Written Answers Nos. 1-27
14. Deputy Jackie Cahill asked the Minister for Health if he will discuss with the Health Service Executive the need for capital funding to secure the future of a facility (details supplied); and if he will make a statement on the matter. [20599/16]
View answerThe beds provided by public nursing homes are an essential part of our healthcare infrastructure, and without them many older people would not have access to the care that they need. These beds will continue to be very much needed over the coming years as the number of older people increases in line with demographic trends. It is therefore essential that they are put on a sustainable footing and that the fabric of the buildings from which they operate is modernised and improved.
€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. This will consolidate our existing public stock and is expected to provide over 200 additional beds.
Significant work was undertaken by the Health Service Executive in determining the most appropriate scheduling of projects over the 5 year period from 2016 to 2021, within the phased provision of funding, to achieve full compliance and registration with HIQA.
The plan includes minor refurbishment works at Dean Maxwell Community Nursing Unit which it is proposed to be completed by 2021.
I would like to reassure the Deputy that the Department will monitor progress on the capital plan on an on-going basis.
15. Deputy Aengus Ó Snodaigh asked the Minister for Health if he will review legislation, given that the Crowe Horwath report into the Nursing and Midwifery Board of Ireland is reported to note that the legislation underpinning the management of fitness-to-practise cases and the corporate governance of the board appears to be a major contributor to the current problems and is in need of urgent review; and if he will make a statement on the matter. [20923/16]
View answerAs the Deputy is aware, two reports have recently been published by the Board which identify historical organisational and financial governance shortcomings in its operation. The NMBI has acknowledged that appropriate operational and governance procedures were not always properly applied. The Board is already implementing the reports' recommendations and is committed to ensuring that all necessary steps will be taken to prevent these events from re-occurring. A new President and a new interim CEO have been appointed and the post of Director of Finance and Corporate Services has been advertised.
The Department continues to work closely with the NMBI to ensure that enhanced corporate governance procedures are implemented and that robust management and operational processes are introduced. Monthly operational and quarterly governance meetings take place between the Department and the Board and any matters arising are addressed on an on-going basis.
The Board is already implementing the reports' recommendations in relation to full compliance with the Code of Practice for Governance of State Bodies and the Department of Health's Framework for Corporate and Financial Governance for Regulatory Bodies under its remit.
On the issue of fitness to practice, the Crowe Horwath report refers to the heavy workload involved in dealing with such matters and to it being extremely resource intensive. The report states that Board members dealing with fitness to practice cases must commit a lot of time to reading extensive documentation, thereby limiting the time available to consider other matters relating to the governance of the NMBI.
The Board will address the report's findings as part of the detailed change management programme currently being undertaken. It will review its own legislative provisions and those of the other statutory regulators, especially the operational experience gained across the professions, and will identify what improvements are needed to ensure that its fitness to practice provisions are fit for purpose.
The action being taken by the NMBI on foot of these reports will provide the Framework for the Board to perform its functions efficiently and effectively, in an open and transparent manner, while delivering on its core responsibilities of public protection and the promotion of the nursing and midwifery professions.
16. Deputy Gino Kenny asked the Minister for Health if he will expedite the recruitment of a full-time consultant medical oncologist with a special interest in sarcoma in St. Vincent's Hospital in Dublin 4; if he will renew the contract of the locum consultant medical oncologist who has a special interest in sarcoma until the post is filled on a permanent basis; if he will agree to meet the Sarcoma Action Group of concerned cancer patients and their families who are seeking an urgent meeting with him; and if he will make a statement on the matter. [20616/16]
View answerI 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.
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.
17. Deputy Willie O'Dea 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 one year for a consultation in University Hospital Limerick. [20983/16]
View answerA key challenge for our health system is to ensure 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 in-patient 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 to finalise a dedicated waiting list initiative focussed on endoscopy. In addition, my Department has asked the HSE to implement an action plan to address 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 Deputy may also wish to note that 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.
