Barry Cowen
Question:11. Deputy Barry Cowen asked the Minister for Health if the Midland Regional Hospital, Tullamore will be designated as a trauma unit. [28297/18]
View answerHospital Services
Questions (11)
Written answers
The Report of the Trauma Steering Group – A Trauma System for Ireland was approved by Government on the 6th February 2018 and published online.
In an inclusive Trauma System, as recommended for Ireland by the Trauma Steering Group, the trauma care pathway is not organised around individual institutions but in the context of networked ones whereby all acute hospitals participate – each has a role as either a Major Trauma Centre, Trauma Unit, Local Emergency Hospital or Injury Unit.
The Trauma Unit is a hospital within a Trauma Network that provides care for most types of injuries. Depending on the injuries sustained, major trauma patients can be taken to these hospitals for definitive care rather than to the Major Trauma Centre.
The detailed proposed designation criteria for Trauma Units are set out in Appendix 6 of the Report of the Trauma Steering Group.
Currently in Ireland, there are 16 acute hospitals that could potentially meet the designation criteria for Trauma Units. The Midland Regional Hospital, Tullamore is one of these 16 hospitals. While at present these 16 hospitals all treat trauma, many of the hospitals would need further enhancement and management to meet the level of service provision required to fulfil the designation criteria for Trauma Units.
The HSE has established an interim implementation group, as recommended in the Report, with Departmental representation, to commence immediate actions including recruitment of a National Clinical Lead and establishment of the National Office for Trauma Services, and selection of a Major Trauma Centre for Dublin. The group met for the first time on 12 April and continues to meet on a regular basis to consider these actions in the first instance. Detailed implementation planning will be required to fully implement the Trauma Strategy over a number of years, and will be led by the National Office for Trauma Services.
Question No. 12 answered orally.
National Dementia Strategy
Questions (13)
Billy Kelleher
Question:13. Deputy Billy Kelleher asked the Minister for Health if his Department has conducted a mapping project for dementia care needs; and if he will make a statement on the matter. [28205/18]
View answerWritten answers
The National Dementia Strategy, launched in December 2014, seeks to increase awareness and understanding of dementia, ensure timely diagnosis and intervention and provide enhanced community based supports and services.
In 2016 and 2017, the National Dementia Office partnered with the Alzheimer Society of Ireland on a project to map dementia-specific community-based services and supports. The project did not look at the generic services that people with dementia or their families and carers may use or the quality of the identified services. However, it offers a useful snapshot and baseline study into what, where and when services are being offered. The study has also been used to inform a service finder hosted on the National Dementia Office’s website. This allows people to search for dementia-specific community services in their area.
The final report, entitled ‘Dementia Specific Services in the Community: Mapping Public and Voluntary Services’, found gaps in access to services and a large variance in what services are provided across the country. The National Dementia Office has met with senior HSE officials in each Community Healthcare Organisation region to highlight gaps in each area and to develop local action plans to improve service provision.
The National Dementia Office has developed a needs analysis framework to support local dementia service planning and development. This framework is a mechanism to help the Office direct time, energy and resources into dementia care that most appropriately meets the needs of people with dementia. It will be used to make dementia service development more responsive and consistent across the country.
In addition to this dementia-specific mapping project, the National Dementia Office plans to work with the Centre for Economic and Social Research on Dementia in NUI Galway to identify the range of dementia-appropriate services available nationally.
Disabilities Assessments
Questions (14)
Michael Moynihan
Question:14. Deputy Michael Moynihan asked the Minister for Health the reason almost half the number of applications for assessment of need under the Disability Act 2005 that were overdue for completion at end of March 2018 were in counties Cork and Kerry; and if he will make a statement on the matter. [28202/18]
View answerWritten answers
Cork Kerry Community Healthcare recognises the long waiting times for clinical assessments within the current Assessment of Need process. A portion of the ‘overdue for completion’ figure under the current AON statistics includes cases where the clinical assessment has been completed and a clinical report has been given to the families. However, the formal report from the Assessment Officer as required by legislation has not issued. Resources have been directed towards this particular piece of work since the beginning of 2018 and it is expected that the backlog of reports will be completed by Assessment Officers by year end. This will in turn reduce the overdue figures.
