Thursday, 13 Jul 2017

Written Answers Nos. 910-929

Hospital Appointments Status

Questions (910)

Michael Healy-Rae

Question:

910. Deputy Michael Healy-Rae asked the Minister for Health the status of a cataract operation for a person (details supplied); and if he will make a statement on the matter. [34641/17]

Written answers

Minister for Health

Under 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 scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.

Health Care Infrastructure Provision

Questions (911)

Billy Kelleher

Question:

911. Deputy Billy Kelleher asked the Minister for Health the dialogue which has been undertaken by his Department with religious organisations on the management and ownership of health care facilities by those organisations, with particular regard to proposed changes in that relationship, especially in circumstances in which the services are predominantly funded by the State. [34642/17]

Written answers

Minister for Health

Ireland is not unique in the participation of voluntary organisations, including those with religious involvement, in the delivery of publicly funded healthcare. However, it is proper that the frameworks within which service providers operate in delivering publicly funded health services are subject to on-going consideration.

In recent years, the nature of the relationship between voluntary organisations and the State has been clarified in a number of ways. The HSE operates a robust Governance Framework which governs grant-funding provided to all Non-Statutory Service Providers and provides for detailed service level agreements. In the voluntary sector, it is required practice for public capital investment to be accompanied by a lien which protects the State's interest. All public hospitals are inspected by HIQA and are subject to national clinical standards and guidelines. These arrangements and controls are what are paramount in ensuring high quality care and patient safety, robust operational and clinical governance, and value for State investments.

I recognise that there are different and evolving views on the ownership and governance of publicly funded healthcare facilities. The recent debate around the location of the National Maternity Hospital has generated increased discussions in recent months on these issues. In this regard, the Deputy will be aware that the Religious Sisters of Charity have announced they are relinquishing their ownership of, and involvement with, the St Vincent’s Healthcare Group. I can assure the Deputy that the St Vincent’s Healthcare Group has directly briefed my officials on this decision.

As I have stated previously, I believe it is now timely to consider more broadly the role of voluntary organisations in the public healthcare system. I intend that this will be an inclusive process of consideration and will provide an opportunity for views from all interested parties. It is my intention to bring proposals to Government shortly.

This process can be expected to raise a broad range of complex policy issues that will need to be addressed on into the future and therefore can, rightfully, be expected to take some time.

Hospital Appointments Status

Questions (912)

Billy Kelleher

Question:

912. Deputy Billy Kelleher asked the Minister for Health the status of a cataract operation for a person (details supplied); and if he will make a statement on the matter. [34643/17]

Written answers

Minister for Health

Under 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 scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.

Disease Awareness

Questions (913)

Michael McGrath

Question:

913. Deputy Michael McGrath asked the Minister for Health if the HSE is following the guidelines issued by the Centre for Disease Control, CDC, in the USA for the testing for Lyme disease; if its attention has been drawn to the change in policy by the CDC whereby it now accepts the need for more than one test and that new forms of test are required; and if he will make a statement on the matter. [34655/17]

Written answers

Minister for Health

Lyme disease (also known as Lyme borreliosis) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. The Health Protection Surveillance Centre (HPSC) of the HSE has extensive information concerning Lyme disease on its website http://www.hpsc.ie/a-z/vectorborne/lymedisease/.

Lyme disease is diagnosed by medical history and physical examination. The infection is confirmed by blood tests which look for antibodies produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease. The standard approach to Lyme diagnostics is a two-stage approach and involves using a sensitive enzyme immunoassay (EIA) as an initial, screening step. Screening EIAs can be insufficiently specific, giving false-positive reactions in the presence of other similar bacteria, and certain other viral infections, including glandular fever. In addition, blood samples from patients with autoimmune disorders and other inflammatory conditions can also lead to false-positive results. Samples giving positive or equivocal results in screening tests are further investigated in a second-stage immunoblot (Western blot) tests. Use of immunoblot testing greatly increases specificity. Using this two stage approach will give a great degree of certainty around the diagnosis of Lyme.