I am advised that University Hospital Limerick has seen an increase of 20.6 % in the number of patients waiting greater than 12 months in the period December 2015 to May 2016. However, I am assured that the University of Limerick Hospitals Group is maximising all available capacity across the Group and additional internal capacity is being provided for particular specialties. In addition, waiting lists are currently being validated in order to ensure accuracy.
18. Deputy Bríd Smith asked the Minister for Health the increases in staffing that have been achieved to deal with the crisis under the home help scheme and the carer respite services; the number of persons who are in hospital with their discharge delayed who are waiting to access these services; the number of carers who have been unable to continue as carers, due to the lack of respite services; and if he will make a statement on the matter. [20910/16]
View answerThe HSE’s National Service Plan for 2016 provides for a target of
- 10.4 million Home Help Hours to support about 47,800 people;
- 15,450 Home Care Packages; and
- 190 Intensive Home Care Packages for clients with complex needs, including 60 co-funded by Atlantic Philanthropies under the Irish National Dementia Strategy.
Home support services are being stretched by demands from more people, and for more hours at times outside of core hours. Activity in the first quarter of 2016 was ahead of the same period last year as efforts continued to alleviate pressure on the acute hospital system. It should be noted that since 2015 the number of home helps employed by the HSE has risen from about 3,390 to 3,515 in whole-time equivalents.
I am delighted that the Government has been able to respond to this demand by providing an extra €40m for home care in 2016. As a result, not only are we maintaining home care services at 2015 levels, but increasing them.
As of 5 July 2016, there were 95 patients awaiting discharge from hospital to return home where they require home supports, 61 have applications currently being processed and the remaining 34 await funding.
Respite services may be provided in a number of different ways and settings to provide support for Carers. There are 1,955 short stay community public beds nationally providing combination of ‘step up/step down’ care, intermediate care, rehab and respite care. These are interchangeable in their use depending on demand.
There are no figures available on the numbers who have discontinued their caring role or why this may have happened.
The Government is committed to providing additional community supports to assist those with care needs and their carers, as shown by the additional resources recently provided and the importance attached to this area in the Programme for Partnership Government.
19. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he expects to be in a position to reduce the waiting lists for various procedures throughout the public health and hospital system with a view to ensuring a readily accessible hospital service; and if he will make a statement on the matter. [20912/16]
View answerA 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 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.
20. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Question Nos. 213 to 215, inclusive, of 23 June 2015, the actions he is taking to ensure patient safety in terms of investigating why certain hospitals have higher than average death rates; if he will undertake any investigations or follow-up action following the publication of the second annual report of the national health care quality reporting system; and if he will make a statement on the matter. [20917/16]
View answer114. Deputy Catherine Murphy asked the Minister for Health if he is satisfied that hospitals are required to trigger inquiries themselves before action can be taken where statistics show an anomaly in patient outcomes, given the findings of the national health care quality reporting system annual report. [20952/16]
View answerI propose to take Questions Nos. 20 and 114 together.
The Second annual National Healthcare Quality Reporting System (NHQRS) Report was published on Thursday 16 June 2016, and included data on a wide range of indicators. The purpose of the annual NHQRS Report is to use easily accessible information to develop a better understanding of whole health system performance. The mechanism was established to provide a broad overall picture of the quality of our health services. It is intended to demonstrate to individual hospitals and other health service providers the importance of examining their own data in order to improve the services they provide. It must however, be understood that the performance and quality of a service cannot be measured by one indicator alone. This is why the report presents an analysis of a range of indicators that reflect different parts of the services and allows progress and priorities in the health system to be identified.
It is important to note that the NHQRS is not intended to act, and was not designed to act, as a performance measurement tool. There are already a variety of existing measures in the broad healthcare sphere that have been put in place to drive improvements in patient safety, including the work undertaken by the Health Information and Quality Authority. Similarly, it is not intended to provide detailed comparative analysis for particular health questions. In relation to the particular figures provided in the NHQRS report, I would note that care must be exercised when considering them given the variation in the numbers of cases that individual hospitals, in particular smaller units, may deal with. Other issues, for example the quality of the data collected, or patients attending one service being more unwell and consequently presenting with more complex needs than those attending other services, can also influence the final outcome.
