Written Answers Nos. 76-86
76. Deputy Peter Burke asked the Minister for Health the status of the major capital plan for the Midlands Regional Hospital, Mullingar, which includes four new operating theatres, a new endoscopy unit, a new stroke unit and a new intensive care unit; and if he will make a statement on the matter. [11902/17]
View answerMy Department is working with the HSE and the Department of Public Expenditure and Reform to conduct a mid-term review of the capital programme. My Department will also conduct a Bed Capacity Review which will assess projected health care needs over the next decade and the associated infrastructural requirements to meet these needs.
Future investment in hospitals must be considered within the overall acute hospital sector infrastructure programme, the prioritised needs of the hospital groups and within the overall capital envelope available to the health service. The HSE will continue to apply the available funding for infrastructure development in the most effective way possible to meet current and future needs, having regard to the level of commitments and the costs to completion already in place.
In relation to the specific service issue raised, I have asked the HSE to respond to you directly.
77. Deputy Clare Daly asked the Minister for Health the steps he has taken or will take to improve the quality of service provided to children with autism; if he is satisfied with the service currently provided by Beechpark services; and if he will make a statement on the matter. [11822/17]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
78. Deputy Robert Troy asked the Minister for Health when the service improvement review of St Christopher's, Longford and St Hilda's, Athlone will be published. [12084/17]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
79. Deputy Mick Wallace asked the Minister for Health the steps he is taking to enforce certain provisions of the Health Act 1970, specifically, to ensure that persons covered by the general medical services scheme are not being incorrectly charged for routine phlebotomy services and other generalised medical services provided by their general practitioner; and if he will make a statement on the matter. [11904/17]
View answerThere is no provision under the GP GMS contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP, or the Practice Nurse on behalf of the GP, which are required to either assist in the diagnosis of illness or the treatment of a condition. The HSE has advised GPs that where a blood test forms part of the investigation or necessary treatment of a patient's symptoms or conditions, this should be free of charge for patients who hold a medical card or GP visit card. Notwithstanding this, I understand that in recent times, some GPs are charging GMS patients for these services.
If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient may make a complaint to the HSE Local Health Office, who will deal with the matter in accordance with the HSE's Complaints Policy.
In order to achieve clarity on this issue, I have asked that any difference of perspective in relation to the provision of phlebotomy services be addressed in the GP contractual review. I am pleased that initial engagement with GP representative bodies to progress this process has commenced and I look forward to constructive and positive further engagements.
80. Deputy Margaret Murphy O'Mahony asked the Minister for Health what plans has has put in place to expand services at Bantry hospital; and if he will make a statement on the matter. [12088/17]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
81. Deputy Niamh Smyth asked the Minister for Health his plans to refurbish the emergency department at Cavan General Hospital; and if he will make a statement on the matter. [11839/17]
View answer110. Deputy Brendan Smith asked the Minister for Health if he will ensure that a project (details supplied) is included in the 2017 HSE capital programme due to the inadequate facilities at the health facility at present; and if he will make a statement on the matter. [11820/17]
View answerI propose to take Questions Nos. 81 and 110 together.
The Emergency Department in Cavan has been performing well this winter and is not currently a site of concern.
The RCSI Hospital Group has identified the need for development of the resuscitation area in Cavan Emergency Department. Any future investment in Cavan General Hospital must be considered within the overall acute hospital infrastructure programme, the prioritised needs of the hospital groups and within the overall capital envelope available to the health service.
The HSE will continue to apply the available funding for infrastructure development in the most cost effective way possible to meet current and future needs, having regard to the level of commitments and costs to completion already in place. During 2017 my Department will work with the HSE and the Department of Public Expenditure and Reform to conduct a mid-term review of the capital programme.
82. Deputy Gino Kenny asked the Minister for Health if his Department has been in touch with or has received any reports from the HSE with regard to the ongoing issue of children with mental health difficulties being treated in adult mental health facilities. [7042/17]
View answerThe reduction in the numbers of children admitted to adult psychiatric units has been a priority for the HSE Mental Health Services over recent years, and this important objective is reiterated in the 2017 HSE Service Plan.
