Barry Cowen
Question:398. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment. [43407/18]
View answerHospital Appointments Status
Questions (398)
Written 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.
Disability Services Funding
Questions (399)
John Brassil
Question:399. Deputy John Brassil asked the Minister for Health his plans to provide funding to an organisation (details supplied); and if he will make a statement on the matter. [43408/18]
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 a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
HSE Staff Data
Questions (400)
Mattie McGrath
Question:400. Deputy Mattie McGrath asked the Minister for Health further to Parliamentary Question No. 822 of 12 June 2018, the number of midwives listed in the response that are student midwives and fully qualified midwives, respectively; if the numbers provided include student midwives; the number of midwives listed that are student midwives; the level of training of the student midwives; the number of the vacancies listed that have been filled; the number of vacancies remaining; and if he will make a statement on the matter. [43413/18]
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.
Hospital Consultant Recruitment
Questions (401)
Michael Moynihan
Question:401. Deputy Michael Moynihan asked the Minister for Health if a full-time consultant in pain medicine will be appointed in the South Infirmary Victoria University Hospital, Cork; if his attention has been drawn to the fact that the HSE has not replaced a consultant post in pain medicine in the hospital since a consultant retired in 2015; if his attention has been further drawn to the waiting lists in this department and the cancellation of outpatient and procedure lists for September, October and November 2018; and if he will make a statement on the matter. [43429/18]
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.
Hospital Facilities
Questions (402)
Eamon Scanlon
Question:402. Deputy Eamon Scanlon asked the Minister for Health the status of the provision of a catheterisation laboratory at Sligo University Hospital; if his attention has been drawn to the fact that the HSE has spent more than eight times the cost of a new catheterisation lab sending patients to other hospitals and facilities; and if he will make a statement on the matter. [43445/18]
View answerWritten answers
The National Review of Specialist Cardiac Services is ongoing and it is expected that the work will be completed by the end of June 2019.
The aim of the Review is to achieve the 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.
Clinical Indemnity Scheme
Questions (403)
Seán Fleming
Question:403. Deputy Sean Fleming asked the Minister for Health his plans to re-examine the conditions by which consultants can prescribe medicinal cannabis for persons with Dravet syndrome in such a way as to not make them personally liable for their entire treatment thereafter which understandably makes them reluctant to prescribe medicinal cannabis in these situations; and if he will make a statement on the matter. [43446/18]
View answerWritten answers
I have not received any reports from hospital consultants regarding insurance companies refusing to provide cover for neurological paediatricians prescribing medicinal cannabis.
Irish-based medical practitioners who wish to prescribe cannabis products containing THC may apply to the Minister for Health for a licence under the Misuse of Drugs Acts.
The Chief Medical Officer has advised that the granting of such a licence must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time.
Under existing arrangements consultants in public hospitals are covered by the Clinical Indemnity Scheme (CIS) in respect of the prescription of THC-based medicines for a patient under their care provided that the consultant is permitted to do so under a licence granted by the Minister for Health under the Misuse of Drugs Acts and where he/she has exhausted all other treatment options for that patient.
In relation to private consultants the CIS covers the excess over the indemnity ceilings (or Caps) set by the State for private indemnifiers of consultants working in private practice settings. Effectively, the private indemnifier’s liability in respect of any claim is capped at the relevant indemnity ceiling and the State assumes responsibility for any amount in excess of the cap. Consultants in private hospitals should check with their Medical Defence Organisations to establish that such organisations will cover them up to the Caps limit in cases where they are considering prescribing THC-based medicines for a patient, under licence from the Minister and where he/she has exhausted all other treatment options for that patient.
Treatment Abroad Scheme
Questions (404)
Seán Fleming
Question:404. Deputy Sean Fleming asked the Minister for Health the position regarding providing medical treatment for a person (details supplied); and if he will make a statement on the matter. [43447/18]
View answerWritten answers
The HSE operates the Treatment Abroad Scheme (TAS) for patients entitled to treatment in another EU/EEA Member State under EU Regulation 883/2004, where the treatment is not available in the Irish public hospital system.
The treatment must be a treatment which the patient could legally avail of in the public healthcare system in Ireland if the treatment were available in Ireland.
GPs refer patients to consultants for acute care and it is the treating consultant who, having exhausted all treatment options including tertiary care within the country, refers the patient abroad under the terms of the TAS. The consultant must specify the specific treatment and in making the referral accepts clinical responsibility in relation to the physician and facility abroad where the patient will attend.
Applications to the TAS are processed and a determination given in accordance with the statutory framework prior to a patient travelling to avail of treatment. The statutory framework stipulates the patient must be a public patient and is required to have followed public patient pathways.
Information on the TAS can be accessed on the HSE treatment abroad website and also by phone at 056 7784551.
