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Tuesday, 5 Feb 2019

Written Answers Nos. 114-134

Hospital Waiting Lists

Questions (114)

Barry Cowen

Question:

114. Deputy Barry Cowen asked the Minister for Health the reason 2,401 persons have been waiting for an outpatient consultation in Tullamore Hospital for more than two years [5397/19]

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Written answers

I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. In this regard, I am committed to improving waiting times for hospital appointments and procedures.

I hope to publish the joint Department of Health, Health Service Executive (HSE) and National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 shortly. This will set out commitments aimed at improving access for patients waiting for hospital operations or procedures, as well as patients waiting for a first Outpatient appointment.

A key element of this Plan is the stabilisation of the Outpatient Waiting List which remains a significant challenge. The HSE, in line with the National Service Plan 2019 will provide 3.3 million outpatient appointments, more than 1 million of which will be first outpatient appointments.

In 2019, the HSE will focus in particular on specialties with a high volume of referrals and large proportions of long-waiting patients including ENT and Dermatology. In addition, the NTPF, with an increased allocation of €75 million in 2019, will fund an additional 40,000 first outpatient appointments through weekend and out of hour’s clinics and ‘see and treat’ clinics.

The NTPF will deliver this additional activity in the health service by working with hospital groups and individual hospitals as well as private health providers to maximise the number of patients treated in both a public and private capacity. I would strongly encourage all hospitals, including The Midland Regional Hospital Tullamore, to collaborate with the NTPF to identify waiting list initiatives.

Hospital Waiting Lists

Questions (115)

Thomas Byrne

Question:

115. Deputy Thomas Byrne asked the Minister for Health the action which will be taken in 2019 to reduce the waiting times for orthopaedic services in Our Lady’s Hospital, Navan. [5403/19]

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Written answers

Improving waiting times for hospital procedures is a key commitment in the Programme for Government and €75 million was allocated to the National Treatment Purchase Fund (NTPF) in Budget 2019 to provide treatment for patients.

I hope to publish the joint Department of Health/HSE/NTPF Scheduled Care Access Plan 2019 for inpatient, day case and outpatients shortly. The plan will ensure an appropriate balance between high volume activities and offering treatment to complex long-waiting patients. It will reflect activity targets from the HSE, in line with the National Service Plan, to reduce waiting times across specialties and improve access to appointments and procedures. The plan will also set out activity levels for the NTPF in line with their increased allocation of funding in 2019.

The NTPF will deliver this activity through working with hospital groups and individual hospitals as well as private health providers to maximise the number of patients treated in both a public and private capacity. Under the Plan the NTPF has committed to make offers of treatment to patients waiting for one of 75 hospital procedures, which will include orthopaedics. The longest waiting patients who are clinically suitable for outsourcing for one of these targeted procedures will be offered treatment in 2019.

In relation to the specific matter raised, I have asked the HSE to respond directly to the Deputy.

Hospitals Building Programme

Questions (116)

Billy Kelleher

Question:

116. Deputy Billy Kelleher asked the Minister for Health the timeframe for the construction of a new elective hospital in County Cork; the action taken to advance this project in 2018; and if he will make a statement on the matter. [5269/19]

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Written answers

Project Ireland 2040 includes significant new healthcare programmes, including projects in relation to additional capacity and the development of three elective only facilities. These projects reflect the next stage of health sector development, and many require significant policy scoping and planning assessment to be carried out.

It is not possible at this stage to give a timeline for the construction of the proposed new dedicated ambulatory elective hospital facilities under Project Ireland 2040.

Detailed policy analysis to underpin this very significant health capital investment is now being considered by the Department of Health, with the aim of ensuring value for money and meeting both current and future service needs. This will guide the service and operational specification for the new facilities and allow for an objective basis for the evaluation of proposals. There will be appropriate consultation in the development of this policy which will be based upon international best practice and national population health planning.

National Cancer Strategy

Questions (117)

Maureen O'Sullivan

Question:

117. Deputy Maureen O'Sullivan asked the Minister for Health the make-up of the cancer patient advisory committee; and his views on the importance of having a lung cancer specialist in view of the lack of lung cancer advocacy groups here. [5267/19]

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Written answers

The Cancer Patient Advisory Committee comprises 15 members, chaired by a representative of my Department. A list of the Members of the Committee, which has been published previously, is attached.

A Call for Expressions of Interest for membership of the Committee was published in September 2018 and there was a very good response. Primarily individuals with direct experience of cancer treatment as a patient were sought as members, although those who supported a family member or close friend through cancer treatment, or those supporting cancer patients as part of their work were also considered. A selection process was undertaken by a group comprising representatives of the Irish Cancer Society, the HSE's National Cancer Control Programme, my Department and a member of the former Cancer Patient Forum.

