Written Answers Nos. 65-80
65. Deputy Ruth Coppinger asked the Minister for Health the progress being made on construction of the national children's hospital at the St. James's Hospital site; and if he will make a statement on the matter. [20951/16]
View answerThe Government decision to co-locate the new children's hospital with St James's was announced on 6 November 2012. Satellite centres of the hospital, providing urgent and outpatient care, are to be built on the campuses of Connolly and Tallaght Hospitals. The decision was clinically led, and was made in the best interests of children, with clinical considerations paramount in the decision.
As announced in June 2015, the Coombe Women and Infants University Hospital will relocate to the campus in time, achieving tri-location of adult, paediatric and maternity services. 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, which are readily accessible for paediatric and maternity patients on the shared campus.
St James’s Hospital has the broadest range of national specialties of all acute hospitals, as well as strong and well established research and education infrastructure, making it the hospital that best meets the criteria to be the adult co-location partner.
The decision of An Bord Pleanála on April 28 last to grant planning permission for the hospital, satellite centres and related buildings is a huge and very welcome milestone for the project. I am delighted that the first phase of construction can now commence, and I expect an enabling works contractor to be on site within weeks. Tenders have also been issued for main works and specialist contracts. 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.
66. Deputy Clare Daly asked the Minister for Health his plans to repeal the Regulation of Information (Services Outside the State for Termination of Pregnancies) Act 1995, particularly in view of the United Nations Human Rights Committee finding (details supplied), in order to enable the medical profession to advise its patients on all medical options available to them, including those currently only available outside Ireland. [20614/16]
View answer549. Deputy Richard Boyd Barrett asked the Minister for Health his views regarding whether women's rights are being vindicated, given the findings of the UN Human Rights Committee in regard to Ireland’s abortion laws; and if he will make a statement on the matter. [17149/16]
View answer550. Deputy Bríd Smith asked the Minister for Health if he believes that the recent United Nation's condemnation of Ireland's treatment of pregnant woman in need of abortions shows that this and previous Governments' failure to legislate or to seek to repeal the eighth amendment proves that Ireland may indeed be guilty of cruelty and inhumane treatment of all female citizens. [17506/16]
View answerI propose to take Questions Nos. 66, 549 and 550 together.
My Department is studying the Views of the United Nations Human Rights Committee on complaints brought by Ms Amanda Mellet against the State, and assessing their findings.
The complaint relates to the inability of Ms Mellet, who was carrying an unborn child with Edwards Syndrome (a fatal foetal abnormality), to access a termination of pregnancy within the State.
As I previously stated, I find the Committee’s description of Ms Mellet’s experience outlined in the Views deeply lacking in compassion and I want to see the issue addressed.
The Deputies will be aware that termination of pregnancy is regulated in Ireland by constitutional and statute law and in particular the Eighth Amendment to the Constitution (Article 40.3.3) which acknowledges and guarantees in its laws to respect and, as far as practicable, to defend and vindicate that right, with due regard to the equal right to life of the mother.
I believe that the Government’s commitment to develop a consensus approach on the Eighth Amendment within a Citizen’s Assembly is the way to move forward. The issue of fatal foetal abnormalities can be examined as part of this process and I would expect the views of the UN Human Rights Committee will also be considered.
Aside from the constitutional issue of the Eighth Amendment I am also considering within the law what other services and supports can be put in place to help women in these circumstances.
In this regard, the Regulation of Information (Services Outside the State for Termination of Pregnancies) Act, 1995 defines the conditions under which information relating to abortion services lawfully available in another state might be made available in Ireland. Medical professionals are not precluded under the Act from giving a pregnant woman all the information necessary to enable her to make an informed decision provided a termination of pregnancy is not advocated or promoted. The Act does not prevent a doctor communicating in the normal way with another medical professional in regard to his/her patient’s care nor does the Act prevent the woman receiving a copy of any medical, surgical, clinical or other records relating to her case.
I intend to ask the HSE to ensure that the medical profession have clarity about what they can do under the Act to support women in these circumstances.
67. Deputy Imelda Munster asked the Minister for Health the number of persons who have accessed health care under the European Union cross-border health care directive in another European Union and European Economic Area member state in each year since Directive 2011/24/EU was transposed; the amount reimbursed in accordance with the legislation; the number of those persons who accessed health care in Northern Ireland; the amount reimbursed in respect of treatment in Northern Ireland; and if he will make a statement on the matter. [20926/16]
View answerThe Health Service Executive operates the EU Directive on Patients’ Rights in Cross Border Healthcare in Ireland. The Health Service Executive has been asked to examine the matter of the data requested and to reply to the Deputy as soon as possible. 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.
