Written Answers Nos. 91-103
91. Deputy Seán Haughey asked the Minister for Health the reason 1,102 persons were waiting more than a year for inpatient and day case treatment in Beaumont Hospital in October 2016; and the reason the numbers waiting more than a year have increased by more than 18,000% since April 2014. [38040/16]
View answerThis Government is committed to improving waiting times for patients. While recognising that demand for acute hospital services has increased this year with a 4% increase in inpatient and day case activity nationally to end October compared with the same period last year, the important issue for patients is how long they wait.
Under the HSE Service Plan 2016 targets, 95% of people should wait less than 15 months for their inpatient or day-case appointment. The latest NTPF inpatient/day-case waiting list figures indicate that the total number of people on the inpatient/day-case waiting list for Beaumont Hospital is 5,769 and that 87% of people at the hospital are waiting less than 15 months for their inpatient or day-case appointment. 4,667 or 81% of people are waiting less than 12 months for their inpatient or day case appointment.
In August, I asked the HSE to develop a Waiting List Action Plan for 2016 to reduce by year end the number of patients waiting over 18 months on the Inpatient Day-case Waiting List. Since then, approximately 6,500 patients have been removed from the waiting list nationally. Additional funding of €11.25 million has been allocated under the Winter Initiative in order to support patient treatment under this Action Plan.
Budget 2017 provides for the treatment of our longest-waiting patients. €20 million is being allocated to the NTPF in 2017, rising to €55 million in 2018. Planning of these initiatives is currently being finalised. I will shortly be asking the HSE to develop a Waiting List Action Plan for 2017 working collaboratively with the NTPF to address inpatient, day-case and outpatient waiting times.
92. Deputy Billy Kelleher asked the Minister for Health the measures he is taking to address the fall in the uptake of the human papilloma virus, HPV, vaccine; the estimated number of deaths annually from cervical cancer that would result from a halving of the uptake of the vaccine; and if he will make a statement on the matter. [38013/16]
View answerEach 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. NIAC recommended that the human papilloma virus (HPV) vaccine be given to all girls aged 12-13 in 2009 and in September 2010 the HPV vaccination programme was introduced for all girls in first year of second level schools. It is estimated that HPV vaccination will eventually save 60 lives annually in this country.
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 220,000 girls have been fully vaccinated against HPV since it was introduced in 2010.
Negative publicity and misinformation is affecting the uptake of the vaccine. We must ensure that people understand that the vaccine is safe and can save lives.
Since early this year the HSE are working with other stakeholders to counteract negative publicity and misinformation about the vaccine. The Irish Cancer Society held two public meetings in Galway and Cork. These are two areas where uptake rates of the vaccine had reduced significantly. These meetings included talks by renowned international HPV cancer expert, Professor Margaret Stanley, cervical cancer survivors and hospital consultants.
The parents of girls in first year of second level school have been given a revised information leaflet, consent form and contact phone numbers for their local immunisation office. Any queries they have concerning the vaccine can be addressed by the school immunisation team prior to vaccination day. In addition girls, who may have declined the first dose of vaccine, will get an opportunity to receive this when the school immunisation team revisits the school.
Information about the vaccine and its benefits has been circulated to all school principals, management bodies, National Parents Councils and GPs. The HSE have also met with the Department of Education and school management bodies.
In addition, prior to the start of the 2016/2017 school immunisation programme there was a coordinated local and national media campaign involving the Irish Cancer Society, HSE Communications and the National Cancer Screening Programmes. It is intended that the promotion of HPV vaccine as a safe and effective vaccine will continue and the HSE plans to commence focus groups with parents in the near future.
These actions should address the concerns of many parents and encourage their daughters to receive this important cancer preventing vaccine.
93. Deputy Aengus Ó Snodaigh asked the Minister for Health the status of the implementation of the 48 recommendations of the national steering group on rare diseases; the specific actions that are being taken on access to medication and technology; and if he will make a statement on the matter. [37862/16]
View answerThe National Rare Disease Plan for Ireland (2014 - 2018) recommended that an Oversight Implementation Group of relevant stakeholders, including patients' groups, be established to oversee and monitor implementation of the plan's recommendations. This group was established by the Department of Health in 2015 and it has met on a number of occasions.
