Written Answers Nos. 192-211
192. Deputy Joe Carey asked the Minister for Health if approval will be given for €500,000 required to enable the cardiology department at University Hospital Limerick to address the waiting list of approximately 40 persons awaiting keyhole valve replacement surgery; and if he will make a statement on the matter. [31691/17]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
193. Deputy Joe Carey asked the Minister for Health if he will expedite an appointment for surgery for a person (details supplied); and if he will make a statement on the matter. [31692/17]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
194. Deputy Catherine Connolly asked the Minister for Health his plans for a memory clinic in the western region in view of the fact that there is only one memory clinic in the west and north west regions in which approximately 10,000 persons are living with dementia; and if he will make a statement on the matter. [31696/17]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
195. Deputy Brendan Smith asked the Minister for Health the status of a project (details supplied); when this project will proceed to the next stage; and if he will make a statement on the matter. [31698/17]
View answerAs the Health Service Executive has responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have arranged for the question to be referred to the Executive for direct reply.
196. Deputy Brendan Smith asked the Minister for Health the status of a project (details supplied); when this project will proceed to the next stage; and if he will make a statement on the matter. [31699/17]
View answerAs the Health Service Executive has responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have arranged for the question to be referred to the Executive for direct reply.
197. Deputy Bernard J. Durkan asked the Minister for Health if a home care package can be facilitated in the case of a person (details supplied); and if he will make a statement on the matter. [31702/17]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
198. Deputy Clare Daly asked the Minister for Health the reason health authorities here are in disagreement with their counterparts in Northern Ireland, the UK and in several other EU countries regarding the public health risks posed by gulls. [31703/17]
View answer199. Deputy Clare Daly asked the Minister for Health if his attention has been drawn to the fact that health authorities here and those in Northern Ireland disagree in respect of the public health risks posed by gulls; the other areas of public health on which the HSE does not agree with its counterpart in Northern Ireland; and if he will make a statement on the matter. [31704/17]
View answer200. Deputy Clare Daly asked the Minister for Health his views on the fact that a large number of EU countries (details supplied) have determined that gulls pose a public health threat and have been acting on this threat in some cases for years now. [31705/17]
View answer201. Deputy Clare Daly asked the Minister for Health his views on the conclusion of studies and publications (details supplied) that gulls can be directly associated with anti-microbial resistance; and if he will make a statement on the matter. [31706/17]
View answerI propose to take Questions Nos. 198 to 201, inclusive, together.
The HSE Health Protection Surveillance Centre (HPSC) has previously considered the evidence pertaining to gulls and potential health risks. A number of scientific studies have looked at the specific issue of human disease and gulls (from the early 1980s on; the most recent in 2005). While there is some evidence that wild birds (including gulls) may transmit salmonella to animal feed and drinking water and by this mechanism potentially lead to human infection, the evidence for this in each instance was considered weak. Studies that have looked at the likelihood of direct spread of salmonella from gulls to humans conclude that gulls as carriers of Salmonella constitute little health hazard to human health concluding that there is only a low risk of transmitting Salmonella from either gulls or feed factories they may contaminate to humans or domestic animals.
The HPSC gathers information on the causes of outbreaks of infectious disease and for individual cases of infectious disease it collects information on individual risk factors (i.e. those factors known to contribute to disease development but not necessarily proven in the particular case being examined). A look back for the last ten years by the HPSC indicates that out of 25,000 reported cases of campylobacter and 3,500 cases of salmonella there have been three cases of salmonellosis that could be explained by bird contact (two of these were pet birds) and two cases of campylobacter, one of which mentioned proximity to gulls. This means an association but does not mean that birds caused the disease.
In recognition of the serious and increasing threat of antimicrobial resistance and the requirement for a ‘whole of Government’ approach to health issues, the Department of Health’s Chief Medical Officer (CMO) and the Department of Agriculture, Food and the Marine’s Chief Veterinary Officer (CVO) established a high level National Interdepartmental AMR Consultative Committee to address this issue. The Committee meets Ireland’s requirements to have an Intersectoral co-ordination mechanism for addressing AMR at the European level.