In an effort to standardise Assessment of Need procedures and to facilitate timely assessments, the HSE identified a requirement to develop a Standard Operating Procedure (SOP). This SOP is intended to replace the suite of approximately 50 guidance notes that have been issued since 2007 and will define the assessment. This will ensure a standardised approach across the state in respect of the operational application of the Disability Act 2005 and provide an important opportunity to balance or ensure equity in terms of assessment and support interventions for vulnerable children and young people with a disability.
The HSE is engaged in a consultation process through Forsa on its introduction and hopes to successfully conclude this engagement in the coming weeks prior to roll out.
Autism Support Services
Questions (15)
Jackie Cahill
Question:15. Deputy Jackie Cahill asked the Minister for Health the status of the review of autism services which took place in 2017; and if he will make a statement on the matter. [28289/18]
View answerWritten answers
My portfolio includes disability related matters in the Department of Justice and Equality and that Department has responsibility for the promotion and co-ordination of disability policy, including the development of the National Disability Implementation Plan. In this context, the Department coordinated the development of a Programme of Additional Actions in relation to Autism in conjunction with the National Disability Authority through the Cabinet Committee on Social Policy and Public Service Reform.
The Programme of Actions on Autism is in keeping with the cross disability, whole of government, social model of disability approach set out in the National Disability Strategy Implementation Plan. This recognises that an increased understanding of autism across the public sector is required to ensure that the implementation of the Plan addresses the needs of people with autism on an equal basis to other people with disabilities.
The overarching principle governing the planning and delivery of health services and supports for adults and children with disabilities including autism is that they should be integrated, as much as possible, with services and supports for the rest of the population. The Government’s agenda in this regard is clearly set out in the current National Disability Strategy which is based on a non-condition specific approach to the delivery of public services and the mainstreaming agenda.
The Minister for Health, in 2017 asked the HSE to carry out a review of the level of supports and services to people with autism spectrum disorder. A cross divisional working group was established by the HSE, lead by Chief Officer Tony Canavan, to undertake the review. The role of the group was to examine the operational effectiveness of existing health service responses in addressing the particular needs of those with autism spectrum disorder and seek to identify models of good practice.
In conjunction with the HSE review of services, the Department of Health carried out a review of data sources and an epidemiological study into the prevalence and future projections for Autism Spectrum disorder earlier this year.
The Minister, Deputy Harris, and I are currently considering the findings from both the working group and the review of research.
Hospital Services
Questions (16)
Bobby Aylward
Question:16. Deputy Bobby Aylward asked the Minister for Health the position regarding his commitment to examine a number of proposals to improve cardiac care in the south east, including the deployment of a modular laboratory that will allow for diagnostic angiograms and intervention procedures; the position regarding efforts by UHW management to recruit additional staff to extend the operation of the existing cath lab by 20%; and if he will make a statement on the matter. [28380/18]
View answerWritten answers
Following an independent review of the need for a second cath lab in University Hospital Waterford, the Herity report concluded that the needs of the effective catchment population for Waterford University Hospital could be accommodated within a single cath lab. Funding has been provided to support extension of the existing cath lab operating hours to 12 weekly sessions per week, or by 20%, as recommended in the Herity Report.
As I advised the Deputy in my response to his most recent Parliamentary Question on 29 May last, approval and funding has been provided for the posts required to facilitate this service expansion and recruitment is currently being progressed by local management and the HSE’s National Recruitment Service. A mobile cath lab has been deployed since October 2017, initially for a period of 20 weeks but since extended to allow time for University Hospital Waterford to complete recruitment of the additional staff required for the service extension to the existing cath lab.
The Herity report also recommended that the current 9 to 5 provision of emergency pPCI services should cease to allow the hospital focus on the much larger volume of planned work. I asked my Department to address the implications of this recommendation by undertaking a National Review of Specialist Cardiac Services. The aim of this Review is to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive by establishing the need for an optimal configuration of a national adult cardiac service. As set out in the National Development Plan 2018-2027, investment in cardiac catheterisation laboratories and other cardiac services infrastructure nationally will be informed by the outcome of the National Review, which is expected to be complete by June 2019.
When I met with South East Oireachtas members on 14 February last, I indicated that I would give some consideration to the various issues raised by the group, including the potential for the deployment of a modular cath lab, as an interim solution, pending the outcome of the National Review of Specialist Cardiac Services. My Department is currently examining this matter at my request and it is envisaged that this examination will be completed shortly.