All clinical (and other) laboratories in Ireland must undergo continuous quality assurance to ensure that the quality of the diagnostics they provide is maintained at the highest international level for human diagnostics. Some laboratories abroad do not use antibody tests like the EIA (screening ELISA test) and Western Blot and instead will use other types of tests, for example, testing for levels of a specific white blood cell (CD-57) or lymphocyte transformation tests (tests to measure how specific cells in a person's immune system respond when exposed to antigens against Borrelia burgdorferi - the bacterium responsible for Lyme disease). These types of tests are not currently recommended by international groups for a number of reasons:

1. There is not enough scientific evidence that they are suitable tests to diagnose Lyme disease;

2. There is no standard method to perform and interpret these kind of tests; and

3. Positive results in these kinds of tests may be due to other illnesses or conditions and not just Borrelia infection.

The Scientific Advisory Committee of the HPSC, the Infectious Diseases Society of Ireland, the Irish Society of Clinical Microbiologists, the Irish Institute of Clinical Neuroscience and the Irish College of General Practitioners agreed a Consensus Statement on the Clinical Management of Lyme Borreliosis, which endorsed the previously referenced, internationally recognised set of guidelines (those of the IDSA) to Medical Practitioners to ensure a standardised approach to the diagnosis and management of Lyme disease in Ireland.

The Scientific Advisory Committee of the HPSC has established a Lyme Borreliosis Sub-Committee, the aim of which is to develop strategies to undertake primary prevention in order to minimise the harm caused by Lyme Borreliosis in Ireland. In addition to staff from the HPSC, the membership of the Sub-Committee includes specialists in Public Health Medicine, Consultants in Infectious Diseases, Clinical Microbiology, Occupational Health an Entomologist from the Parks and Wildlife Service, a representative from the Local Government Management Agency, an Environmental Health Officer and, very importantly, a representative from Tick Talk Ireland, the primary Support Group for Lyme disease in Ireland.

The initial work of the Lyme Borreliosis Sub-committee involved a survey of laboratory methods for the diagnosis of Lyme borreliosis in Ireland, the development of Lyme borreliosis guidance for general practitioners, the publication of medical media articles to highlight diagnostics and laboratory methods relating to Lyme borreliosis available in Ireland. Material has been produced which is aimed both at the general public and General Practitioners.

There is extensive information for the public and health professionals on the HPSC website. This information for the public includes:

- Lyme Disease Frequently Asked Questions;

- Laboratory testing for Lyme Disease: FAQs for general public;

- Lyme Disease Illustrations; and

- CDC's instructions on how to remove a tick.

There is significant support and information for health professionals on the HPSC website. These supports include a fact sheet on tick borne diseases, including Lyne Disease. This fact sheet gives information on clinical the disease, transmission routes, prevention measures, diagnosis, and management and treatment. There is also an erythema migrans (EM) diagnostic tool to aid health professionals in the diagnosis of EM, which is frequently the earliest clinical manifestation of Lyme borreliosis.

The Deputy refers to guidelines issued by the Centre for Disease Control in the USA. It would be inappropriate for me to comment on guidelines used in other countries.

Hospital Services

Questions (914)

Bobby Aylward

Question:

914. Deputy Bobby Aylward asked the Minister for Health further to Parliamentary Questions Nos. 432 of 18 October 2016, 339 of 6 December 2016, and 496 of 21 of February 2017 when the national steering group established by him to develop policy on a major trauma system for Ireland will publish its first report; if the group visited St. Luke's General Hospital to assess its current services; the status of the group's recommendations specifically in respect of St Luke's General Hospital, County Kilkenny; and if he will make a statement on the matter. [34659/17]

Written answers

Minister for Health

The primary aim of developing a Trauma Policy will be to improve patient outcomes and lead to a reduction in preventable death and disability. The future trauma system will build on the strengths of pre-hospital care, all of our acute hospitals and post-acute care and will require hospitals to work together to provide an optimal configuration of trauma services.

The Steering Group has engaged with the Department of Health, the HSE and all relevant HSE National Clinical Leads, including Surgery, Pre-Hospital Emergency Care, Critical Care, Orthopaedics and Trauma on the development of the policy. The report of the Trauma Steering Group is now nearing completion and it is anticipated that the final Report will be submitted to me in the coming weeks.

Health Services Provision

Questions (915, 916, 917)

Bobby Aylward

Question:

915. Deputy Bobby Aylward asked the Minister for Health if he is satisfied that adequate services are in place to cater for children in the south east with type 1 diabetes in University Hospital Waterford; his plans to examine the provision of services to manage children with type 1 diabetes on insulin pumps attending University Hospital Waterford; and if he will make a statement on the matter. [34662/17]

Bobby Aylward

Question:

916. Deputy Bobby Aylward asked the Minister for Health the progress made in filling the vacant consultant paediatrician post for provision of services for children with type 1 diabetes in University Hospital Waterford; and if he will make a statement on the matter. [34663/17]

Bobby Aylward

Question:

917. Deputy Bobby Aylward asked the Minister for Health the number of children under 16 years of age with type 1 diabetes that attend University Hospital Waterford; the number of same being treated with insulin pump therapy; the number of same waiting on insulin pump initiation training at the hospital; and if he will make a statement on the matter. [34664/17]

Written answers

Minister for Health

I propose to take Questions Nos. 915 to 917, inclusive, together.

