Written Answers Nos. 1248-1267
1248. Deputy John Lahart asked the Minister for Health the funding allocated to the Tallaght drugs and alcohol task force in each of the years 2011 to 2017, inclusive; the projected funding for 2018; and if he will make a statement on the matter. [38595/17]
View answerThe budget allocation for the Tallaght Local Drug and Alcohol Task Force from the Drugs Initiative of the Department of Health and the Health Service Executive in each of the years referred to by the Deputy is set out in the following table:
|
2011 DOH |
2012 DOH |
2013 DOH |
2014 DOH |
2014 HSE |
|
|
Tallaght |
€1,281,356 |
€1250,347 |
€1,262,837 |
€452,712 |
€782,240 |
|
Total |
€1,281,356 |
€1250,347 |
€1,262,837 |
€1,234,952 |
Table cont
|
2015 DOH |
2015 HSE |
2016 DOH |
201 6HSE |
2017 DOH |
2017 HSE |
|
|
Tallaght |
€341,438 |
€893,514 |
€336,022 |
€898,930 |
€336,022 |
€898,930 |
|
Total |
€1,234,952 |
€1,234,952 |
€1,234,952 |
Funding for 2018 will be determined in the context of the estimates process.
1250. Deputy Thomas P. Broughan asked the Minister for Health the estimated full year cost of recruiting an additional 130 dentists for the public health service; and if he will make a statement on the matter. [38649/17]
View answerI have asked the HSE to respond to the Deputy directly on this matter.
1251. Deputy Thomas P. Broughan asked the Minister for Health the estimated full year cost of recruiting an additional 20 full-time bereavement counsellors; and if he will make a statement on the matter. [38650/17]
View answerI have asked the HSE to respond to the Deputy directly on this matter.
1252. Deputy Stephen S. Donnelly asked the Minister for Health if he will report on the State's bid to host the European Medicines Agency; and if he will make a statement on the matter. [38662/17]
View answerOn 31 July 2017, Ireland officially submitted its proposal for Dublin to be the new host city of the European Medicines Agency to the European Council and the European Commission. The bid was developed by a cross-sectoral working group, led by my Department, with colleagues from the Department of the Taoiseach and Department of Foreign Affairs and Trade, as well as representatives from the Health Products Regulatory Authority (HPRA), IDA Ireland and other Government Departments.
Whole-of-Government support is a key factor in the bid in order to provide confidence to the EMA and its staff that the work of the Agency will be protected during and after transition, and that staff will be assisted in relocating to Dublin. The Government has shown its commitment to the proposal by offering financial support and a family relocation package, a commitment to provide office space for an advance party from the EMA and a dedicated transition team to work with them in the relocation process.
I firmly believe that the proposal meets the criteria agreed by the Council. Relocation of the EMA to Dublin provides the best opportunity to main business continuity of the Agency and provides the best option for the staff and their families.
Dublin offers an unmatched opportunity as the new seat of the EMA. Dublin has excellent air connectivity with EU capitals and internationally to serve the needs of the 30,000 visitors per annum hosted by the Agency. The bid identified three high-quality office locations which are within a short distance of both the airport and the city centre. Dublin has all the amenities of a modern capital city and is an open, safe, friendly multicultural environment with excellent educational and employment opportunities.
Dublin provides the EMA with a politically stable environment and Irish public support for the EU remains very high. As a member of the Eurozone, Ireland also offers the EMA and the EU budgetary certainty, free from the threat of currency fluctuations.
Ireland’s national medicines agency, the HPRA, is highly regarded. It already provides significant support to the EMA and this can be rapidly scaled up in the event of relocation.
I have at all times maintained that the core of our proposal is continuation of the EMA’s work and that Dublin can successfully facilitate the EMA’s relocation. Since submitting the proposal, the working group has continued to promote Dublin as the ideal location for the Agency.
The final decision on the EMA’s new location will be taken at the General Affairs Council (Art. 50) in November. The Minister for Foreign Affairs will lead a diplomatic campaign to promote the Dublin bid across all Member States in the interim. I will also continue to hold bilateral meetings with EU colleagues.
Officials in my Department will continue to work in close co-operation with their colleagues in the Department of the Taoiseach and the Department of Foreign Affairs and Trade on the strategy to promote the bid and demonstrate why we feel Dublin represents the best choice for the EMA, for Europe and for its citizens.
