Written Answers Nos. 425-445
425. Deputy Robert Troy asked the Minister for Health when he will release funding for the regional hospital in Mullingar in County Westmeath to employ another paediatrician to allow the hospital to raise the adult age in the hospital to 16 years of age given that children of 14 years of age are under the care of the adult team while awaiting another paediatrician. [11308/16]
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.
426. Deputy Robert Troy asked the Minister for Health when he will release the €23 million (details supplied) development funding; and if he will make a statement on the matter. [11316/16]
View answerFunding for mental health in 2016 will increase from the 2015 outturn of €785m, to a projected budget of €826m in the 2016 National Service Plan, an increase of €41m or 5.2% which includes the €35m ring-fenced for mental health.
Staff recruitment is a key element of both existing and new developments. As staff recruitment takes time, however, the 2016 Service Plan provided that time-related savings of approximately €12m from the €35m would be used, on a once-off basis, to maintain services in home care and transitional care beds and for vaccine procurement.
In 2016, it is proposed to advance the following development priorities from the additional funding: continued development of counselling services across both primary and secondary care including the provision of three new Jigsaw mental health services in Cork, Dublin city centre and Limerick; the continued development of Community Mental Health teams; improved 24/7 response and Liaison Services; Psychiatry of Later Life; Perinatal Mental Health, and two new mental health clinical programmes, specifically ADHD in Adults and Children, and Dual Diagnosis of those with Mental Illness and Substance Misuse.
In addition to new developments, the HSE is committed to the ongoing development of adult and child & adolescent services. Up to 1,150 posts have already been filled up to end 2015 from the developmental funding provided since 2012, with 270 posts approved for the Child & Adolescent Services.
The Department of Health is currently examining proposals from the HSE relating to the development of these priority services, as well as proposals for the ongoing development of a range of existing and new specialist mental health services. Clarifications are being sought from the HSE on certain details and it is expected that a decision on the release of the funding will be made shortly.
427. Deputy Robert Troy asked the Minister for Health if he will introduce an independent mechanism for persons to complain if they have had a negative or adverse experience of Health Service Executive mental health services. [11317/16]
View answerThe Health Service Executive has a complaints management process in place entitled 'Your Service, Your Say’ which is committed to safeguarding rights and providing for a fair and impartial investigation of any complaint received. There are a variety of ways in which complaints can be made and all staff in the HSE are enabled and empowered to appropriately handle complaints with designated Complaints Officers in place to ensure the effective management of complaints throughout their relevant areas of responsibility. In addition complainants have a right of an independent review by a Review Officer while the Office of the Ombudsman can also examine complaints about certain actions of the HSE. The HSE’s National Advocacy Service is also available to assist people make complaints.
While the Mental Health Commission does not investigate individual complaints, the Mental Health Act 2001 provides that during the annual inspection of approved centres, the Inspector of Mental Health Services shall see every patient whom he or she has been requested to examine by the resident himself or herself or by any other person. In this regard, the Inspector of Mental Health Services can make enquires of the relevant approved centre on subsequent inspection.
The Expert Group Review of the Mental Health Act 2001 which was published in 2015 looked at the complaints procedures that currently exist within the mental health service and examined a suggestion of providing for a separate Mental Health Ombudsman. It was felt by the Group that as complaints about mental health services already have access to the existing Office of the Ombudsman and the fact that a separate complaints system for mental health patients could be seen as discriminatory, it would be premature to recommend a Mental Health Ombudsman at this juncture, however it was recommended that it should be re-examined as part of the suggested five to ten year review of any new Act.
428. Deputy Robert Troy asked the Minister for Health his plans to have equality of service for counselling and suicide prevention available in the mental health catchment areas. [11318/16]
View answerAs 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.
429. Deputy Robert Troy asked the Minister for Health his plans to introduce information systems for mental health services given that there is no indication of waiting times for adults waiting for the services. [11319/16]
View answerAs 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.
430. Deputy Robert Troy asked the Minister for Health when he will review A Vision for Change; and if he will have a clear implementation plan with accountability. [11320/16]
View answer'A Vision for Change', published in 2006, sets out a 10-year policy framework for Ireland's mental health services. Since 2012, the Government has provided additional funding of €160m ring-fenced for mental health. Ongoing developments that occurred under the term of the Government include: the development of the Counselling in Primary Care Service (CIPC) for adults over 18 years who are medical card holders; a greater awareness of fostering mental health promotion in society through campaigns like the 'Let's Talk' and 'The Little Things' campaigns; the publication last year of the Expert Review Group Report on the Mental Health Act 2001 and the new Suicide Prevention Strategy 'Connecting for Life' a reduction in the Child and Adolescent Mental Health Services (CAMHS) waiting lists for those waiting over 12 Months; the commencement of work on the new National Forensic Hospital to replace the Central Mental Hospital in Dundrum; the development of counselling services across both primary and secondary care, including early intervention at primary care level; and five new Jigsaw youth mental health services planned for Cork (2), Dublin (2) and Limerick and the development of Perinatal Mental Health Services.
