Written Answers Nos. 401-415
401. Deputy Mattie McGrath asked the Minister for Health when construction will proceed on the new hospice unit at St Theresa's Hospital; the efforts are being made to bring into operation further hospices, the construction of which local communities have funded; and if he will make a statement on the matter. [32325/17]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
402. Deputy Billy Kelleher asked the Minister for Health to outline in tabular form the reason health capital expenditure was €36 million behind profile at the end of June 2017; and the projects that have not been in receipt of funds that should have been allocated at this stage. [32326/17]
View answerI am advised by the HSE that expenditure on construction and equipping is currently under profile due to timing issues on the progress of a number of projects which have not progressed as initially projected. Expenditure is expected to progress steadily as construction begins, and the notified capital allocation in 2017 will be spent.
403. Deputy Mattie McGrath asked the Minister for Health to set down the number of children and adolescents waiting for mental health services in County Tipperary; the waiting times for services in County Tipperary; the efforts that have been taken to improve capacity in the child and adolescent mental health services to ensure that all children and teenagers receive the appropriate care; if he has satisfied himself with the waiting times for CAMHS; and if he will make a statement on the matter. [32330/17]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
404. Deputy Micheál Martin asked the Minister for Health to outline his views on the lack of respite care provision for both persons with disabilities who are under and over 18 years of age; if he has discussed this issue with his Department officials; and if he will make a statement on the matter. [32337/17]
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. The Health Service Executive's (HSE’s) Social Care Operational Plan for 2017 aims to provide 182,000 overnight stays in centre-based respite services, in addition to 41,000 day respite sessions. There are 210 new home support / in home respite supports for emergency cases and 185 new emergency residential placements in the 2017 HSE National Service Plan.
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.
405. Deputy Micheál Martin asked the Minister for Health if he has received correspondence or met groups from the disability sector regarding its inability to pay the recent increases from the public sector pay deal to its staff; if it does so, the estimated impact this will have on actual disability services; and if he will make a statement on the matter. [32340/17]
View answerI wish to inform the Deputy that I recently received correspondence from a number of Section 39 agencies in the disability sector regarding the matter of pay increases for staff.
Section 39 of the Health Act 2004, provides that the Health Service Executive (HSE) may "give assistance to any person or body that provides or proposes to provide, a service similar or ancillary to a service that the Executive may provide." Such assistance may range from contributing to the expenses incurred by that person or body, to allowing them use of an HSE premises. Financial assistance is provided in the form of a grant and the value of such grants can vary.
Where the HSE provides a grant to a voluntary service provider under Section 39, the HSE puts in place a Service Level Agreement with the provider. This sets out the level of service to be provided for the grant received. It is important to note that any individuals employed by these Section 39 organisations are not HSE employees. The HSE has no role in determining the salaries or other terms and conditions applying to these staff. It is an accepted fact that staff of these Section 39 organisations are not public servants. This means they were not subject to FEMPI legislation which imposed pay reductions or to the provisions of the subsequent Public Service Agreements which provide for pay restoration.
It is a matter for Section 39 organisations to negotiate salaries with their staff as part of their employment relationship and within the overall funding available for the delivery of agreed services.
406. Deputy Robert Troy asked the Minister for Health to outline his plans for a new health centre in Moate, County Westmeath; the timeframe for same; and if he will make a statement on the matter. [32341/17]
View answerAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
407. Deputy Billy Kelleher asked the Minister for Health if the non-payment of a subcontractor by a contractor that was awarded a contract by the HSE can be investigated (details supplied); if the HSE was satisfied with the works carried out by the subcontractor; if they fully complied with certification and standards; if the main contractor has been paid the full amount of the contract price; his views and the views of the HSE on whether it is appropriate for non-payment to the subcontractor; and if he will make a statement on the matter. [32364/17]
View answerThe management of the healthcare property estate and the delivery of health care projects is a service matter. Therefore, the Health Service Executive has been requested to reply directly to you in relation to your question on the payment of subcontractors by contractors.
408. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 1309 of 20 June 2017 to outline the rationale for selling this property and the HSE leasing it back; and if he will make a statement on the matter. [32386/17]
View answerYour question has been referred to the Health Service Executive for direct reply as the management of the healthcare property estate is a service matter.
409. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 1310 of 20 June 2017 to outline the reason for the delay in bringing the memo to Government relating to the proposal that the proceeds of the sale of the Central Mental Hospital, Dundrum will be made available to the HSE for investment in health care projects; and if he will make a statement on the matter. [32387/17]
View answerThe Government commitment to delivering a new central mental hospital is clearly articulated in the Programme for Government, and funding has been earmarked for this purpose in the Capital Plan. Therefore, the construction of the National Forensic Mental Health Services Hospital in Portrane is not dependant on the sale of the Dundrum site. That said, there is a Government decision and policy as set out in ‘A Vision for Change’ that proceeds from the sale of older mental health assets, such as the Dundrum site, will be reinvested in new developments within mental health.
As previously advised, the disposal or otherwise of the site of the Central Mental Hospital in Dundrum cannot proceed until such time as the hospital is vacated, following the completion of the new National Forensic Mental Health Services Hospital in Portrane.
410. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 1078 of 20 June 2017 if he will direct the relevant national clinical programme office to assess the practices at a clinic (details supplied) as a potential model of best practice; and if he will make a statement on the matter. [32388/17]
View answerDeveloping a dedicated clinic for diagnosis and treatment of Myalgic encephalomyelitis (ME) has many challenges. The HSE has advised that within the model of care for the National Clinical Programme for Neurology, the development of tertiary services/clinics are advocated in conditions with lower prevalence, where there isn’t the volume to support development of expertise across a larger number of sites, for example specialist clinics in Motor Neurone Disease.
The suggestion of developing one dedicated clinic to oversee the care of 12,000 ME patients may not be an answer to supporting patients appropriately. One clinic supporting this number of patients would inevitably result in significant waiting times of patients, both new and review, and may not allow the service be responsive to the needs of patients with ME. This has reportedly been the experience in the Stora Sköndal ME/CFS clinic in Sweden, where they had to refuse referrals with demand outweighing capacity.
At present, it is difficult to determine how many people with ME are being seen in Neurology OPD services nationally.
Information on waiting times per speciality and per hospital is all that is currently available to the neurology programme, and as such we do not have accurate information on the demand on neurology services or indeed other specialties including:
- Rheumatology;
- Pain Specialists;
- Endocrinology;
- Immunology;
- Cardiology etc.
An ME clinic would need to have representation from across these speciality areas, therefore, to have a clinic led or delivered by one speciality may not meet the needs of patients appropriately. While the need for accurate diagnosis is crucial, it is acknowledged that the ‘hospital’ based services represent a very limited aspect of the overall patient journey and the focus going forward is on how the whole health service, not only hospitals, support people in managing their health and well-being.
411. Deputy Mattie McGrath asked the Minister for Health to outline his plans to address concerns that are emerging regarding the incurring of additional social charges for nursing home residents; and if he will make a statement on the matter. [32399/17]
View answerThe Nursing Homes Support Scheme (NHSS), commonly referred to as A Fair Deal is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost.
The NHSS covers the cost of the standard components of long-term residential care which are:
- Nursing and personal care appropriate to the level of care needs of the person;
- Bed and board;
- Basic aids and appliances necessary to assist a person with the activities of daily living; and
- Laundry service.
A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. In determining the services covered by the NHSS it was considered very important that the care recipient and the taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the NHSS, as this would involve effectively paying twice for the same service.
Although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers or hairdressing. In recognition of this, anyone in receipt of financial support under the NHSS retains at least 20% of their income. The minimum amount that is retained is the equivalent of 20% of the State Pension (Non-Contributory). An operator should not seek payment from residents for items which are covered by the NHSS, the medical card or any other existing scheme.
Part 7 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 stipulates that the registered provider of the nursing home must agree a contract in writing with each resident on their admission to the nursing home. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should never be charged fees which are not set out in the contract. The Department of Health and the HSE are not a party to such contracts which are concluded between each resident and the private or voluntary nursing home.
Registered providers of nursing home care are obliged to provide an accessible and effective complaints procedure. Concerns about additional charges should in the first instance be taken up with the nursing home provider. The Office of the Ombudsman can examine complaints about the actions of a range of public bodies and, from 24 August 2015, complaints relating to the administrative actions of private nursing homes. The Office of the Ombudsman normally only deals with a complaint once the individual has already gone through the complaints procedure of the private nursing home concerned.
I have recently met with both Nursing Homes Ireland and Age Action to discuss this issue in detail. In order to improve the transparency of these additional charges, I outlined that a schedule of charges should be provided to potential residents on enquiry to an individual nursing home, rather than at the point of admission. Nursing Homes Ireland undertook to advise their members to do so. I will also be meeting with both the National Treatment Purchase Fund and HIQA over the coming weeks to discuss this matter further.
I have asked the Interdepartmental/Agency Working Group established to oversee the implementation of certain recommendations contained in the 2015 Review of the Nursing Homes Support Scheme to also consider this matter and examine the options that might be available, as part of its ongoing work.
I am committed to ensuring that our older population are protected, that they get the care that they deserve, and that they have access to all of the information they need in order to be able to make an informed decision, especially at such a vulnerable stage in their lives.
412. Deputy Dara Calleary asked the Minister for Health if there is a protocol in place for the way in which hospitals deal with the belongings and possessions of those who pass away in hospital; if so, the requirements in this regard; if not, if his Department will give consideration to preparing a protocol to include sanctions for breaching the protocol; and if he will make a statement on the matter. [32401/17]
View answerIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
413. Deputy Michael Healy-Rae asked the Minister for Health to set down the number of mental health nurse vacancies in a hospital (details supplied); and if he will make a statement on the matter. [32409/17]
View answerI have asked the HSE to respond to the Deputy directly on this matter.
414. Deputy Alan Kelly asked the Minister for Health if he will support a request by an organisation (details supplied) for an increased allocation of €40 million in budget 2018 to provide additional intensive home care packages for persons suffering from dementia, the appointment of back-up advisers and co-ordinators to support persons suffering from dementia and their families; and if he will make a statement on the matter. [32416/17]
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 €27.5 million, with the Atlantic Philanthropies contributing €12 million and the HSE €15.5 million.
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.
I have seen the organisation's pre-budget submission and have noted the contents. The proposals contained in the pre-buget submission will be considered as part of this process.
415. Deputy Jack Chambers asked the Minister for Health if a person (details supplied) who is being transitioned to adult services will receive a minimum of six days respite care a month, as recommended by treating physicians; if the person will not receive a reduction in service hours; and if he will make a statement on the matter. [32421/17]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
