Written Answers Nos. 445-460
445. Deputy Róisín Shortall asked the Minister for Health the position regarding the new national forensic mental health services hospital, Portrane, County Dublin; the target completion date for the new facility; if the building works remain on schedule; and if he will make a statement on the matter. [32020/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
446. Deputy Róisín Shortall asked the Minister for Health the number of approved hospital consultant posts by specialty and hospital group; and the basis on which these posts are allocated [32021/18]
View answerI have asked the HSE to respond to the Deputy directly on this matter.
447. Deputy Róisín Shortall asked the Minister for Health the number of hospital consultant posts which are vacant by specialty and hospital group [32022/18]
View answerI have asked the HSE to respond to the Deputy directly on this matter.
448. Deputy Róisín Shortall asked the Minister for Health if he will report on the adequacy of the hospital consultant training schemes; the body responsible for the design and operation of these schemes; and if he will make a statement on the matter. [32023/18]
View answerIn accordance with the requirements in the Medical Practitioners Act 2007 (MPA) the Medical Council regulates the practice of medicine and protects the public by ensuring high standards of medical practice. I am satisfied that the Medical Council carries out its role effectively in this regard.
As part of this role, the Medical Council sets standards for undergraduate and postgraduate education and training and monitors compliance with those standards. Its remit includes responsibility for determining, with the consent of the Minister for Health, the medical specialties that it recognises under the MPA.
The Council works with my Department, the HSE and other relevant stakeholders with the aim of ensuring that the number and types of specialties recognised in Ireland address population health needs by identifying best practice recommendations for specialty recognition, incorporating best practice in the area, and reflecting the Medical Council's priorities in the areas of education, training and lifelong learning.
There are over forty programmes of specialist training in Ireland in which a medical practitioner may choose to specialise. These programmes are delivered by thirteen training bodies. They are: the College of Anaesthetists of Ireland, College of Psychiatrists of Ireland, Faculty of Occupational Medicine, Faculty of Paediatrics, Faculty of Pathology, Faculty of Public Health Medicine, Faculty of Radiologists, Faculty of Sports and Exercise Medicine, Institute of Obstetricians and Gynaecologists, Irish College of General Practitioners, Irish College of Ophthalmologists, Irish Committee for Higher Medical Training and the Royal College of Surgeons in Ireland.
All postgraduate training bodies must meet Medical Council postgraduate accreditation standards and criteria.
449. Deputy Róisín Shortall asked the Minister for Health the policy in respect of type A full-time public service hospital consultants whereby salary for new recruits is €134.272 compared to €211,000 for pre-2012 staff; his views on whether this is a significant factor in the difficulties in recruitment; and the steps he will take to address this matter [32024/18]
View answerThe Labour Relations Commission Agreement of 7th January 2015 substantially reversed the reductions made in the pay of new entrant consultants in September 2012. Pursuant to the Agreement, as set out in the 'Consolidated Salary Scales' applicable from 1st April, 2018, the maximum of a 9-point scale for new entrants recruited from 1 October 2012 is €185,884 compared with the maximum of a 6-point scale for those recruited prior to 1 October 2012 of €189,783. While the first point of the scales is set at €134,271, the scales include provision for incremental credit being granted up to the 6th point, having regard to experience and/or qualifications.
Arising from the recent settlement of legal proceedings by consultants in relation to pay increases provided for in the 2008 Consultants Contract, the maximum point of the scales for Type A consultants recruited prior to 1 October 2012 increases to €211,109. That increase is confined to consultants recruited prior to 1 October 2012.
Pay of consultants is one of a range of factors that impact on recruitment. However, the pay of consultants cannot be considered in isolation from other public servants. A number of processes are currently in train that encompass consultants pay:
- the Public Service Stability Agreement (PSSA) provided a statutory roadmap for the unwinding of FEMPI. This includes a series of salary increases that will see public servants, including consultants, receiving on average a 7% increase over the lifetime of the agreement.
- the Public Service Pay Commission is to report this month on certain health sector grades, including consultants, where recruitment and retention issues have been identified, and
- new entrant pay across the whole public service is being reviewed through a process which is being led by the Department of Public Expenditure and Reform.
Separate to pay considerations, the HSE has been focused on addressing issues associated with the creation and approval of consultant posts and successful recruitment. It is now giving effect to the report 'Towards Successful Consultant Recruitment, Appointment and Retention', completed in December 2016. It is also focused on implementing the recommendations of the 'MacCraith Group' to support the recruitment and retention of consultants and NCHDs.
Notwithstanding recruitment and retention challenges, the number of consultants has increased by 113 in the 12 months to end May 2018 to 2,997 (whole time equivalents); and by 479 in the past five years.