In addition, funding has been made available to facilitate the transfer of some patients from the Forensic Mental Health Services to the community, investment in high observation in acute mental health units, the improvement of 24/7 services through additional liaison psychiatry services, new clinical programmes for dual diagnosis and adults with ADHD, provision of additional clinical space in community services and more funds for clinical programmes directed at eating disorders, self-harm in Emergency Departments and early intervention in psychosis.
'A Vision for Change' comes to the end of its 10-year term this year and plans for its review are underway. Currently, an appropriate team is being selected to undertake a comprehensive study of the mental health services in Ireland and best practice internationally, to inform the review. Once this information is collected and analysed, the decision as to whether an implementation plan will be formed will be made at that point.
431. Deputy Robert Troy asked the Minister for Health the number of times the interdepartmental group which launched the Connecting for Life suicide strategy has met since its launch in June 2015; if he has an implementation plan in place; and his progress in implementing it. [11321/16]
View answerThe Cross-Sectoral Connecting for Life Implementation Steering Group was established in 2015 in response to the actions set out in Connecting for Life, the national strategy to reduce suicide. This strategy contains a detailed and clear plan to achieve each of the goals it proposes, with defined actions and a lead agency and key partners in place for each individual action; however the implementation process for Connecting for Life is particularly complex because it is a cross-cutting, whole-of-society strategy, which requires consistent co-operation and communication between relevant stakeholders.
The Cross-Sectoral Connecting for Life Implementation Steering Group met on 23 February 2016. At this meeting, the members discussed the current position on suicide trends in Ireland and the challenges involved, the background to the development of the new Strategy, and the establishment of the Steering Group, including detailed discussion on what form implementation will take.
The Department of Health plans to hold the second meeting of the National Cross-Sectoral Steering & Implementation Group in June. The Implementation Template has been finalised and comprises an action template for each lead government department or lead agency with responsibility for one or more actions in the strategy. This has been sent to members, with a progress report on all actions due at the June meeting.
432. Deputy Michael Healy-Rae asked the Minister for Health the status of respite care for persons with special needs (details supplied); and if he will make a statement on the matter. [11323/16]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
The Programme for Partnership Government commits to more respite care to facilitate full support for people with a disability.
As 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.
433. Deputy Bernard J. Durkan asked the Minister for Health the status of the eligibility of a person (details supplied) under the medical card scheme, including when he will issue a decision; and if he will make a statement on the matter. [11326/16]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has recently issued to Oireachtas members.
If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them.
434. Deputy Eamon Ryan asked the Minister for Health the number of vacancies which have been filled by hiring agency staff in the Health Service Executive and in organisations it funds, including voluntary hospitals and agencies in each of the years 2010 to 2016 to date. [11332/16]
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.
435. Deputy Eamon Ryan asked the Minister for Health the measures in place to ensure promotional opportunities are not denied to existing staff within Health Service Executive funded organisations; the measures in place to ensure European Union tendering legislation is complied with and that the cost of employing agency staff provides value for money; and the total number of days lost to each health care profession due to delays in recruitment practices in these organisations. [11333/16]
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.
436. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment at the Midland Regional Hospital, Tullamore. [11335/16]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, 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.
437. Deputy Brendan Griffin asked the Minister for Health the up-to-date position on the provision of a dedicated obstetrics theatre at University Hospital Kerry; and if he will make a statement on the matter. [11376/16]
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.
438. Deputy Jack Chambers asked the Minister for Health the measures being undertaken to ensure bed availability for the significant cohort of the population that will require nursing home care in coming years; and if he will make a statement on the matter. [11377/16]
View answer440. Deputy Jack Chambers asked the Minister for Health if, following the commitment by the outgoing Minister of State at his Department in January 2016, he plans to bring stakeholders together through a forum that will consider and advise regarding the appropriate planning and policy required to sustain current provision and plan for substantial growth in requirement for nursing home care; and if he will make a statement on the matter. [11379/16]
View answerI propose to take Questions Nos. 438 and 440 together.