Progress in this area has been significant since 2008 when there were 247 such admissions to adult units in that year. This declined to 68 in 2016, despite a background of increasing demands overall on Child and Adolescent Mental Health services. It is important to note, that the number of admissions does not necessarily equate to the actual number of children admitted, as an individual child may be admitted on more than one occasion in any given year. In 2016, there were a total of 380 Child and Adolescent Mental Health admissions, of which 312 (82%) were to age-appropriate units and 68 (18%) were to Adult Units. In terms of bed days used, in 2016, based on the most recent figures available, 97.4% of bed days used were in Child and Adolescent Inpatient Units. Performance generally continues to be above the HSE Service Plan target figure of 95%, and indications are that where a child has been admitted to an adult acute in-patient unit, the length of stay has been kept to a minimum.
The current HSE Service Plan allows for some operational flexibility surrounding emergency placements in Adult Units, particularly where very short-term placements take place. Full account is taken of all relevant factors such as the preferences of all those involved, and geographical factors relating to access or visiting. In this context, the HSE continues to closely monitor on a weekly basis all child admissions to adult units, with a view to minimising such admissions as much as possible.
I, and my Department officials, regularly meet with the HSE to review various mental health issues, including the potential for further improvement on age appropriate CAMHS admissions. In addition, relevant data is published as part of the monthly Performance Reports, available on the HSE website, and this is subject to regular monitoring by the Department of Health. I will continue to engage with the Executive over coming months, on possible additional Child and Adolescent Mental Health acute beds, and also further enhancing community based care for young people nationally, as additional mental health staffing comes on-stream. Bearing in mind all the circumstances, I am satisfied that, where children have to be placed short-term in adult mental health units, the Executive makes any special arrangements necessary, such as one-to-one care, to protect and monitor these young people. The Mental Health Commission is also notified of such admissions.
83. Deputy Billy Kelleher asked the Minister for Health the number of centres with regard to the primary care centre projects announced on 17 July 2012 that are now open; and if he will make a statement on the matter. [12081/17]
View answerDelivery of primary care infrastructure is a dynamic process, constantly evolving to take account of changing circumstances including the feasibility of implementation. The following table gives details of the 35 locations and their current status including opening dates. One of these primary care centres is already operational and a further six are projected to open in 2017 and ten in 2018. However, it should be noted that 56 primary care centres have been opened since 2011.
In addition to the primary care centres shown in the following table a further 13 primary care centres are projected to open in 2017 or early 2018.
|
Count |
HSE Region |
County |
Location/PCT Name |
Delivery Method |
Project Status - Q4 2016: PQ 12081/17 answer date 08/03/2017 |
|
1 |
DML |
Dublin |
Rowlagh/North Clondalkin |
Direct build |
Stage 2a design team report completed. HSE finalising purchase agreement of site at Collinstown Park School. Purchase agreement is subject to planning permission being granted for the development. |
|
2 |
DML |
Dublin |
Curlew Road/Crumlin/Drimnagh |
Direct build |
Planning permission in place |
|
3 |
DML |
Dublin |
Knocklyon/Rathfarnham |
Direct build |
Planning permission in place |
|
4 |
DML |
Wicklow |
Rathdrum |
Operational Lease |
Planning approved. HSE has finalised layouts. Construction due to commence to commence Q2 2017 and projected to open Q3 2018 |
|
5 |
DML |
Kildare |