However, I recognise that there are areas identified where further room for improvement exists. In particular, considerable variation can be seen between counties in rates of hospitalisation for common chronic diseases such as chronic obstructive pulmonary disease, asthma, diabetes and heart failure. Identifying this variation is a first step to addressing the reasons why this variation exists and to improving it. For example, the information on chronic obstructive pulmonary disease is already informing requirements in Primary Care and the National Clinical Effectiveness Committee Guideline being developed by the HSE Clinical Programme for the management of this disease.
Nevertheless, rather than initiating enquiries, the intent of the report would be for any apparent anomalies which come to light to prompt further research into their possible causes; in the first instance, that is the responsibility of individual hospitals which are required, under the National Standards for Safer Better Healthcare, to provide safe and effective care and treatment to patients.
21. Deputy John McGuinness asked the Minister for Health his plans to improve psychiatric services at acute and at community level in counties Carlow and Kilkenny. [20987/16]
View answerThe HSE Carlow/Kilkenny Mental Health Service delivers Mental Health services across a broad range of primary and community based services, together with specialised services for children and adolescents, adults and older people. Services include home care, inpatient facilities, outpatient clinics, various day services, and high, medium or low support community accommodation. The comprehensive development of Community Mental Health Teams facilitates key professionals to provide mental health interventions. These teams comprise of consultant psychiatrists, junior doctors, specialist and community mental health nurses, social workers, psychologists, occupational therapists and addiction counsellors who provide treatment based on assessed need. The development of Home Based Service Teams in Carlow/Kilkenny facilitates Recovery in the service users own home.
There is a significant focus on meaningful involvement for the service user in the management of their illness, with a more Recovery focussed service. Initiatives here include Involvement Centres which are peer-led support services, located in both Carlow and Kilkenny, the development of a Recovery College which delivers programmes by people who have lived experience in mental health, and delivery of the Wellness Recovery Access Programme to help people better manage their mental health. Other measures include the Advanced Recovery Ireland project to promote Recovery from mental ill health, and Service User Forums to facilitate feed back on service delivery and development. Carlow/Kilkenny Mental Health Service continues to work closely with relevant voluntary and statutory partners on all these fronts, including those relating to various Suicide prevention and self-harm programmes.
The HSE provides a 24/7 Psychiatric Liaison Assessment service through the Emergency Department in St. Luke’s Hospital Kilkenny. This allows for early identification and referral for treatment of acute mental health difficulties in the Emergency Department setting. In addition, there are day hospitals in Carlow and Kilkenny which provide 7 day acute day hospital services, and also provide access to the home care teams. The service operates a single point of entry which facilitates a stream lined access for General Practitioners.
A strong system of corporate and clinical governance has been developed in Carlow/Kilkenny/South Tipperary in the last two years, with governance being provided by the Executive Management Team, and the Committees reporting to it. These Committees include the Quality Safety Executive Committee, the Operational Team, and the Dept. of Psychiatry Operational Group. The development of clinical governance has been supported by the appointment of a Risk Manager to the service. The Carlow/Kilkenny service is also engaging in the Reform Programme to realign services to primary care networks, in line with national policy to facilitate integration and improvement of services.
22. Deputy John McGuinness asked the Minister for Health the status of the establishment of a statutory commission of investigation into a foster home in the south east. [20988/16]
View answerI wish to assure the House that I am fully committed to the establishment of a Commission of Investigation into this matter. I am very concerned about the issues which have been raised in this case and cannot stress highly enough that the safety and protection of all vulnerable people in the care of the State is paramount. The previous Government's approval to the establishment of a Commission of Investigation, was given in principle, subject to a further decision to be made by the Government on detailed terms of reference, timelines and costs which will be informed by the work currently being undertaken by Mr Conor Dignam Senior Counsel into related matters. In accordance with the provisions of the Commissions of Investigation Act 2004, the Terms of Reference will then require the approval of the Oireachtas.
