Written Answers Nos. 192-203
192. Deputy Billy Kelleher asked the Minister for Health if he will address concerns raised by groups (details supplied) in respect of the delays with reporting decisions relating to a drug; if he has examined these issues; the action being taken to address these concerns; and if he will make a statement on the matter. [21256/17]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines 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.
193. Deputy Maureen O'Sullivan asked the Minister for Health to outline his Department's policy on the return of funding lost during the recession to section 39 organisations to enable them to restore pay to their employees in line with the pay restoration measures proposed by the Lansdowne Road Agreement for public sector workers that commenced on 1 April 2017. [21262/17]
View answerUnder section 39 of the Health Act 2004, the HSE has in place Service Level Agreements with voluntary providers which set out the level of service to be provided for the grant to the individual organisation. Any individuals employed by these section 39 organisations are not HSE employees and therefore, the HSE has no role in determining the salaries or other terms and conditions applying to these staff. It should also be made clear that as the staff of these Section 39 organisations are not public servants, they were not subject to the provisions of the Public Service Agreements or the FEMPI legislation which imposed the associated pay reductions. Accordingly, any arrangements offered by each service provider in relation to its employees terms and conditions, including rates of pay, may vary.
194. Deputy Noel Grealish asked the Minister for Health to outline the communication process that was used to notify interested older persons in advance of the stakeholder forum on the national positive ageing strategy, which took place in his Department on 30 March 2017; the selection criteria applied for those in attendance; the senior official assigned to liaise with the relevant stakeholders; and if he will make a statement on the matter. [21269/17]
View answerThe National Positive Ageing Strategy (NPAS), published on 24 April 2013, provides a framework for cooperation to address age-related policy and service delivery across Government and society in the years ahead. The Strategy is intended to promote older people’s health and well being so that older people can continue to contribute to social, economic, cultural and family life in their own communities for as long as possible, thereby representing a vision for an age-friendly society. The Strategy highlights that ageing is not just a health issue, but rather requires a whole of Government approach to address a range of social, economic and environmental factors that affect the health and well-being of our ageing citizens.
In advance of the development of the NPAS, given that the Strategy has a wider focus than any previous policy document for older people, it was considered important that the views and opinions of people in all sectors of Irish society could inform its development – public, private, community and voluntary, institutions, agencies and representative groups as well as those of individual older people.
In this regard, a public consultation process, which represented the most comprehensive and wide-ranging consultation exercise ever between Government and older people in Ireland, was carried out.
This consultation process comprised:
- a public call for written submissions (190 written submissions were received from statutory agencies, organisations in the community and voluntary sectors, academic and cultural institutions, as well as from older people themselves);
- a series of public regional consultation meetings which were attended by over 1,100 people;
- meetings between the Minister for Older People and groups representing vulnerable and marginalised older people to discuss in greater detail issues raised in their submissions; and
- a round table meeting in Co Louth to hear at first hand the learnings and experience so far of the Louth Age Friendly County Initiative.
A report of the consultation process, In Our Own Words, was published in 2010 on the Department of Health's website ww.doh.ie.
At the launch of the Strategy, a commitment was made to publish an Implementation Plan to facilitate the translation of the Goals and Objectives of the Strategy into action on the ground. The approach to implementation originally included in the Strategy would have worked where a finite number of discrete and concrete steps could be taken after which the implementation could be deemed complete. However, many of the objectives included in this Strategy are quite broad, and can be viewed as a set of principles to which Government has committed, and which will inform policies that affect older people on an indefinite basis into the future, rather than concrete objectives that can be delivered in the short term.
The Department therefore formulated new arrangements to implement and monitor the implementation of the National Positive Ageing Strategy. The revised arrangements were approved by the Cabinet Committee on Social Policy and Public Service Reform on 27 October, 2016.
The new arrangements establish mechanisms that will give stakeholder groups effective and on-going access to Government Departments and State Agencies relevant to older people. This includes an annual Forum for stakeholders to identify what they consider to be their key priorities for Government for the coming year and the next three years; and establishing clear channels of communications between stakeholders and relevant Government Departments. In this regard, relevant Departments will be requested to assign a named senior official(s) to engage with stakeholder representatives on issues relevant to their remit, in order that the priorities identified by the stakeholders at the Forum can be pursued.
As noted by the Deputy, the inaugural stakeholder Forum took place on 30 March 2017. Civic society organisations who are representative of the needs and views of older people in Ireland were invited via direct written communication to attend the Forum. Other groups and individuals who are not members of NGO organisations, but who would have an interest and expertise in the area of older people and ageing, and who expressed an interest in attending, were also invited. The wide range of attendees present at the Forum resulted in interesting and diverse discussions. Although the various organisations may have differing focuses and concerns, the Forum was an opportunity for stakeholders to reach a consensus on the matters of most importance and relevance to older people. At the Forum a stakeholder representative group was formed by the stakeholders to progress matters arising from the Forum, directly with the relevant Departments.