One of the principal recommendations in the Plan was the establishment of a National Clinical Programme for Rare Diseases. This programme was to be responsible, over time and among other functions, to assist with mapping and developing care pathways for rare diseases; facilitating timely access to centres of expertise – nationally and internationally; in developing care pathways with European Reference Centres for those ultra-rare disorders where there may not be sufficient expertise in Ireland.
In line with this recommendation, a National Clinical Programme for Rare Diseases was established in 2013 under the National Clinical Strategy and Programmes Division of the HSE. The programme is a joint initiative between the HSE and the Royal College of Physicians of Ireland. This clinical programme is a channel for assisting with the advancement of a number of other recommendations in the plan, such as those on National Centres of Expertise for rare diseases; and in this vein, the programme designed a framework for the designation of Irish Centres of Expertise in cooperation with HSE Acute Hospitals Division in line with the recommendations stipulated in the national plan.
The Rare Diseases National Plan also recommended that ‘the National Clinical Programme for Rare Diseases through a National Office for Rare Diseases develop the clinical and organisational governance framework that would underpin care pathways and access to treatment for rare disease patients, particularly in the context of transition from paediatrics to adult care'.
As such the National Clinical Programme has developed a draft transition model of care which will be entering a consultation stage very shortly.
The National Clinical Programme for Rare Diseases and the Department of Health encouraged designated Centres of Expertise to participate in European Reference Networks (ERNs) for Rare Diseases in line with the national plan. ERNs are European networks connecting health care providers and centres of expertise so that international expertise on specific rare diseases may be pooled together for the benefit of patients. Any centre applying for membership of an ERN must have strategies in place to ensure that care is patient-centred; that patients' rights and preferences are respected; and must show a research component to their work.
Hence, the recommendations in the national plan that related to empowering and protecting patients and carers, and research on rare diseases will be fulfilled in part through this process. It is expected that ERNs will have a major structuring effect by linking thematic expert centres across the EU.
With the encouragement of the National Clinical Programme for Rare Diseases, Acute Hospital Divisions in the HSE and the Department of Health, five centres of expertise were designated in June this year during the first round of calls from the European Commission for participation in European Reference Networks. Three of these designated centres applied for membership of ERNs.
In 2014, the Minister for Health announced €850,000 for investment into charity-led research priorities, which particularly benefits rare disease research. Five charities were to provide matching funding bringing the total investment to €1.9 million. They were to share €850,000 in State funding to take part in international research into rare medical conditions. In 2016, the next cohort of projects was funded by the State with €1.686 million, matched by charity funding of €1.224 million. The total funding of €2.91 million is shared between 14 charities. The next round of this joint funding initiative will open in 2017. The EU commission now intends to explore the possibility to further strengthen the collaboration between member states and the Commission in the area of research on rare diseases.
The establishment of a National Rare Disease Office (NRDO) featured prominently in the recommendations of the Rare Disease plan. The national office was established by the HSE in June 2015. Its work is currently led by the NCPRD Clinical Lead, supported by an Information Scientist, part-time Administrative Officer, part-time Genetic Counsellor and by a 0.2 FTE Consultant Geneticist. It is, among other functions, providing up-to-date information regarding new treatment and management options, including clinical trials. In addition, the post of Information Scientist for the office is being funded jointly by the HSE and the EU Commission.
The NRDO has already performed a preliminary situation analysis of the existing rare disease registries and is in the process of assigning these known registries on our national Orphanet site, which is the international rare disease reference and information portal funded by the EU. The EU Commission has started the development of a European Platform on Rare Diseases Registration. Its principal goal is to enable sharing and use of rare diseases patient data across Europe, among the multitude of existing patient registries, within and across rare diseases.
A number of recommendations about access to appropriate drugs and technologies were contained in the plan. One chief recommendation in this regard refers to the HSE developing a Working Group to bring forward appropriate decision criteria for the reimbursement of orphan medicines and technologies; and that the approach should include an assessment system similar to that for cancer therapies established under the National Cancer Control Programme. The HSE has advised my Department that its Acute Hospitals Division is developing the terms of reference, required membership and reporting relationship for this committee which will parallel the National Cancer Control Programme Technology Review Committee.
