John Curran
Question:172. Deputy John Curran asked the Minister for Health the progress made to date regarding the development of a new statutory homecare scheme; and if he will make a statement on the matter. [27177/18]
View answerDepartmental Schemes
Questions (172)
Written answers
The Department of Health is currently engaged in a detailed process to develop plans for a new statutory scheme and system of regulation for home care services. The statutory scheme for home care will introduce clear rules in relation to the services for which individuals are eligible and in relation to service-allocation. For that reason, developing a new statutory scheme will be an important step in ensuring that the system operates in a consistent and fair manner for all those who need home care services. It will also help to improve access to the home care services that people need in an affordable and sustainable way. The system of regulation for home care will help to ensure that the public can be confident that the services provided are of a high standard.
As an initial step in this process, the Department commissioned the Health Research Board to undertake a review of the home care systems in four other European countries. This review, which was published in April 2017, will help us to learn from the experiences of other jurisdictions and will inform the debate and future consideration of approaches to formal home care financing and regulation here in Ireland. I, along with Minister Harris, also launched a public consultation process in July 2017 which closed in October 2017. The purpose of this consultation was to allow all those with views on this topic to have their say, including older people themselves, their families, and healthcare workers. There was a very high response rate to the consultation process with approximately 2,600 submissions received. I intend to publish a report of the findings of the consultation process next week.
It is important to note that a significant amount of detailed work remains to be carried out before final decisions are taken on the form of home care scheme and the system of regulation for these services. This is required if reforms are to be successful, affordable and sustainable.
However, while the new home care scheme is under development, the Department of Health and Health Service Executive (HSE) are continuing efforts to incrementally improve the existing services. The HSE has begun streamlining services in 2018 by bringing together the funding for home help and standard home care packages, which now operate as a single home support service. This new approach will provide significant benefits including making the services easier to understand; streamlining the application and decision-making processes; and facilitating service users to move to changed levels of service as their assessed needs change, without the need for an additional application process.
2018 has also seen a significant increase in the provision of home support services. The HSE’s National Service Plan provides for a target of some 17.094m home support hours to be provided to 50,500 people. This represents an increase of 754,000 hours to 500 more people over last year. In addition 235 intensive home care packages will provide 360,000 home support hours for people with complex needs.
The HSE will also continue to encourage local integration of services and build appropriate care pathways, in particular for people with dementia and complex needs.
Home Help Service Provision
Questions (173)
John Curran
Question:173. Deputy John Curran asked the Minister for Health his plans to deal with the continued increases in persons waiting for home care supports in the short-term; and if he will make a statement on the matter. [27178/18]
View answerWritten answers
As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Hospital Consultant Contracts
Questions (174)
Michael McGrath
Question:174. Deputy Michael McGrath asked the Minister for Health further to Parliamentary Question No. 160 of 14 June 2018, and in view of the recent settlement that has been agreed, the role his Department played in the sanctioning of the use of private investigators to monitor the work of hospital consultants in the context of a current pay claim; the nature and extent of the surveillance; the duration and number of consultants involved; the other departments or State agencies involved in the decision to undertake such surveillance; the role of the HSE in the matter; if the HSE approved the method; and if he will make a statement on the matter. [27204/18]
View answerWritten answers
I welcome the opportunity to clarify the position in relation to the use of private investigators in defending the legal cases taken by consultants. I am aware that there has been some criticism of the Departments approving the use of private investigators as part of the defence. The use of these services is not unusual where legal proceedings are in train and where evidence is being gathered.
Arising from the High Court proceedings taken against the State for alleged breach of Consultant Contract 2008, the Government made a decision to vigorously defend these cases. Examination of possible non-compliance with the terms of the plaintiff’s contract was part of the defence strategy mounted against the plaintiffs; particularly in relation to the level of private practice undertaken. Under the 2008 Contract, consultants with certain contract types may engage in off-site private practice, others are limited to on-site private practice up to specified levels and others are not allowed engage in private practice. Of the ten lead cases, three were subject to particular scrutiny.