As well as work on enhancing surveillance between the health and agriculture sectors, the Committee’s work in 2017 has overseen the development of Ireland’s first National Action Plan on Antimicrobial Resistance 2017-2020. This ambitious 3-year Plan has been jointly prepared by the two Departments in collaboration with all relevant stakeholders and covers the use of antimicrobial medicines in animal health and agriculture, as well as human health. Following the World Health Organisation's Global Action Plan on Antimicrobial Resistance (2015), which requires all countries to have a national action plan in place by mid-2017, Ireland's draft Plan lists Strategic Interventions and Activities, responsible bodies and priority rankings of timelines for implementation.
It is intended that a Memorandum for the Government on the National Action Plan on Antimicrobial Resistance 2017-2020 will be submitted this week to Cabinet seeking its approval and publication. Subject to approval of the National Action Plan, an implementation plan will be developed separately which will address means of tackling antimicrobial resistance as appropriate to each sector.
It would be inappropriate for me to comment on public health risks in other EU Member States.
202. Deputy Sean Fleming asked the Minister for Health the status of plans being considered by him regarding the accident and emergency department in the Midland Regional Hospital, Portlaoise; and if he will make a statement on the matter. [31719/17]
View answerMy Department and the HSE are committed to securing and developing the role of Portlaoise Hospital within the Dublin Midlands Hospital Group.
Reports on Portlaoise Hospital in recent years point to the need for reconfiguration of some services to ensure that patients are treated in the most appropriate setting by specialist staff that can safely meet their needs. The HSE has submitted a draft Action Plan to my Department and it is currently being reviewed in detail.
The most important issue in relation to any changes at Portlaoise Hospital is that patient safety and good quality outcomes must come first. Any changes to services at Portlaoise, once approved, will be undertaken in a planned and orderly manner to further improve services for patients at the hospital and will take account of existing patient flows and demands in other hospitals, as well as the need to develop particular services at Portlaoise in the context of the overall service configuration in the Dublin Midlands Hospital Group.
203. Deputy Sean Fleming asked the Minister for Health the number of long-stay residents in Abbeyleix community hospital; and if he will make a statement on the matter. [31720/17]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
204. Deputy Catherine Murphy asked the Minister for Health the community supports for persons with dementia here; his plans to expand the support levels for persons with dementia; his further plans to meet dementia advocacy groups to discuss increases in funding in the context of budget 2018; and if he will make a statement on the matter. [31735/17]
View answerThe Irish National Dementia Strategy was launched in December 2014, with the objective of increasing awareness, ensuring early diagnosis and intervention and developing enhanced community-based services.
In parallel with the Strategy, the Department of Health and the HSE have agreed a joint initiative with the Atlantic Philanthropies to implement significant elements of the Strategy over the period 2014-2017. This Implementation Programme represents a combined investment of €27.5m, with the Atlantic Philanthropies contributing €12m and the HSE €15.5m.
Key elements of the initiative include:
- the roll-out of a programme of Intensive Home Supports and Home Care Packages for people with dementia valued at €22.1 million over a three year period;
- the provision of additional dementia-specific resources for GPs, to include training materials and guidance on local services and contact points valued at €1.2 million;
- measures to raise public awareness, address stigma and promote the inclusion and involvement in society of those with dementia valued at €2.7 million.
The roll out of Intensive Home Care packages commenced in January 2015 and monitoring of the allocation and uptake of these packages to persons with dementia is ongoing. By May 2017, the HSE had delivered a total of 217 dementia-specific intensive homecare packages at an average cost of €953 per week. There are currently 122 people with dementia in receipt of an Intensive Home Care Package with a further 16 approved and 12 applications in progress. In addition to the Intensive Home Care Packages, the HSE has continued to provide mainstream home help and routine Home Care packages to people with dementia whose needs have been assessed as requiring these supports and within available resources. Up to 500 people with dementia and their families are expected to benefit from Intensive Home Care Packages over the lifetime of the implementation programme.
It is Government policy that, wherever possible and appropriate, people should be cared for in their own homes and communities, and the National Dementia Strategy specifically restates this commitment to those living with dementia.
The Department and the HSE are working on a mid-term review of the implementation of the National Dementia Strategy which will be published in the Autumn and will identify the achievements so far and set out the further work that is required to implement the Strategy over the next 12 months and beyond. The resources required for the ongoing implementation of the Strategy can only be considered in the context of the Estimates and Budget process. The mid-term review will assist in identifying further actions required and will be helpful in the context of budgetary considerations.