This Committee will also be supported by the National Clinical Programme for Rare Diseases Clinical Advisory Group. The national plan for Rare Diseases recommended that the Health Identifiers Bill and the Health & Patient Safety Bill be published. The former was published in 2013 and enacted in 2014. It is now being implemented by the HSE. A revised and much expanded General Scheme of a Health Information and Patient Safety Bill was approved by the Government in November 2015 and published on the Department's website.
Two recommendations referred to training in rare diseases for healthcare professionals. The Department of Health has contacted formally the various healthcare representative and professional bodies about implementing these recommendations.
Finally, rare diseases have already been tabled on the agenda for North-South meetings. Therefore, future work to deepen cooperation between both jurisdictions on rare diseases is anticipated.
94. Deputy Jim O'Callaghan asked the Minister for Health the reasons for the substantial increase in emergency department overcrowding in St. Vincent’s hospital over the past two years. [38053/16]
View answerTrolley numbers nationally have been high in November due to increased ED attendances, greater incidence of infection in several hospitals and a high rate of elective activity in hospitals to address waiting lists. The HSE has advised that there has been a 1.6% increase in attendances at the ED in St Vincent's since 2015 and a 5.3% increase in emergency discharges. Infection control issues at the hospital have had a particular impact on patient flow in the last few weeks.
It is unacceptable that patients wait on trolleys for long periods especially elderly and vulnerable patients. Over the coming months it is essential that the health service plans effectively for expected surges in emergency care demand. My Department, working with the HSE, has been driving a range of measures to improve patient ED experience times.
Following the formation of Government an additional €40 million was provided to assist in the management of winter pressures. Utilising this additional funding the HSE developed the Winter Initiative Plan 2016 – 2017 which was published in September. Key aspects of this plan are being implemented at hospital and community services level across the country. St Vincent's Hospital has developed a Winter Capacity Plan to assist in managing the demand for services over the winter period and is liaising with the HSE to maximise patient discharges and manage patient flow.
Today the HSE convened a Winter Initiative Health Summit and I met with Hospital Group CEOs, as well as hospital and Community Health Organisation managers, to reinforce the importance of driving key performance improvements across primary, acute and social care to reduce ED overcrowding and to plan for expected surges in demand in our EDs in the New Year.
I can assure the Deputy that there is a very strong focus on reducing ED overcrowding in all my interactions with the HSE, hospitals, including St Vincent's hospital, and the wider health service.
95. Deputy Eamon Scanlon asked the Minister for Health the reason for the 162% increase in inpatient and day case waiting lists in Sligo University Hospital since April 2014, significantly ahead of the national average increase of 57%. [38028/16]
View answerThis Government is committed to improving waiting times for patients. While recognising that demand for hospital inpatient and day case activity nationally has increased by 4% year on year to end October, the important issue for patients is how long they wait.
Under the HSE Service Plan 2016 targets, 95% of people should be waiting less than 15 months for their inpatient or day-case appointment. The latest NTPF inpatient/day-case waiting list figures indicate that the total number of people on that list for Sligo University Hospital is 3,147 and that the hospital is meeting the 15 month target in respect of 97% of people. Based on the HSE Performance Reports, inpatient discharges have increased by 5.5% since the end of 2013 at the hospital.
In August, I asked the HSE to develop a Waiting List Action Plan for 2016 to reduce by year end the number of patients waiting over 18 months on the inpatient/day-case waiting list. Since then, approximately 6,500 patients have been removed from the waiting list. Additional funding of €11.25 million has been allocated under the Winter Initiative in order to support patient treatment under this Action Plan.
Budget 2017 provides for the treatment of our longest-waiting patients. €20 million is being allocated to the NTPF in 2017, rising to €55 million in 2018. Planning of these initiatives is currently being finalised. I will shortly be asking the HSE to develop a Waiting List Action Plan for 2017 working collaboratively with the NTPF to address inpatient, day-case and outpatient waiting times.