Hospital Waiting Lists Action Plans
Questions (17)
Kevin O'Keeffe
Question:17. Deputy Kevin O'Keeffe asked the Minister for Health the action that will be taken to reduce outpatient waiting times for ophthalmology consultations in Cork University Hospital in which 2,888 appointments are outstanding for more than 12 months. [28199/18]
View answerWritten answers
Improving waiting times for hospital procedures and outpatient appointments is a key commitment in the Programme for Government. In Budget 2018 the NTPF budget was increased to €50 million. The priority for this funding is reducing waiting time for hospital procedures, and the Inpatient/Day Case Action Plan 2018, published in April, targets a reduction in the number of patients waiting for a hospital procedure to under 70,000 by the end of this year. A key target under this plan is patients waiting for Ophthalmology services, specifically Cataract procedures, and the NTPF will fund over 5,000 procedures this year.
However, the issue of growing outpatient waiting list numbers is one that impacts on patients across a wide number of health specialties, including ophthalmology. The NTPF has allocated €3 million of its 2018 funding for Outpatient initiatives and my Department, the HSE and the NTPF are in the process of finalising an Outpatient Action Plan for 2018. All Hospital groups have been invited by the HSE and the NTPF to develop and bring forward proposals for outpatient initiatives for inclusion in the Action Plan.
This plan will support the HSE’s compliance with its National Service Plan targets, reduce the growth 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.
Cork University Hospital advice that the development of Ophthalmology services in Cork is being progressed and that this may include the recruitment of medical ophthalmologists whose work would focus on outpatient clinics. I have asked Cork University Hospital to provide greater details on their plans to reduce outpatient waiting times for this service and I will forward them to the Deputy as soon as I received them.
Home Care Packages Funding
Questions (18)
John Curran
Question:18. Deputy John Curran asked the Minister for Health his plans for a more flexible funding system to limit the delays being experienced by vulnerable older persons on waiting lists for home supports in view of the changing demographics in the provision of home care supports and intensive home care packages and the funding for these supports being finite; and if he will make a statement on the matter. [28405/18]
View answerWritten answers
The Government is committed to promoting care in the community so that people can continue to live with confidence, security and dignity in their own homes for as long as possible. To support this, we plan to establish a new statutory scheme for home care services. The potential for changes to the funding system for home support will be considered as part of the process of developing the new scheme.
I am happy to say that we reached an important milestone in this process earlier this week when I published the report of the findings of the public consultation on home care. The consultation process took place last year and approximately 2,600 submissions were received. The report includes a number of interesting points made by respondents in relation to innovative funding models and is available from the Department’s website. The findings will now be used help to inform the design of the new home care scheme.
I am committed to progressing the development of the new scheme as quickly as possible. However, this is a complex undertaking and will require a significant amount of detailed preparatory work.
In the meantime, the Department and the HSE are continuing to improve existing services, including in 2018 the introduction of a single funding stream for home support services. Also in 2018, an additional 754,000 hours will be delivered, bringing the total to over 17m hours, along with 235 Intensive Home Care Packages.
HSE Correspondence
Questions (19)
Richard Boyd Barrett
Question:19. Deputy Richard Boyd Barrett asked the Minister for Health if his attention has been drawn to communications received by the Ombudsman for Children from HSE management in 2011 regarding the resources available and the referral pathway in counties Laois and Offaly CAMHS; and if he will make a statement on the matter. [28386/18]
View answerWritten answers
I am not aware of the communication referred to by the Deputy.
Initial enquiries with the HSE indicate that they are so far unable to identify the communication mentioned by the Deputy. I have requested the HSE to examine the question and reply directly to the Deputy. In the meantime if the Deputy would like to provide further information to clarify his request I will be happy to pursue further with the HSE.
I wish to reiterate the Government's strong commitment to develop all aspects of mental health. Since 2012, around €200m additional funding has been provided for this care programme, including approval of some 2,000 new posts. The HSE continues to enhance various aspects of its CAMHS service, including improved access at local level for areas such as Laois and Offaly.
There has been increased funding for Child and Adolescent Mental Health Services for Laois/Offaly from €1.387m in 2011 to €2.528m in 2018. Overall staffing levels for the service increased from approximately 16 in 2011 to 34 in 2018. It should be noted too that there has been a significant increase in activity levels for the respective years with, for example the number of referrals received increasing from 167 to 1044; new appointments offered increased from 146 to 797; and new clients seen increased from 107 to 484.