Gathering data in relation to off-site private practice is more difficult than on-site practice and to do so in a thorough manner required the services of a private investigator in order to establish if excessive off-site private practice work was being undertaken by the consultants and the extent of such work. The HSE instructed private investigators to gather evidence to support the HSE's counter-claim in relation to non-compliant consultants. This approach was approved by the Departments of Health, Finance, and Public Expenditure and Reform and was reaffirmed by the Departments as appropriate in the lead-up to the hearing date in conjunction with the State’s legal advisors. It should be noted that no consultants outside of the lead cases were subject to surveillance by a private investigator.
The settlement agreement reached between the parties provides that by accepting the settlement, eligible consultants who settle under this agreement affirm the terms of the Consultants Contract 2008. This is a positive commitment that the HSE and the Department can use to strengthen monitoring of compliance and sends a strong signal that there is renewed commitment by all sides to ensuring adherence to public/private practice ratios as set out in the contract.
State Bodies Data
Questions (175)
Michael McGrath
Question:175. Deputy Michael McGrath asked the Minister for Health the number of positions on the board in respect of the board of agencies and commercial State companies under his Department’s aegis in tabular form; the quorum required for a board meeting; the number of ministerial appointee vacancies on the board to date; the length of time the ministerial appointee vacancy has been present for each vacancy; and if he will make a statement on the matter. [27222/18]
View answerWritten answers
The nomination and appointment process for boards of bodies under the aegis of my Department is set out in legislation. In line with Government Decision SI80/20/10/1617 of 2014 and Guidelines set out by the Department of Public Expenditure and Reform relating to the advertising for expressions of interest in vacancies on State Boards, my Department in conjunction with the Public Appointments Service (PAS) currently advertises for board vacancies as they arise, where I, as Minister for Health, have nominating rights under relevant legislation. I also appoint members on the nomination of various bodies, again in accordance with relevant legislation.
The following table sets out most of the information requested by the Deputy. It has not been possible to obtain quorum details for each board in the time-frame requested. This information will be sent to the Deputy as soon as it is collated.
|
State Body |
Number of positions on the board as per legislation |
Number of vacant positions |
Date vacancy occurred |
|
Dental Council |
19 |
1 |
Dec 17 |
|
Dublin Dental Hospital Board |
14 |
0 |
|
|
Food Safety Authority of Ireland |
10 |
1 |
Feb 18 |
|
Health and Social Care Professionals Council |
29 |
1 |
Dec 17 |
|
Health Information and Quality Authority |
12 |
1 |
May 18 |
|
Health Insurance Authority |
5 |
0 |
|
|
Health Products Regulatory Authority |
9 |
0 |
|
|
Health Research Board |
10 |
0 |
|
|
Irish Blood Transfusion Service |
12 |
1 |
May 17 |
|
Medical Council |
25 |
1 |
Jun 18 |
|
Mental Health Commission |
13 |
0 |
|
|
National Cancer Registry Board |
7 |
2 |
Aug 17 / Dec 17 |
|
National Treatment Purchase Fund Board |
9 |
0 |
|
|
Nursing and Midwifery Board of Ireland |
23 |
2 |
Dec 17 / Jun 18 |
|
Pharmaceutical Society of Ireland Council |
21 |
0 |
|
|
Pre-Hospital Emergency Care Council |
17 |
0 |
|
|
Voluntary Health Insurance Board |
12 |
2 |
Feb 18 / Mar 18 |
Hospital Waiting Lists
Questions (176)
Barry Cowen
Question:176. Deputy Barry Cowen asked the Minister for Health the status of the €35 million allocated to the waiting list initiative as outlined in budget 2018; the amount that has been spent; the way in which the money has been spent; and if he will make a statement on the matter. [27228/18]
View answerWritten answers
Improving waiting times for hospital procedures is a key commitment in the Programme for Government and in 2018 €50 million was allocated to the NTPF to provide treatment for patients. This more than doubled its 2017 total allocation of €20m. This funding was to build on the work started in 2017 in addressing waiting times for Inpatient/Daycase (IPDC) procedures, and to create a strategy to ensure a continued downward trend in waiting times.