Hospital Waiting Lists
Questions (405)
Robert Troy
Question:405. Deputy Robert Troy asked the Minister for Health if an appointment for a person (details supplied) will be expedited; and if he will make a statement on the matter. [43464/18]
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.
Home Care Packages Provision
Questions (406)
Frank O'Rourke
Question:406. Deputy Frank O'Rourke asked the Minister for Health when a homecare package will be approved for a person (details supplied) in view of the fact that an application for an increase in homecare hours has been made on medical grounds; and if he will make a statement on the matter. [43477/18]
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 (407)
Robert Troy
Question:407. Deputy Robert Troy asked the Minister for Health if an appointment for an MRI scan for a person (details supplied) will be expedited; and if he will make a statement on the matter. [43478/18]
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 (408, 447)
Pat the Cope Gallagher
Question:408. Deputy Pat The Cope Gallagher asked the Minister for Health the progress made on the PPP for Donegal town health centre; the further progress made since the confirmation of the intention to proceed with a PPP in March 2018; the timeframe for the complete delivery of this project; and if he will make a statement on the matter. [43483/18]
View answerPat the Cope Gallagher
Question:447. Deputy Pat The Cope Gallagher asked the Minister for Health the progress made on the PPP for the Dunfanaghy health centre; the exact progress made since the confirmation of the intention to proceed with a PPP in March 2018; the timeframe for the complete delivery of this project moving forward; if a contract has been signed for the new building; and if he will make a statement on the matter. [43688/18]
View answerWritten answers
I propose to take Questions Nos. 408 and 447 together.
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.
National Treatment Purchase Fund Eligibility
Questions (409)
Seán Fleming
Question:409. Deputy Sean Fleming asked the Minister for Health when the National Treatment Purchase Fund will approve funding for a procedure to be carried out for a person (details supplied); and if he will make a statement on the matter. [43507/18]
View answerWritten answers
Reducing waiting time for patients for hospital operations and procedures is a key priority for the Government. The Inpatient and Daycase Action Plan 2018 outlines the combined impact of Health Service Executive (HSE) and National Treatment Purchase Fund (NTPF) activity in 2018 to reduce the number of patients waiting for treatment. The Plan has already resulted in ongoing improvements with a 16% decrease in the number of patients waiting for procedures since July 2017.
Under the Waiting List Action Plan the NTPF have committed to make offers of treatment to patients waiting for one of 50 high-volume procedures including hip replacement. All patients who are clinically suitable for outsourcing who are waiting more than 9 months for one of these targeted procedures will be offered treatment in 2018 and 2019.
In terms of treatment offers, 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 been 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.
National Maternity Hospital
Questions (410)
Joan Collins
Question:410. Deputy Joan Collins asked the Minister for Health when he plans to sign contracts with the new national maternity hospital; the guarantees he has secured to ensure that reproductive services including abortion will be provided in this hospital; and if he will report to Dáil Éireann before contracts are signed [43519/18]
View answerWritten answers
Following extensive mediation discussions, agreement was reached between the St Vincent’s Healthcare Group and the National Maternity Hospital (NMH) on the relocation of the NMH to the Elm Park campus. The terms of this agreement provides for the establishment of a new company which will have clinical and operational, as well as financial and budgetary independence in the provision of maternity, gynaecology and neonatal services.
It is vitally important that the legal and governance arrangements associated with this project are robust. Considerable work has been undertaken to develop a legal framework to protect the State's significant investment in the new hospital. This legal framework will underpin the operational and clinical independence of the new hospital, ensuring care in the new maternity hospital will be delivered without religious, ethnic or other distinction and any medical procedure which is in accordance with the laws of the land will be carried out there. Once finalised, proposals will be subject to consideration with the parties concerned.
While the approval process is one for myself, as Minister for Health, I can confirm that I intend to brief Government once the legal framework has been finalised. I will, of course, be very happy to share the agreement with the House, as appropriate, in due course.
Hospital Consultant Remuneration
Questions (411)
Thomas P. Broughan
Question:411. Deputy Thomas P. Broughan asked the Minister for Health the estimated cost to restore junior consultants' salaries to bring salaries in line with their colleagues; and if he will make a statement on the matter. [43520/18]
View answerWritten answers
The Public Service Pay Commission recently concluded a review in relation to recruitment and retention in respect of key health service grades, including consultants.
In terms of pay, it identified the two-tier pay system as being one of number of factors affecting recruitment and found that the differential in pay between pre-existing and new entrant consultants is greater than for other categories of public servants. The Commission proposed that the Parties to the Public Service Stability Agreement jointly consider what further measures could be taken, over time, to address this difficulty.
It is estimated that it would cost approximately €45m to bring the pay of new entrant consultants into line with their colleagues. The Department of Public Expenditure and Reform, my Department and the HSE have noted the Commission's views and consideration will need to be given to potential solutions which are in line with public sector pay policy and available budgets.
