Billy Kelleher
Question:162. Deputy Billy Kelleher asked the Minister for Health if dental services such as teeth cleaning are available under the medical card scheme. [49795/17]
View answerGeneral Medical Services Scheme
Questions (162)
Written answers
As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
Health Services Provision
Questions (163)
Brendan Smith
Question:163. Deputy Brendan Smith asked the Minister for Health when essential services will be restored in view of the ongoing needs of persons who have availed of a service (details supplied) up to recently; and if he will make a statement on the matter. [49797/17]
View answerWritten answers
As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
Hospital Waiting Lists
Questions (164)
Joan Collins
Question:164. Deputy Joan Collins asked the Minister for Health the reason a person (details supplied) is still waiting for a procedure. [49803/17]
View answerWritten answers
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 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.
Hospital Procedures
Questions (165, 166, 167)
Catherine Connolly
Question:165. Deputy Catherine Connolly asked the Minister for Health his plans for an independent review of the use of mesh implants; his further plans to hold a formal investigation into the concerns attributed to the use of surgical mesh implants in view of reports (details supplied); and if he will make a statement on the matter. [49805/17]
View answerCatherine Connolly
Question:166. Deputy Catherine Connolly asked the Minister for Health the number of persons who have had a vaginal mesh implant surgery in each of the past ten years; the number of persons requiring repeated operations to resolve issues in respect of the implant surgery; the number of implants that have been removed; the steps he is taking to assist those affected by complications relating to the implants; and if he will make a statement on the matter. [49806/17]
View answerCatherine Connolly
Question:167. Deputy Catherine Connolly asked the Minister for Health the number of complaints received regarding transvaginal mesh implants in each of the past ten years; the number of persons pursuing legal action over complications they suffered as a result of receiving implants; and if he will make a statement on the matter. [49807/17]
View answerWritten answers
I propose to take Questions Nos. 165 to 167, inclusive, together.
As I recently told the Dáil, it is important that the clinical facts and evidence determine what further response I give to these and other issues raised in relation to mesh implants. I have therefore asked the Chief Medical Officer to provide me with a report on the issues. He informs me that the engagements he will require with national and international bodies, the professional colleges and others will require some months to complete before he can make his recommendations to me. I would ask that the Deputy await the completion of that work.
In the interim, I advise any woman who experiences or suspects that she has experienced such a complication to discuss this with her GP and indeed with the hospital from which she received the implant.
Departmental Strategies
Questions (168)
Róisín Shortall
Question:168. Deputy Róisín Shortall asked the Minister for Health the schedule for full implementation of the eHealth programme; the proposed funding allocation to ensure this happens; and if he will make a statement on the matter. [49810/17]
View answerWritten answers
The Government published a strategy for eHealth in December 2013 that outlined a programme of work to underpin and develop eHealth delivery within the Irish health system. Significant developments have taken place over the last 3 years to improve the capacity of the health system to move to a digital environment. New strategic systems are being put in place such as the new medical laboratory platform known as MedLIS, the continued roll out of the national radiology solution NIMIS, the eReferrals initiative in primary care and the Maternal and New Born System which is transforming the delivery of maternity care and has gone live in both Cork (2016) and Kerry (2017) and most recently in the Rotunda Hospital over last weekend.
I also welcome the recognition of the priority required for investment in the EHR Programme in the Sláintecare Report which recommended “continued strong support of the e-health strategy - particularly ensuring the necessary funding for timely roll-out of the EHR system" and advancement in eHealth will be considered as part of the implementation response to Sláintecare, currently being developed by my Department.
The scale of the task to implement a national electronic health record programme is very large, challenging and requires a complex planning, approval and tendering process. The EHR business case, which has been developed by the HSE, highlights a number of optional timescales and investment approaches for implementation and roll-out including a 5 year and a 9 year technology investment programme.
The Electronic Health Record (EHR) has 4 main elements - the Shared Care Record, the Community & Primary Care EHR, the Acute Operational EHR and the EHR integration suite. The HSE appointed a programme manager to oversee the implementation of the Electronic Health Record in May 2017. The next phase of the EHR programme is to develop detailed business cases for each of the components including specification of requirements, procurement documentation and support during the procurement process. The HSE sought and received conditional sanction from the Department of Health and the Department of Public Expenditure to procure additional services to further develop the business case in preparation for submission for permission to tender. Tenders sanctioned are for the delivery of support in the following areas:
1. programme office,
2. acute EHR,
3. community EHR and
4. Shared Care Record and Integration.
The tender documents were published in August and the tender process closed mid-September. To date, one contract for this work has been awarded for the acute hospital EHR in view of the requirements for the National Children's Hospital. In the case of the other two lots, a re-tendering exercise is underway. The outputs from this work will allow greater clarity on the scope of the individual components for what is being procured and the detailed costings for each of the areas that will make up the electronic health care record. Only when this detailed work is completed can the procurement process be considered for submission to the Department of Public Expenditure and Reform and prioritisation assigned to the work. The work in relation to EHR will continue and feed into the implementation response to the Sláintecare report being prepared by my Department.