68. Deputy Richard Boyd Barrett asked the Minister for Health if there is evidence available that the rescheduling of benzodiazepines or Z drugs could prevent the misuse of dangerous or harmful drugs; the specific requests the Garda made to him regarding the rescheduling of these drugs; and if he will make a statement on the matter. [20705/16]
View answerBenzodiazepines, as a group of medicines, are commonly used to treat anxiety, sleep disturbance and insomnia. Benzodiazepines are known to be associated with dependence and withdrawal symptoms and consequently are primarily recommended for short-term treatment only. The 'Z drugs' are a group of medicines (zopiclone, zolpidem and zaleplon) which are used to treat insomnia. They have a shorter duration of action than benzodiazepines. The problem of the misuse of prescription drugs has been recognised at national, European and international levels.
The supply of prescription medicines in Ireland is controlled in a number of ways. Under the Medicinal Products (Prescription and Control of Supply) Regulations, it is prohibited for a person to supply a prescription medicine except in accordance with a prescription, and the supply must be made from a registered pharmacy by or under the personal supervision of a registered pharmacist. A person who contravenes these Regulations is guilty of an offence. Medicines which have a high potential to be misused are controlled under the Misuse of Drugs legislation. The Misuse of Drugs Acts and Regulations impose restrictions on the production, supply, importation and exportation of controlled drugs, such as morphine, methadone and amphetamines. A person who has in his possession a prescription medicine containing a controlled drug under the Misuse of Drugs legislation for the purpose of selling or supplying it unlawfully, is guilty of an offence under that legislation.
The Garda has indicated to officials in my Department that introducing stricter controls on benzodiazepines and controlling zopiclone and other z-drugs will assist in disrupting street dealing in these drugs. The Misuse of Drugs (Amendment) Bill brings under the scope of the legislation certain prescription medicines including zopiclone. The legislation will also control certain psychoactive drugs such as 'clockwork orange'. Following enactment of the Bill the associated regulations will be introduced. These regulations will apply import and export controls, tighter prescribing and dispensing controls as well as an offence of possession, thereby assisting the Customs and An Garda Síochána in protecting public health and local communities.
69. Deputy Charlie McConalogue asked the Minister for Health the reason he is allowing a situation to arise at Letterkenny University Hospital where the necessary infrastructure and staff are not being provided to the orthodontic department there and as a result clinics are being cancelled on a continuous basis and waiting lists are growing; why there is no radiography equipment available in-house for the orthodontic department at the hospital; when a full complement of six dental nurses will be made available to the orthodontics department; and if he will make a statement on the matter. [20457/16]
View answerAs 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.
70. Deputy Maurice Quinlivan asked the Minister for Health further to Parliamentary Question No. 714 of 31 May 2016, how the co-investment programme of €27.5 million for the national dementia strategy has been spent; the funding available from this; the cost to date of providing intensive home care packages since January 2015 to the 133 persons nationally; the cost of rolling out dementia specialist intensive home care packages to all local health office, LHO, areas, as was piloted in eight LHOs as part of the national dementia strategy; and if he will make a statement on the matter. [20933/16]
View answerAs this is a service matter it has again been referred to the Health Service Executive for direct reply. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
71. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the number of children waiting for disability assessment reports from the Health Service Executive; if he is aware that this impedes the ability of children obtaining the assessments they need in order to access essential services; the action being taken to ensure that there is no undue delay in this process, particularly as schools will be applying for special needs assistants; and if he will make a statement on the matter. [20929/16]
View answerAs 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.
72. Deputy Gino Kenny asked the Minister for Health the increases in staffing that have been achieved to deal with the crisis in primary care psychology, speech and language therapy and occupational therapy services; and if he will make a statement on the matter. [20942/16]
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 the matter with them.
73. Deputy Lisa Chambers asked the Minister for Health his plans to increase the current rheumatology consultant service being provided at Mayo University Hospital. [20981/16]
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.
74. Deputy Bernard J. Durkan asked the Minister for Health his plans to reduce the congestion at accident and emergency departments in public hospitals here; and if he will make a statement on the matter. [20911/16]
View answerPressures on EDs have been rising, as the population is both growing and ageing. To date, the HSE has reported an average increase in ED attendances of nearly 6% compared with the same period last year.
Despite the sustained increase in attendances, overall this year there has been a decrease of just over 7% in the number of patients who have had to wait on a trolley, in comparison with the same period in 2015.
ED performance has been improving due to a combination of coordinated initiatives. These include reducing patient attendances at EDs by developing alternative primary care services, such as Community Intervention Teams and Primary Care Centres and increasing hospital capacity by opening or reopening 374 additional beds and employing more than 750 nurses and almost 80 consultants.
Further, initiatives have also focussed on reducing delayed discharges from hospitals, and improving how hospitals manage surges in demand for emergency care.
In order to progress the Government’s commitment to reducing ED wait times for patients, on 8 June I announced funding of €40 million for a “Winter Initiative”, €10m of which has been ring-fenced for homecare services.
