Written Answers Nos. 31-50
31. Deputy Willie O'Dea asked the Minister for Health the action that will be taken to reduce outpatient waiting times for neurology consultations in University Hospital Limerick in which 443 appointments are outstanding for more than 18 months. [28290/18]
View answerImproving waiting times for hospital procedures and outpatient appointments is a key commitment in the Programme for Government.
The University of Limerick (UL) Hospital Group has advised that all patients who are waiting on outpatient lists, including for neurology, are prioritised according to clinical need. In addition UL Hospitals Group continues to focus on seeing and treating those who have been waiting the longest.
The Hospital Group further advises that neurology outpatient activity at UL has been steadily increasing year-on-year since 2016, and saw a 7% increase from 2017 to 2018 (Jan to April). UL advises that the increase is growth in demand and an increase in the number of urgent referrals are the main reasons for these increases.
The Hospital Group also advises that it continues to explore further waiting list initiatives, including long-waiter clinics and outsourcing, to make further improvements to waiting lists across the Hospital Group.
In order to address the issue of growing outpatient waiting list numbers, 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. I look forward to publishing the plan in the coming weeks.
32. Deputy Eugene Murphy asked the Minister for Health if a full review of cases carried out by the audiologist who worked in counties Mayo and Roscommon for over a ten year period from the early 2000s will now be carried out in view of the recent failings identified as part of the review of paediatric audiology services; and if he will make a statement on the matter. [27794/18]
View answer86. Deputy Eugene Murphy asked the Minister for Health if the failings identified as part of the review of paediatric audiology services in more than 900 cases by one audiologist in counties Mayo and Roscommon in each of the years 2011 to 2015, which left some children with lifelong impairments, will be addressed; and if he will make a statement on the matter. [27793/18]
View answerI propose to take Questions Nos. 32 and 86 together.
The Report of the look-back of paediatric services in Mayo and Roscommon provided between 2011 and 2015 represents a thorough analysis of the quality of service delivery in the area against standards for such services that were set out in the National Audiology Review Group Report (2011). Since 2011, the recommendations of this Report, including clinical governance and quality assurance processes, have been the benchmark for the quality of service delivery throughout the country.
The Report and accompanying communication from the HSE includes an apology for the failures identified and for the anxiety that this has caused to families and those who may have been harmed. The HSE has invited parents of the children to meet with a senior manager and a senior audiologist to discuss the findings of this report and be updated on their child’s care.
All 49 children who needed follow up as a result of the look back process are either currently receiving, or have already received, the appropriate care they need.
The HSE is reviewing the employment history of the individual clinician who provided the service with a view to determining if any further action is required. This is being expedited as quickly as possible.
33. Deputy Timmy Dooley asked the Minister for Health the processes in place for the recruitment of psychiatrists; the number of vacancies for consultant psychiatric posts; the number of same filled on a non-specialist basis; and if he will make a statement on the matter. [28209/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
34. Deputy Brian Stanley asked the Minister for Health the steps being taken to address the chronic shortage of services for children such as occupational therapy, physiotherapy and speech and language therapy in counties Laois and Offaly. [27893/18]
View answerThe 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.
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.
35. Deputy Darragh O'Brien asked the Minister for Health the number of persons waiting for home care packages in the north County Dublin LHO area. [28229/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
36. Deputy Seán Haughey asked the Minister for Health if the level of ambulance provision in Dublin can be increased; and if he will make a statement on the matter. [28192/18]
View answerDublin Fire Brigade provides emergency ambulance services in Dublin city and county, by arrangement between Dublin City Council and the HSE. The HSE National Ambulance Service also provides some emergency capacity in the greater Dublin area. Where required, the NAS provides additional resources from neighbouring counties to address demand in Dublin, including motorbikes, rapid response vehicles and emergency ambulances. In addition, ambulances from other parts of the country, which may be travelling to or from a Dublin hospital, are available to respond to emergency calls in the Dublin area where they are the nearest resource to a patient.
Of course the Capacity Review identified a requirement for increased ambulance resources in the eastern region, which covers Dublin, Kildare and Wicklow. That review underlined the need for a multi-annual programme of phased investment in ambulance manpower, vehicles and technology. In that context, over recent years the Government has provided additional annual investment for ambulance services. This year, an additional sum of €10.7m has been made available which includes €2.8m to fund new developments.