Kilcock |
PPP |
In construction. Projected opening 2018 |
|
6 |
DNE |
Dublin |
Coolock/Darndale |
PPP |
In construction. Projected opening 2018 |
|
7 |
DNE |
Dublin |
Summerhill, north inner city Dublin |
PPP |
In construction. Projected opening 2018 |
|
8 |
DNE |
Dublin |
Balbriggan |
Operational Lease |
Construction completed, projected to open Q2 2017 |
|
9 |
DNE |
Dublin |
Swords |
Operational Lease |
Expressions of interest received. Currently being reviewed |
|
10 |
DNE |
Louth |
Drogheda north |
Operational Lease |
Developer re-engaged. Existing building requires fit-out. If legal discussions complete successfully, projected completion Q1 2018 and operational Q2 2018. |
|
11 |
DNE |
Meath |
Laytown and Bettystown |
Operational Lease |
Project is progressing as operational lease. Schedule of accommodation under review |
|
12 |
DNE |
Meath |
Kells |
Operational Lease |
Operational since Q1 2016 |
|
13 |
DNE |
Monaghan |
Carrickmacross |
Operational Lease |
Viable expression of interest has recently been received. Currently waiting for formal submissions. |
|
14 |
South |
Carlow |
Tullow/Rathvilly/Hacketstown |
Direct build |
Adjoining landowner has re-engaged with HSE. Options being reviewed. |
|
15 |
South |
Kilkenny |
Kilkenny city (East) |
Operational Lease |
Priced offer approved. Letter of Intent issued. |
|
16 |
South |
Wexford |
Wexford town |
PPP |
In Construction. Projected opening 2018 |
|
17 |
South |
Waterford |
Dungarvan |
PPP |
In Construction. Projected opening 2018 |
|
18 |
South |
Waterford |
Waterford city (east) |
PPP |
In Construction. Projected opening 2018 |
|
19 |
South |
Cork |
Cork city - Ballyphehane/Togher/Greenmount/The Lough |
Operational Lease |
Stage 3 submissions under review |
|
20 |
South |
Kerry |
Tralee |
Operational Lease |
Stage 3 submissions under review |
|
21 |
South |
Tipperary |
Carrick-on-Suir |
PPP |
In Construction. Projected opening 2018 |
|
22 |
South |
Tipperary |
Clonmel |
Operational Lease |
Awaiting stage 3 submissions |
|
23 |
West |
Tipperary |
Thurles |
Operational Lease |
Letter of Intent issued 10/12/2015. Project progressing towards Agreement for Lease. |
|
24 |
West |
Limerick |
Limerick city (Ballinacurra/Weston) |
PPP |
In Construction. Projected opening late 2017 |
|
25 |
West |
Clare |
Ennis |
Operational Lease |
Expressions of interest received. Currently being reviewed |
|
26 |
West |
Galway |
Tuam |
PPP |
In Construction. Projected opening late 2017 |
|
27 |
West |
Galway |
Gort |
Operational Lease |
Letter of Intent withdrawn 24/05/2016. Possible re-advertisement. |
|
28 |
West |
Roscommon |
Boyle |
PPP |
In Construction. Projected opening late 2017 |
|
29 |
West |
Roscommon |
Ballaghadereen |
Operational Lease |
Letter of Intent issued 27/10/2015. Project progressing to Agreement for Lease. |
|
30 |
West |
Mayo |
Westport |
PPP |
In Construction. Projected opening 2018 |
|
31 |
West |
Mayo |
Claremorris |
PPP |
In Construction. Projected opening late 2017 |
|
32 |
West |
Sligo |
Ballymote |
PPP |
In Construction. Projected opening late 2017 |
|
33 |
West |
Donegal |
Dungloe - An Clochán Liath |
Operational Lease |
Re-advertised for Operational Lease option. Expressions of interest received. |
|
34 |
West |
Donegal |
Donegal town |
Operational Lease |
Expressions of interest received. Currently being reviewed |
Coolock and Darndale were announced as two separate locations
While the Government's objective is to deliver a high quality, integrated and cost effective health care service the mechanism and timescale for delivery of primary care centres is dependent on a number of factors. Some of these factors are outside the control of the Health Service Executive. Regardless of the delivery mechanism, all potential primary care infrastructure is subject to suitable locations being offered/provided/available, to successful planning processes and GP commitment to sharing accommodation and delivering health care services with HSE staff. In addition the operational lease mechanism is subject to market pressures such as the developers' access to adequate financing.
