Written Answers Nos. 416-433
416. Deputy Maureen O'Sullivan asked the Minister for Health if he has engaged with the Minister for Finance regarding the VAT liable on counselling and psychotherapy services; and his views on whether there should be an exemption for these services in view of the increasing number of persons presenting with mental health issues. [43533/18]
View answerThe Minister for Health has not held any discussions with the Minister for Finance concerning the issue raised by the Deputy.
The criteria in relation to tax relief for medical expenses is primarily a matter for decision by the Minister for Finance, and the Revenue Commissioners. It is open to any individual who experiences financial hardship in respect of certain health or personal social care to apply, in certain circumstances for medical card assistance.
417. Deputy Maureen O'Sullivan asked the Minister for Health if the difficulties faced by hospitals in getting consultants to fill vacancies will be addressed in view of the significant number of vacancies; if the vacancy for a temporary consultant psychiatrist at Beaumont Hospital has been filled; if the position of paediatric pathologist at Temple Street Children's University Hospital has also been filled; and the number of vacancies to date. [43534/18]
View answerThe Public Sector Pay Commission in its Report published on 4 September identified difficulties in attracting consultant applications for many posts at present. The 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 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 equivalents). 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.
I have asked the HSE to revert to you directly in relation to the filling of the posts at Beaumont Hospital and Temple Street Children's University Hospital.
418. Deputy Maureen O'Sullivan asked the Minister for Health if his attention has been drawn to the effects pay discrimination for new entrants is having on the recruitment and retention of medical consultants here; and if he will make a statement on the matter. [43535/18]
View answerThe Public Sector Pay Commission in its Report published on 4 September 2018 identified difficulties in attracting consultant applications for many posts at present and acknowledged that the pay rates for new entrants had been highlighted as a factor in this. The Commission also 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.
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. It did not consider that recently announced measures for new entrants generally would address the difference.
Notwithstanding recruitment and retention challenges, the number of consultants employed in the public health service has increased by 118 in the 12 months to end August 2018 and by 479 in the past five years and the Government remains committed to further growth. 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.
419. Deputy Niamh Smyth asked the Minister for Health the status of the introduction of the 20 week anomaly scan at a hospital (details supplied); if it is now available to all women; if not, if it will be available; and if he will make a statement on the matter. [43539/18]
View answerThe National Maternity Strategy is very clear that all women must have equal access to standardised ultrasound services. The Strategy is being implemented on a phased basis and this work is being led by the National Women and Infants Health Programme. The Programme's Implementation Plan for the Strategy includes a number of actions to facilitate the provision by all maternity hospitals/units of dating and anomaly scans to all pregnant women.
Furthermore, additional development funding of €4.15 million is being allocated to maternity services this year. The Programme has prioritised improving quality and safety, establishing community midwifery teams and increasing access to anomaly scans. I understand that the Programme has approved the appointment of an additional 28 ultrasonographers which was the total requirement identified to provide 100% access to anomaly scanning.
Pending the completion of the requisite recruitment and training processes, I am assured that the Programme will continue to work with the six Hospital Groups to assist in increasing access to anomaly scans for those units with limited availability. The Programme is also working with the Maternity Networks to ensure foetal medicine expertise is available when an anomaly is identified. In relation to Cavan General Hospital specifically, I have asked the HSE to reply to you directly.
420. Deputy Thomas P. Broughan asked the Minister for Health the funding allocated to HSE addiction services in CHO area 9 in each of the years 2016, 2017 and to date in 2018; and if he will make a statement on the matter. [43548/18]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
421. Deputy Thomas P. Broughan asked the Minister for Health the number of HSE staff and grade employed in CHO area 9 addiction services; the number of positions vacant; the length of time each has been vacant; and if he will make a statement on the matter. [43549/18]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
422. Deputy Mick Wallace asked the Minister for Health if all four assistant psychologist positions for County Wexford have been filled as per the south-east community healthcare operation plan 2018. [43628/18]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
423. Deputy Brendan Smith asked the Minister for Health his plans to ensure that the HSE reviews the decision to reduce funding to a voluntary organisation (details supplied) that is providing essential services for children with autism; if the funding will be restored in respect of this particular project to the level of grant aid provided in previous years; and if he will make a statement on the matter. [43629/18]
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 a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
425. Deputy Stephen S. Donnelly asked the Minister for Health the research or data he has commissioned or his attention has been drawn to regarding the number and location of general practitioner surgeries that are no longer accepting new patients; and if he will make a statement on the matter. [43637/18]
View answerI am aware of reports of some general practitioners no longer accepting new patients.