As the allocation of the additional funding is an operational matter, I have asked the HSE to respond to you directly with any further information which may be available.
37. Deputy Margaret Murphy O'Mahony asked the Minister for Health the action being taken on foot of HIQA’s finding that the level of compliance with the health and safety and risk management outcome in disability centres was less than 50% in 2017; and if he will make a statement on the matter. [28318/18]
View answerAll centre-based residential and respite care facilities for older persons and persons with disabilities are subject to registration and inspection by the Health Information and Quality Authority (HIQA), in accordance with the provisions of the Health Act 2007. The purpose of regulation is to safeguard and support the delivery of person-centred care to vulnerable people of any age who are receiving residential care services and to ensure that their health, well-being and quality of life is promoted and protected.
HIQA is a fully independent authority charged with ensuring high-quality and safe care for people using health and social care services in Ireland. Compliance with HIQA standards is a requirement under the Service Level Arrangements between the HSE and voluntary service providers under Section 38 and 39 of the Health Acts. It should be noted, in this context, that HIQA has reported evidence of good practice in the delivery of many residential services to people with disabilities where the support and care needs of residents have been prioritised and there is a strong focus on the needs of service providers.
The particular issue raised by the Deputy is a service matter for the HSE. Accordingly, I have arranged for the Deputy's question to be referred to the HSE for direct reply to the Deputy.
38. Deputy Declan Breathnach asked the Minister for Health the reason CHO 8 was 51,000 home support hours behind target in the first quarter of 2018; and if he will make a statement on the matter. [28226/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
39. Deputy Stephen S. Donnelly asked the Minister for Health when a cannabis for medicinal use access programme will be put in place; and if he will make a statement on the matter. [28316/18]
View answerOn foot of the HPRA report ‘Cannabis for Medical Use – A Scientific Review’, I announced my intention to establish a ‘Cannabis for Medical Use Access Programme’ to facilitate access to cannabis-based products, that are not authorised as medicines but are of a standardised quality and meet an acceptable level of quality assurance. The programme will provide access to cannabis treatments for patients who are under the care of a medical consultant, for certain medical conditions which have failed to respond to standard treatments.
An Expert Group has drawn up clinical guidance for healthcare professionals treating patients through the Access Programme, which includes guidance on which cannabis products are appropriate for medical use.
The Access Programme is not yet operational, as further work is required in relation to certain elements, in particular the availability of appropriate quality-approved medical cannabis products that are affordable to patients. This is a critical aspect in establishing the access programme. The Department is working intensively on finding solutions to the supply of appropriate products for Irish patients.
In the meantime, prescribing of cannabis for medical treatment by medical consultants, for their individual patients is being facilitated via the Ministerial licence application route.
40. Deputy Brendan Smith asked the Minister for Health his plans to increase orthopaedic capacity for patients in the north east in view of delays in persons accessing assessments and follow-up procedures; and if he will make a statement on the matter. [28237/18]
View answerImproving waiting times for hospital procedures is a key commitment in the Programme for Government and €50 million was allocated to the National Treatment Purchase Fund (NTPF) in 2018 to provide treatment for patients.
The recently launched Inpatient/Day Case Action Plan outlines the combined impact of HSE and NTPF activity in 2018 to reduce the number of patients waiting for treatment. Under the Plan, the NTPF will outsource 22,000 inpatient day cases across a range of specialties, while the HSE will deliver 1.14 million hospital operations or procedures. The Action Plan places a particular focus on hip and knee replacements, and commits to offering procedures to all patients waiting more than 9 months for a hip and/or knee replacement in 2018, if clinically suitable for treatment at an outsourced facility. The NTPF will also offer treatment for a range of other orthopaedic treatments in 2018.
Under the Plan, the NTPF and HSE will also invite proposals from hospitals for waiting list initiatives. The NTPF will provide funding to the solutions proposed if appropriate.
In response to this particular query, I have also asked the Health Service Executive to respond to you as soon as possible outlining any specific plans to increase orthopaedic capacity in the North East.