Following the decision by Government concerning the establishment of a Commission, additional resources were allocated to Mr. Dignam and he was also asked to identify matters which would assist in framing the Terms of Reference for the Commission.
Mr. Dignam has informed me that he is close to finalising his report, which is expected in the coming weeks.
23. Deputy Maureen O'Sullivan asked the Minister for Health why the Health Service Executive is not engaging with the Reactions and Effects of Gardasil Resulting in Extreme Trauma, REGRET, group; if he has confidence in the human papilloma virus vaccine; and if he will engage with the group to discuss the serious illnesses suffered by over 370 girls and address the lack of possible information on side-effects provided to parents of students receiving the vaccine. [20613/16]
View answerThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health. The committee's recommendations are informed by public health advice and international best practice.
The HPV vaccine protects girls from developing cervical cancer when they are adults. It is available free of charge from the HSE for all girls in 1st year of secondary school.
Each year in Ireland around 300 women are diagnosed with cervical cancer. The HPV vaccine protects against two high risk types of HPV (16 & 18) that cause 73% of all cervical cancers. Vaccinated women and girls will still be at risk from other high risk types of HPV that can cause cervical cancer and will therefore need to continue to have regular cervical smear tests.
By January 2016, over 200 million doses of Gardasil had been distributed worldwide. In Ireland over 580,000 doses of Gardasil have been administered and over 200,000 girls have been fully vaccinated against HPV since it was introduced in 2010.
In Ireland, the Health Products Regulatory Authority (HPRA) is the statutory regulatory authority for medicines in Ireland. While no medicine (including vaccines) is entirely without risk, the safety profile of Gardasil has been continuously monitored since it was first authorised both nationally and at EU level. This is done by both monitoring of individual adverse reaction reports received by competent authorities across Europe (including the HPRA) and Periodic Safety Update Reports submitted by the Marketing Authorisation Holder (i.e. license holder) for the vaccine on a regular basis.
As part of its monitoring of the safety of medicines, the HPRA operates an adverse reaction reporting system, where healthcare professionals and patients are encouraged to report adverse reactions they consider may be associated with their treatment, through the range of options in place for reporting. All reports received are evaluated and considered in the context of the safety profile of the product concerned, with reports followed up as necessary for further information, that may assist in the assessment of the case.
In November 2015 the European Medicines Agency completed a detailed scientific review of the HPV vaccine. The review which the HPRA participated in, specifically focused on rare reports of two conditions, complex regional pain syndrome and postural orthostatic tachycardia syndrome associated with heart rate increase. The outcome of the review found no evidence of a causal link between the vaccine and the two conditions examined.
On 12 January 2016 the European Commission endorsed the conclusion of the European Medicines Agency stating that there is no need to change the way HPV vaccines are used or to amend the product information. This final outcome by the Commission is now binding in all member states.
I am aware of claims of an association between HPV vaccination and a number of conditions experienced by a group of young women. It appears that some girls first suffered symptoms around the time they received the HPV vaccine, and understandably some parents have connected the vaccine to their daughter’s condition.
I want to make it quite clear that anyone who is suffering ill health is eligible to seek medical attention, and to access appropriate health and social care services, irrespective of the cause of their symptoms. The individual nature of the needs of some children may require access to specialist services.
The HSE are currently working to put in place a clinical care pathway appropriate to the medical needs of this group. I hope to be in a position to meet representatives from REGRET in the near future.
24. Deputy Louise O'Reilly asked the Minister for Health if he will consider introducing a legislative based accountability framework for Health Service Executive employees; the consultation or meetings he has had on this; and if he will make a statement on the matter. [20913/16]
View answerWhile I recognise that continually strengthening accountability and good governance within the HSE is of critical importance, I have no plans to introduce a legislative based accountability framework for the HSE. My Department has, however, engaged intensively with both the HSE and the Department of Public Expenditure and Reform over recent weeks with a view to considerably strengthening the existing HSE Accountability Framework and deliberations are ongoing in this regard. I expect that this enhanced Performance and Accountability Framework will be put into effect by the HSE in the near future, particularly in the context of the additional funding recently approved by Government for the health services.
