Kevin O'Keeffe
Question:417. Deputy Kevin O'Keeffe asked the Minister for Health the stage a project (details supplied) has reached. [42030/18]
View answerPrimary Care Centres Provision
Questions (417)
Written answers
As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
Addiction Treatment Services
Questions (418)
Joan Burton
Question:418. Deputy Joan Burton asked the Minister for Health if his attention has been drawn to the pre-budget submission by an organisation (details supplied) calling for four specific actions in respect of the expansion of addiction services to women with children seeking recovery; if his officials have examined these proposals; his plans in respect of these four actions; and if he will make a statement on the matter. [42034/18]
View answerWritten answers
The Department of Health does not directly fund the Organisation referred to in the Details Supplied by the Deputy. The organisation does however receive funding from the HSE and drug and alcohol task forces.
The Department has noted the contents of the pre-budget submission from the Organisation. The proposals in the submission fall under the remit of a number of government departments and agencies.
The progression of the health related proposals outlined in the submission can be considered by the HSE in the context of its deliberations on priorities for the 2019 National Service Plan.
Implementing the health-led national drugs strategy continues to be a Government priority. Within the increased envelope of resources available in the health budget, my intention is to prioritise funding for community drug and alcohol projects in task force areas of greatest need, additional drug and alcohol midwives working with vulnerable mothers-to-be and enhanced treatment services to address existing and emerging needs.
Disability Services Data
Questions (419)
Gerry Adams
Question:419. Deputy Gerry Adams asked the Minister for Health the number of additional staff needed to facilitate the policy of decongregation across County Louth; the number of additional staff recruited to date to facilitate this process; the number that will be recruited to complete the process; and if he will make a statement on the matter. [42037/18]
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.
The Department of Health is also responsible for the development of policy on, and oversight of, the provisions of specialist health and personal social services for people with disability, including the reform programme for health funded specialist disability services.
Transforming Lives is the programme to implement the recommendations of the Value for Money and Policy Review of Disability Services. The Review is a multi-year project which is resulting in very significant changes to the way in which services and supports for people with disabilities are delivered in moving away from institutional models of care and service delivery to community based, person centred, models of service. The implementation of the recommendations in the VFM Review continues to be a priority in the HSE’s National Service Plan for 2018.
The Report “Time to Move on from Congregated Settings – A Strategy for Community Inclusion” proposes a new model of support in the community moving people from Congregated settings to the community in line with Government policy.
The Programme for Partnership Government contains a commitment to continue to move people with disabilities out of congregated settings, to enable them to live independently and to be included in the community. The objective is to reduce this figure by one-third by 2021 and ultimately, to eliminate all congregated settings.
At the end of December 2017, there were less than 2,400 people with a disability living in congregated settings. The HSE has prioritised the transition of 170 people from congregated settings in 2018 under its Service Plan. The HSE has established a subgroup, under the Value for Money Steering Group, which is developing an implementation plan for moving people from institutions that will be rolled out at a regional and local level, in full consultation with residents and their families.
To ensure that the needs of people transitioning from congregated settings are fully taken into account during the process, the model of care for individuals will be based on a person centred plan (PCP). The PCP may change over time in line with an individual’s needs and circumstances and the model of service delivery applicable at a particular time.
As the HSE is responsible for leading out on the recommendations on "Time to Move on from Congregated Settings - A Strategy for Community Inclusion", I have arranged for the specific issues raised in the Deputy's question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
Services for People with Disabilities
Questions (420)
Gerry Adams
Question:420. Deputy Gerry Adams asked the Minister for Health the services offered at community hubs for persons with disabilities; and the regulatory framework for these hubs. [42038/18]
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.
Domestic Violence
Questions (421)
Gerry Adams
Question:421. Deputy Gerry Adams asked the Minister for Health if those receiving therapy for sexual abuse receive information regarding their vulnerability to domestic abuse in view of the links between sexual abuse and domestic abuse. [42039/18]
View answerWritten answers
I understand that the funding of therapeutic services to victims of sexual violence is primarily a matter for Tusla. I am advised that in 2018, the Tusla national provision for frontline Domestic, Sexual and Gender-based Violence services was €23.8 million.
The Department of Children and Youth Affairs, may be in a position to advise further. The Department of Health has no remit in the area.
Domestic Violence
Questions (422)
Gerry Adams
Question:422. Deputy Gerry Adams asked the Minister for Health if there is a domestic abuse team operating at Our Lady of Lourdes Hospital, Drogheda. [42040/18]
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.
