Tuesday, 12 Jul 2016

Medicinal Products Prices

Questions (97)

Seán Fleming

Question:

97. Deputy Sean Fleming asked the Minister for Health the savings he anticipates from the agreement with the Irish Pharmaceutical Healthcare Association. [20975/16]

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Written answers

A negotiating team representing the State has reached agreement in principle with the Irish Pharmaceutical Healthcare Association on a new drug pricing and supply agreement. Work will continue between the parties over the coming days to finalise the terms of the agreement.

Until the agreement is finalised, I cannot comment on anticipated savings.

Hospital Services

Questions (98)

Eamon Scanlon

Question:

98. Deputy Eamon Scanlon asked the Minister for Health the status of the development of a catheterisation laboratory at Sligo University Hospital; and if he will make a statement on the matter. [20947/16]

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Written answers

Minister for Health

The Acute Coronary Syndrome (ACS) Programme produced a model of care in March 2012. This set out the model of care for the treatment of ACS, and for the provision of Primary Percutaneous Intervention (PPCI) nationally.

A new Cross-Border Cardiology Service commenced in May 2016. Patients residing in the Donegal catchment area who suffer a suspected ST-Elevation Myocardial infarction, and who previously would have been transported to University Hospital Galway by road or air, will now be transported the shorter distance to Altnagelvin Area Hospital Derry, for emergency pPCI treatment.

This service is provided by the Saolta University Healthcare Group in conjunction with the Western Health and Social Care Trust and will provide treatment for approximately 60 patients per annum, who, post treatment, will be repatriated to Letterkenny University Hospital or Sligo University Hospital. A consultant interventional cardiologist has recently been appointed, who is based at Letterkenny University Hospital and contributes to the services at Altnagelvin Hospital.

The cardiology service in Sligo University Hospital is provided by two consultants. A range of in-patient, outpatient and day case treatments are provided by the Sligo Cardiology Service to a catchment population of Sligo/Leitrim/South Donegal/West Cavan/North Roscommon.

Development of cardiology services at Sligo University Hospital will be considered in the context of the agreed model of care developed by the Acute Coronary Syndrome Programme.

My Department will shortly meet with the Saolta Hospital Group to discuss issues including catheterisation laboratory services on Sligo.

Hospital Consultant Recruitment

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Eamon Ryan

Question:

585. Deputy Eamon Ryan asked the Minister for Health when a decision on whether a new post for a sarcoma specialist in St. Vincent's hospital will be decided; and if he will make a statement on the matter. [21159/16]

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John Curran

Question:

603. Deputy John Curran asked the Minister for Health the steps he has taken to extend the contract of a person (details supplied); if he will ensure that a permanent position is offered to this person based on expertise in treating sarcoma cancer; if he is aware of the concern of patients at the loss of this person and their desire to have them made permanent; and if he will make a statement on the matter. [21222/16]

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Written answers

Minister for Health

I propose to take Questions Nos. 99, 512, 529, 577, 584, 585 and 603 together.

I met with members of the Sarcoma Action Group last Wednesday and discussed sarcoma services with them.

The recruitment of a consultant medical oncologist with a special interest in sarcoma, based in St. Vincent’s University Hospital, will be prioritised to facilitate further development of the service there. The Director General of the HSE has directed that work on the open recruitment process is to begin immediately.

Meanwhile, arrangements are being made to facilitate any current patient of the Locum Consultant to continue to be treated by her in respect of their medical oncology needs.

It is intended to increase, in line with available resources, the number of consultant medical oncologists working in the eight designated cancer centres to meet demand. Patients diagnosed with sarcoma are seen at one of the two multidisciplinary teams in St Vincent's University Hospital and Cork University Hospital. Both of these hospitals are designated cancer centres and have an extensive range of multidisciplinary services and expert clinical advice available to them across surgery, medical oncology, radiation oncology, radiology and pathology.

Dr Charles Gilham is the National Clinical Lead in Soft Tissue Sarcomas and he provides advice to the National Cancer Control Programme in relation to the development of services nationally.

My Department is currently developing a National Cancer Strategy 2016 - 2025 that will focus on prevention, early diagnosis and further improvements in treatment and patient care. This Strategy will be published in the coming months.

Question No. 100 answered with Question No. 60.