41. Deputy Sean Fleming asked the Minister for Health his plans to provide a treatment purchase fund for mental health services; and if he will make a statement on the matter. [28299/18]
View answerThe development of all aspects of mental health services remains a priority for the Government. Services have benefitted from the significant additional investment for mental health over recent years which has resulted in an overall provision of some €910 million for this care programme in the current year. This is an increase of over €200m, or around 28%, in six years. I have already secured agreement from the Minister for Public Expenditure that the budget will increase by a further €55 Million in 2019.
While the level of vacancies and difficulty in recruiting skilled staff continues to pose a significant challenge to service provision, particularly in CAMHS, the provision of 136 new Primary Care Psychologists (including 22 basic grade psychology posts and 114 Assistant Psychologists) aims to reduce pressure on specialist CAMHS. These are currently being put in place by the HSE. In addition, we have funded the increase of Psychiatric Nurse Undergraduates places by 130 per year by 2021/22.
Work is also continuing on improvements to Out-of-Hours liaison, seven-day response services, and the progression of several National Clinical Specialist Mental Health Programmes.
I am open to considering all avenues that will assist with the timely treatment of mental health service users, and services such as CIPC are good examples of this. There are no specific mental health services that I am considering for inclusion under the National Treatment Purchase Fund at this current time.
42. Deputy Bríd Smith asked the Minister for Health his views on whether the resignations of three consultant child and adolescent psychiatrists in the south east are least partly a result of the lack of resources at primary care level and the resulting over-burdening of an already grossly under-resourced secondary care CAMHS operating at less than a quarter of recommended resources for a safe service; his further views on whether this is the case in other CAMHS areas nationally; the advice his Department will give to consultant child psychiatrists operating in these circumstances that triage the children referred to them and must reject the less severe and waitlist the most severe of the non-urgent referrals; and if he will make a statement on the matter. [28375/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
43. Deputy Bernard J. Durkan asked the Minister for Health the categories of patients now on various waiting lists throughout the country; if the most common causes for the accumulation of such waiting lists has been identified with a view to specific intervention to deal with the issue within a reasonable time and in accordance with best international practice; and if he will make a statement on the matter. [28332/18]
View answerImproving waiting times for hospital procedures is a key commitment in the Programme for Government.
In recent years, public acute hospital inpatient / daycase activity has increased on a year-on-year basis. In 2016, there was a 2% increase in inpatient/day-case activity over 2015, with almost 1.69 million patients receiving treatment in public hospitals, an increase of almost 40,000 on the previous year.
Waiting list data from the past three years show that the highest waiting lists have been across the specialties of orthopaedics, ophthalmology and Otolaryngology (ENT).
The National Treatment Purchase Fund (NTPF) collects and collates information in respect of the Inpatient, Day Case, Planned Procedure (IDPP) and Outpatient (OP) Waiting Lists.
NTPF publishes monthly figures in the following categories:
- Patients waiting for an appointment date for their treatment are categorised as 'Active';
- Patients who have a scheduled appointment date for their treatment are categorised as 'TCI', or 'To Come In';
- Patients suspended because they are temporarily unfit or unable to attend due to clinical or personal/social reasons are categorised as 'Suspension'. The Suspension category is also used where patients are at the stage of being offered treatment through various Insourcing or Outsourcing Initiatives.
The recently launched Inpatient/Day Case Action Plan outlines the combined impact of HSE and NTPF activity in 2018 and includes a particular focus on those specialties with high waiting lists.
Under the Action Plan, the HSE will deliver 1.14 million elective inpatient and day case discharges and the NTPF will deliver 22,000 Inpatient Day Case treatments through both outsourcing and HSE insourcing. As part of this process the NTPF and the HSE are currently reviewing proposals from hospitals for waiting list initiatives. The NTPF will provide funding to the solutions proposed if appropriate.
The NTPF initiatives will include a number of high volume specialties and in particular 5,000 cataracts, 800 hip/knee replacements, 1,200 tonsillectomies. In addition, under the Plan, the NTPF commits to offer treatment to all clinically-suitable patients waiting more than 9 months for treatment in these high volume specialties.
Finally, my Department has placed a particular priority on performance improvement in scheduled and unscheduled care in order to improve access for patients. At the end of 2017, a new Unit was established in my Department with a remit to work with colleagues, with the HSE and NTPF to provide strategic direction and drive a whole of Department approach to performance oversight and innovation in this area. The monitoring of waiting lists is a key activity of this Unit.