Residential care in Ireland is provided through a mix of public, voluntary and private provision. It is worth highlighting that the net budget for long-term residential care in 2016 is €940m and the Nursing Homes Support Scheme will support 23,450 clients (on average per week)- an increase of 649 clients per week on 2015 projections.
Public Nursing Units are an essential part of our national nursing home infrastructure. They provide 5,000 long stay residential care beds i.e. approximately 20% of the total stock of nursing home beds. They also provide about 2,000 short stay beds. €385 million in capital funding has been secured for a programme for the replacement and refurbishment of public nursing homes across the country over the next five years which will consolidate our existing public stock and is expected to provide 250 additional beds.
With regard to private facilities, it was announced in Budget 2016 that nursing home expansion works would henceforth be included in the Employment and Investment Incentive Scheme.
When the Nursing Homes Support Scheme commenced in 2009, a commitment was made that it would be reviewed after three years. This Review was published in July 2015 and identifies a number of key issues for more detailed consideration across Departments and Agencies. The Review recommends that the National Treatment Purchase Fund (NTPF) review the present pricing arrangements with a view to:
- Ensuring value for money and economy, with the lowest possible administrative cost for clients and the State and administrative burden for providers;
- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and
- Ensuring that there is adequate residential capacity for those residents with more complex needs.
A Steering Committee has been established to oversee the review of the pricing system for private long-term residential care facilities. This Steering Committee is chaired by the NTPF and includes representatives from the Department of Health, the Department of Public Expenditure and Reform, and the NTPF, and has commenced its work in this area.
On-going consultation with all stakeholders and the public in general is already a standard feature of our approach across policy issues. There is already a broad consensus on the direction that our approach to caring for older people should take, including the importance of allowing more older people to stay at home and in their own communities for as long as possible, the need to cater for people at the lowest appropriate level of complexity and the need to provide residential care when and if this is needed. The Programme for Government commits to increasing funding for Home Care Packages and Home Help year on year, additional funding for the NHSS and seeking ways to incentivise private nursing home investment and new supported living/assisted living arrangements.
The decisions that remain to be taken are therefore less about what we be need to do, but about how to do it. This relates in a large part to resourcing and balancing of priorities within the health sector and within Government overall. This is not an area that can be readily progressed by the kind of forum that is proposed by the Deputy. Further, it would be inappropriate to delegate elements of public policy, possibly including budgetary policy, to any consultative forum, particularly where some of those represented may have a commercial vested interest in the outcome.
439. Deputy Jack Chambers asked the Minister for Health if he is aware of criticisms levelled at the nursing home support scheme funding model by Nursing Homes Ireland, the representative body for private and voluntary nursing home care, which states the funding model fails to recognise the reality of the costs incurred to provide nursing home care; if the long-awaited review of the fair deal scheme will recommend a further review of the funding model; when the review will be published; and if he will make a statement on the matter. [11378/16]
View answer441. Deputy Jack Chambers asked the Minister for Health if he is aware of the findings within the recently published DKM Economic Consultants report which was commissioned by his Department, Potential Measures to Encourage the Provision of Nursing Home and Community Nursing Unit Facilities; if he accepts the report is stark in its analysis, stating the funding model to support nursing home care lacks logic and is not fit for purpose; his plans to address the issues highlighted; and if he will make a statement on the matter. [11380/16]
View answer503. Deputy Jack Chambers asked the Minister for Health why the working group reviewing the pricing system of the nursing home support scheme pricing system, as advanced within his Department’s review of the scheme, has not met with Nursing Homes Ireland, which represents the majority of providers of nursing home care; to request the working group to consult with Nursing Homes Ireland; and if he will make a statement on the matter. [11744/16]
View answer504. Deputy Jack Chambers asked the Minister for Health to introduce an independent appeals process under the fair deal scheme; to apply the principle of a right of independent appeal; why this does not apply to the National Treatment Purchase Fund; and if he will make a statement on the matter. [11745/16]
View answerI propose to take Questions Nos. 439, 441, 503 and 504 together.
The legislation underpinning the Nursing Homes Support Scheme requires each private nursing home to negotiate and agree a price for long-term residential care services with the National Treatment Purchase Fund (NTPF) should they wish to be an approved nursing home for the purposes of the Scheme. The NTPF has statutory independence in the performance of its function, and negotiates with each nursing home on an individual basis. The Department of Health has no role in such individual negotiations. The NTPF may examine the records and accounts of nursing homes as part of the process with the objective of setting a fair price which delivers value for money to the individual and the State.