Hospital Groups
Questions (20)
Stephen Donnelly
Question:20. Deputy Stephen S. Donnelly asked the Minister for Health the procedures in place to enable the sharing of best practice between hospital groups; and if he will make a statement on the matter. [28313/18]
View answerWritten answers
The Reports The Establishment of Hospital Groups as a transition to Independent Hospital Trusts (DoH, 2013) and Securing the Future of Smaller Hospitals: A Framework for Development (HSE, 2013) provided the foundations for the reorganisation of hospital services into Hospital Groups. The goal of this reform is to develop a world class person-centred hospital service that values and empowers staff to deliver safe, high quality, integrated services based on health care needs and driven by efficiency and best clinical evidence, research, practice, education and innovation leading to better patient outcomes.
The implementation of Hospital Groups is continuing, with a more co-ordinated approach to the planning and delivery of services across all the hospitals within the group. This allows for a stronger role for smaller hospitals in delivering less complex care while ensuring that patients who require true emergency or complex planned care are managed safely in larger hospitals.
The HSE has established a Hospital Group CEO Forum that enables and supports information sharing across Hospital Groups. The membership includes all Hospital Group CEOs and the Forum is now well established with meetings held monthly. The Hospital Group CEOs also meet regularly with the HSE National Director for Acute Operations.
Further, the HSE Clinical Strategy and Programmes Division (CSPD) was established to rethink the delivery of health and social care in order to improve and standardise patient care across all healthcare settings, irrespective of location. The CSPD works to bring together clinical disciplines, enabling them to share innovative, evidence-based solutions in the interest of providing improved person-centred care. As part of this, the National Clinical Programmes have been established to improve and standardise patient care by bringing together clinical disciplines and enabling them to share innovative solutions to deliver greater benefits to every user of our services. The programmes involve close collaboration between the HSE and the Colleges, working in partnership with patients, nursing and therapy leads, and with the Department of Health. Each of the Clinical Programmes has a Clinical Lead, a multi-disciplinary Working Group (including patient representatives), and a Clinical Advisory Group. Having a wide range of clinicians involved means that the proposed solutions are more robust in their conception, and supports effective implementation.
The Clinical Programmes are tasked with improving specific areas of the health service. This is achieved by designing and specifying standardised models of care, guidelines, pathways and associated strategies for the delivery of integrated clinical care. The programmes provide clinical leadership to support local implementation teams where needed. Examples include National Clinical Programmes for Acute Medicine, Acute Surgery, COPD, Diabetes, Emergency Medicine, Critical Care, Chronic Heart Disease, Stroke and many more.
A further platform to share good practice is through the Health Service Excellence Awards. Held annually, these enable the HSE to identify new and creative service developments that can be shared and implemented, as appropriate, in different parts of the health system.
Air Ambulance Service
Questions (21)
Aengus Ó Snodaigh
Question:21. Deputy Aengus Ó Snodaigh asked the Minister for Health if his Department tendered for the provision of air ambulance services. [27761/18]
View answerWritten answers
In late 2016 the Department of Defence informed my Department that due to a shortage of pilots and air traffic controllers, the Air Corps would not be able to sustain the level of service previously provided for the transfer of Priority One paediatric transplant patients to the UK. This was compounded when, following a review, the Irish Aviation Authority indicated that all patient transfers provided by the Irish Coast Guard had to be operated under Helicopter Emergency Medical Services (HEMS) rules. This meant that aircrew providing HEMS would be restricted to a maximum of 12-hour duty cycles with the result that for UK Priority 1 patient transfers, the Coast Guard was no longer available to provide air transfers between the hours of 7pm and 7.30am from 5 September 2017.
At my Department’s request, HIQA carried out an urgent Health Technology Assessment to provide advice on the options for the treatment and transport of Priority 1 transfer patients. The Health Technology Assessment advised that in the short term, Priority 1 transfers would best be provided through a private provider. A temporary arrangement was made by the HSE with a private provider pending the completion of a tender process.
The HSE has now completed the formal tendering process for the provision of an established air ambulance service to transfer Priority 1 paediatric transplant patients to the UK between 7pm and 7.30am. The contract was awarded to Air Alliance Express and will be in place for a 2-year period. It is envisaged that most of the patients who will use this service will be children who need to go the UK to undergo major organ transplant. The Air Alliance Express service has been operational since 23 April 2018.
