Michael McGrath
Question:214. Deputy Michael McGrath asked the Minister for Health the position regarding the provision of appropriate adult day services for persons (details supplied) in County Cork. [42844/18]
View answerServices for People with Disabilities
Questions (214)
Written 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 Appointments Status
Questions (215)
Michael Healy-Rae
Question:215. Deputy Michael Healy-Rae asked the Minister for Health the status of an operation for a person (details supplied); and if he will make a statement on the matter. [42845/18]
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.
Health Services Staff Recruitment
Questions (216)
Seán Fleming
Question:216. Deputy Sean Fleming asked the Minister for Health the number of persons who have been placed on a panel for the post of home help for CHO areas; the expected number to be recruited from this panel by county in 2019; the length of time this panel will remain in place; and if he will make a statement on the matter. [42854/18]
View answerWritten answers
As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Hospital Appointments Status
Questions (217)
Michael Healy-Rae
Question:217. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [42856/18]
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.
Primary Care Centres Provision
Questions (218)
Fergus O'Dowd
Question:218. Deputy Fergus O'Dowd asked the Minister for Health the position on the progression of the primary care centre for the east County Meath area; the reason for the delays; the expected date of completion; and if he will make a statement on the matter. [42988/18]
View answerWritten 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.
Services for People with Disabilities
Questions (219)
Michael McGrath
Question:219. Deputy Michael McGrath asked the Minister for Health if a person (details supplied) in County Cork is on a waiting list for a residential placement; the position of the person on the waiting list; if the allocation of respite care can be increased while a residential placement is awaited; and if he will make a statement on the matter. [42992/18]
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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
Health Reports
Questions (220, 221)
John Curran
Question:220. Deputy John Curran asked the Minister for Health if the Chief Medical Officer's report on transvaginal mesh implants has been finalised; if the report will be published and all its recommendations implemented in full; and if he will make a statement on the matter. [42994/18]
View answer
Brendan Griffin
Question:221. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied); and if he will make a statement on the matter. [42996/18]
View answerWritten answers
I propose to take Questions Nos. 220 and 221 together.
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 CMO's report, a number of significant system actions in relation to mesh implants have already been advanced on foot of priority recommendations which were identified in the course of preparation of that report.
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:
1. 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.
2. 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 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.
General Medical Services Scheme Data
Questions (222)
Stephen Donnelly
Question:222. Deputy Stephen S. Donnelly asked the Minister for Health the estimated full year cost of reversing the cuts to reduce fees payable to general practitioners introduced under the Financial Emergency Measures in the Public Interest Act 2009. [43010/18]
View answerWritten answers
Under the General Medical Services (GMS) contract, GPs are reimbursed for a range of services they provide to medical card and GP visit card holders. GPs are remunerated for these services primarily on a capitation basis, with a range of additional support payments and fees for specific items of service. GPs are also remunerated for services they provide on behalf of the HSE under other public health schemes, such as the Maternity and Infant Care Scheme, Primary Childhood Immunisation Scheme, etc.
The Financial Emergency Measures in the Public Interest (FEMPI) Act 2009 imposed a range of adjustments to health contractor payments. These included different levels of reductions to various GP fees and allowances and the elimination of certain payments, resulting in savings of approximately €120 million per annum.
Despite reductions to the payment rates of health contractors made under FEMPI legislation, the total fees paid to GPs under the GMS scheme have increased from just over €472 million in 2009 to approximately €525 million in 2017. This increase in fees is largely due to significant developments and investment in GP services introduced in recent years, with more services being made available to our citizens and additional financial support provided by the HSE.
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 recently re-engaged with the Irish Medical Organisation 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.
Medical Card Applications
Questions (223)
Bernard Durkan
Question:223. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in the determination of an application for a medical card in the case of a person (details supplied); and if he will make a statement on the matter. [43012/18]
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.