25. Deputy Colm Brophy asked the Minister for Health the status of the provision of needs assessments by needs assessment officers in areas (details supplied); the number of officers in place; the reason for the delay in provision; when he will clear the backlog of applicants; and if he will make a statement on the matter. [20454/16]
View answerThe Disability Act 2005 provides for an assessment of the needs of eligible applicants occasioned by their disability. The assessment of need must commence within three months of receipt of a completed application and must be completed within a further three months. The HSE works towards completing the assessment within three months unless there are exceptional circumstances. Applicants are further entitled to a Service Statement which sets out the services that will be provided to meet the needs identified in the Assessment Report. The Service Statement should be issued within one month of the completion of the Assessment of Need Report.
The position of Assessment Officer for the Dublin South West area became vacant in March 2016 and HSE is working to recruit to this post. In the absence of the Assessment Officer, systems have been put in place to process applications and provide for assessments to be conducted. Individual assessment reports are being provided directly to parents/guardians however the final Assessment Report cannot be completed in the absence of this warranted officer.
The HSE is also in the process of recruiting a Liaison Officer as provided for by section 11 of the 2005 Act. The Assessment Reports cannot be progressed and Service Statements cannot be issued in accordance with the Disability Act until the Liaison Officer has been appointed.
In the absence of the Liaison Officer the Dublin South West Disability service is identifying appropriate services and issuing services statements when directed to do so by the statutory Disability Complaints Officer (Disability Act 2005).
The HSE Dublin South West office receives an average of 45 applications per month. The waiting list in Dublin South West for an Assessment of Need is currently at 218 and the number of clients awaiting Services Statements is 478.
Once the vacant posts are filled it is estimated that it will take 18 months to clear the current backlog of cases. The fact that a child is waiting for their assessment to be completed should not be interpreted as meaning that the child is necessarily waiting for necessary, identified interventions.
26. Deputy Sean Fleming asked the Minister for Health how Ireland’s expenditure on medicines compares to other European Union member states when considered as a share of overall health expenditure. [20976/16]
View answer43. Deputy David Cullinane asked the Minister for Health why, according to 2013 figures from the OECD, Ireland had the highest per capita spend on medicines in the European Union; the areas in which the €775 million in savings in the drugs bill have been made including a breakdown of this; and if he will make a statement on the matter. [20935/16]
View answerI propose to take Questions Nos. 26 and 43 together.
OECD statistics serve as a useful metric to compare expenditure in medicines and other areas. However, per capita figures represent one of a number of metrics that can be used to develop a view of drugs spending in Ireland. For example, aggregate spending on the GMS, Drugs Payment Scheme, and Long-Term Illness scheme has reduced since 2009, despite an increase in numbers with eligibility and the introduction of more expensive new medicines, such as new oral anticoagulants.
According to OECD data for 2014, the last year for which full figures are available, expenditure on prescription and over-the-counter medicines accounted for just over 14 percent of overall health expenditure in Ireland. Although this was higher than several other EU countries, including Denmark, Finland, and Belgium, it was lower than Germany, France, Italy, and Spain, and significantly lower than Greece or Hungary.
OECD data on pharmaceutical prices is based on list prices of products. Such data does not consider the actual commercially confidential discounted prices in place, and therefore has limitations. In addition, expenditure on medicines in hospitals is excluded in the OECD statistics. Many expensive speciality medicines are provided in primary care settings in Ireland, meaning that Ireland's spend per capita is over-stated relative to EU countries in which these medicines are supplied mainly through hospitals.