In April 2018 I launched the Inpatient/Day Case Action Plan which outlines the combined impact of HSE and NTPF activity in 2018 to reduce the number of patients waiting for treatment to below 70,000 in 2018. This plan marks a very important milestone in delivering on this commitment.
In 2018 the NTPF will outsource 20,000 inpatient day cases, while the HSE will deliver 1.14 million hospital operations or procedures. This will mean that by the end of 2018 we will expect to see a significant reduction in the number waiting for a procedure to under 70,000 - from a peak of 86,100 in July 2017.
There are seven high-volume procedures that are the focus of the NTPF funded treatments, specifically cataracts, hip/knee replacements, tonsils, angiograms, cystoscopies, skin lesions and varicose veins. All patients who are waiting more than 9 months and suitable for treatment at an outsourced facility will be offered treatment in 2018 for targeted high-volume procedures. For patients who are waiting longest for other procedures, the NTPF and HSE will work together to identify the requirements, develop treatment plans, and where possible offer treatments from within existing HSE and NTPF resources.
In terms of treatment offers, the NTPF authorises public hospitals to offer outsourced treatment to clinically suitable long waiting patients who are on an inpatient/day case waiting list for surgery, having been referred on to such a list following clinical assessment by a consultant/specialist at an outpatient clinic. NTPF authorisations are made in respect of the longest waiting patients first.
Furthermore, the funding provided to the NTPF for 2018 is also being used to address the Outpatient waiting list, which remains a significant challenge to be addressed this year. Each year, 3.3 million patients attend Hospital Outpatient clinics for appointments. It is worth noting that in 2017 almost half a million (477,000) outpatients did not attend their appointment.
In order to address the issue of growing Outpatient waiting list numbers, I instructed the HSE to commence development of an Outpatient Action Plan for 2018, which has been submitted to my Department and is currently being finalised. This plan will support the HSE’s compliance with their National Service Plan targets, reduce the increase in the number of patients waiting for outpatient services, improve the accuracy of the waiting list, and trial a number of NTPF funded interventions, including weekend and out of hours clinics.
Hospital Services
Questions (177)
Barry Cowen
Question:177. Deputy Barry Cowen asked the Minister for Health the status of the €50 million allocated to acute services as outlined in budget 2018; the amount has been spent; the way in which the money has been spent; and if he will make a statement on the matter. [27229/18]
View answerWritten answers
In Budget 2018, €50 million was allocated to improve access to scheduled and unscheduled care services and this is the funding that I understand the Deputy is referring to in his question.
I can confirm that €40 million of this funding was allocated to implement measures aimed at alleviating pressure in our Acute Hospitals over the winter period and €10 million was allocated to improve access to scheduled care in the area of orthopaedic services and scoliosis. Between January and June 2018, over €38 million of this funding was released to the HSE.
This funding has been spent on a range of measures this winter, including the opening of new bed capacity in Drogheda, Limerick, Kilkenny, Cork and the provision of home support packages and transitional care beds to support the timely discharge of patients from hospital.
This funding has also supported the treatment of young patients with scoliosis under the 2018 Scoliosis Action Plan.
Health Services Expenditure
Questions (178)
Barry Cowen
Question:178. Deputy Barry Cowen asked the Minister for Health the status of the €32 million allocated to older persons as outlined in budget 2018; the amount that has been spent; the way in which the money has been spent; and if he will make a statement on the matter. [27230/18]
View answerWritten answers
As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Patient Safety
Questions (179)
Barry Cowen
Question:179. Deputy Barry Cowen asked the Minister for Health the status of the €2.5 million allocated to patient safety and quality as outlined in budget 2018; the amount that has been spent; the way in which the money has been spent; and if he will make a statement on the matter. [27231/18]
View answerWritten answers
The Department, in recognising the challenges of healthcare associated infections and antimicrobial resistance for the health system, held back dedicated funding of €2 million for 2018. Of this, €1.8 million (FYC) has been allocated to date. The HSE has prioritised work programmes for this funding in line with assessed risk. The majority of the funding available has been allocated for the purposes of providing support to hospitals currently managing CPE/HCAI outbreaks, hospitals that have had a CPE/HCAI outbreak in the past, and the National Reference Laboratory for CPE.