44. Deputy Willie Penrose asked the Minister for Health his plans to provide a mobility allowance or similar supports to those in receipt of disability allowance and other related payments. [26563/18]
View answerThe Deputy will be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in February 2013.
Since the closure of the Mobility Allowance, the Government has directed that the Health Service Executive should continue to pay an equivalent monthly payment of up to €208.50 per month to the 4,046 people in receipt of the Mobility Allowance, on an interim basis, pending the establishment of a new Transport Support Scheme.
With regard to the Motorised Transport Grant, this scheme operated as a means-tested grant to assist person with severe disabilities with the purchase or adaptation of a car, where that car was essential to retain employment. The maximum Motorised Transport Grant, which was payable once in any three year period, was €5,020. Following the closure of the scheme in February 2013, no further Motorised Transport Grants have been payable.
The Government decided that the detailed preparatory work required for a new Transport Support Scheme and associated statutory provisions should be progressed by the Minister for Health. The Programme for a Partnership Government acknowledges the ongoing drafting of primary legislation for a new Transport Support Scheme, to assist those with a disability to meet their mobility costs. The Health (Transport Support) Bill is on the list of priority legislation for publication in the Spring / Summer session 2018.
My colleague, the Minister for Health and I recently brought a Memorandum to Government for proposals for a new Transport Support Payment Scheme. Following consideration of the matter, it was decided to withdraw the Memorandum from the Cabinet agenda on 8 May last. I intend to revert to Government with revised proposals to reflect the discussion at Cabinet, in due course.
While I cannot comment on the specific proposals under consideration, I can confirm that the proposals seek to ensure that:
- There is a firm statutory basis to the Scheme's operation;
- There is transparency and equity in the eligibility criteria attaching to the Scheme;
- Resources are targeted at those with the greatest needs; and
- The Scheme is capable of being costed and is affordable on its introduction and on an ongoing basis.
It is important to note that the Disabled Drivers and Disabled Passengers scheme, operated by the Revenue Commissioners, remains in place. This scheme provides VRT and VAT relief, an exemption from road tax and a fuel grant to drivers and passengers with a disability, who qualify under the relevant criteria set out in governing regulations made by the Minister for Finance. Specifically adapted vehicles driven by persons with a disability are also exempt from payment of tolls on national roads and toll bridges. Transport Infrastructure Ireland has responsibility for this particular scheme.
There are improvements in access to a range of transport support schemes available to persons with disabilities in the State and on-going work is being carried out by Government Departments, agencies and transport providers to further improve access to public transport services. Under the National Disability Inclusion Strategy, the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of public transport for people with a disability.
45. Deputy Marc MacSharry asked the Minister for Health the action that will be taken to reduce outpatient waiting times for neurology consultations in Sligo University Hospital in which 263 appointments are outstanding for more than 18 months. [28207/18]
View answerImproving waiting times for hospital procedures and outpatient appointments is a key commitment in the Programme for Government. While the Inpatient and Day Case (IPDC) Action Plan was published in April to address waiting times for IPDC procedures, the Outpatient waiting list remains a significant challenge to be addressed in 2018.
There are currently 650 patients on the neurology outpatient waiting list in Sligo, representing a decrease of 7% on figures for July 2017.
In order to address the issue of growing outpatient waiting list numbers, 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 their 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.
It is worth noting that in 2017 almost half a million (477,000) outpatients did not attend their appointment. Therefore, the validation of waiting lists is an important part of the Outpatient Action Plan and of the successful management of waiting lists and clinics. This month I approved the establishment of a Central Validation Office in the National Treatment Purchase Fund in order to centralise the validation of all waiting lists across the HSE. The NTPF envisages being in a position to commence validation of patient files from September of this year.
In relation to the specific measure being taken by Sligo University Hospital, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
46. Deputy Niamh Smyth asked the Minister for Health if urgent investment will be provided for hospital services in counties Cavan and Monaghan; and if he will make a statement on the matter. [28107/18]
View answer69. Deputy Niamh Smyth asked the Minister for Health his plans to invest in Cavan and Monaghan hospitals; and if he will make a statement on the matter. [28108/18]
View answerI propose to take Questions Nos. 46 and 69 together.