In negotiating with nursing homes, the NTPF has regard to:
- Costs reasonably and prudently incurred by the nursing home and evidence of value for money;
- Price(s) previously charged;
- Local market price; and
- Budgetary constraints and the obligation on the State to use available resources in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public.
During 2015 the Department of Health commissioned DKM Economic Consultants to conduct an analysis of potential measures to encourage the provision of nursing home and Community Nursing Unit facilities. This analysis is a useful input to policy in this area, but the DKM Report reflects the views of the consultants rather than those of the Department of Health.
When the Nursing Homes Support Scheme commenced in 2009, a commitment was made that it would be reviewed after three years. In advance of the Review, submissions were sought from groups or bodies who wished to make a contribution, and Nursing Homes Ireland made a submission in this regard on which they expanded at a subsequent meeting with officials of the Department of Health. The Report of the Review was published in July 2015. A number of issues have been identified for more detailed consideration, including a review of pricing mechanisms by the NTPF, with a view to:
- Ensuring value for money and economy, with the lowest possible administrative cost for clients and the State and administrative burden for providers;
- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and
- Ensuring that there is adequate residential capacity for those residents with more complex needs.
The Terms of Reference of the NTPF pricing review include consideration being given to the appeals mechanism. However, it is not deemed feasible to effectively address this issue in isolation and it must be considered as part of the totality of the pricing system.
A Steering Committee has been established to oversee the review of the pricing system for private long-term residential care facilities. This Steering Committee is chaired by the NTPF and includes representatives from the Department of Health, the Department of Public Expenditure and Reform and the NTPF, and has commenced its work in this area. The NTPF are in the process of developing an implementation plan that inter alia will include appropriate engagement with stakeholders.
442. Deputy Ruth Coppinger asked the Minister for Health his views on the location of the National Children's Hospital at the St. James's Hospital site; if he will review the decision and the decision-making process; and if he will make a statement on the matter. [11382/16]
View answerThe previous Government's decision to locate the new children's hospital at the St James's campus was based on the over-riding priority of best clinical outcomes for our children and, in particular, the sickest of these. That decision is unequivocally supported by this Government and by me as Minister. As announced in June 2016, it is intended that the Coombe Women and Infants University Hospital will relocate to the campus in time, achieving tri-location of paediatric, maternity and adult services on one campus. Tri-location has benefits for children, adolescents, newborns and mothers. In all cases, the benefits of tri-location are maximised where the adult hospital provides the broadest possible range of clinical sub-specialties and expertise, and delivers significant breadth and depth of clinical and academic research on site. St. James's Hospital has the widest range of sub-specialties and highest level of clinical complexity of all hospitals in the country, as well as a strong and well-developed research infrastructure, making it the hospital that best meets the criteria to be the adult co-location partner.
I am delighted at the decision by An Bord Pleanála to grant planning permission for these vital new facilities. The decision means that enabling works can begin this summer. It is expected that the satellite centres can open in 2018, significantly enhancing access to urgent care and outpatient services for children from the Greater Dublin Area. Building work on the main site will be completed in 2020, providing 380 inpatient rooms, all of which will be single en-suite rooms with in-room parent accommodation, 93 daycare beds and 20 operating theatres. The hospital will also include play areas, external gardens and courtyards. During the design process, there has been extensive engagement and consultation with families, young people and children who are former or current users of the service, with staff from the existing three children’s hospitals and with local residents. This has led to the development of a world-class building which has been designed to enable staff to deliver the best possible clinical care for children and young people.
443. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) may expect the occupational therapist to carry out a report for Donegal County Council relating to the housing adaptation grant for people with a disability; and if he will make a statement on the matter. [11384/16]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As 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.
444. Deputy Charlie McConalogue asked the Minister for Health for a status update on the recruitment of a second permanent consultant neurologist for the north-west region; and if he will make a statement on the matter. [11386/16]
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.
445. Deputy Aengus Ó Snodaigh asked the Minister for Health why the Health Information and Quality Authority has instructed all those who use the services of home help providers to have key lock boxes installed outside their home to store their house keys in rather than placing it in the care of the home help provider; and if he will make a statement on the matter. [11389/16]
View answerThe Health Information and Quality Authority (HIQA) is the independent authority established under the Health Act 2007 to drive continuous improvement and to monitor safety and quality in Ireland’s health and personal social care services. HIQA currently does not regulate, or set standards for, the homecare sector.