Where a medical card or GP visit card holder experiences difficulty in finding a GP to accept him/her as a patient, the HSE has the power to assign that person to a GP's GMS patient list where the person has been removed from another GP's list or refused entry onto a GP's list, and the person has unsuccessfully applied to at least three GPs in the area who are contracted to provide services under the GMS scheme.
The assignment of a GMS patient to a GP's list can be reviewed by the HSE on the request of the GP after 6 months from the date of assignment, and, if appropriate, the patient can then be reassigned to an alternative GP.
Persons who do not hold a medical card or GP visit card access GP services on a private basis.
GPs are private contractors and issues relating to the acceptance of private patients are a matter of private contract between the clinician and his/her patients.
While I have no role in relation to such matters, I would expect clinicians to consider the importance of patients having access to a GP service close to home when deciding whether or not to accept private patients.
More generally, the 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 193 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 remains committed to the continued development of GP capacity to ensure that patients across the country continue to have access to GP services and that general practice remains an attractive career option.
426. Deputy Stephen S. Donnelly asked the Minister for Health his views on whether the NTPF should be extended to cover children with special needs who are waiting for treatment; and if he will make a statement on the matter. [43638/18]
View answerReducing waiting time for patients for hospital operations and procedures is a key priority for the Government. In Budget 2019 we have further increased investment in this area, with funding to the National Treatment Purchase Fund to increase from €55 million in 2018 to €75 million in 2019, an overall increase of 150% since this government came into office.
In 2019, the NTPF plans to deliver 25,000 Inpatient Day Case treatments, an increase of 5,000 from the 20,000 procedures committed to in the Waiting List Action Plan 2018. Furthermore, 40,000 first outpatient appointments will be arranged as part of the 2019 activity.
NTPF activity next year will cover approximately 50 high to medium volume procedures and will be through a combination of treating patients in outsourced facilities and supporting the public system initiatives. In addition, the NTPF will take a targeted approach in 2019 for procedures not included in the high to medium volume bracket.
My Department is working closely with the NTPF and the HSE to finalise a coherent Waiting List Action Plan for 2019 before the end of the year. The priority of my Department is to maintain a seamless continuation of the considerable progress made this year into next year. This will include the continuing engagement of the NTPF with the HSE and public hospitals, inviting proposals for waiting list initiatives either through the private sector or through public sector insourcing. The NTPF will provide funding to the solutions proposed if appropriate.
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.
427. Deputy Stephen S. Donnelly asked the Minister for Health the number of meetings he has had with general practitioner representative organisations including organisations (details supplied) in relation to talks on the new general practitioner contract; and if he will make a statement on the matter. [43639/18]
View answerThe Government is committed to engaging with the representatives of general practitioners on the development of a package of measures and reforms to modernise the GMS Contract.
The 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.
I have not met with either of the organisations referred to by the Deputy in relation to the talks on the GMS contract this year.
However, officials from my Department and the HSE are due to recommence engagement with GP representatives shortly.
428. Deputy Stephen S. Donnelly asked the Minister for Health the status of the new general practitioner contract negotiations; and if he will make a statement on the matter. [43640/18]
View answerThe Department and HSE recommenced engagement with the IMO in early October on a package of measures consisting of service improvements and contractual modernisation and reform.
The 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.
Agreement on the delivery of these service improvements and contractual reforms has the potential to facilitate a substantial increase in the resourcing of general practice on a multiannual basis.
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.
429. Deputy Stephen S. Donnelly asked the Minister for Health if previously closed acute beds in Letterkenny University Hospital will be reopened in 2019; if so, the number of beds which will be reopened; when this will happen; and if he will make a statement on the matter. [43641/18]
View answer€10 million in 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, including a 20-bed short stay ward in Letterkenny University Hospital.
My Department is currently in discussions with the HSE, in the context of the National Service Plan 2019, to agree a capacity programme for 2019 that maximises this investment and supports the management of winter pressures into the future.
430. Deputy Stephen S. Donnelly asked the Minister for Health the number of new acute beds opened in 2018; the locations of those beds; the breakdown of those beds by type, for example, ICU, HDU, ward and rehab; and if he will make a statement on the matter. [43643/18]
View answerIncreasing bed capacity is a Government priority.
