Written Answers Nos. 344-364
344. Deputy Brendan Griffin asked the Minister for Health if the medication of a person (details supplied) is on a list of medications that may be affected by Brexit; and if he will make a statement on the matter. [9339/19]
View answerAs part of the overall Government response to Brexit, my Department is working on a comprehensive and coordinated set of actions to ensure, as far as is possible, continuity of supply of medicines in the event of a "no-deal" Brexit.
Significant work has been undertaken by my Department, the HSE, and the Health Products Regulatory Authority (HPRA), together with medicines manufacturers and suppliers, to ensure that risks to the continuity of supply are mitigated to the greatest possible extent.
The Department of Health, HSE and HPRA do not anticipate an immediate impact on medicine supplies should there be a no-deal Brexit on 29 March. There are already additional stocks of medicines routinely built into the Irish medicine supply chain, and these additional stocks, together with planning by Revenue to allow the fast-tracking of essential drugs into Ireland, where necessary, will help deal with any delays that may arise.
It is important to note that there is no need for hospitals, pharmacists or patients to order extra quantities of medicines, or for doctors to issue additional prescriptions. To do so could disrupt existing stock levels and hamper the supply of medicines for other patients.
In 2018, the HPRA developed and launched a multi-stakeholder Medicine Shortages Framework to anticipate and manage medicine shortages when they occur. The health system is therefore well placed to anticipate and respond to any additional shortages, should they arise because of Brexit.
As an additional safeguard, my Department requested that consideration be given to those categories of medicines which are considered most essential to public health. As a result, HSE and HPRA technical experts are undertaking a process to verify the contingency planning in place for the continuity of supply of medicines essential to public health, in order to determine those medicines that have the potential to be vulnerable to supply disruption and, where necessary, identify clinically appropriate alternatives. Work on this process is ongoing and will continue in the months before and after Brexit.
Both the HPRA and HSE have requested that medicines manufacturers and suppliers highlight any issues regarding the availability of specific products associated with Brexit and, to date, no major issues have been identified through this process.
345. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) is waiting on a bed in the Mater Hospital; and if he will make a statement on the matter. [9340/19]
View answerUnder 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.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
346. Deputy Brendan Griffin asked the Minister for Health if he will address a matter (details supplied) in relation to the use of agency staff in the health service; and if he will make a statement on the matter. [9341/19]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
347. Deputy Róisín Shortall asked the Minister for Health the steps he is taking to implement the Public Health (Alcohol) Act 2018, in particular the policy regarding minimum unit pricing; and if he will make a statement on the matter. [9353/19]
View answerThe Public Health (Alcohol) Bill was enacted in October 2018. In November I commenced 23 of the 31 Sections of the Act including to provide that:
From 12 November 2019:
- Alcohol advertising in or on public service vehicles, at public transport stops or stations and within 200 metres of a school, a crèche or a local authority playground will be prohibited.
- Alcohol advertising in a cinema will be prohibited except around films with an 18 classification or in a licensed premises in a cinema.
- Children’s clothing that promotes alcohol will be prohibited.
From 12 November 2020:
In mixed retail outlets alcohol products and advertising are confined to one of the following:
- an area separated by a 1.2 metre high barrier, or
- units in which alcohol products are not visible up to 1.5 metres height, or
- up to three units that can be a maximum of 1 metre wide by 2.2 metres high.
In addition alcohol products can be contained but not be visible in a unit behind the counter.
From 12 November 2021:
- Alcohol advertising on a sports area during a sporting event, at events aimed at children or at events in which the majority of participants or competitors are children is prohibited.
- Alcohol sponsorship of events aimed at children, events which the majority of participants or competitors are children and events involving driving or racing motor vehicles is prohibited.
I am continuing to progress the remaining sections of the Act and will seek a revised Government Decision to implement the Minimum Unit Pricing provision after there is more certainty in relation to the exit of the United Kingdom from the European Union and its impacts.
348. Deputy Billy Kelleher asked the Minister for Health the cost of the first contract awarded to a company (details supplied) for the national children’s hospital; the variation of final cost from original tender; if there were changes to the design of the initial contract; if so, if these changes were carried out during construction stage of the initial contract; and if he will make a statement on the matter. [9356/19]
View answer349. Deputy Billy Kelleher asked the Minister for Health if there were changes to the detail design of the national children’s hospital after the initial contract was signed and construction commenced on the site; if such changes had an impact on the construction costs associated with the first contract awarded to a company (details supplied); if there were material changes to the foundations and underground car park layout and other associated site works; and if he will make a statement on the matter. [9357/19]
View answerI propose to take Questions Nos. 348 and 349 together.