Orthodontic Services Data

Questions (101)

Dessie Ellis

Question:

101. Deputy Dessie Ellis asked the Minister for Health the number of orthodontic treatments that the Health Service Executive has outsourced for patients who are waiting over four years for routine orthodontic treatment and for how many patients; the hospitals these treatments have been outsourced to; how many patients are waiting one, two, three and more than four years for these treatments; and if he will make a statement on the matter. [20931/16]

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Written answers

Minister for Health

As this is a service matter, 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 them.

Hospital Waiting Lists

Questions (102)

Dara Calleary

Question:

102. Deputy Dara Calleary asked the Minister for Health the reason for the substantial increase between December 2015 and May 2016 in the number of outpatients waiting more than a year for a consultation in Mayo University Hospital. [20986/16]

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Written answers

Minister for Health

A key challenge for our health system is ensuring timely access to health services. This Government recognises that a sustained commitment to improving waiting times is required, with a particular focus on those waiting longest.

While waiting list numbers nationally have increased in the first half of the year, this must be seen in the context of increased demand for care in our health system. There has been a 4% increase in inpatient and day-case activity in acute hospitals and an almost 6% increase in attendances at EDs in comparison with last year. The key issue for patients is how long they wait. Approximately 60% of patients wait less than 6 months for a required outpatient appointment or inpatient/day-case procedures.

Regarding 2016, my Department is currently engaging with the NTPF and the HSE in finalising a dedicated waiting list initiative focussed on endoscopy. In addition, my Department has asked the HSE to implement an action plan addressing waiting times with hospitals and Hospital Groups. This will focus on improving chronological scheduling, clinical and administrative validation of lists and optimising existing capacity.

The Programme for a Partnership Government commits to €15m funding for the NTPF in 2017 to address waiting lists for those waiting longest, as part of a continued investment of €50m per year to reduce waiting times. My Department is currently engaging with the NTPF and the HSE to deliver on the Programme's waiting list commitments.

In relation to waiting lists at Mayo University Hospital, as 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.

Question No. 103 answered with Question No. 40.

Hospital Staff Recruitment

Questions (104)

Aindrias Moynihan

Question:

104. Deputy Aindrias Moynihan asked the Minister for Health his plans to recruit additional gynaecologists in Cork University Hospital. [20991/16]

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Written answers

Minister for Health

Cork University Hospital are currently in discussions with the South South West Hospital Group in relation to Obstetric and Gynaecological posts.

As 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.

Health Care Policy

Questions (105)

Martin Kenny

Question:

105. Deputy Martin Kenny asked the Minister for Health the research that is being conducted specifically on universal health care; if he is aware of research being undertaken by other groups outside his Department on universal health care; if he will bring these strands together to ensure co-operation, information exchange and economies of scale. [20936/16]

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Written answers

Minister for Health

My Department is funding the Joint Department of Health/ ESRI Research Programme in Healthcare Reform. The initial phase of this programme involved a research project on costing the UHI model outlined in the White Paper on Universal Health Insurance. The reports setting out the findings of the costing project were published on the 18th November, 2015. Links to these reports are available on the Department’s website (www.health.gov.ie).

The current programme of work for the Research Programme focuses on the development of a medium-term projection model for healthcare demand and expenditure, which includes analysis of utilisation and unmet need. Separately, my Department is part of the SWITCH Research Programme which enables the Department to estimate the impact of changes to health policy on the population. While these various projects each have value in their own right they are also relevant to work on universal health care.

In addition, the Health Research Board has provided funding to a number of groups outside my Department that are undertaking research relevant to universal healthcare. These include the following projects:

Mapping the Pathways to Universal Health Care in Ireland, a three year project which runs from October 2014 into 2017 involving a collaboration between the Centre for Health Policy and Management, TCD and staff from the Health Systems Strengthening Offices of WHO Europe and the European Observatory.

An Inter-sectoral analysis by geographic area of the need for and the supply and utilisation of health services in Ireland undertaken by the ESRI which is due to report in 2017.

Developing a unit cost database for non-acute services in Ireland, this five year award is led by NUI Galway including national and international collaborators.

Study of the Impact of Reconfiguration on Emergency and Urgent Care Networks (SIREN), this programme of research is led by University College Cork in collaboration with a number of co-applicants.