Abortion Services Provision
Questions (22)
Thomas Pringle
Question:22. Deputy Thomas Pringle asked the Minister for Health the way in which it will be ensured that women from Northern Ireland will have unfettered access to abortion services in County Donegal in view of its proximity to Northern Ireland and in further view of the fact that women in the jurisdiction do not have access to full healthcare rights; and if he will make a statement on the matter. [28255/18]
View answerWritten answers
The Thirty-Sixth Amendment of the Constitution Bill 2018 seeks to delete Article 40.3.3 of the Constitution and substitute it with wording confirming that the Oireachtas may make laws for the regulation of the termination of pregnancy. The Bill passed all stages in the Houses of the Oireachtas on 28 March 2018. A Polling Day Order for a referendum was held on 25 May 2018. A certificate with the provisional result of the referendum was published in Iris Oifigiuil on Tuesday, 29 May 2018.
Three applications for permission to challenge the result of the referendum have been made to the High Court under section 42 of the Referendum Act 1994. The High Court began to hear the applications on Tuesday the 26 June. It is possible that the hearings may run over a number of days, after which a decision will be made by the Court.
Work is ongoing on the legislation to regulate termination of pregnancy with the intention of finalising it by mid-July. This legislation will be based on the General Scheme of a Bill to Regulate Termination of Pregnancy approved by Government on the 27 of March and published on my Department’s website.
A range of issues are being considered in developing the legislation and operational response to the referendum. I will continue to keep opposition spokespersons and the wider House updated on developments.
Health Services
Questions (23)
Ruth Coppinger
Question:23. Deputy Ruth Coppinger asked the Minister for Health if he will report on the availability of healthcare for transgender persons wishing to avail of hormone treatment and surgery; if he will report on the implementation of guidelines (details supplied) here; and if he will make a statement on the matter. [28323/18]
View answerWritten answers
Transgender-specific guidelines have been developed by the World Professional Association for Transgender Health and the Endocrine Society. The guidelines recommend a comprehensive assessment prior to commencement of hormone therapy. They highlight several criteria which must be met prior to referral for hormonal intervention, so that people access the supports needed to manage co-morbid difficulties.
International best practice involves an assessment by a multi-disciplinary team and shared decision making in the best interests of the individual. The assessment must be carried out by a mental health professional with experience in transgender healthcare and possess specific skills.
The HSE Quality Improvement Division has developed a model of care for transgender children, adolescents and adults, in consultation with clinicians, policy makers, advocates and service users.
I am committed to ensuring the provision of appropriate care for transgender persons wishing to avail of hormone treatment and surgery, in line with best practice, and taking into account the resources and clinical expertise available within the HSE.
Mental Health Services Staff
Questions (24)
Mary Butler
Question:24. Deputy Mary Butler asked the Minister for Health the action that will be taken to bolster mental health services in County Waterford and the south east following the decision of three consultant paediatric psychiatrists to resign; and if he will make a statement on the matter. [28185/18]
View answerWritten answers
The pending resignation of three psychiatrists in the South East is currently being examined by the HSE with a view to minimising disruption of services. Last week, I met with national and local HSE representatives who assured me that they are exploring every possible option to ensure that the vacancies in the CAMHS services in the South East are filled and to ensure continuity of service.
Notwithstanding the global lack of availability of mental health specialists, the HSE is currently conducting an extensive advertising campaign to fill these vacancies. In terms of immediate cover, they have established weekend Consultant Paediatric Psychiatry clinics in Waterford by availing of support from Galway-based Consultants. In addition, the HSE has been in contact with other CHO areas and with agencies both abroad and in the private sector to look for locum cover.
I wish to strongly re-state the Government’s commitment to mental health. This is reflected by the allocation of an additional €200 million for mental health services since 2012 resulting in around €910 million being available to the HSE for mental health this year. While this amount is significant by any standard I will continue to press for further resources annually in line with Programme for Partnership Government commitments.
The HSE Service Plan 2018 commits to further development of CAMHS. This is against a background where the demand for CAMHS has increased by 26% between 2012 and 2017. Around 18,800 referrals are expected for HSE CAMHS this year alone.