97. Deputy Richard Boyd Barrett asked the Minister for Health the alternatives he will put in place in view of the fact that orthodontic surgery at St. James's hospital is no longer taking referrals from Loughlinstown hospital; and if he will make a statement on the matter. [37962/16]
View answerAs this is a service matter it has been referred to the HSE for reply to you.
98. Deputy Joan Collins asked the Minister for Health the reason and the basis on which the medicines management programme is ceasing the reimbursement for products (details supplied); and if he will make a statement on the matter. [37781/16]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.
99. Deputy Lisa Chambers asked the Minister for Health the action being taken to address the fact that the latest figures indicate some 240 persons under 18 years of age waiting more than a year for a first-time assessment for occupational therapy in County Mayo. [38026/16]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to you.
100. Deputy Michael McGrath asked the Minister for Health the reason some 623 five to 17 year olds are waiting more than a year in Cork city for a first-time assessment for occupational therapy; and if he will make a statement on the matter. [38059/16]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to you.
102. Deputy Darragh O'Brien asked the Minister for Health the measures that will be put in place to assist the 4,027 persons waiting more than a year for an outpatient appointment in the Mater hospital; and if he will make a statement on the matter. [38057/16]
View answerThis Government is committed to improving waiting times for patients. While recognising that demand for acute hospital services has increased, the important issue for patients is how long they wait.
Under the HSE Service Plan 2016 targets, 85% of people should wait less than 52 weeks for their first outpatient appointment. The latest NTPF Outpatient Waiting List figures indicate that 85% of people in the Mater Hospital are waiting less than 52 weeks for their first outpatient appointment and 95% of people are waiting less than 18 months for access to outpatient services.
In August, I asked the HSE to develop a Waiting List Action Plan for 2016 to reduce by year end the number of patients waiting over 18 months for an inpatient or day-case procedure. Since then, approximately 6,500 patients have been removed from the waiting list nationally.
Regarding outpatient waiting lists in particular, the HSE recently launched the Strategy for the design of Integrated Outpatient Services 2016-2020. It seeks to improve waiting times for outpatient services by enhancing patient referral pathways and utilising technology to enable better planning.
Budget 2017 provides for the treatment of our longest-waiting patients. €20 million is being allocated to the NTPF in 2017, rising to €55 million in 2018. Planning of these initiatives is at an advanced stage. I will shortly be asking the HSE to develop a Waiting List Action Plan for 2017, working collaboratively with the NTPF, to address inpatient, day-case and also outpatient waiting times, including in the Mater Hospital.
103. Deputy Margaret Murphy O'Mahony asked the Minister for Health the status on the implementation of the congregated settings report; the measures being put in place to support persons when they leave residential institutions; and if he will make a statement on the matter. [38018/16]
View answerThe Programme for Partnership Government commits to moving people with disabilities out of congregated settings, to facilitate them in living more independently and to be included in their community. Currently, 2649 people live in congregated settings and the objective is to reduce this figure by one-third by 2021 and ultimately, to eliminate all congregated settings. It is anticipated that 97 people will have completed their move to the community during 2016, with a further 63 ready to move early in 2017. A similar additional number of people will be supported to move throughout 2017.
A subgroup, under the Transforming Lives Programme is developing an implementation plan for moving people from institutions in accordance with the recommendations of the Time to Move on from Congregated Settings report. The needs and wishes of people moving from congregated settings will be prioritised during this process with a model of support based on a person centred plan.
I wish to emphasise that appropriate plans and resources are being put in place to ensure that people are properly supported as they move out of institutional care. Earlier this year, I announced the provision of €100 million in capital funding between now and 2021 to provide more appropriate homes for people currently living in a number of institutions. Further supports are provided by a Service Reform Fund involving the Department of Health, the Atlantic Philanthropies, the HSE and Genio.
Separately, the Department of Housing, Planning, Community and Local Government has provided €10 million under the Capital Assistance Scheme for people transitioning from institutions in 2016, benefitting an estimated further 100 people. €1 million in ring-fenced funding is also being made available by that Department in 2016 to support people moving from institutions into suitable social housing. This demonstrates the joined up commitment of both Departments to support the de-congregation programme.
This process of moving people to more suitable accommodation in the community will take place over a number of years and will be done in full consultation with all residents and their families.