Estimates Process
Questions (423, 441, 443, 459)
Róisín Shortall
Question:423. Deputy Róisín Shortall asked the Minister for Health the reason for the large increase in funding under section H of the health Estimates for 2019 from €96 million in 2018 to €491 million in 2019; and if he will make a statement on the matter. [42056/18]
View answerRóisín Shortall
Question:441. Deputy Róisín Shortall asked the Minister for Health further to the budget 2019 announcement that €20 million extra would be provided for the National Treatment Purchase Fund in 2019, the reason only €10 million extra is provided in the health Estimates published; and the way in which it is proposed to make up the shortfall. [42163/18]
View answerRóisín Shortall
Question:443. Deputy Róisín Shortall asked the Minister for Health the reason for the 58% rise in funding in 2019 for developmental, consultative, supervisory, regulatory and advisory bodies. [42166/18]
View answerRóisín Shortall
Question:459. Deputy Róisín Shortall asked the Minister for Health the current estimate of the outturn in health spending in 2018. [42264/18]
View answerWritten answers
I propose to take Questions Nos. 423, 441, 443 and 459 together.
Up to 2018 the H subhead reflected funding for statutory pension lump payments only. All other pension funding was held in the Health Service Executive subheads I1 to I5. To improve transparency and the linkage between the Health Vote subheads and the Health Service Executives National Service Plan in 2019 subhead H was amended to reflect all HSE pension funding including lump sums. From 2019 this subhead will now reflect the full pension costs as set out in the National Service Plan for 2019.
A data entry error occurred which resulted in €10m of NTPF funding being included in error in the subhead E1, instead of E3. The NTPF allocation for 2019 is €75m. The full allocation to the NTPF is now reflected in the published Expenditure Report 2019 available on www.budget.gov.ie and will be reflected in the Revised Estimates for Public Services 2019 published before year end.
The provision for E.1 in 2019 is €99.131m an increase of €30.013m (43%) over 2018. This increase is primarily the additional funding for the Sláintecare Integration Fund as announced in the budget. The remainder will be used for essential health care projects as required during 2019.
The Department of Health is engaging closely with the HSE, but it is too early yet to be definitive in terms of the final outturn for the health services at year end 2018.
Home Help Service
Questions (424)
Darragh O'Brien
Question:424. Deputy Darragh O'Brien asked the Minister for Health when the gratuity payment due to certain home help workers will be made in lieu of pension payments; and if he will make a statement on the matter. [42058/18]
View answerWritten answers
The Deputy is referring to Home Help workers who are employed by voluntary providers of home help services which are funded under section 39 of the Health Act 2004.
I advised the Deputy previously that as these home help workers are not employed by the HSE, the HSE and the Department have no role in determining the salaries or other terms and conditions applying to these staff including any pension arrangements.
In addition, the Deputy is aware that a joint working group was established, as agreed as part of the 2015 Lansdowne Road talks, to consider a number of issues in relation to section 39 organisations. Unfortunately it was not possible to reach an agreement between the parties on the issue of gratuity payments.
Diabetes Strategy
Questions (425)
Mary Butler
Question:425. Deputy Mary Butler asked the Minister for Health the supports and services available to patients with type 1 and type 2 diabetes at University Hospital Waterford, for example, nurses, dieticians, training, workshops and counsellor support; and if he will make a statement on the matter. [42059/18]
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 Charges
Questions (426)
Seán Haughey
Question:426. Deputy Seán Haughey asked the Minister for Health if he will abolish inpatient charges for cancer patients; and if he will make a statement on the matter. [42060/18]
View answerWritten answers
The Health Act 1970 (as amended) provides that all persons ordinarily resident in the country are eligible, subject to certain charges, to public in-patient hospital services. The current public hospital statutory in-patient charge is €80 per night, subject to a maximum of €800 in any period of twelve consecutive months. All persons accessing public in-patient services in a public hospital are liable for the statutory public in-patient charge, subject to a number of exemptions, including where a person is a medical cardholder. There are no currently no plans to exempt further categories of patients from the public in-patient charge.
Hospital charges represent a nominal yet important contribution towards the cost of providing hospital services. Any curtailment of this funding stream would put further pressure on the Exchequer and the taxpayer in order to maintain service levels.
Services for People with Disabilities
Questions (427)
John Lahart
Question:427. Deputy John Lahart asked the Minister for Health the status of an application by a person (details supplied) who is entering adult services; and if he will make a statement on the matter. [42067/18]
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.
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.