To meet this demand, we have increased the supply of services. We have approved over 2,000 new posts in Mental Health since 2012. We now have 69 CAMHS teams and three Paediatric Liaison Teams supported by around 75 CAMHS beds nationally. Further beds are planned to come on-stream as quickly as possible. In addition, we have funded an extra 140 Psychiatric Nurse Undergraduate places each year.
The recent appointment by the HSE of around 114 Assistant Psychologists and 20 Psychologists will help to develop counselling services in Primary Care. I understand that 13 Assistant Psychologists posts have been introduced in CHO 5, which includes Waterford & Wexford. It is anticipated that these posts will deal with the less complex child and adolescent cases thereby reducing the demand on CAMHS.
I will be meeting the HSE again on 3 July next where they will provide me with a progress report on addressing the issue raised by the Deputy.
Drug and Alcohol Task Forces
Questions (25)
John Curran
Question:25. Deputy John Curran asked the Minister for Health the status of the development of a performance measurement system to improve accountability across all sectors of local and regional drug task forces; and if he will make a statement on the matter. [28406/18]
View answerWritten answers
Measuring the effectiveness of responses to the drug problem is an important objective of the national drugs strategy, Reducing Harm, Supporting Recovery. The level of progress in delivering the strategy can be measured using performance indicators linked to specific objectives and actions. Measuring progress is supported by a coordinated system of monitoring, evaluation and research.
External consultants have advised the Department on the development of a performance measurement system. The system is concerned with the net effects of the strategy at the population level, in particular the health, wellbeing and quality of life of people living in local areas.
A performance measurement system will enable the targeting of communities which face a higher risk of substance misuse. It will also help to improve accountability in the use of government funding by linking outcomes with resources.
The Department of Health is committed to implementing a performance measurement system in consultation with relevant stakeholders, including drugs and alcohol local and regional task forces.
I strongly believe that resources should be directed towards interventions that are most effective in reducing problem substance use. I am confident that a performance measurement system will improve accountability across all sectors.
Community Pharmacy Services
Questions (26)
John Brassil
Question:26. Deputy John Brassil asked the Minister for Health the action he will take to boost the role of community pharmacists in primary care; and if he will make a statement on the matter. [28224/18]
View answerWritten answers
I wish to acknowledge the vital role that pharmacies play in their communities. In that regard, the Programme for a Partnership Government contains a commitment to expand the role of community pharmacy in managing patient health, and this is an issue I intend to progress.
Work has been done in recent years on wider healthcare roles for pharmacies, including the Pharmaceutical Society of Ireland’s Future Pharmacy report, concerning expansion of professional pharmacy practice. It is clear from this and other work that there is potential to increase the range of publicly funded health services delivered through community pharmacy. Important new services, including influenza vaccination and emergency contraception services, have already been introduced.
New public services in community pharmacy should improve health outcomes and provide value for money and benefits for patients. Any new or transferred services should be based on sound evidence with matching improvements in governance and administration.
My Department intends to consult with contractor representative bodies on putting in place a new multi-annual approach to fees, in return for service improvement and contractual reform and in line with Government priorities for the health service. This approach is also intended to deliver a phased exit pathway from FEMPI for contractors and this will form part of the proposed consultation.
Hospital Waiting Lists Action Plans
Questions (27)
Anne Rabbitte
Question:27. Deputy Anne Rabbitte asked the Minister for Health if the outpatient action plan will contain measures to help children waiting long periods for rheumatology appointments. [28319/18]
View answerWritten answers
Improving waiting times for hospital procedures and outpatient appointments is a key commitment in the Programme for Government. My Department, the HSE and the NTPF are in the process of finalising an Outpatient Action Plan for 2018. This plan will support the HSE’s compliance with its National Service Plan targets, reduce the growth 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.
The Children's Hospital Group (CHG) continues to work with the NTPF to manage long waiting lists for clinically appropriate groups. CHG has received investment in 2018 in Paediatric Orthopaedic services, that will assist rheumatology. An additional €9 million has been allocated in the HSE 2018 National Service Plan for paediatric orthopaedics, including scoliosis services, to further reduce waiting times for paediatric orthopaedic services and support the development of a sustainable paediatric orthopaedic service.
Part of the rationale for the development of the new children’s hospital is the challenges with existing physical infrastructure across the hospitals in the Group. The design of the new children’s hospital and Paediatric Outpatient and Urgent Care Centres at Connolly and Tallaght Hospitals is based on a thorough analysis of capacity and demand and services will be provided in line with best practice and the National Model of Care for Paediatrics and Neonatology, the acute strand of the HSE’s Integrated Care Programme for Children.