Over the past 12 months an additional 240 beds have been opened of which:
- 148 opened by end quarter 4 2017; as detailed in Table 1
- 92 opened by end quarter 3 2018, as detailed in Table 2
A further 79 additional beds are planned for quarter 4 2018 and early 2019, as detailed in Table 3.
Table 3 does not take account of the impact of the €10 million in funding in Budget 2019 to increase acute bed capacity in line with the recommendations of the Health Service Capacity Review. My Department is currently in discussions with the HSE, in the context of the National Service Plan 2019, to identify the sites for investment and the associated number of beds, as part of an agreed capacity programme for 2019.
Table 1 - Q4 2017 Acute Beds
|
Hospital Group |
Hospital |
Type of bed |
Number of beds |
|
RCSI |
Our Lady of Lourdes Drogheda |
Acute beds (part of new bed block) |
25 |
|
RCSI |
Beaumont Hospital |
Acute beds |
20 |
|
Dublin Midlands |
St James’ Hospital |
Acute beds |
23 |
|
Dublin Midlands |
Naas General Hospital |
Acute beds |
11 |
|
Ireland East |
The Mater Hospital |
Acute beds |
24 |
|
Saolta |
Galway University Hospital |
Acute beds |
28 |
|
UL |
Limerick University Hospital |
Short Stay beds |
17 |
|
Total |
|
|
148 |
Table 2: Q1 - Q3 2018 Acute Beds
|
Hospital Group |
Hospital |
Type of bed |
Number of beds |
|
Ireland East |
St Vincent’s Hospital |
Acute beds |
22 |
|
Ireland East |
Mater Misericordiae University Hospital |
HDU beds |
2 |
|
Ireland East |
St Luke’s Hospital Kilkenny |
Acute beds |
14 |
|
RCSI |
Our Lady of Lourdes Hospital Drogheda |
Acute beds (part of new ward block) |
4 |
|
South South West |
Cork University Hospital |
Acute beds |
30 |
|
South South West |
Cork University hospital |
Critical care beds |
2 |
|
South South West |
Waterford University Hospital |
Acute beds |
18 |
|
Total |
|
|
92 |
Table 3: Planned beds - Q4 2018 and early 2019
|
Hospital Group |
Hospital |
Type of bed |
Number of beds |
|
Ireland East |
Mater |
ICU |
1 (2018) |
|
Ireland East |
Mater |
HDU |
4 (early 2019) |
|
South South West |
Cork |
HDU |
4 (Q1 2019) |
|
South South West |
South Tipperary General Hospital |
Acute beds (additional modular ward) |
40 (2019) |
|
RCSI |
Our Lady of Lourdes Drogheda |
Acute beds (additional ward) |
30 (early 2019) |
|
Total |
|
|
79 |
431. Deputy Stephen S. Donnelly asked the Minister for Health the number of new acute beds he plans to open in 2019; the locations of those beds; the breakdown of those beds by type, for example, ICU, HDU, ward and rehab; and if he will make a statement on the matter. [43644/18]
View answerImproving access to health care 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 Hospital Drogheda, a 40-bed modular ward block in South Tipperary General Hospital and 4 high dependency beds in the Mater and Cork University Hospital respectively. In addition, the new ED planned for Our Lady of Lourdes Hospital Drogheda is due to open early in 2019.
Furthermore, €10 million in 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 implementation of the Capacity Plan, which has identified over 600 acute beds to be phased in between 2018 and 2020. My Department is currently engaging with the HSE to finalise the details of this investment.
432. Deputy Stephen S. Donnelly asked the Minister for Health his plans to include funding to upgrade the Rotunda Hospital in the capital plan in view of ongoing multi-year delays in a new campus being built; and if he will make a statement on the matter. [43645/18]
View answerAs the Health Service Executive is responsible for the delivery of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
433. Deputy Stephen S. Donnelly asked the Minister for Health the preparations being made to increase acute hospital capacity in winter 2018-2019; and if he will make a statement on the matter. [43646/18]
View answerMy 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 €10 million in funding is being provided for once-off initiatives in 2018 to manage the known increase in demand that our hospital services will experience in the coming months, with a focus on supporting patients in the over 75 age group.
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.
Furthermore, €10 million in 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 implementation of the Capacity Plan, which has identified over 600 acute beds to be phased in between 2018 and 2020. My Department is currently engaging with the HSE to finalise the details of this investment.