HRB Centre for Primary Care Research, this Centre was established in 2008, is a national centre for research in primary care in Ireland, led by the Royal College of Surgeons in Ireland, in collaboration with Trinity College Dublin, Queen’s University Belfast.

My Department works to ensure appropriate linkages and cooperation between the various strands and stakeholders.

Health Care Policy

Questions (106)

Martin Kenny

Question:

106. Deputy Martin Kenny asked the Minister for Health further to Parliamentary Question No. 106 of 2 June 2016, if the research being undertaken by his Department and the Economic and Social Research Institute three-year programme on health reform will be available to the new joint Oireachtas committee that has been established to develop cross-party consensus on the future of the health service over ten years, as per the programme for Government and Government approval; if he will make available the research undertaken to date to the committee; if he will designate a liaison officer within his Department in order that members of this committee may direct queries specific to the committee work to that person; and if he will make a statement on the matter. [20937/16]

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Written answers

Minister for Health

I welcome the establishment of the Committee on the Future of Healthcare which is a key commitment in the Programme for a Partnership Government.

The resourcing of the Committee and how it discharges its functions are matters for the Committee and the Houses of the Oireachtas Service. Senior officials from my Department have already met with the Committee and my Department will continue to assist and advise the Committee, as appropriate. As part of that commitment to provide support, my Department is currently making arrangements for the secondment of an Assistant Principal Officer - Health Sector Policy Analyst - to the Houses of the Oireachtas Service Committees' Secretariat to support the work of the Joint Committee on Health and the Committee on the Future of Healthcare.

Health Services Staff Recruitment

Questions (107)

Fiona O'Loughlin

Question:

107. Deputy Fiona O'Loughlin asked the Minister for Health if there continues to be a recruitment freeze on allied health professionals, as the absence of such recruitment is putting some health services in County Kildare under pressure. [20994/16]

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Written answers

Minister for Health

An easing of restrictions on the employment of additional staff was announced in Budget 2015. Under this new approach public sector organisations can obtain delegated sanction to recruit within the parameters of their pay budget once they obtain approval for their Pay and Numbers Strategy from their parent Department and from the Department of Public Expenditure and Reform.

This change allows for greater autonomy to be delegated to Departments and Agencies to manage their own staffing levels within allocated pay frameworks. It also provides for further recruitment flexibility, for example where it is determined that offering permanent contracts can achieve more economical service delivery than agency usage.

Recent measures taken in relation to service areas in the HSE remaining within budget have been portrayed, incorrectly, as a recruitment freeze. The HSE is currently working with the Department of Health on the finalisation of its 2016 Pay and Numbers Strategy. This has involved the development of detailed workforce plans at hospital and community service level.

These measures do not impact on a hospital’s ability to recruit where funding exists to facilitate that recruitment; for example in the case of funded replacement posts or where additional funding has been allocated for new positions under the HSE service plan. Recruitment can also take place in areas of critical care and emergency services. All posts are being actively monitored at Group level and National level to ensure that clinical risks are appropriately managed.

It is this Government’s intention to continue to grow the health budget as the economy improves and to obtain further resources to deliver the level of service that we all want to provide to our patients.

Hospital Waiting Lists

Questions (108)

James Browne

Question:

108. Deputy James Browne asked the Minister for Health when he expects to see a sustained improvement in hospital waiting lists. [20955/16]

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Written answers

Minister for Health

A key challenge for our health system is ensuring timely access to health services. This Government recognises that a sustained commitment to improving waiting times is required, with a particular focus on those waiting longest.

While waiting list numbers have increased nationally in the first half of the year, this must be seen in the context of increased demand for care in our health system. There has been a 4% increase in inpatient and day-case activity in acute hospitals and an almost 6% increase in attendances at EDs in comparison with last year. The key issue for patients is how long they wait. Approximately 60% of patients wait less than 6 months for a required outpatient appointment or inpatient/day-case procedure.

Regarding 2016, my Department is currently engaging with the NTPF and the HSE in finalising a dedicated waiting list initiative focussed on endoscopy. In addition, my Department has asked the HSE to implement an action plan addressing waiting times with hospitals and Hospital Groups. This will focus on improving chronological scheduling, clinical and administrative validation of lists and optimising existing capacity.

The Programme for a Partnership Government commits to €15m funding for the NTPF in 2017 to address waiting lists for those waiting longest, as part of a continued investment of €50m per year to reduce waiting times. My Department is currently engaging with the NTPF and the HSE to deliver on the Programme's waiting list commitments.