ICT Capital allocation in the HSE has grown from a low base in 2012 of €22m to €55m in 2017. The Government has committed to increase ICT capital spending over the next four years for the HSE with an indicative capital allocation of €60m in 2018, €85m in 2019, €100m in 2020 and €120m in 2021 to support eHealth, in the context of the Mid-Term Capital Review. Provision of revenue funding to support ICT has also increased in recent years and sanction for 49 additional posts was granted in 2016. For a programme of this scale and scope, realistic timescales and funding options are important to ensure that the adoption of both the technology and the business change required by front line staff can be absorbed and managed in a coherent way.
Hospital Consultant Contracts
Questions (169)
Róisín Shortall
Question:169. Deputy Róisín Shortall asked the Minister for Health the systems in place for the oversight of the hospital consultant contracts; the accountability structures which exist to ensure compliance with this contract; and if he is satisfied that this operates properly. [49811/17]
View answerWritten answers
Arrangements concerning implementation and monitoring of Consultant Contract 2008 including the provisions in relation to private practice are matters for the HSE in the first instance. The responsibility for reporting individual consultant compliance with their contract was formally delegated to the Hospital Groups in 2014. The main reason for this was to ensure local accountability. Hospitals know their consultants and the work they deliver.
However it seems clear that the arrangements in place are not robust enough to deliver compliance in all circumstances and, as a result, some consultants are able to engage in private practice activity at levels that significantly exceed the permitted levels, or else they may engage in significant levels of off-site private practice, although their contract does not provide for this. It is incumbent on publicly-funded hospitals to ensure compliance with the terms of the contract, including the provisions in relation to private practice. For some time my Department has been working closely with the HSE on this.
I am very clear that consultants must deliver their work commitment to the public system. It is the responsibility of management to make sure these contracts are being enforced and I have asked the HSE to ensure that more robust measures are in place in 2018 to make sure consultants comply with their contractual obligations. I will require absolute assurances on this point.
In the longer term I have established an independent group, chaired by Dr Donal de Buitléir, to examine the impact of separating private practice from the public hospital system. This was one of the key recommendations of the Sláintecare Report.
Hospital Waiting Lists
Questions (170)
Róisín Shortall
Question:170. Deputy Róisín Shortall asked the Minister for Health the hospitals that are operating a single waiting list in public hospitals as provided for under the consultant contract; the reason hospital management is allowed to ignore this stipulation; the action he will take to address this matter; and if he will make a statement on the matter. [49812/17]
View answerWritten answers
The HIQA Report and Recommendations on Patient Referrals from General Practice to Outpatient and Radiology Services, including the National Standard for Patient Referral Information, published in 2011 makes a number of recommendations in relation to Secondary Care Referral Management Systems, including that GPs should address referrals in the first instance to a central point within a hospital, then to the relevant specialty/service, followed by named consultant if relevant. The approach is supported in the report by international evidence.
With regard to the Consultant Contract 2008, a key objective of the Contract is to improve access for public patients to public hospital care. Under the Consultant's Contract 2008 and HSE guidance issued from the National Director of Acute Hospitals in September 2009 a common waiting list for treatment, diagnostic investigations, tests and procedures on an outpatient basis in public hospitals is identified. In addition, under HSE policy, private outpatients may not attend public outpatient consultant-led clinics.
Finally, under the HSE National Framework for operation and management of Outpatient Departments published in 2013, referrals for outpatient appointments to a named consultant should be treated as general to the specialty involved, unless it is more appropriate for a particular patient to be managed by a specific consultant.
In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
Hospital Services
Questions (171, 172)
Thomas Pringle
Question:171. Deputy Thomas Pringle asked the Minister for Health the status of the future of long-term residential beds at St. Joseph's Hospital in Stranorlar, County Donegal; and if he will make a statement on the matter. [49813/17]
View answerThomas Pringle
Question:172. Deputy Thomas Pringle asked the Minister for Health if a report (details supplied) has been sent to HIQA or to the HSE's national social care division; if not, the timeframe for same; the reason for delays in drafting a plan for community hospital infrastructure for Stranorlar, Ramelton and Lifford; and if he will make a statement on the matter. [49814/17]
View answerWritten answers
I propose to take Questions Nos. 171 and 172 together.