Hospital Consultant Recruitment
Questions (412, 413)
Thomas P. Broughan
Question:412. Deputy Thomas P. Broughan asked the Minister for Health the number of consultant doctor vacancies here; the actions he is taking to fill these vacancies; and if he will make a statement on the matter. [43521/18]
View answerThomas P. Broughan
Question:413. Deputy Thomas P. Broughan asked the Minister for Health the actions he is taking to attract and retain medical consultants; and if he will make a statement on the matter. [43522/18]
View answerWritten answers
I propose to take Questions Nos. 412 and 413 together.
The Public Sector Pay Commission in its Report published on 4 September 2018 addressed consultant vacancies and identified difficulties in attracting applications for many posts at present. It acknowledged that the pay rates for new entrants had been highlighted as a factor in this and recognised that the implementation of the settlement of the 2008 Consultant Contract claim, while necessary of itself, would serve to highlight further the differential in pay between the pre-existing cadre of consultants and new entrants. It also stated that the proposed incremental measures for new entrants across the public service, including consultants, that have now been confirmed, would not be sufficient to address the differential.
In terms of the number of consultant vacancies, the Pay Commission noted that at the end of 2017 the number of serving consultants at 2,971 (whole time equivalents) was 169 below the total Establishment figure of approved consultant posts of 3,140 and that it had been advised of approximately 400 posts either vacant or filled on a temporary or agency basis.
Given its analysis, the Pay Commission proposed that the Parties to the Public Service Stability Agreement jointly consider what further measures could be taken, over time, to address the pay differential between pre-existing consultants and new entrant consultants which has increased following the settlement of the 2008 Consultant Contract claim. The Department of Public Expenditure and Reform and my Department have noted the Commission's views and consideration will need to be given to potential solutions which are in line with public sector pay policy and available budgets. This will be a significant challenge given the amounts involved.
The Government remains committed to increasing the consultant workforce. Notwithstanding recruitment and retention challenges, the number of consultants employed in the public health services has increased by 118 in the 12 months to end August 2018 and by 479 in the past five years to 3,032(whole time equivalent's). Where vacancies exist, the HSE endeavours to fill essential posts on a locum or temporary contract basis to support service delivery. The HSE is also committed to improving the recruitment process, offering contracts to the Hospital Group rather than individual sites and focusing on family friendly arrangements.
Hospital Accommodation Provision
Questions (414)
Thomas P. Broughan
Question:414. Deputy Thomas P. Broughan asked the Minister for Health when the additional 2,600 hospital beds promised in the National Development Plan 2018-2027 will be delivered; and if he will make a statement on the matter. [43523/18]
View answerWritten answers
The Health Service Capacity Review was a key commitment in the Programme for a Partnership Government, and was commissioned in response to the growing demand for health services. The Review, which reported earlier this year, examined capacity requirements in key elements of acute care, primary care and services for older people.
Increasing capacity alone will not address the challenges faced, but on the basis of significant reform over the next 10-15 years, the report recommends an additional 2,600 acute beds by 2031. The National Development Plan (NDP) provides for a major increase in capacity across the health system including the full complement of additional acute beds by 2028 - 3 years ahead of schedule.
Arising from the recommendations in the Health Service Capacity Review, my Department engaged with the HSE this year to identify the location and mix of beds which could be opened to alleviate overcrowding in our hospital Emergency Departments for Winter 2018/19. This process culminated in the development by the HSE of a Capacity Plan, which identified over 600 acute beds and 290 residential care beds, to be phased in between 2018 and 2020.
As a first step towards the implementation of the Capacity Plan, €10 million in funding is being made available in 2019 to enable additional acute beds to be opened for winter 2019/2020. My Department is currently engaging with the HSE to finalise the details of this investment.
Under the NDP three new dedicated elective-only hospitals will be introduced which will increase capacity in the hospital system and provide a better separation of scheduled and unscheduled care.
Medicinal Products Reimbursement
Questions (415)
Maureen O'Sullivan
Question:415. Deputy Maureen O'Sullivan asked the Minister for Health when the HSE drug assessment committee will consider the application of Translarna which is of benefit for muscular dystrophy; and if he will make a statement on the matter. [43532/18]
View answerWritten answers
The Health Service Executive has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. The 2013 Act does not give the Minister for Health any powers in this regard.
The Act specifies the criteria to be applied in the making of reimbursement decisions which include the clinical and cost effectiveness of the product, the opportunity cost and the impact on resources that are available to the HSE.
The HSE has received a new application for the reimbursement of Ataluren (Translarna) from PTC Therapeutics.
The application is being assessed at present in accordance with the criteria set out in the Health (Pricing and Supply of Medical Goods) Act 2013.
Negotiations between the HSE and the company are actively underway. Once these negotiations have concluded, the application will be considered by the HSE Drugs Group and Leadership team.