Health Services Provision

Questions (109)

Paul Murphy

Question:

109. Deputy Paul Murphy asked the Minister for Health if he will review the outsourcing of health services to non-governmental organisations in view of an issue (details supplied); and if he will make a statement on the matter. [20997/16]

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Written answers

Minister for Health

Voluntary/non-statutory service providers have a long history of providing health and personal social services in Ireland. These organisations vary in scale and complexity, ranging from large acute hospitals to local community based organisations providing social care services. Funding provided to agencies for the provision of services under Section 38 of the Health Act 2004 relates to 24 non-acute agencies and 16 voluntary acute hospitals currently within the HSE Employment Control Framework. Grants to the other voluntary agencies are covered under the provisions of Section 39 of the Act. In 2015, over €3.7 billion of the HSE’s total expenditure related to services provided by all agencies on behalf of the HSE.

This arrangement is not outsourcing, but rather the purchase of health and social services from agencies in accordance with strict criteria set out in governance documents and outlined in the National Financial Regulation, NFR- 31 Grants to Outside Agencies and detailed in a comprehensive operational manual. The National Standard Governance Documentation, operating procedures, guides and process control forms are maintained on the HSE’s intranet site. Both the Governance Documentation and the operating procedures detail the requirements for performance review, including submission and review of financial Health Service Executive Code of Governance statements and periodic performance review meetings with agencies, with the frequency based on a number of criteria including the amount of funding and previous compliance history.

The following revision was received from the Department on 20 July 2016

The Reply at that time indicated that there were 40 Section 38 agencies. This was incorrect; there are 39 section 38 agencies. Annual funding to these agencies ranges between €1.7 million to Cork University Dental School and Hospital and €361.4 million to St James’ Hospital. Total funding allocated by the HSE in each year to those agencies was €2.69 billion, €2.7 billion and €2.84 billion respectively.

Question No. 110 answered with Question No. 32.

Charitable and Voluntary Organisations

Questions (111)

Catherine Connolly

Question:

111. Deputy Catherine Connolly asked the Minister for Health when irregularities and concerns first came to or were brought to his attention and that of the Health Service Executive in the matter of a charity (details supplied); the steps that were taken or reviews carried out; the documentation available on these reviews; the safeguards that have been put in place to ensure the continuation of the services provided by this charity; and if he will make a statement on the matter. [20608/16]

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Written answers

Minister of State at the Department of Health

Console is one of the charities funded in part through the HSE’s National Office for Suicide Prevention, to provide counselling, therapy and support services to people who have been bereaved by suicide.

In 2009 concern was raised in the HSE in relation to cash flow issues in Console. The Department of Health was notified in writing. An attached briefing indicated that the HSE was confident that the matters raised would be resolved.

In 2011, an official in the mental Health Unit of the Department was made aware of an allegation that the CEO of Console had impersonated a doctor in Baggot St Hospital. The Concern CEO advised that the impersonation had been a “prank” in his student days some 30 years earlier and that this had been dealt with in Court at the time where the Probation Act was applied

A revised Governance Framework was put in place by the HSE in 2014 and this is followed in respect of all organisations funded by it.

The HSE audit into Console was initiated in April 2015 by the National Office for Suicide Prevention following an examination of the 2013 returns from Console to the HSE, which were received in late 2014. The HSE has confirmed that concerns arose in a number of areas, including in relation to the corporate governance and financial management of the agency. The HSE advised the Department of Health of this on 17th June 2015, providing an update to the Department in December 2015. It later reported this case to the Garda Síochána in February 2016. On 15th April 2016, the HSE Director of Mental Health provided a briefing to the Department of Health on the status of this report. On 24th June 2016, the audit report was finalised and a copy was sent to the HSE’s Mental Health Division and to the Department of Health on 1st July 2016.

While this is a serious matter that needs to be comprehensively investigated, it is of equal importance that the valuable services offered by Console are not adversely affected. The HSE has informed my Department that it has not uncovered any issues with the standard of the Console services funded by the Executive. However, the issues uncovered by the audit are extremely serious and require detailed consideration to ensure that services are delivered in future under the most appropriate governance and financial frameworks. Consideration by the HSE of alternative service options has been underway in parallel with the audit process.