1253. Deputy Brendan Smith asked the Minister for Health his views on the implementation to date of the national stroke programme; and if he will make a statement on the matter. [38685/17]
View answerThe National Clinical Programme for Stroke (NCPS) has been in place since early 2010. The vision of the programme is to design standardised models of integrated care pathways for the delivery of clinical care to ensure sustained quality clinical operational management. Overall, the NCPS aims to improve quality, access and cost-effectiveness of stroke services in Ireland.
The majority of strokes are caused when blood clots travel to a blood vessel in the brain and block the flow of blood to that area. Clot-dissolving treatment (thrombolysis) can contribute to improved outcomes for treated patients, with one-third experiencing important improvements in their ability to walk or self-care and other possible disabling conditions caused by the stroke with sometimes complete reversal of the effects of the stroke. More recently a new therapy, Thrombectomy, has been developed where people with the most severe strokes can have their strokes treated by skilled interventional neuroradiologists who remove the obstructing clots via their blood vessels. This has been shown to halve the mortality and disability from such strokes in some patients.
Some of the achievements of this programme to date include:
National 24/7 access to safe stroke thrombolysis
Emergency thrombolysis is provided to patients in all parts of the country, via improved hospital and ambulance protocols, health professional training and the appointment of new stroke physicians. The national stroke thrombolysis rate has increased from 1% in 2006 to a current rate of 12% (2016).
The NCPS has developed a number of initiatives including a telemedicine programme to allow delivery of expert thrombolysis therapy in smaller level three hospitals. It has been involved in the training of over 250 doctors nationally to deliver thrombolysis therapy and has participated in a training programme for Stroke in the Royal College of Physicians of Ireland.
Improved access to stroke unit care
Access to stroke unit care has been shown to improve stroke patient outcomes through reduced mortality rates, reduced dependency and shorter lengths of stay in hospital by patients. Since the commencement of the NCPS, nine new stroke units have been opened, bringing the total number of stroke units in acute hospitals to twenty-two. Two further stroke units are currently in development with a third at planning stages.
|
Stroke Unit Available n22 |
Stroke Unit in development / planning n3 |
No Stroke Unit n2 |
|
Mater Misericordiae University Hospital |
University Hospital Kerry |
Midland Regional Hospital Tullamore |
|
St Vincent’s University Hospital |
Connolly Hospital |
Our Lady’s Hospital Navan |
|
Midland Regional Hospital Mullingar |
Letterkenny University Hospital |
|
|
Wexford General Hospital |
||
|
St Luke’s Hospital Kilkenny |
||
|
St James’s Hospital |
||
|
Tallaght Hospital |
||
|
Naas General Hospital |
||
|
Midland Regional Hospital Portlaoise |
||
|
Beaumont Hospital |
||
|
Our Lady of Lourdes Hospital Drogheda |
||
|
Cavan General Hospital |
||
|
University Hospital Limerick |
||
|
University Hospital Waterford |
||
|
South Tipperary General Hospital Clonmel |
||
|
Cork University Hospital |
||
|
Mercy University Hospital |
||
|
Bantry General Hospital |
||
|
University Hospital Galway |
||
|
Portiuncula Hospital |
||
|
Mayo University Hospital |
||
|
Sligo University Hospital |
This is a major improvement from the first national stroke care audit report in 2006 which reported one stroke unit in the country. However stroke units are typically too small and the recent national Audit showed that only half of stroke patients admitted spent any time in a stroke unit.
Admission to a stroke unit is a National Key Performance Indicator. In 2016, 65.6% of Stroke patients were admitted to a Stroke Unit.
Early Discharge of Stroke Patients
It has been recognised internationally that Early Supported Discharge of stroke patients from hospital, improves outcomes, reduces need for long term care and increases acute hospital capacity by freeing up beds. It is estimated the 10-25% of patients could benefit from an ESD service.
The programme has helped establish 3 small but effective ESD teams in Dublin and Galway. In 2016, 137 patients were discharged to ESD services representing 15.6% of total stroke discharges. It is estimated that there was an average reduction in length of stay of 10.4 days per ESD patient.
Funding for increasing capacity in the three operational sites has been secured for 2017 with further funding secured to support the establishment of two further teams in University Hospital Limerick and Cork University Hospital. Recruitment of these ESD staff is on-going. University Hospital Limerick is due to commence its ESD Service on 11/9/17.