In addition, it is intended that the balance of the €500,000 will be allocated to a number of HSE patient safety initiatives. The HSE is also establishing a Patient Safety Programme that will coordinate efforts in this area both to enhance existing efforts and bring forward new initiatives.
Services for People with Disabilities
Questions (180)
Barry Cowen
Question:180. Deputy Barry Cowen asked the Minister for Health the status of the €15 million allocated to disabilities as outlined in budget 2018; the amount that has been spent; the way in which the money has been spent; and if he will make a statement on the matter. [27232/18]
View answerWritten answers
The 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.
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.
Mental Health Services Expenditure
Questions (181)
Barry Cowen
Question:181. Deputy Barry Cowen asked the Minister for Health the status of the €35 million allocated to mental health as outlined in budget 2018; the amount has been spent; the way in which the money has been spent; and if he will make a statement on the matter. [27233/18]
View answerWritten answers
Budget 2018 made allowance for an additional €35 million for mental health services, bringing the total HSE Mental Health Budget to €910 million. This represents an increase of over €200 million since 2012.
€30.7 million has been allocated to the HSE so far in 2018, with the remaining €4.3 million to be allocated in September 2018.
This increase has funded improved Mental Health Nurse training, enhanced drug treatment options for Mental Health service users, enhanced access to counselling and talk therapies, improvements to the mental health physical infrastructure and an increase in specialist rehab services. It has also helped to facilitate improved 7-day-a-week Mental Health services, improvements to Eating Disorder and Perinatal Mental Health services, an increase in Psychiatric Nurse undergraduate places and the introduction of Advanced Nurse practitioners.
Primary Care Services Provision
Questions (182)
Barry Cowen
Question:182. Deputy Barry Cowen asked the Minister for Health the status of the €40 million allocated to primary care as outlined in budget 2018; the amount that has been spent; the way in which the money has been spent; and if he will make a statement on the matter. [27234/18]
View answerWritten answers
The additional funding for primary care development announced by the Minister for Finance and Public Expenditure and Reform in Budget 2018 is detailed in the table. The Deputy may wish to note that the allocation for new primary care developments was finalised at €39m under the HSE National Service Plan for 2018.
|
- |
Allocation (€m) |
Drawn Down at end Q1 (€m) |
|
New Primary Care Centre Lease and Operating Costs |
10.2 |
9.68 |
|
Community Intervention Team expansion and OPAT provision from Q3 2018 |
2.8 |
0 |
|
60 Additional Paediatric Home Care Packages |
2.1 |
2.1 |
|
Occupational Therapy Posts (40 OTs to be recruited from Q3 2018) |
1.043 |
0 |
|
|
|
|
|
Nursing Development Initiatives |
3 |
0 |
|
|
||
|
GP Initiatives |
2.357 |
0 |
|
GP Out of Hours expansion (Dublin South, South-East and North Wicklow) |
2 |
0 |
|
GP Training (additional places to bring total to 198) |
1.5 |
1.5 |
|
|
|
|
|
TOTAL |
25 |
13.28 |
As can be seen from the table, some of the measures are being supported to cover full-year costs while in other instances funding is intended to cover costs arising in the latter part of 2018. In those instances where moneys have not yet been drawn down, it is expected that this funding will be utilised in the second half of the year. However, savings have been identified under the heading of Nursing Development Initiatives, and sanction has been given to reallocate €1m to support the further rollout of the Taskforce for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings.
In addition to the measures outlined above, a further €14m was provided for the funding of new drugs under the Primary Care Reimbursement Scheme. To date in 2018, the HSE has given approval for the reimbursement of a number of new medicines with cost implications for the current year of approximately €11 million.