Cancer Screening Programmes
Questions (28)
Bríd Smith
Question:28. Deputy Bríd Smith asked the Minister for Health his views on whether the two site visits conducted on the laboratories that conducted the cervical screening programme over the ten years of the programme to be a sufficient way to ensure standards and quality of the screening process; and if he will make a statement on the matter. [28379/18]
View answerWritten answers
Currently, the testing of cervical smear tests is carried out by the following three institutions:
- Quest Diagnostics Inc, Teterboro, New Jersey USA;
- MedLab Pathology Ltd, Dublin (US company); and
- Coombe Women and Infant’s University Hospital, Dublin.
Approximately 50% of the testing is done in Ireland, with the remaining 50% being done outside Ireland. Currently, approximately 250,000 smear tests are processed each year.
The clinical advice is that there is no evidence that the clinical and technical aspects of the programme have performed outside or below international standards or the quality guidelines set for the programme. Smear tests can produce both false positive and false negative results. However, the Scoping Inquiry and the Independent Clinical Expert Panel Review will provide independent and international scrutiny of performance.
The site visits to the laboratories in 2011 and 2014 were additional and complementary to the continued external accreditation of laboratories, the continued participation by laboratories in external quality assurance schemes and the continuous monitoring of quality metrics with reference to the Guidelines for Quality Assurance in Cervical Screening (Cytopathology, HPV testing).
Dietician Service Provision
Questions (29)
Mick Barry
Question:29. Deputy Mick Barry asked the Minister for Health if he will report on the availability of ketogenic diets for children with particular reference to availability in Cork University Hospital; and if he will make a statement on the matter. [28325/18]
View answerWritten answers
The ketogenic diet is used in the treatment of intractable epilepsy (as per NICE Guidance Ketogenic Diet and other Dietary Treatments for Epilepsy 2016) and metabolic disorders including glutathione 1 deficiency. This is a highly specialised service at Cork University Hospital, requiring specific training and experience, and currently provided to a small number of patients.
Following retirement of one dietician, the HSE has advised that a suitably qualified replacement has not yet been secured. In the meantime, the service is currently being covered by another dietician at Cork University Hospital. Cork University Hospital has also supported the training of three dieticians to deliver backup service for this treatment and, once completed, this will allow for a small number of additional cases to be treated. It is understood that a Business Case is being developed for an additional ketogenic dietician post at the hospital. As with all service requirements, this will be considered in the context of the Estimates process.
Hospital Waiting Lists Action Plans
Questions (30)
Shane Cassells
Question:30. Deputy Shane Cassells asked the Minister for Health the initiatives that will be taken to reduce long waiting times for an outpatient appointment in Our Lady’s Hospital, Navan; and if he will make a statement on the matter. [28292/18]
View answerWritten answers
The National Treatment Purchase Fund (NTPF) data published on 13 June 2018 indicates that there is a total of 5,815 adults waiting for an outpatient appointment in Our Lady’s Hospital Navan. This is an increase of 3.5% on the numbers waiting in May 2017 (5,618).
The Ireland East Hospital Group advises that Our Lady’s Hospital has undertaken a number of initiatives to deliver additional outpatient clinics and to address some of the long waiters on the outpatient waiting list.
In Orthopaedics, the hospital has added an Arthroplasty Clinical Nurse Specialist since February 2018 to assist with outpatient clinics. The appointment of a new Musculoskeletal Physiotherapist is planned for early autumn which should free up additional capacity for new patients.
Cardiology services will be improved with the upcoming appointment of a new Cardiologist between Our Lady’s in Navan and the Mater Hospital. This is one of a number of additional posts approved between both hospitals as part of the Navan redesign programme.
The regional rheumatology service will be supported with the appointment of two new Advanced Nurse Practitioners – these nurses will manage existing patients in nurse-led clinics thus freeing up space to accommodate new referrals.
New organisational structures are to be introduced in the hospital. A recruitment campaign is currently underway to appoint a Scheduled Care Lead who will oversee scheduling of patients in a timely manner, and support the validation of outpatient lists and measures to improve the rates of "Did Not Attend" (DNA) patients at outpatient clinics.