Cancer Patient Advisory Committee Members*

Name

County

Louise Carolan McKeon

Cavan

Sarah Carty

Wicklow

Edel Chadwick

Clare

Ann Cullen

Dublin

Noelle Duddy

Donegal

Deirdre Fitzpatrick

Dublin

Ken Loughran

Wicklow

Mairead Mangan

Dublin

Fiona McEntee

Dublin

Ciara Morris

Dublin

Michael Nowlan

Dublin

Miriam O’Driscoll

Cork

Mary Powell

Dublin

P.J Rainey

Mayo

Mary-Claire Rennick

Meath

*The Committee is chaired by Michael Conroy, Department of Health

Primary Care Centres Provision

Questions (118)

Maureen O'Sullivan

Question:

118. Deputy Maureen O'Sullivan asked the Minister for Health the future status of a centre (details supplied) in view of the concerns of staff and community regarding the possible closure; and if he will make a statement on the matter. [5266/19]

View answer

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.

Dental Services Waiting Lists

Questions (119)

Stephen Donnelly

Question:

119. Deputy Stephen S. Donnelly asked the Minister for Health the initiatives being taken to address the long waiting times for dental waiting lists for children; and if he will make a statement on the matter. [5391/19]

View answer

Written answers

As this is a service matter it has been referred to the HSE for direct reply to the Deputy.

Medical Aids and Appliances Provision

Questions (120)

Aindrias Moynihan

Question:

120. Deputy Aindrias Moynihan asked the Minister for Health if the age restriction will be ceased and a monitoring system and associated devices (details supplied) made free and accessible to all persons with type 1 diabetes; and if he will make a statement on the matter. [5386/19]

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Written answers

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Mental Health Services Provision

Questions (121)

Donnchadh Ó Laoghaire

Question:

121. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the supports available to those presenting to emergency departments displaying signs of mental illness but have yet to receive an official diagnosis; and if he will make a statement on the matter. [5365/19]

View answer

Written answers

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Abortion Services Provision

Questions (122)

Joan Collins

Question:

122. Deputy Joan Collins asked the Minister for Health his plans to introduce exclusion zones around facilities which are providing abortion services. [5129/19]

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Written answers

It is my intention to introduce legislation to ensure safe access to premises in which termination of pregnancy services may be provided. The intention of the legislation would be to allow patients, service providers, healthcare staff and members of the public to enter such premises without fear of intimidation or harassment.

While it was originally intended to provide for such safe access in the Health (Regulation of Termination of Pregnancy) Bill 2018, a number of legal issues were identified during the drafting process. In order to allow full consideration of these issues, Government approved the drafting of a separate piece of legislation on safe access to health services.

Officials in my Department will work with the Office of the Attorney General on this legislation.

HSE Reports

Questions (123)

Louise O'Reilly

Question:

123. Deputy Louise O'Reilly asked the Minister for Health if he has spoken with officials in the Department of Health in Northern Ireland on ensuring access for persons here to a clinic (details supplied) for mesh survivors; and if he will make a statement on the matter. [5314/19]

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Written answers

In late 2017, concerns arose about the frequency and severity of complications associated with the use of mesh devices in the surgical treatment of Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP) in women in Ireland. In responding to these questions and in recognition of the complexity of the matters arising, I requested the Chief Medical Officer (CMO) to prepare a report on the clinical and technical issues involved in ensuring both:

a) the safe and effective provision of mesh procedures in urogynaecology; andb) an appropriate response to women who suffer complications as a result of undergoing such procedures.

Preparation of the report has involved consultation and engagement with national and international bodies. The report has been informed by review of international reports and safety reviews of mesh surgery which have been published in recent years. The report has also been informed by the personal experiences of women who have suffered complications following mesh surgery.

The Report identifies that for many women, surgical procedures using synthetic mesh devices have provided a more effective and less invasive form of treatment than traditional SUI and POP procedures. However, mesh devices are associated with significant and severe complications in a minority of women. These are of concern given the difficulties of mesh implant removal.

The Report makes 19 recommendations including:

- the development of patient information and informed consent materials;

- surgical professional training and multidisciplinary expertise in units carrying out mesh procedures;

- the development of clinical guidance;

- the development of information systems to monitor the ongoing use of mesh devices;

- ensuring the reporting of mesh related complications; and

- ensuring timely, appropriate and accessible care pathways for the management of women with complications.

The report was completed and published on the Department of Health website on 21 November 2018.