450. Deputy Róisín Shortall asked the Minister for Health the steps he is taking to address the urgent problem of the shortage of general practitioners; and if he will make a statement on the matter. [32025/18]
View answerThe Government is aware of workforce issues facing general practice, including the influence of demographic factors, and has implemented a number of measures to improve recruitment and retention in general practice.
GPs play a crucial role in the provision of primary care services. The number of GPs on the specialist register continues to increase – up from 2,270 in 2010 to 3,668 in 2018 - and the number of GPs with a GMS contract has also risen, from 2,098 in 2008 to 2,494 as at 1 July 2018.
GP training places have been increased from 120 in 2009 to 194 in 2018 and the Government's objective is to continue to achieve annual increases in the number of training places available while ensuring that all of the places are filled.
Entry provisions to the GMS scheme have been changed to accommodate more flexible GMS contracts and the retirement age has been extended to 72. An enhanced support package for rural practices has been introduced with improved qualifying criteria and an increased financial allowance of €20,000 per annum.
The Government is committed to engaging with GP representatives on necessary service improvements and reforms to the current GMS contract.
My Department and the HSE met with the Irish Medical Organisation at the beginning of May to set out the State's position concerning the GMS contract and subsequently wrote to the Organisation setting out these proposals formally and its response is awaited.
451. Deputy Róisín Shortall asked the Minister for Health the reason for the delay in negotiating a new general practitioner contract; and the timeline for completion of this process [32026/18]
View answerReform of the GMS contract will enable GPs to better meet the needs of their patients while promoting general practice as a viable and rewarding career for both existing doctors and future medical graduates. Agreement on the delivery of service improvements and contractual reform has the potential to facilitate a substantial increase in the resourcing of general practice on a multiannual basis.
Officials from my Department and the HSE met with the Irish Medical Organisation at the beginning of May to set out the State's position in relation to reform of the GMS contract. The Department subsequently wrote to the IMO setting out these proposals formally. While officials remain available for further discussion, the Organisation has yet to respond.
In line with the long-established approach to such processes, and by agreement of the parties concerned, I am not in a position to give further details at this stage.
452. Deputy Róisín Shortall asked the Minister for Health the reason he has missed the promised deadlines for the publication of his response to Sláintecare; and when he now plans to do so [32027/18]
View answer488. Deputy Brendan Smith asked the Minister for Health when he plans to publish a Sláintecare implementation plan; and if he will make a statement on the matter. [32262/18]
View answerI propose to take Questions Nos. 452 and 488 together.
I have supported the work of the All-Party Committee on the Future of Healthcare from its establishment and welcomed the publication of the Sláintecare report
The 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 a proposal for Government on the Sláintecare report, with a focus on the initial three-year period. It is my intention to bring this to Government very shortly and, subject to Government approval, to publish thereafter.
453. Deputy Róisín Shortall asked the Minister for Health the number of vacant nursing posts; and his plans to address the matter [32028/18]
View answerThe Government and the HSE remain committed to recruiting and retaining nurses and midwives in the public health service. As part of the Nursing Recruitment and Retention Agreement with the INMO and SIPTU, the HSE agreed to appoint 1,224 additional nurses and midwives in 2017.
The HSE has submitted the final report setting out progress on implementation of the Agreement as at end December 2017. The report shows that there has been significant growth in the appointment of nurses and midwives in the final months of the year with 942 WTE of the 1,224 posts filled (including student nurses) or 69% (847 WTE) excluding the student nurses. The HSE remain committed to the Agreement and efforts will continue to fill the remaining posts.
The measures put in place by the HSE to recruit nurses and midwives included two international recruitment campaigns in 2017, the "Bring Them Home" campaign and the "New Year New Career" campaign. Nurses who relocate to work in the Irish public health service can receive up to €3,000 in relocation expenses. The HSE is also in the process of offering all 2018 graduate nurses and midwives permanent posts within a Hospital Group or CHO subject to them attaining registration and satisfactory performance.
Retention measures undertaken by the HSE include a pre-retirement initiative, career breaks and education and training opportunities. In 2017, an additional 130 nursing undergraduate places were made available in the nursing degree programme to increase the supply of nurses. Also 120 Advanced Nurse Practitioner education places were made available.
The Public Service Pay Commission has already recognised that nurses and midwives are one of the grades which have recruitment and retention difficulties. Their second phase of work is underway, with nurses and midwifery grades being one of the first groups to be looked at. I expect their report in June and look forward to hearing what recommendations they will make.
In terms of the number of vacant nursing posts, I have asked the HSE to reply directly to the Deputy on that matter.
454. Deputy Róisín Shortall asked the Minister for Health the basis on which allied health professional posts are allocated; and if he will make a statement on the matter. [32029/18]
View answerI have asked the HSE to respond to the Deputy directly on this matter.