While the care delivered to residents in our community hospitals is generally of a very high standard, many of theses services are delivered in buildings that are less than ideal in the modern context. It is important therefore that we upgrade our public bed stock and this is the aim of the 5 year Capital Investment Programme for Community Nursing Units which was announced last year. This provides the framework to allow for an enhanced programme to replace, upgrade and refurbish these care facilities, as appropriate. Significant work was undertaken to determine the most optimum scheduling of projects within the phased provision of funding to achieve compliance with National Standards.
This investment programme will see the provision of two new centres in Donegal, namely in Ballyshannon and also a 130 bed centre, centrally located in Letterkenny.
Since the announcement in 2016, and following discussions with public representatives, Health Forum members and local community groups, local HSE management in CHO 1 agreed to review overall requirements for the area. The Terms of Reference for the Rhatigan's review were as follows:
1. Assess current and future needs for short/long term bed capacity taking into account of up to date census data from the Central Statistics Office;
2. Based on current planning norms define scale of public/private provision required to meet this need up to 2026;
3. Assess the adequacy of existing facilities in St Joseph’s Hospital Stranorlar, Ramelton and Lifford, taking account of amended legislation governing residential care standards 2016;
4. Recommend changes to the approved capital programme, if appropriate, taking into account capital and revenue costs, geographical factors, integration of care with acute services and time frames for delivery;
5. Make specific recommendations regarding dementia care provision; and
6. Based on the above to finalise brief and options appraisals for infrastructural developments proposed.
I understand that the review has been completed and a report is to be submitted to the HSE’s National Social Care Division in the first instance, and then the HSE’s National Capital Property Steering Group.
Any proposals for changes to the approved Capital Investment Programme for Community Nursing Units would have to be considered in the context of capital funding available to Health, potential revenue implications and compliance with the agreed capital approval process.
Hospital Waiting Lists
Questions (173)
Joan Collins
Question:173. Deputy Joan Collins asked the Minister for Health when an operation will be scheduled for a person (details supplied); and if he will make a statement on the matter. [49820/17]
View answerWritten answers
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 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.
Hospital Waiting Lists
Questions (174)
Joan Collins
Question:174. Deputy Joan Collins asked the Minister for Health the status of an operation for a person (details supplied); and the reason for the delay. [49821/17]
View answerWritten answers
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 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.
Hospital Waiting Lists
Questions (175)
Billy Kelleher
Question:175. Deputy Billy Kelleher asked the Minister for Health when a person (details supplied) will be moved to Beaumont Hospital to have the required surgery; and if he will make a statement on the matter. [49825/17]
View answerWritten answers
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 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.
Agriculture Scheme Payments
Questions (176)
Michael Fitzmaurice
Question:176. Deputy Michael Fitzmaurice asked the Minister for Agriculture, Food and the Marine when areas of natural constraint, ANC, and basic payment scheme, BPS, payments will issue to a person (details supplied); the reason for the delay in processing same; and if he will make a statement on the matter. [49675/17]
View answerWritten answers
An application in respect of the 2017 Basic Payment Scheme and Areas of Natural Constraint Scheme was received from the person named on 18 July 2017, thus incurring a 100% penalty on account of the lateness of the application.
An appeal was submitted in relation to this case citing particular circumstances. This appeal has been allowed. Accordingly, the late penalty will be waived and payment will issue to the nominated bank account of the person named as soon as possible.
Agriculture Scheme Payments
Questions (177)
Michael Fitzmaurice
Question:177. Deputy Michael Fitzmaurice asked the Minister for Agriculture, Food and the Marine when a person (details supplied) will receive areas of natural constaint, ANC, and basic payment scheme, BPS, payments; the reason for the delay in payment of same; and if he will make a statement on the matter. [49676/17]
View answerWritten answers
Payment under the 2017 Areas of Natural Constraints Scheme for the above herd has now been processed and will issue in the coming days.
Payments under the Basic Payment Scheme have been subject to delay pending the resolution of issues pertaining to multiple transfer of entitlement applications associated to the person named.
My Department has been in direct contact with the person named and is in the process of resolving outstanding issues to facilitate payment issuing as soon as possible.