Hospital Procedures
Questions (428)
Seán Haughey
Question:428. Deputy Seán Haughey asked the Minister for Health the details of the synthetic mesh devices advisory group established by the HSE; if all women affected can input into this forum; and if he will make a statement on the matter. [42068/18]
View answerWritten answers
As Minister for Health I am committed to putting in place the measures necessary to ensure that both the current use of Transvaginal mesh implants (TVMIs) in surgical procedures in Ireland, and the ongoing clinical management of women who have had these procedures in the past are in line with international best practice and emerging evidence. At my request, the Chief Medical Officer (CMO) is preparing a report which will make recommendations in relation to the clinical and technical issues involved. I am informed that the CMO’s Report is anticipated to be completed in the coming weeks.
Pending finalisation of the report, a number of significant system actions in relation to mesh implants have already been advanced.
The CMO wrote to the Acting Director General of the Health Service Executive on 20 July 2018 to request that the Executive put immediate measures in place to:
- Pause the use of all procedures involving uro-gynaecological/transvaginal mesh implants for the management of Stress Urinary Incontinence (SUI) or Pelvic Organ Prolapse POP) in HSE funded hospitals, in cases where it is clinically appropriate and safe to do so.
- Ensure that in situations where expert clinical judgment is that there is an urgency to carry out the procedure and no suitable alternative exists, surgery should proceed only if a delay would risk harm to the patient and should be based on multidisciplinary team decision and fully informed consent.
This pause is to remain in place pending confirmation of implementation by the Health Service Executive, working in conjunction with the Institute of Obstetricians and Gynaecologists (IOG) and the Royal College of Surgeons in Ireland (RCSI), of three urgent recommendations relating to:
(i) Surgical Training,
(ii) Informed Consent and
(iii) the Development of an agreed Dataset of Mesh Procedures.
The Department also wrote to the Institute of Obstetricians and Gynaecologists, the Royal College of Surgeons in Ireland and the Continence Foundation of Ireland on requesting that they assist the HSE in progressing these recommendations on an urgent basis.
It is anticipated that the Executive will be in a position to indicate to the Department that these recommendations have been implemented within a number of months. The HSE has published information concerning the pause on its website for patients affected.
The provision of appropriate aftercare for women suffering from mesh complications, including appropriate diagnostic facilities, has also been identified as a priority recommendation for immediate advancement by the Executive in the course of preparation of the CMO’s report. The CMO wrote to the Acting Director General of the HSE, and to the Institute of Obstetricians and Gynaecologists (IOG), the Royal College of Surgeons in Ireland (RCSI), and the Continence Foundation of Ireland (CFI) on May 28 2018, requesting that the Executive commence work on (i) the development of appropriate patient information resources and consent materials and (ii) clarification and development of treatment pathways and appropriate referral services for women suffering from mesh-related complications, in conjunction with the IOG, the RCSI and the CFI.
The HSE has confirmed that work has commenced by the National Women and Infants Health Programme (NWIHP) in the HSE to progress all the recommendations above. A Learning Notice concerning mesh devices in uro-gynaecological procedures was circulated by the NWIHP on 26 June 2018 to all maternity hospitals and acute hospitals with gynaecological services to highlight the importance of appropriate patient selection, adequate information and consent and also to inform the service providers that a Response Group has been convened to propose remedies for and address the provision of aftercare for complications. This learning notice has been posted on the NWIHP website.
The HSE has informed the Department of Health that a Synthetic Mesh Devices Advisory Group has been convened by the NWIHP which includes three patient representatives, as well as representatives of the HPRA, the IOG, the RCSI, the CFI and all Hospital Groups to advise on and action all of the recommendations above.
The HSE has advised that it is unable to facilitate membership on the Advisory Group to every patient or patient group who has a mesh experience. The NWIHP has sought to have a range of mesh experiences from the patient’s perspective represented by a patient advocate on the Group – including patients who have had mesh with post-operative problems, patients who have had successful mesh surgery and patients who are on the waiting list for a mesh procedure. The HSE advises that women who wish to submit views or submissions to the overall work of the Group should contact the National Women & Infants Health Programme at smi.nwihp@hse.ie.
The HSE advice is that all patients who have experienced complications due to mesh devices are advised to contact their consultant’s clinic in the first instance. Each hospital group has nominated an individual to coordinate a response to this group of patients. If patients are having trouble accessing information they can contact the National Women & Infants Health Programme at smi.nwihp@hse.ie.for help.
Hospital Waiting Lists
Questions (429)
Niamh Smyth
Question:429. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) has been waiting nearly three years for an appointment at Beaumont Hospital. [42078/18]
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.