455. Deputy Róisín Shortall asked the Minister for Health the reason his Department is drawing up an implementation plan for Sláintecare when the Oireachtas Select Committee on the Future of Healthcare recommended that the new lead executive for the implementation office should be charged with this responsibility; and if he will make a statement on the matter. [32030/18]
View answerI intend to announce the appointment of the Sláintecare Lead Executive today.
I am conscious of the Committee's recommendations and of the importance of the Office having a significant input into the reform programme. As I have said publicly before, it is not my intention that this plan will be a static document and I am confident that the Programme Office will play a leading role in designing and implementing the programme in the years to come.
The 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 has been progressing work on this in advance of the full establishment of a Sláintecare Programme Office to provide certainty on the overall vision and priority actions that will be taken in the coming years and to ensure momentum is maintained behind the reform programme. For that reason, its development was progressed alongside the recruitment of the Executive Director.
456. Deputy Róisín Shortall asked the Minister for Health if he will report on the recruitment of a lead executive for the Sláintecare implementation office; if the recruitment process is now complete; if the post has been offered to a person; and when he will announce this appointment [32031/18]
View answerThe recruitment process for an Executive Director for the Sláintecare Programme Office has been completed following a competitive process run independently by the Public Appointments Service. I expect to announce this appointment today.
457. Deputy Róisín Shortall asked the Minister for Health if he will report on progress on the promise to recruit salaried general practitioners; and if he will make a statement on the matter. [32032/18]
View answerThe Programme for Government commits to mandating the HSE to employ GPs on a salaried basis where needed, and put in place support structures and staff.
During talks with GP representatives in 2017 the issue of greater flexibility in relation to the type of GP contracts available was raised, and this remains an issue the Government wishes to progress in the context of the need to retain GPs.
Any proposed model involving salaried GP positions would require careful consideration to ensure the required level of service could be provided for medical card and GP visit card patients.
458. Deputy Róisín Shortall asked the Minister for Health when he plans to reverse the FEMPI cuts for general practitioners; and if he will make a statement on the matter. [32033/18]
View answerI acknowledge the contribution made by health contractors, including General Practitioners, through reductions in their fees to addressing the unprecedented economic crisis faced by the State.
The Public Service Pay and Pensions Act 2017 now allows the setting and varying of contractor payments on a non-emergency statutory basis. It is my intention to put in place a new multiannual approach to fees in return for service improvements and contractual reforms based upon health policy considerations and engagement with representative bodies.
Officials from my Department and the HSE met with the Irish Medical Organisation at the beginning of May to set out the State's position in relation to reform of the GMS contract. Agreement on the delivery of service improvements and contractual reform has the potential to facilitate a substantial increase in the resourcing of general practice on a multiannual basis.
The Department subsequently wrote to the IMO setting out these proposals formally. While officials remain available for further discussion, the Organisation has yet to respond.
In line with the long established approach to such processes, and by agreement of the parties concerned, I am not in a position to give further details while discussions between the parties are underway.
459. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to the fact that there are 6,000 persons waiting for home help and home care services; and his plans to ensure that funding is released immediately to address this problem [32034/18]
View answerHome support services were a particular focus in Budget 2018, with an additional €18.25m allocated. The total budget for home support services is now €408m. The HSE has operational responsibility for planning, managing and delivering home and other community-based services for older people. Services are provided on the basis of assessed healthcare need. The HSE 2018 National Service Plan provides for over 17 million home support hours to be delivered to 50,500 people at any time. A further 156,000 hours, relating to adverse weather funding, will be provided this year. Intensive Home Care Packages for people with more complex needs are being provided to approximately 235 people at any time, delivering approximately 360,000 hours in the full year.
The HSE, working within its available resources, has sought to maintain and where possible to expand the range and volume of services available to support people to remain in their own homes, to prevent early admission to long-term residential care and to support people to return home following an acute hospital admission.
Despite this significant level of service provision, the demand for home support continues to grow. There is considerable demand for home support services over and above existing service levels. The Programme for Partnership Government includes commitments to increase funding for home support services and an additional funding of €112 million has been provided for home support services over the past three years.
460. Deputy Róisín Shortall asked the Minister for Health the reason the Scally Inquiry has not yet been given access to the laboratory data in respect of the accuracy rates of smear testing; the steps he will to address this matter; and if he will make a statement on the matter. [32035/18]
View answerI have made it clear from the outset that the HSE must do everything it can to support the inquiry underway by Dr Scally who has been appointed by Government. Dr Scally has confirmed to me that he is happy that the HSE is providing him with access to the information, which is welcome, and I am available to him at any time should issues arise.