The prices of medicines vary between countries for a number of reasons, including different prices set by manufacturers, different wholesale and pharmacy mark-ups, different dispensing fees and different rates of VAT. The size of the market can also be a factor in the prices set by manufacturers.
We will continue to build on a number of measures implemented in recent years to reduce the cost of medicines; these measures include the establishment of the HSE's Medicines Management Programme, which has a particular focus on cost-effective prescribing, and the continued implementation of generic substitution and reference pricing.
My Department has recently created a new Community Pharmacy, Dental, Optical and Aural Policy unit to bring a renewed focus to the development of policy in relation to community pharmacy and the issues associated with achieving maximum benefit to patients.
Negotiations and agreements with industry represent just one element of the Government’s strategy to reduce expenditure on medicines; other initiatives will continue to be pursued in the coming months and years to ensure that we achieve affordable prices for medicines for both patients and the State.
A negotiating team representing the State recently reached agreement in principle with the Irish Pharmaceutical Healthcare Association on a new drug pricing and supply agreement. Until the agreement is finalised, I cannot comment on any anticipated savings.
27. Deputy Bríd Smith asked the Minister for Health the actions he is taking to progress the development, staff levels and contracts of general practitioners including the provision of care free at the point of use to persons under 12 years of age; and if he will make a statement on the matter. [20909/16]
View answer82. Deputy Gino Kenny asked the Minister for Health the action he is taking to progress the development and staff levels and contracts of general practitioners, including the provision of care free at the point of use to children under 12 years of age; and if he will make a statement on the matter. [20943/16]
View answer552. Deputy Jack Chambers asked the Minister for Health the way he plans to deal with the increased waiting times at general practitioner clinics; his further plans to extend free general practitioner care with the current difficulties in meeting existing demand in general practitioner clinics; and if he will make a statement on the matter. [20453/16]
View answerI propose to take Questions Nos. 27, 82 and 552 together.
There have been significant developments in the general practice service recently, with more services being made available to our citizens and additional support provided by the HSE. Under a Framework Agreement, signed in 2014, the HSE, Department of Health and IMO are currently engaged in a comprehensive review of the GMS and other publicly funded health sector contracts involving GPs. A number of service developments have already arisen out of this process including the implementation in 2015 of a universal GP service for all children under 6 years and all persons aged 70 years and over. In addition, a cycle of care for asthma for children under 6 years, and a cycle of care for diabetes for medical card and GP cardholders were also introduced last year. More recent developments in 2016 were the enhanced support framework for general practices services in rural areas and the revised list of special items of service that can be provided by GPs.
In Budget 2016, the Government has also provided for the extension of GP care without fees to all children aged under 12 years in the latter part of 2016. This extension is subject to negotiation and will be implemented in the context of a new GP contract. In addition, the Programme for Partnership Government, commits to the introduction of free GP care for all under-18s, subject to negotiations with GPs and noting the need for additional GPs to support the additional workload.
I have recently met with GP representative bodies to discuss the future development of general practice and I have assured them of the Government's commitment to developing primary healthcare services for all our citizens and the key role of general practice in that context. In order to ensure that the potential benefits of an enhanced integrated primary healthcare sector can be realised and supported by a new contract for general practice services, I am currently considering a number of options around this process, including the possibility of broader consultations with stakeholders.
The Programme for Partnership Government emphasises the need to focus on enhancing primary healthcare services including building up GP capacity, increasing the number of therapists and other health professionals in primary care. The number of GP contract holders has been increasing incrementally in recent years, from 2,258 at the end of 2010 to 2,469 at the end of May 2016. The annual GP training intake has also increased from 120 prior to 2010 to 158 in 2015. In 2016, this will increase to 172 and it is envisaged that the intake number will increase further in 2017 and 2018.
In relation to the issue of waiting times for an appointment to see a GP, I would like to point out that GPs do not currently provide information to the HSE in relation to patient visit activity, waiting times etc. In the absence of such general practice activity data, it is not possible to provide further information to the Deputy as to whether a problem exists and, if it does, the extent of any such problem.