The Department of Health, as secretariat, will shortly communicate with each of the Government Departments identified as having responsibility for the priorities agreed by stakeholders, in order to inform them of the context of the NPAS and the Forum and to make them aware of the issues raised at the Forum relevant to them. This will assist in setting a foundation for the stakeholder group to engage with the relevant Department thereafter. The Department of Health will meet with the stakeholder representative group in late 2017 to establish progress made and assist with any issues arising.
195. Deputy Pat Casey asked the Minister for Health to outline his plans to introduce specific measures to resolve the crisis in paediatric plastic surgery at Our Lady's Children's Hospital, Crumlin (details supplied); and if he will make a statement on the matter. [21276/17]
View answerIn relation to the query raised by the Deputy, as this is a service issue, I have asked the HSE to respond to you directly.
196. Deputy Róisín Shortall asked the Minister for Health if his Department or the HSE have commissioned further forensic audits of a group (details supplied) subsequent to the review which concluded in April 2016; and if he will make a statement on the matter. [21278/17]
View answer198. Deputy Róisín Shortall asked the Minister for Health to outline the progress in separating St Vincent's University Hospital, a publicly-funded hospital, from the private elements of the St. Vincent's Healthcare Group, in view of statements made by the HSE (details supplied); if he has satisfied himself that all consultants are now working within the terms of their contracts; and if he will make a statement on the matter. [21280/17]
View answerI propose to take Questions Nos. 196 and 198 together.
The HSE has service agreements with hospitals such as St. Vincent’s University Hospital, under Section 38 of the Health Act 2004, which require compliance with national health and public service pay and conditions policies. The HSE aims to ensure that appropriate systems are in place to effectively manage the services and funding which are provided on its behalf. It has developed a Governance Framework for the purpose of its arrangements for delivery of services by providers funded under Section 38. The Governance Framework provides for national standard governance documentation and administrative processes and it seeks to ensure that both the HSE and the recipient service providers comply with their respective obligations, and that the services delivered provide best outcomes for the service user and represent effective use of public Exchequer funding.
The HSE is responsible for ensuring compliance with the provisions of Consultant Contract 2008 as the statutory provider and commissioner of public health services. In relation to the specific queries raised in relation to the operation and governance of St Vincent's University Hospital, as these are service matters, I have asked the HSE to respond to you directly.
197. Deputy Róisín Shortall asked the Minister for Health to provide detail on the publicly-funded hospitals that are currently used as security in private loan or mortgage agreements; and if he will make a statement on the matter. [21279/17]
View answerAs this is a service matter, I have asked the HSE to reply directly to the Deputy.
199. Deputy Róisín Shortall asked the Minister for Health if the proposed changes to the governance of the national maternity hospital will require an Act of the Houses of the Oireachtas to amend or repeal the 1936 Act; and if he will make a statement on the matter. [21282/17]
View answer202. Deputy Thomas P. Broughan asked the Minister for Health to outline the composition of the board of the new national maternity hospital to be built on land owned by a religious order (details supplied); the way in which he will ensure that the hospital will be owned by the State; and if he will make a statement on the matter. [21321/17]
View answer203. Deputy Thomas P. Broughan asked the Minister for Health if a religious order (details supplied) was requested to gift the land for the new national maternity hospital to the State; the reason he will not initiate a compulsory purchase order or otherwise to acquire the land; and if he will make a statement on the matter. [21322/17]
View answer209. Deputy Róisín Shortall asked the Minister for Health to outline the details of the proposed breakdown of public and private rooms in the new national maternity hospital; and if he will make a statement on the matter. [21355/17]
View answer210. Deputy Róisín Shortall asked the Minister for Health to outline the details of the provision of private consulting rooms in the new national maternity hospital; the cost to consultants of private consulting rooms per annum; and if he will make a statement on the matter. [21356/17]
View answer211. Deputy Róisín Shortall asked the Minister for Health if he will confirm media reports that facilities would be provided in the new national maternity hospital for a not-for-profit firm (details supplied); the services this firm will provide; when he was informed of this arrangement; and if he will make a statement on the matter. [21358/17]
View answerI propose to take Questions Nos. 199, 202, 203 and 209 to 211, inclusive, together.
Following extensive mediation discussions, agreement was reached late last year between the St. Vincent’s Healthcare Group and the National Maternity Hospital (NMH) on the relocation of the NMH to the Elm Park campus. The terms of the agreement, which has now been published, provides for the establishment of a new company - "The National Maternity Hospital at Elm Park DAC (limited by shares)”.