The planning and management of future health expenditure is considered as part of the annual estimates and budgetary process which seeks to balance available funding across all service areas to achieve the best possible outcomes for the greatest number of service users and prioritise areas of greatest need. The 2018 HSE National Service Plan outlines the HSE's need to continue to pursue increased efficiency, value for money and budgetary control in delivering safe and effective healthcare services within its budget allocation.
In response to the particular query raised, I have asked the Health Service Executive to respond to you as soon as possible outlining any specific investment plans at these two hospitals.
47. Deputy Eamon Scanlon asked the Minister for Health the reason CHO 1 was 61,000 home support hours behind target in the first quarter of 2018; and if he will make a statement on the matter. [28188/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
48. Deputy Martin Heydon asked the Minister for Health if he will address the delays being experienced in the delivery of home care packages in the CHO 7 areas in counties Kildare and Wicklow; and if he will make a statement on the matter. [28304/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
49. Deputy Stephen S. Donnelly asked the Minister for Health when a Sláintecare implementation plan will be published; and if he will make a statement on the matter. [28312/18]
View answerThe successful delivery of the ambitious reform plans envisaged in the Sláintecare report will be a significant undertaking and needs to be translated into a detailed and phased programme of work to be delivered over a ten year timeframe. In this regard, my Department is currently finalising an implementation plan in response to the Sláintecare report, with a focus on the initial three year period. It is my intention to bring proposals to Government before the summer recess and to publish the implementation plan shortly thereafter. While I accept that this is later than originally envisaged, it is important that we get it right.
I have already acted on several of the specific recommendations proposed in the Sláintecare report. A Sláintecare Programme Office is being established in the Department of Health and a provision of €1 million was made available for the Office in Budget 2018. This office will be tasked with implementing a programme of reform, as agreed by Government, arising from the Sláintecare Report. The process for the appointment of an Executive Director to lead the Sláintecare Programme Office has been managed independently by the Public Appointments Service. This has been a thorough process involving a national and international executive search. An appointment will be made shortly.
An independent board for the HSE is being established as recommended in the Sláintecare report. The General Scheme of a Bill has been published and it is hoped that legislation will be enacted this year.
The Sláintecare Report recommended the removal of private practice from public hospitals. I have established an Independent Review Group to examine how private practice can be removed from public hospitals. It will report later this year.
A public consultation on the geographical alignment of Hospital Groups and Community Healthcare Organisations has recently been completed and responses are being analysed. This will inform work on broader health service structural reform as recommended in the Sláintecare report.
Finally, the Government has demonstrated significant commitment to invest in our health and social care services since the publication of the Sláintecare report. Funding for new initiatives in Budget 2018 were closely aligned with proposals in Sláintecare. In addition, funding of €10.9 billion has been earmarked for health projects in the National Development Plan. This will include the development of primary care centres, community diagnostics, community care beds and additional acute hospital capacity, including three elective facilities.
This is the first time in the history of the State that cross-party consensus of this scale has been achieved on health policy and I welcome this. I intend to harness the consensus generated by the Report to move forward with a significant programme of health reform. The Government is committed to making tangible improvements in our health service and the Sláintecare Report provides the direction of travel for this.
50. Deputy Paul Murphy asked the Minister for Health when Parts 2 and 3 of the Children and Family Relationships Act 2015 will be commenced; the reason for the delay in their commencement; his plans to uphold the rights of those impacted; and if he will make a statement on the matter. [28151/18]
View answerThe Children and Family Relationships Act 2015 reforms and updates family law to address the needs of children living in diverse family types, the commencement of Parts 2 & 3 of the Act is the responsibility of the Minister for Health. During the preparation of regulations to facilitate the commencement of Parts 2 & 3 of the Act a number of technical drafting issues came to light that required amendments to the Act of 2015 through primary legislation.
The Minister for Health received Government approval on Tuesday 26 of June to draft an amendment Bill to remedy the defect in the Act of 2015. The commencement of parts 2 and 3 of the Children and Family Relationships Act 2015 will allow same-sex couples to apply to the courts for parentage rights. This will be a very welcome step for lots of families. I hope to be in a position to introduce this legislation into the Dáil as soon as possible and commence in the autumn.”
The registration of births is the responsibility of the Department of Employment Affairs and Social Protection.