As this is a service matter, I have asked the HSE to respond to you directly.

The referred reply under Standing Order 42A was forwarded to the Deputy.

Protected Disclosures

Questions (918)

Clare Daly

Question:

918. Deputy Clare Daly asked the Minister for Health his views on whether HIQA is an appropriate authority to receive protected disclosures regarding private nursing homes from employees or ex-employees of same. [34667/17]

Written answers

Minister for Health

Under the Protected Disclosures Act 2014 (Section 7 (2)) Order 2014 (SI 339 of 2014) HIQA is mandated to receive protected disclosures on all matters relating to the standards of safety and care of persons receiving health and social care services in the public and voluntary health care sectors and social care services in the case of the private health care sector, as provided for by the Health Act, 2007 (No. 23 of 2007). Therefore, under the Protected Disclosures Act 2014 workers or ex-workers can make a disclosure that came to the attention of the worker in connection with the worker's employment.

Emergency Departments

Questions (919)

Róisín Shortall

Question:

919. Deputy Róisín Shortall asked the Minister for Health his plans to address the poor conditions facing persons in emergency departments that present with suicide risk; and if he will make a statement on the matter. [34669/17]

Written answers

Minister of State at the Department of Health

In March 2016, the HSE Mental Health Division established the National Clinical Programme for the Assessment and Management of Patients Presenting to Emergency Departments following Self-Harm.

This clinical programme specifically addresses the care and treatment required by people who present to the Emergency Departments of acute hospitals following an episode of self-harm or with prominent suicidal ideation.

The aim of this programme is to develop a standardised and effective process for the assessment and management of individuals of all age ranges, including children, adolescents, adults and older adults, who present with self-harm to an Emergency Department.

Training offered by this programme ensures that patients and their families have access to clinicians with sufficient expertise to provide high-quality, evidence-based care and treatment. Critical to the success of this clinical programme is the consolidation and further development of close working relationships between the Emergency Department clinical team, mental health liaison staff and Community Mental Health teams and GP services.

The objectives of this programme are to improve the assessment and management of all individuals who present to an Emergency Department with self-harm, reduce rates of repeated self-harm; improve access to appropriate interventions at times of personal crisis; ensure rapid and timely linkage to appropriate follow-up care, and optimise the experience of families and carers in trying to support those who present with self-harm.

Following clinical assessment of a person who presents to an Emergency Department following self-harm, a decision with regard to ongoing treatment of the individual is required. This may indicate admission to a general hospital if physical care is required. If significant mental health considerations are clinically identified, referral to mental health services in accordance with the criteria set out in the Mental Health Acts may be appropriate.

Alternatively, the individual could be referred to appropriate primary care services and supports. All such clinical decisions are set out in the Discharge and Management Plan – Emergency Care Plan developed with and given to the patient and family/friend (with consent).

In general, the HSE Service Plan, including that for Mental Health, stresses the need for more person-centred and responsive care. In addition, significant progress has been made in recent years to improve the infrastructure of health facilities including Emergency Departments.

Health and Social Care Professionals Regulation

Questions (920)

Róisín Shortall

Question:

920. Deputy Róisín Shortall asked the Minister for Health the details of registration and regulation of those offering hypnosis as a method of prompting weight loss, assisting with quitting smoking and so on; and if he will make a statement on the matter. [34674/17]

Written answers

Minister for Health

There is at present no statutory regulation of complementary therapists, including hypnotherapists, in Ireland. While complementary therapists are not subject to professional statutory regulation, they are subject to a range of legislation and regulation, similar to other practitioners including consumer legislation, competition, contract and criminal law.

The report of the National Working Group on the Regulation of Complementary Therapists was published in 2005. Department policy has been informed by this Report and while considering it, the Department of Health has supported greater voluntary self-regulation of complementary therapy. Since 2005, much has changed: changes of Government – revised Programmes for Government; resource constraint and the Financial Emergency Measures in the Public Interest Act 2009; changes nationally and internationally in relation to policy on statutory regulation.

Since then, the immediate priority has been the establishment of the boards of the remaining professions designated under the Health and Social Care Professionals Act 2005, including the newly designated professions of counsellor and psychotherapist. I recently concluded a public consultation on my proposal to regulate counsellors generally under the Act. On foot of the consultation process, I decided last month to proceed with the designation of two distinct professions, that of counsellor and psychotherapist. Each will have its own register under one registration board. This decision has now been communicated to the Health and Social Care Professionals Council, the relevant professional bodies and all of the respondents to the public consultation process.