Agriculture Scheme Payments
Questions (178)
Michael Fitzmaurice
Question:178. Deputy Michael Fitzmaurice asked the Minister for Agriculture, Food and the Marine when a person (details supplied) will receive areas of natural constraint, ANC, and basic payment scheme, BPS, payments; the reason for the delay in payment of same; and if he will make a statement on the matter. [49677/17]
View answerWritten answers
Payment under the 2017 Areas of Natural Constraint Scheme was processed and issued to the above herd in September 2017.
Payments under the Basic Payment Scheme have been subject to delay pending the resolution of issues pertaining to multiple transfer of entitlement applications associated to the person named.
My Department has been in direct contact with the person named and is in the process of resolving outstanding issues to facilitate payment issuing as soon as possible.
Targeted Agricultural Modernisation Scheme
Questions (179)
Michael Fitzmaurice
Question:179. Deputy Michael Fitzmaurice asked the Minister for Agriculture, Food and the Marine when a decision will be made on the targeted agricultural modernisation scheme, TAMS, tranche 8 applications; and if he will make a statement on the matter. [49679/17]
View answerWritten answers
A decision has been made in relation to approvals for applications under TAMS II Tranche 8. These approvals will begin to issue in the near future.
Harbours and Piers
Questions (180)
James Browne
Question:180. Deputy James Browne asked the Minister for Agriculture, Food and the Marine the resources his Department dedicates to the removal of old boats; the powers local authorities possess in compelling the removal of old boats; and if he will make a statement on the matter. [49707/17]
View answerWritten answers
My Department has responsibility under the Fishery Harbours Centre Act, 1968 (as amended) for the six Fishery Harbour Centres located at Howth, Dunmore East, Castletownbere, An Daingean, Ros an Mhíl and Killybegs. The Fishery Harbour Centres (Management, Control, Operation and Development) Bye-Laws 1979 give the Harbour Master powers to remove wrecked or derelict vessels from the confines of these six Fishery Harbour Centres. This is a rare occurrence and monies are made available when necessary on a case by case basis.
The Receiver of wrecks, who is a Revenue Official appointed by the Minister for Transport, Tourism and Sport, also has a role in respect of any wrecks found in or on the shores of the sea or any tidal water or harbour.
The Deputy will be aware that there is other State owned harbour infrastructure around the coast that does not fall within the remit of my Department. I would therefore suggest that the Deputy contact the relevant public body with responsibility for these, including the Department of Transport, Tourism and Sport in respect of State port companies and the Department of the Housing, Planning and Local Government in respect of ports or harbours managed by local authorities.
Pesticide Use
Questions (181)
John Brassil
Question:181. Deputy John Brassil asked the Minister for Agriculture, Food and the Marine the position on the safety of the use of a product (details supplied) as a weedkiller in view of the recent controversy in renewing its licence at European Union level; and if he will make a statement on the matter. [49711/17]
View answerWritten answers
In June 2016 the European Commission extended the approval of glyphosate for a limited interim period to allow for the completion of a safety assessment by the Committee for Risk Assessment (RAC) of the European Chemicals Agency (ECHA). This extension followed an earlier comprehensive review by the European Food Safety Authority which concluded that glyphosate is unlikely to pose a carcinogenic hazard to humans and can be used safely without putting consumers or users at risk. Both the EFSA and ECHA assessments included detailed consideration of a report produced by the International Agency for Research on Cancer of the World Health Organisation in relation to glyphosate.
The RAC concluded in March 2017, in an opinion adopted with the full support of all members, that glyphosate does not warrant classification as carcinogenic, mutagenic or toxic for reproduction. This means that legally glyphosate does not meet any of the substance non-approval criteria specified in Regulation 1107/2009. A final decision on renewing the approval of glyphosate is due to be taken by 15 December 2017.
Based on the conclusions of the risk and hazard assessments conducted by the European Food Safety Authority and the European Chemicals Agency, the Commission has prepared draft proposals for renewal of the approval of glyphosate. These proposals have been discussed by Member State representatives at technical experts standing committee meetings but there has not been qualified majority support at these meetings for the draft renewal proposals that have been presented by the Commission. This process will now move to a further meeting of member states, called an ‘appeals committee’, later this month. This meeting will consider and vote on this proposal again at that time.
In my view it is important that decisions such as this are based on the best scientific information that is available to us as policy makers. In this instance the latest scientific information available from assessments completed by the European Food Safety Authority and the European Chemicals Agency supports the continued approval of glyphosate.