answerThe National Ambulance Service has undertaken a major programme of reform in recent years, to reconfigure the management and delivery of pre-hospital care services, for a clinically driven, nationally co-ordinated system, supported by improved technology. A core part of this programme has been the rationalisation of the NAS command and control function from local regional centres to one national centre, the National Emergency Operations Centre (NEOC), operating across two sites in Dublin and Ballyshannon.
The establishment of the NEOC was undertaken in order to ensure that the ambulance service operates as a national fleet, rather than in regional divisions. Staff working in the NEOC operate using an integrated platform which enables them to have sight of every ambulance resource in the country. This means that they can deploy resources accordingly and ensure that the nearest available resource is dispatched to the patient within minutes of receipt of the call. This level of co-ordination and deployment of resources was not possible under the localised regional call centre configuration which existed previously.
The service is moving away from the model of care where services are provided to a local area from a fixed ambulance base located in that area, and moving to a model of strategic deployment, where paramedics and advanced paramedics are deployed in a manner which ensures that practitioners with the appropriate skill level are located strategically to provide optimum cover. Cover is provided across the Southern region from NAS bases in Killarney, Dingle, Listowel, Cahirciveen, Kenmare and Tralee. Resources are deployed to incidents as required in accordance with the system of Advanced Medical Priority Dispatch Protocols and are not confined to a specific geographic area.