Social Inclusion and Community Activation Programme Expenditure
Questions (183)
Barry Cowen
Question:183. Deputy Barry Cowen asked the Minister for Health the status of the €7.5 million allocated to social inclusion as outlined in budget 2018; the amount that has been spent; the way in which the money has been spent; and if he will make a statement on the matter. [27235/18]
View answerWritten answers
The social inclusion remit of the Department of Health provides targeted interventions for people from socially excluded groups who experience severe health inequalities. These groups include people involved in substance misuse, the homeless, Travellers and Roma, and refugees and asylum seekers. They frequently have difficulties accessing mainstream services and present with complex health and needs that require integrated and tailored responses.
Additional funding of €7.5 million was provided in 2018 for new developments in social inclusion and drugs policy. This funding is being used to:
Address the health needs of people who are homeless and have mental health and addictions issues in line with the Rebuilding Ireland,
Respond to the pressing health needs of refugees arriving in Emergency Reception & Orientation Centres by improving access to primary care services, with a particular focus on addressing oral health needs,
Expand drug and alcohol services, with the objective of reducing waiting times and promoting person-centred care, and
Implement priority actions in the national drugs strategy, Reducing Harm, Supporting Recovery.
To date, nearly €4m has been released to the HSE to progress these initiatives. The HSE is expected to drawdown the remainder of its allocation in Quarter 4.
A further €930,000 is allocated to the Department under the Drugs Initiative Fund, including an additional €250,000 for local and regional task forces and new programmes targeting young people at risk of substance misuse and community action on alcohol.
I am committed to ensuring that adequate resources are provided to implement the national drugs strategy and to meet departmental commitments on homeless, refugees and Travellers.
Health Services
Questions (184)
Niamh Smyth
Question:184. Deputy Niamh Smyth asked the Minister for Health the test results of a facility (details supplied); the impact this delay is having on the facility; and if he will make a statement on the matter. [27257/18]
View answerWritten answers
As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
Hospital Services
Questions (185)
Niamh Smyth
Question:185. Deputy Niamh Smyth asked the Minister for Health if delays in x-ray readings at a hospital (details supplied) will be addressed; if extra staff to clear the backlog will be allocated; the number of persons waiting to date; the number of weeks it is taking to turn results around; and if he will make a statement on the matter. [27258/18]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
Hospital Appointments Status
Questions (186)
Michael Healy-Rae
Question:186. 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. [27262/18]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
Orthodontic Services Provision
Questions (187)
Michael Healy-Rae
Question:187. Deputy Michael Healy-Rae asked the Minister for Health the status of orthodontic treatment for a person (details supplied); and if he will make a statement on the matter. [27266/18]
View answerWritten answers
As this is a service matter it has been referred to the HSE for direct reply to the Deputy.
Hospital Appointments Status
Questions (188)
Robert Troy
Question:188. Deputy Robert Troy asked the Minister for Health when a person (details supplied) will be called for cataract surgery. [27267/18]
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 since 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 the Deputy directly.
Psychological Assessments
Questions (189)
Michael Healy-Rae
Question:189. Deputy Michael Healy-Rae asked the Minister for Health the status of a physiological assessment for a person (details supplied); and if he will make a statement on the matter. [27271/18]
View answerWritten answers
As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Dental Services
Questions (190)
Niamh Smyth
Question:190. Deputy Niamh Smyth asked the Minister for Health the reason there is no provision for dental care at a centre (details supplied); the reason the service has been removed; if it will be replaced; if so, when it will be replaced; and if he will make a statement on the matter. [27272/18]
View answerWritten answers
As this is a service matter it has been referred to the HSE for direct reply to the Deputy.
Home Care Packages Data
Questions (191, 192)
Mary Butler
Question:191. Deputy Mary Butler asked the Minister for Health the budget by CHO for home care packages in 2018, in tabular form; and if he will make a statement on the matter. [27279/18]
View answerMary Butler
Question:192. Deputy Mary Butler asked the Minister for Health if CHOs have already exceeded their budget for 2018 in relation to the provision of home care packages and are not able to allocate new packages due to lack of funding by CHO in tabular form; and if he will make a statement on the matter. [27280/18]
View answerWritten answers
I propose to take Questions Nos. 191 and 192 together.
As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.