My Department and the HSE are currently working to finalise a proposal to support initiatives across primary care, acute hospitals and social care, all directed towards reducing winter pressure on EDs.
Further, the Programme for a Partnership Government commits to a number of initiatives intended to contribute to alleviating ED overcrowding, such as a review of bed capacity and a review of the hours of service of Medical Assessment and similar units.
75. Deputy Shane Cassells 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 Our Lady’s Hospital, Navan, County Meath. [20970/16]
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 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 Our Lady's Hospital Navan, 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.
76. Deputy John Lahart asked the Minister for Health the reason for the substantial increase between December 2015 and May 2016 in the number of children waiting more than a year for an outpatient consultation in Our Lady's Hospital for Sick Children, Crumlin, Dublin 12. [20973/16]
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 procedure.
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 Our Lady's Hospital for Sick Children, Crumlin, 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.
77. Deputy Gino Kenny asked the Minister for Health the increases in staffing that have been achieved to deal with the crisis in home help and carer respite services; the number of persons in hospital with their discharge delayed waiting to access these services; the number of carers that have been unable to continue as carers due to the lack of respite services; and if he will make a statement on the matter. [20944/16]
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.
78. Deputy James Browne asked the Minister for Health the number of children under 18 years of age who have been admitted to acute hospitals on mental health grounds; and the number of individual children these admissions relate to and the number of subsequent readmissions for 2015 and 2016 to date. [20957/16]
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.
79. Deputy Jack Chambers asked the Minister for Health when regulations will be introduced to provide for the introduction of suboxone as an alternative to methadone. [20967/16]
View answerSuboxone is authorised as a substitution treatment for opioid drug dependence, within a framework of medical, social and psychological treatment. It is currently being provided to a cohort of patients involved in the pilot and feasibility study for Suboxone.
If the provision of Suboxone is to be given the same statutory basis as methadone, in order to ensure its safe, appropriate and cost-effective use, an amendment to the Misuse of Drugs (Supervision of Prescription and Supply of Methadone) Regulations 1998 will be necessary.
The Misuse of Drugs (Amendment) Act 2015 was enacted as emergency legislation in March 2015 following a Court of Appeal decision on a constitutional challenge to section 2(2) of the Misuse of Drugs Act 1977. The 2015 Act reconfirmed the existing ministerial regulations and orders made under the 1977 Act, including the Misuse of Drugs Regulations 1988 and the 1998 Methadone Regulations. As a result, these Regulations may only now be amended by primary legislation.
As you know, on Tuesday 21 June the Misuse of Drugs (Amendment) Bill 2016 was published. The primary purpose of this Bill is to protect public health by bringing certain substances which are open to misuse and known to be traded on the illicit market under the scope of the misuse of drugs legislation, as well as aiding the law enforcement functions of An Garda Síochána and the Customs Service. The Bill also provides for the revocation of the previously confirmed regulations and ministerial orders. It is hoped that the Bill can be enacted before the summer recess.
New regulations will then be required to allow legitimate users (patients with a prescription, health professionals) to possess the newly controlled substances. Work is under way on drafting these regulations as a matter of priority. Any regulations made in relation to Suboxone will be drafted subsequent to this legislative agenda and will then be subject to the 3-month EU notification under the Technical Standards and Regulations Directive 2015/1535/EU.
80. Deputy Margaret Murphy O'Mahony asked the Minister for Health his plans for a national respite strategy to help those caring for persons with very profound disabilities. [20961/16]
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 states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.
Respite care for children and adults with disabilities is provided by the HSE directly in some instances, or by agencies funded by the HSE to provide services on its behalf. In many instances respite services are part of the overall suite of services provided by voluntary service providers to people with disabilities under their service level agreements with the HSE. The HSE remains committed to working with all voluntary disability service providers to ensure that all of the resources available for specialist disability services, including respite services, are used in the most efficient and effective manner possible.
The HSE’s Social Care Operational Plan for 2016 aims to provide 180,000 overnight stays in centre-based respite services to circa 5,300 people. The HSE is also committed to continuing to explore methods of community respite care as an alternative to centre-based respite care, including advancing the Host Family Support Model.
Agencies which provide centre-based respite care are subject to inspection by HIQA under the Health Act 2007 (Care and Support of Residents in Designated Centres for Persons (Children And Adults) With Disabilities) Regulations 2013, Health Act 2007 (Registration of Designated Centres for Persons (Children and Adults) with Disabilities) Regulations 2013 and the National Standards for Residential Services for Children and Adults with Disabilities.
Compliance with HIQA standards is a requirement under the Service Level Arrangements (SLA) between the HSE and voluntary service providers in the disability sector, including providers of respite services. The introduction of registration and inspection represents a significant advance in terms of delivering consistent and high quality services for people with disabilities in centre-based respite services.
I do not have any plans to introduce a national respite strategy in the immediate future.