The new company will have clinical and operational, as well as financial and budgetary independence in the provision of maternity, gynaecology and neonatal services. This independence will be assured by the reserved powers which are set out in the agreement and will be copper fastened by the golden share which will be held by the Minister for Health of the day. These reserved powers can only be amended with the unanimous written approval of the Directors and with the approval of the Minister for Health. The Board of the new NMH will comprise nine directors; four nominated by St. Vincent’s Healthcare Group, four by NMH, including the Master, and one will be an international expert in obstetrics and gynaecology. Two of the NMH Directors will also sit on the St. Vincent’s Board.
The agreement ensures that a full range of health services will be available at the NMH at Elm Park without religious, ethnic or other distinction. In that regard, I welcome the confirmation by the Board of St. Vincent’s Healthcare Group that any medical procedure, which is in accordance with the laws of this State, will be carried out at the new hospital. I should also acknowledge that the St. Vincent’s Healthcare Group is making valuable land available, at no cost to the State, to facilitate the new NMH. In doing so, they have foregone the opportunity to put this land to alternative use. The site was, at the time when the relocation was recommended in the 2008 KPMG report, 'Independent Review of Maternity and Gynaecology Services in the Greater Dublin Area', and still is, in private ownership and was not on the market. The question of the purchase of the site did not therefore arise.
As set out in the agreement, the establishment of the new company will necessitate an amendment of the NMH Charter. However as we are still in the very early stages, my Department has not yet been in communication with the NMH in relation to this issue.
Now that the planning application for the development has been submitted we must now turn our focus to the legal mechanisms necessary to complete the project. The hospital will be publicly funded, built on lands in the ownership of the St. Vincent’s and operated by the new company. Over the next few weeks I will meet with both hospitals and will consider further the legal mechanisms necessary to absolutely protect the State's considerable investment in the hospital, including the issue of ownership of the new facility. I have indicated that, prior to the HSE entering into any construction contract, I will formally sanction the necessary arrangements to ensure that the facilities are legally secured on an on-going basis for the delivery of publicly funded maternity, gynaecology and neonatal services commitments. I should add that over the years we have made very significant capital investment in voluntary hospitals, and such facilities have always continued to be used for the delivery of publicly funded healthcare as intended.
I intend to report to Government on this project at the end of May. At that stage I expect to have further details on the legal and other arrangements envisaged and will make this information available publicly. This will allow for the necessary clarity well in advance of contractual or other commitments being entered into in respect of this project.
With regard to the designs for the new hospital, there is no differentiation between public and private in-patient rooms and indeed all in-patient rooms are of a similar design. In order to support the current commitment in the Consultants' contracts, some private outpatient consulting space will be provided. The charge to consultants for the use of those rooms is an operational matter and will be determined in due course. While there is no provision for the facility referred to by the Deputy in the design of the new maternity hospital, there is provision in the design for an assisted conception area within the development.
Finally, I would like reaffirm my commitment to this hugely important project. The facilities at Holles St are no longer fit for purpose. It is also acknowledged that for optimal clinical outcomes, maternity services should be co-located with adult acute services. I look forward to working with all stakeholders to deliver the new National Maternity Hospital which is so badly needed to provide women and infants with modern healthcare facilities.
200. Deputy Bobby Aylward asked the Minister for Health to outline the reason the proposed temporary respite house in Bagenalstown for children with disabilities in counties Carlow and Kilkenny, which was due to open in 2017, will not go ahead; the status of this project; the alternative respite services that are available to parents to cater for children with disabilities in counties Carlow and Kilkenny in the immediate to short term; his long-term plans for a respite house for children with disabilities in counties Carlow and Kilkenny area in view of recent announcements; the timeline for same; and if he will make a statement on the matter. [21306/17]
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.
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.
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.
201. Deputy Caoimhghín Ó Caoláin asked the Minister for Health to outline the reason medications (details supplied) are no longer available under the medical card scheme; if his attention has been drawn to the impact this is having on persons that suffer from macular degeneration and that now pay in excess of €17 per month to access this drug; his plans to reverse this decision; and if he will make a statement on the matter. [21309/17]
View answerIn June 2016, the HSE Medicines Management Programme (MMP) reviewed the clinical evidence available on the effectiveness of eye supplements for people with macular degeneration. The MMP then recommended that the HSE does not reimburse these products.
The manufacturer of Macushield and Ocuvite lutein indicated that it had further evidence to provide. After reviewing this additional evidence, the MMP did not change its original recommendation.
The clinical community of ophthalmologists also had an opportunity, at the end of 2016, to provide to the MMP any clinical evidence considered relevant. No clinical evidence that would change the MMP’s original recommendation was provided and the HSE ceased reimbursement support for eye supplements from 1 January 2017.