205. Deputy Michael Healy-Rae asked the Minister for Health if he will reconsider proposed changes to the packaging of medication by chemists for older persons (details supplied); and if he will make a statement on the matter. [31738/17]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
206. Deputy Brian Stanley asked the Minister for Health if routine blood tests are covered under the general medical service contract. [31740/17]
View answerThere is no provision under the GMS GP 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 am aware that in recent times some GPs have begun to charge GMS patients for phlebotomy services in some circumstances.
This is a matter of concern for me as it has long been the position of the Government and the Oireachtas that no user charges should apply to GP services provided to GMS and GP visit card patients. 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 process, which is currently under way. I look forward to constructive and positive engagements with a view to achieving a satisfactory outcome.
207. Deputy Brian Stanley asked the Minister for Health if screening for conditions such as diabetes and high cholesterol is covered under the general medical service contract. [31741/17]
View answerUnder the terms of the current GMS contract, GPs are required to provide eligible patients with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess." Screening for specific illnesses or diseases is not a requirement of the contract but may be offered by some GPs.
The next phase of discussions on a new GP contract is underway. The aim is to develop a new modern GP contract which will facilitate the shift within the health service away from hospital services towards an integrated primary care service in order to deliver better care close to home in communities across the country. I want to see a new contract which has a population health focus, providing in particular for health promotion and disease prevention and for the structured ongoing care of chronic conditions.
Officials in my Department and the HSE are in discussions with GP representatives with a view to drawing up a new contract. The appropriate arrangements in relation to the screening and management of chronic conditions, including diabetes, will be considered as part of the new GMS contract.
208. Deputy Brendan Smith asked the Minister for Health if he will ensure an equal distribution of funding throughout a community health area (details supplied) in respect of the provision of health services; and if he will make a statement on the matter. [31743/17]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
209. Deputy Brendan Smith asked the Minister for Health his views on the concerns outlined by an organisation (details supplied) regarding the Health and Social Care Professionals (Amendment) Bill 2017; and if he will make a statement on the matter. [31750/17]
View answerThe Health and Social Care Professionals (Amendment) Bill 2017 has been referred to committee stage in Dáil Éireann. It is a short Bill, with only nine sections, and proposes amendments to the Health and Social Care Professionals Act 2005 in three main areas. It will address gaps in the Act in relation to appointments to the State boards established under the Act; it will provide for new conditions or criteria to apply to applicants for registration who have not yet practised their professions; and it will introduce temporary provisions relating to registration in the register of physiotherapists in advance of regulations to protect the title of physical therapist alongside the title of physiotherapist, the protection of which is already provided for under the Act.
The Irish Society of Chartered Physiotherapists, the professional body for physiotherapists, is circulating proposed amendments to the Bill to TDs, senators and to its members. These amendments are generally technical in nature and relate to the provisions in the Bill relating to registration in the register of physiotherapists, on a once-off basis, of qualified users of the title of physical therapist. Officials of my Department have given careful consideration to the amendments proposed and are continuing to engage with the professional body to clarify the Bill's provisions.
210. Deputy Ruth Coppinger asked the Minister for Health if he will report on the implementation of the national dementia strategy. [31784/17]
View answerThe National Dementia Strategy was published in December 2014. It is estimated that there are currently 55,000 people with dementia in Ireland today. Furthermore, these numbers are expected to increase significantly in the years ahead.
The aim of the Strategy is to improve dementia care so that people with dementia can live well for as long as possible, can have services and supports delivered in the best way possible, and can ultimately die with dignity. The Strategy emphasises that most people with dementia live in their own communities and can continue to live well and to participate in those communities. The Strategy contains a set of priority actions capable of implementation within existing resources or by reconfiguring resources. It also contains a number of additional actions which may require resources additional to what is currently available and which will be considered as these become available in the future.
The Department of Health and the HSE are working on a mid-term review of the implementation of the National Dementia Strategy which will be published in the Autumn and will identify the achievements so far and set out the further work that is required to implement the Strategy over the next 12 months and beyond. The resources required for the ongoing implementation of the Strategy can only be considered in the context of the Estimates and Budget process. The mid-term review will assist in identifying further actions required and will be helpful in the context of budgetary considerations.