84. Deputy Kevin O'Keeffe asked the Minister for Health if he will address the serious delays in ophthalmic appointments at Cork University Hospital; if his attention has been drawn to the fact that all five ophthalmic surgeons at the hospital have written to the hospital's risk management division warning that the hospital must accept full responsibility for any adverse consequences to patients as a result of the failure to adequately resource the doctors to carry out the service demanded of them; if his attention has been further drawn to the fact that as a result of inadequate capacity, patient appointments are being delayed beyond that clinically recommended; and if his attention has been drawn to the figures from surgeons at the hospital that show an estimated shortfall in capacity of 28,260 patient appointments per year. [11828/17]
View answerThis Government is committed to reducing waiting times for patients, both for patients waiting for inpatient or daycase procedures and for outpatient appointments.
During 2016, there has been evidence of a considerable increase in demand for health services, as our population grows and ages.
In order to reduce the numbers of long-waiting patients, the HSE is currently developing Waiting List Action Plans for 2017 in the area of Inpatient Daycase, Scoliosis and Outpatient Services.
Draft Waiting List Action Plans for Inpatient Daycase and Scoliosis have been submitted. My Department is currently reviewing these plans and engagement is ongoing with the HSE and the NTPF.
In addition, in November, the HSE launched the Strategy for the Design of Integrated Outpatient Services 2016-2020. This strategy seeks to improve waiting times for outpatient services in the long term by restructuring referral pathways and utilising technology to improve service delivery. The HSE has also significantly progressed the development of a draft Outpatient Waiting List Action Plan. In this Plan, the HSE will identify proposals to reduce the number of patients waiting long periods of time for outpatient appointments across all hospitals.
I expect to make known the details of the HSE's Outpatient Waiting List Action Plan in the coming weeks. In relation to your specific query regarding Cork University Hospital, I have asked the HSE to reply to you directly.
85. Deputy Eoin Ó Broin asked the Minister for Health further to Parliamentary Question No. 125 of 1 February 2017, the exact details of his Department’s robust monitoring framework that will be implemented to ensure quality patient treatment, value for money and efficient processes in all NTPF initiatives; the person or body that will monitor the hospital performance on the criteria against which tenders will be evaluated; the chain of accountability that exists between the HSE, his Department and the NTPF in relation to waiting list initiatives and the way funding is spent; and if he will make a statement on the matter. [11894/17]
View answerI wish to advise the Deputy that, in line with procurement practice, the criteria against which tenders received by the NTPF will be evaluated is set out in the tender documentation. These criteria consist of a combination of price per treatment and the experience of the hospital in providing similar treatments to its patients during 2016. The performance of each hospital against these criteria will be monitored by the NTPF on a constant basis.
Each hospital that is successful in the tendering process will be required to sign up to a formal comprehensive contract, which contains detailed provisions and obligations in relation to providing patient treatment, to ensure that all patient treatment delivered under the initiatives meet with the appropriate quality standards and that costs are in line with tendered prices. The detailed contract management process will be undertaken by the NTPF.
In addition to managing the tender process, the NTPF has developed a set of operational plans to ensure that all aspects of the patient treatment process are mapped and that the patient journey follows the agreed process to ensure quality outcomes for the patient and value for money for the State.
Furthermore the NPTF will be asked by the Department of Health to submit monthly reports on the number of patients treated, referring hospitals, treating hospitals, and treatment specialty. It may not be possible to make specific information on costs in relation to individual private hospitals available due to its commercial sensitivity, however, the NTPF will be required to provide to the Department of Health financial reports regarding the waiting list initiatives.
In relation to initiatives run by the NTPF, the Department will continue to engage on an ongoing basis bilaterally with the NTPF and in a tripartite manner with the NTPF and the HSE as appropriate to monitor their performance in the delivery of their targets in terms of reduction of waiting times for patients.
86. Deputy Richard Boyd Barrett asked the Minister for Health if he will initiate an early screening programme for scoliosis and adequate early intervention measures, including physiotherapy as preventative measures which can reduce the need for invasive surgery and unnecessary deterioration and resulting suffering; and if he will make a statement on the matter. [12069/17]
View answerI have recently been in contact with the Director General of the HSE on this matter and have asked my Department to review policy and provide me with advice.