In advance of the report’s completion, the HSE was requested in May 2018 to begin work immediately on the development of national standardised patient information and informed consent materials and the clarification and development of treatment pathways and appropriate referral services for women suffering serious complications. The HSE was also asked by the Chief Medical Officer on 24 July to pause all mesh procedures where clinically safe to do so, until a number of key recommendations are implemented.

A Synthetic Mesh Devices Advisory Group has been convened by the HSE, to advise on and progress all of the recommendations. I am informed that an ongoing work programme for the development of appropriate patient information resources and consent materials, and the clarification and development of treatment pathways and appropriate referral services for women suffering from mesh-related complications is being progressed through this Group. The HSE has advised that many women have already engaged with this pathway system and have attended centres for second opinion and follow up appointments.

I am informed that work is ongoing by the HSE to examine options for sourcing services from abroad to address any immediate shortfalls identified, either through utilisation of the treatment abroad scheme or through agreement with relevant centres.

The Secretary General of my Department wrote to the HSE on November 27 2018 to request that it prepare a detailed Implementation Plan for the complete set of recommendations set out in the CMO’s Report, to be approved by the Leadership Team in the HSE and published on the HSE website within three months of receipt of the report, or sooner if completed. It was also requested that a copy of the Implementation Plan, together with an interim report on the implementation of those recommendations on which work has already commenced, should be submitted to the Department at the time of publication of the Implementation Plan.

Services for People with Disabilities

Questions (124)

Thomas P. Broughan

Question:

124. Deputy Thomas P. Broughan asked the Minister for Health the way in which there will be an increase of 170,000 personal assistant hours to persons with disabilities over the 2018 target without an increase in funding; the number of persons who will receive personal assistant hours in 2019; the average number of hours that will be provided per person daily; and if he will make a statement on the matter. [4712/19]

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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 questions relate to service matters, I have arranged for the questions to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Abortion Services Provision

Questions (125)

Joan Collins

Question:

125. Deputy Joan Collins asked the Minister for Health the level of general practitioner based abortion services coverage nationally by county. [5126/19]

View answer

Written answers

To date 259 general practitioners have signed the contract and each day more are signing up as the service evolves.

There is a good geographical spread of general practitioners taking part, as well as the Well Woman and Irish Family Planning Association clinics.

Hospital Services

Questions (126)

Catherine Connolly

Question:

126. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 394 of 20 November 2018, the outcome of the tender process for the provision of a modular theatre facility to provide two replacement theatres; the date on which it went to tender; the person or body that was granted the tender; when the facility will be in place and operational; and if he will make a statement on the matter. [5336/19]

View answer

Written answers

As 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.

Health Services Staff

Questions (127)

Barry Cowen

Question:

127. Deputy Barry Cowen asked the Minister for Health the action that will be taken to address the significant shortage of specialist psychiatrist positions in the midlands; and if he will make a statement on the matter. [5398/19]

View answer

Written answers

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Capital Expenditure Programme

Questions (128)

Stephen Donnelly

Question:

128. Deputy Stephen S. Donnelly asked the Minister for Health the projects identified as required or likely to be delayed in view of the additional funds required for the National Children's Hospital; and if he will make a statement on the matter. [5390/19]

View answer

Written answers

The Health Service Executive is currently developing its Capital Plan for 2019. The HSE Capital Plan will determine the projects that can progress in 2019 and beyond having regard to the available capital funding, the number of large national capital projects currently underway and the relevant priority of each project. The requirements of the new children's hospital and other health capital projects, currently at various stages of development, are being considered as part of this process. Once the HSE has finalised its Capital Plan for 2019, it will then be submitted to me for consideration.

HSE Waiting Lists

Questions (129)

Bernard Durkan

Question:

129. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he continues to monitor the waiting lists throughout the health services with particular reference to specific procedures (details supplied); if the utilisation of the treatment purchase scheme can be used to clear backlogs in the first instance thereby facilitating smoothness and efficiency throughout the service; and if he will make a statement on the matter. [5385/19]

View answer

Written answers

Improving waiting times for hospital procedures is a key commitment in the Programme for Government and €75 million was allocated to the National Treatment Purchase Fund (NTPF) in Budget 2019 to provide treatment for patients.

I hope to publish the joint Department of Health/HSE/NTPF Scheduled Care Access Plan 2019 for inpatient, day case and outpatients shortly. The plan will ensure an appropriate balance between high volume activities and offering treatment to complex long-waiting patients. It will reflect activity targets from the HSE, in line with the National Service Plan, to reduce waiting times across specialties and improve access to appointments and procedures. The plan will also set out activity levels for the NTPF in line with their increased allocation of funding in 2019.