Emergency Endovascular Therapy – Thrombectomy
Thrombectomy is an emergency endovascular procedure that permits patients with severe strokes caused by clots occluding the major vessels of the brain and neck to have these clots removed using specialist devices. HIQA has completed a Health Technology Assessment which finds that this intervention is value for money. Full report of the HIQA HTA can be found at: https://www.hiqa.ie/reports-and-publications/health-technology-assessments/hta-mechanical-thrombectomy-stroke.
Provision of emergency endovascular thrombectomy remains highly specialised in Beaumont Hospital and Cork University Hospital and this model has been endorsed by the HSE, Acute Hospital Division with a view to a third centre when numbers increase as expected.
To date, the number of patients undergoing this procedure has risen annually, on average almost 50% increase each year: 2015=122 cases, 2016=172 cases, 2017 – end of August=154 cases. These patients have been referred from 20 different hospitals around the country.
Stroke Prevention
NCPS has completed an Atrial Fibrillation Screening Study in partnership with the acute hospitals and primary care division. One hundred GPs in Galway and Sligo/Leitrim participated in the study to assess the feasibility of opportunistic screening for the common cardiac arrhythmia atrial fibrillation in general practice. Atrial Fibrillation causes about one-third of strokes in Ireland and a Health Technology Assessment by HIQA has shown that opportunistic screening for Atrial Fibrillation in general practice is likely to be highly cost effective in Ireland. Such a screening protocol is in discussion as part of the new GP contract negotiations. If introduced, Ireland would be the first country in the world to introduce such screening. Further information can be found at: http://www.hse.ie/eng/about/Who/clinical/natclinprog/strokeprogramme/audit/afscreening.html.
Further developments will be subject to the estimates process.
1254. Deputy Stephen S. Donnelly asked the Minister for Health the status of the development of sectorial response plans to Brexit, the publication date of these plans; and if he will make a statement on the matter. [38696/17]
View answer1255. Deputy Stephen S. Donnelly asked the Minister for Health the issues identified for consideration in the context of Brexit, including opportunities and their prioritisation; and if he will make a statement on the matter. [38712/17]
View answer1256. Deputy Stephen S. Donnelly asked the Minister for Health the details of issues identified for consideration in the context of Brexit, including threats and their prioritisation; and if he will make a statement on the matter. [38728/17]
View answer1257. Deputy Stephen S. Donnelly asked the Minister for Health the scenario planning that has been conducted by his Department for Brexit; and if he will make a statement on the matter. [38744/17]
View answer1258. Deputy Stephen S. Donnelly asked the Minister for Health the methodology employed in the prioritisation of responses to Brexit; and if he will make a statement on the matter. [38760/17]
View answer1259. Deputy Stephen S. Donnelly asked the Minister for Health the funds that have been requested in response to threats resulting from Brexit; and if he will make a statement on the matter. [38776/17]
View answer1260. Deputy Stephen S. Donnelly asked the Minister for Health the funds have been allocated in response to threats resulting from Brexit; and if he will make a statement on the matter. [38808/17]
View answer1262. Deputy Stephen S. Donnelly asked the Minister for Health his Department’s priorities for risk mitigation in response to Brexit; and if he will make a statement on the matter. [38840/17]
View answer1263. Deputy Stephen S. Donnelly asked the Minister for Health the membership and role of all Brexit-related stakeholder engagement groups working with his Department on Brexit issues; the number of times each stakeholder group has met; and if he will make a statement on the matter. [38856/17]
View answer1264. Deputy Stephen S. Donnelly asked the Minister for Health the Brexit-related research currently being undertaken by his Department; the topics under consideration; the date this research commenced; the expected date for completion and publication in tabular form; and if he will make a statement on the matter. [38888/17]
View answerI propose to take Questions Nos. 1254 to 1260, inclusive, and 1262 to 1264, inclusive, together.
The comprehensive document “Ireland and the negotiations on the UK’s withdrawal from the European Union: The Government’s Approach” published on 2 May outlined in detail the structures put in place by the Government to ensure a strategic and whole-of Government response to Brexit that ensures a coordinated approach to the identification of key priority issues for the EU-UK negotiations and the wider domestic response. Since the publication of the comprehensive document, the Government has sought to further increase its strategic oversight of Brexit through the addition of a dedicated responsibility for Brexit matters to the role of the Minister for Foreign Affairs & Trade. The Cabinet Committee structures have also been reformed and a new Cabinet Committee has been established to deal with EU Affairs including Brexit.