General Practitioner Contracts
Questions (430)
Stephen Donnelly
Question:430. Deputy Stephen S. Donnelly asked the Minister for Health the details of the significant multi-annual investment in general practice which he announced in budget 2019; the specific funding to be provided in 2018 to general practitioners; and if he will make a statement on the matter. [42079/18]
View answerWritten answers
The Government is committed to engaging with the representatives of general practitioners on the development of a package of measures and reforms to modernise the 1989 GMS Contract.
Our goal is to develop a contractual framework that has a population health focus, providing in particular for health promotion, disease prevention and for the structured care of chronic conditions. This will enable general practitioners to better meet the needs of patients and will also promote general practice as a viable and rewarding career for both existing doctors and future medical graduates.
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 the Department of Health and the HSE recently re-engaged with the IMO and 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 Deputy will understand that it would not be appropriate at this stage of the process to discuss the proposed package of reform which has not yet been agreed.
Health Services Funding
Questions (431)
Stephen Donnelly
Question:431. Deputy Stephen S. Donnelly asked the Minister for Health the details of the additional funding for winter pressures in 2018-19 and new beds in 2019-20 which he announced in budget 2019; the specific funding to be provided for winter pressures; the additional services that will be provided with this funding; the number of new beds that will be provided in 2019-20; and if he will make a statement on the matter. [42080/18]
View answerWritten answers
My Department is working closely with the HSE to ensure that local and regional winter plans at hospital and local level are consolidated and supported through policies and plans at national level to ensure the most effective response to the winter challenges to unscheduled care provision.
As part of Budget 2019, an additional €10m in funding is being provided in 2018 to prepare for and manage the expected peak in demand for health services in the winter ahead. This funding will focus on initiatives to enable the hospital system to de-escalate before Christmas, with a focus on supporting patients in the over 75 age group. I have asked my Department to engage with the HSE in relation to the programming of this funding and have emphasised the need for increased provision of social care measures, particularly in the first quarter of 2019, to respond to the likely surge in demand for services after the Christmas period.
Improving access to health services is a key priority in 2019. In the first quarter of 2019, in the region of 80 additional beds will be brought on stream, including an additional 30-bed ward in Our Lady of Lourdes Drogheda, a 40-bed modular ward block in South Tipperary General Hospital, and four high dependency beds in the Mater and Cork University Hospital respectively. In addition, the new ED planned for Our Lady of Lourdes Drogheda is due to open early in 2019.
A further €10 million in capital funding is being made available in 2019 to enable additional acute beds to be opened for Winter 2019/2020. This is the first step in the process of implementing the Capacity Plan which identifies over 600 acute beds to be phased in by the end of 2020. My Department is currently engaging with the HSE to finalise the details of this investment.
Mental Health Policy
Questions (432)
Gerry Adams
Question:432. Deputy Gerry Adams asked the Minister for Health further to Parliamentary Question No. 420 of 18 September 2018, the timeline for the production of the first draft of the model of care for dual diagnosis by a person (details supplied); if the inclusion of County Louth as a pilot site on completion of this draft will be considered; and if he will make a statement on the matter. [42098/18]
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.
National Treatment Purchase Fund
Questions (433)
Marcella Corcoran Kennedy
Question:433. Deputy Marcella Corcoran Kennedy asked the Minister for Health the reason the National Treatment Purchase Fund does not operate in Beaumont Hospital; if his attention has been drawn to the fact that a person (details supplied) is on the waiting list for surgery for over 18 months; the position of the person on the list; and if he will make a statement on the matter. [42099/18]
View answerWritten answers
Improving waiting times for hospital procedures is a key commitment in the Programme for Government. In Budget 2019 the Government has further increased investment in this area, with funding to the NTPF to increase from €55m in 2018 to €75m in 2019.
The Inpatient/Day Case Action Plan 2018 outlines the combined impact of HSE and NTPF activity to reduce the number of patients waiting for treatment. The Action Plan has been developed to ensure an appropriate balance between high volume activities and offering treatment to complex long waiting patients. Under the Plan, the NTPF, working closely with the HSE, has invited all hospital groups to develop proposals to maximise the use of existing facilities and capacity.
The NTPF advises it has received a variety of proposals from across all hospital groups, including the RCSI group. 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 being 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.
In relation to the status of the appointment for specific patient outlined by the Deputy, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
Mental Health Services Data
Questions (434)
James Browne
Question:434. Deputy James Browne asked the Minister for Health the HSE spend on mental health agency staff to date in 2018; and if he will make a statement on the matter. [42121/18]
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.