The NTPF will deliver this activity through working with hospital groups and individual hospitals as well as private health providers to maximise the number of patients treated in both public and private capacity. Under the Plan the NTPF has committed to make offers of treatment to patients waiting for one of 75 hospital procedures, which will include orthopaedics. The longest-waiting patients who are clinically suitable for one of these targeted procedures will be offered treatment in 2019.

My Department has placed a particular priority on performance improvement in scheduled care in order to improve access for patients and oversees the performance of the HSE and the NTPF against agreed targets. This includes weekly analysis of waiting list figures provided by the NTPF and regular review meetings with the HSE and the NTPF.

Cancer Screening Programmes

Questions (130)

Bríd Smith

Question:

130. Deputy Bríd Smith asked the Minister for Health the reason his Department and HSE officials are refusing to release information that would detail the number of false negative tests in the cervical screening programme by each laboratory; and if he will make a statement on the matter. [5368/19]

View answer

Written answers

I want to be clear that neither my Department nor the HSE is refusing to release the information requested. As has previously been advised to the Deputy, the HSE has advised that analysis is required in order to make the requested data available. The requirement for analysis reflects the complexities involved.

For example, some women may have had multiple smears, not necessarily read in the same lab; slides may have changed by one grade or multiple grades which is a complexity that would not be shown by a simple breakdown across labs; labs dealt with different regional populations; in the early years of the programme, it was dealing with an unscreened population which is a further complexity. Following significant efforts on the part of the HSE, a person with appropriate expertise was identified in late 2018 to carry out this analysis, and this work is ongoing. The HSE has advised it expects this work to be completed within the coming weeks.

Primary Care Centres

Questions (131)

Aengus Ó Snodaigh

Question:

131. Deputy Aengus Ó Snodaigh asked the Minister for Health the reason for the delay in building a primary healthcare facility (details supplied) in Dublin 12. [5310/19]

View answer

Written answers

As 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.

Cancer Screening Programmes

Questions (132)

Stephen Donnelly

Question:

132. Deputy Stephen S. Donnelly asked the Minister for Health if there are potential clinical implications, including the potential for delayed initiation of treatment for women being asked to take repeat smear tests due to the delays in testing; and if he will make a statement on the matter. [5392/19]

View answer

Written answers

The unprecedented demand in cervical screening in 2018, due to understandable concerns from women as well as increased uptake of screening, has led to long and very regrettable delays in the reporting of results. The HSE has advised me that results are currently being reported on average within 22 weeks of the test being taken. While in some cases results are reported in a shorter period of time, in other cases this period of time is longer.

I would like to sincerely apologise to the women affected by these delays and assure them that this is a top priority for myself, my Department and the HSE. The HSE is working actively to manage the issue and to identify additional capacity where possible, although the global shortage of cytology capacity means this is very challenging.

The HSE has advised that the natural history of cervical cancer would indicate that the disease would normally develop over a period of 10 to 15 years. Due to this very fact, it is important that any woman of screening age attends for cervical screening when she is invited to do so. In this context, the current reporting time of cervical screening results, whilst undesirable and regrettable, poses a very low risk to women.

As the Deputy will be aware, false negatives are inherent in all cervical screening programmes, and cervical screening will not prevent all cancers. However, we know that cervical screening saves lives. Regular smear testing is the most important thing a woman can do to prevent cervical cancer, and that is why my focus is on ensuring continuation of the screening programme and that the current challenges in relation to smear test turnaround are addressed.

Oireachtas Joint Committee Reports

Questions (133)

Denise Mitchell

Question:

133. Deputy Denise Mitchell asked the Minister for Health the work being undertaken regarding the report of the Oireachtas Joint Committee on Children and Youth Affairs on tackling childhood obesity; if he is satisfied with the recommendations contained in the report; and if he will make a statement on the matter. [52296/18]

View answer

Written answers

The national Obesity Policy Implementation Oversight Group (OPIOG) established under the Chair of the Department of Health, is comprised of individuals from a range of Government Departments and Agencies. It is providing oversight to the implementation of the recommendations of the national Obesity Policy and Action Plan (OPAP). At its next meeting, the OPIOG will consider the Report on Tackling Childhood Obesity from the Joint Oireachtas Committee on Children and Youth Affairs for the purposes of, among others, aligning both sets of recommendations.

Hospitals Building Programme

Questions (134)

Brian Stanley

Question:

134. Deputy Brian Stanley asked the Minister for Health the status of a hospital (details supplied); the timeframe for the project; and when funding will be ring-fenced. [5029/19]

View answer

Written answers

As 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.

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