The Government’s National Risk Assessment 2017, which provides a systematic overview of strategic risks facing the country, was published on 29 August following a public consultation process. The National Risk Assessment acknowledges the significance of risk arising from Brexit, and that Brexit represents an overarching theme that could have far-reaching impacts on nearly all aspects of national life. It identifies areas where Brexit poses a specific risk, particularly in relation to the economy. As set out in the document of 2 May, the Government’s continuing work to ensure that Ireland’s interests are reflected in the EU’s approach to the ongoing EU-UK negotiations is a central dimension of Ireland’s strategic response to Brexit.
The Department of Health and its agencies have been conducting detailed analysis on the impacts of Brexit in the area of health. A number of issues are being examined and contingency planning for a range of eventualities is underway. A key issue will be to ensure that there is minimum disruption to health services and that essential services are maintained on a cross-border, all-island and Ireland-UK basis. The health sector has a highly mobile workforce and free movement issues and the mutual recognition and assurance of professional qualifications are being considered. On regulatory issues, it is clear that having a single set of rules across the European Union is enormously helpful – to protect human health, to ensure consumer protection and to provide a level playing field for industry. The UK no longer being part of a harmonised regulatory system in relation to food safety standards, pharmaceuticals, medical devices and cosmetics could necessitate increased certification requirements or disrupt trade between Ireland and the UK. Ensuring continuity in the supply of medicines and medical devices following the UK’s departure from the EU is a priority. The issue of customs is of relevance as it relates to additional food safety controls and medicines. The implications of Brexit for networks and organisations such as the EU Rapid Alert System for Food and Feed, European Reference Networks on rare diseases, or the European Centre for Disease Prevention and Control are also under consideration.
These issues are currently being examined by my Department and its agencies and this work will continue over the period ahead. The key priorities for my Department are to ensure continuity in the provision of health services and provision of health services and to avoid, or mitigate against, changes to the current situation that would have a negative impact on human health. These are also key factors in considering the prioritisation of risks.
The Department of Health will continue to work closely with the Department of the Taoiseach, the Department of Foreign Affairs and Trade and other departments on Brexit, and to work and contribute as required to the cross Governmental response, including on the themes identified, in light of the ongoing cross-Government research, analysis and consultations with stakeholders.
Stakeholder engagement on Brexit is very important. I hosted an All-Island Civic Dialogue on the implications of Brexit for cross-border health co-operation on 8 September. Stakeholders concerned with all-island health matters gathered to discuss the potential impact of Brexit on the health sector, particularly cross-border health co-operation. Contributions made at the event will help to inform and deepen the understanding of the implications of Brexit in respect of health across the island of Ireland.
An extensive programme of engagement with all other EU Governments and the EU institutions is under way. I am continuing to engage with my EU counterparts on an ongoing basis.
1265. Deputy Róisín Shortall asked the Minister for Health the expenditure savings that are earmarked for his Department for 2018 that are not accounted for in the mid-year expenditure report or are not included in the fiscal space calculations for 2018. [38904/17]
View answerThe level of funding available for my Department is being considered as part of the national Estimates and budgetary process for 2018 which is currently underway. Pending completion of this process it is not appropriate for me to comment further at this stage.
1266. Deputy Mick Barry asked the Minister for Health the rate of non-compliance with documentary requirements from other EU member states experienced by the HSE related to the cross-border directive and accessing medical procedures abroad; and if he will make a statement on the matter. [38928/17]
View answerThe Directive on Patients' Rights in Cross Border Healthcare provides rules for the reimbursement of patients' of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State (Member State of Affiliation) and supplements the rights that patients already have at EU level through the legislation on the coordination of social security schemes (Regulation 883/04). The Directive seeks to ensure a clear and transparent framework for the provision of cross- border healthcare within the EU, for those occasions where the care patients seek is provided in another Member State rather than in their home country. S.I. 203 of 2014 provides the legal basis for the Health Service Executive to operate the EU Directive on Patients' Rights in Cross Border Healthcare in Ireland, including the reimbursement of the cost of treatment..
As the HSE has responsibility for the administration of the Cross Border Directive, I have asked the HSE to examine the issues raised and to reply to the Deputy as soon as possible.
1267. Deputy John McGuinness asked the Minister for Health if physiotherapy and other support services will be arranged for a person (details supplied); the reason there has been no follow-up in this case; if the person has been referred as an outpatient or otherwise to REHAB Dún Laoghaire, County Dublin; and if he will make a statement on the matter. [38930/17]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