The Department is now preparing the necessary regulations to designate the professions. These regulations, when drafted by the Office of the Parliamentary Counsel, will require the prior approval of this House and that of the Seanad. These will be the first in a suite of regulations that will need to be made over a period of time. It is hoped that the draft regulations will be ready for submission to the Oireachtas in the autumn.

Question No. 921 answered with Question No. 901.

Freedom of Information Requests

Questions (922)

Róisín Shortall

Question:

922. Deputy Róisín Shortall asked the Minister for Health the reason his Department has not responded to an FOI request (details supplied) regarding the national maternity hospital within the statutory period; and if he will expedite this matter. [34676/17]

Written answers

Minister for Health

The Freedom of Information Act, 2014 provides for the decision-making functions in respect of FOI requests to be delegated, by the Head of the Department, to designated staff of the FOI Body. The Decision Maker assigned to your request will correspond with you in relation to it.

In circumstances where a decision, in respect of an FOI request, does not issue within the legislative time-frame (generally 20 working days), the records are deemed to have been refused and the requester has the right to submit an application for an internal review of the case. An internal review decision should issue within three weeks of receipt of the internal review application.

Misuse of Drugs

Questions (923)

Róisín Shortall

Question:

923. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to the recent reports of the increasing use of crack cocaine in Dublin; his views on recent claims that the HSE is ill-equipped to deal with the abuse of a drug (details supplied); his further views on engaging with treatment providers to ensure that appropriate prevention and treatment strategies for this drug are developed; and if he will make a statement on the matter. [34678/17]

Written answers

Minister of State at the Department of Health

My Department and the Health Service Executive have a range of mechanisms for sharing information about the drugs situation with An Garda Síochána, including the Early Warning Emerging Trends Sub-Committee (EWET) of the National Advisory Committee on Drugs and Alcohol and the HSE Public Alert System for adverse events due to drugs.

The EWET provides a forum for representatives from my Department, An Garda Síochána, the Health Service Executive and other relevant experts to exchange information on emerging trends and patterns in drug use.

I understand that anecdotal reports of an increase in the use of crack cocaine and apparent paraphernalia being found have been raised by service providers attending the EWET. The authorities remain vigilant for the possibility of an increase in the use of crack cocaine in Ireland.

Health Promotion

Questions (924)

Róisín Shortall

Question:

924. Deputy Róisín Shortall asked the Minister for Health his strategy to address a matter (details supplied) in respect of awareness campaigns on the dangers of drinking alcohol during pregnancy; and if he will make a statement on the matter. [34696/17]

Written answers

Minister of State at the Department of Health

The provision of services including awareness campaigns for fetal alcohol syndrome is the responsibility of the Health Service Executive and as such, I have arranged to have the Deputy's question referred to the Health Service Executive for attention and direct reply.

Hospital Appointments Status

Questions (925)

Michael Healy-Rae

Question:

925. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for surgery for a person (details supplied); and if he will make a statement on the matter. [34716/17]

Written answers

Minister for Health

Under 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 scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.

Hospital Appointments Status

Questions (926)

Michael Healy-Rae

Question:

926. Deputy Michael Healy-Rae asked the Minister for Health if he will expedite a surgical appointment for a person (details supplied); and if he will make a statement on the matter. [34739/17]

Written answers

Minister for Health

Under 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 scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.

Home Care Packages Provision

Questions (927)

Brendan Smith

Question:

927. Deputy Brendan Smith asked the Minister for Health his plans to provide additional funding in 2017 for counties Cavan and Monaghan for home support programmes; and if he will make a statement on the matter. [34759/17]

Written answers

Minister of State at the Department of Health

As this is a service matter it has been referred to the Health Service Executive for direct reply.

Drug Treatment Programmes Funding

Questions (928)

Brendan Smith

Question:

928. Deputy Brendan Smith asked the Minister for Health if additional resources will be provided in counties Cavan and Monaghan to assist a project (details supplied); and if he will make a statement on the matter. [34760/17]

Written answers

Minister of State at the Department of Health

As this is a service matter it has been referred to the HSE for direct reply.

HSE Properties

Questions (929)

Fergus O'Dowd

Question:

929. Deputy Fergus O'Dowd asked the Minister for Health the properties in Louth and east Meath, which includes a portion of Meath East, which are leased or occupied or rented or owned by the HSE and are vacant; the reason for such continuing vacancy; the cost of same in each case; and if he will make a statement on the matter. [34761/17]

Written answers

Minister for Health

Your question has been referred to the Health Service Executive for direct reply as the management of the healthcare property estate is a service matter.