The contract for the new children's hospital project is subject to a two-stage process. Stage 1 consists of a full tender and contract for Phase A works (below ground, including basement works) on the basis of a detailed design, and a tender for Phase B works (the main above ground works) on the basis of a preliminary 1st stage design with an approximate and remeasurable bill of quantities reflecting the preliminary 1st stage design. Stage 2 consists of the completion of the detailed design for the above ground Phase B works, with a full bill of quantities priced at the Stage 1 preliminary design tendered rates. This approach allowed the early phases of work to commence on site while also allowing for the detail of later phases to be finalised and agreed, resulting in the determination of a Guaranteed Maximum Price prior to the instruction to proceed with the main Phase B works.
Contract tenders were received from the main contractor, mechanical and electrical installation contractors and lift contractors in October 2016. The most competitive tender sum, excluding VAT, was €637m in total, of which €432m applied to the main contractor. Following completion of the Guaranteed Maximum Price Process (GMP) in November 2018, the total adjusted GMP construction budget is €890m, of which €556m applies to the main contractor.
As the particular details regarding material changes to the foundations and underground car park layout and other associated site works are operational matters, I have asked the National Paediatric Hospital Development Board to reply to you directly, as soon as possible.
350. Deputy Niall Collins asked the Minister for Health if his attention has been drawn to a survey and a report carried out by a company (details supplied); if so, if his attention has been further drawn to the fact that 31% of respondents claimed discrimination in relation to their trade union activity; the action taken to rectify the situation; and if he will make a statement on the matter. [9360/19]
View answer351. Deputy Niall Collins asked the Minister for Health if his attention has been drawn to the fact that 48% of respondents claimed to have experienced bullying and-or harassment in the National Ambulance Service within the previous two years of a survey (details supplied) being carried out; the action he has taken to date to rectify the situation; and if he will make a statement on the matter. [9361/19]
View answer352. Deputy Niall Collins asked the Minister for Health if his attention has been drawn to the fact that 68% of respondents claimed to have witnessed bullying and-or harassment in the National Ambulance Service within the previous two years of a survey (details supplied) being carried out; the action he has taken to date to rectify the situation; and if he will make a statement on the matter. [9362/19]
View answer361. Deputy Michael Healy-Rae asked the Minister for Health if he has read the health sector national staff survey 2016 National Ambulance Service report from January 2017 carried out by a company (details supplied); if so, if his attention has been drawn to the issues raised in the report; and if he will make a statement on the matter. [9400/19]
View answer370. Deputy Peadar Tóibín asked the Minister for Health his views on the fact that only 4% of staff have confidence in senior management within the National Ambulance Service according to the health sector national staff survey 2016; and if he will make a statement on the matter. [9488/19]
View answer371. Deputy Peadar Tóibín asked the Minister for Health the steps he will take to address the fact that only 5% of staff agree that communication between senior management and staff is effective in the National Ambulance Service according to the health sector national staff survey 2016; and if he will make a statement on the matter. [9489/19]
View answer381. Deputy Peadar Tóibín asked the Minister for Health if his attention has been drawn to the fact that 31% of respondents of a 2016 survey and a report (details supplied) claimed discrimination in relation to their trade union activity; if his attention has been further drawn to the fact that 48% of respondents to the report claimed to have experienced bullying and or harassment in the National Ambulance Service within the previous two years of the survey being carried out; if his attention has been further drawn to the fact that 68% of respondents claimed to have witnessed bullying and or harassment in the service within the previous two years of the survey being carried out; the action he has taken to date to rectify each of these situations; and if he will make a statement on the matter. [9506/19]
View answerI propose to take Questions Nos. 350 to 352, inclusive, 361, 370, 371 and 381 together.
The Deputies have raised a number of issues in relation to a Health Sector National Staff Survey which was carried out in 2016. The purpose of the survey was to measure employee sentiment and engagement within the publicly funded Health Sector. I understand that within the National Ambulance Service there was a 50% response rate.
As with all surveys, it raised a number of both positive and negative results. These results have prompted the National Ambulance Service to take a range of measures to address the areas where improvements could be made.
I am clear that bullying or harassment in any workplace must not be tolerated and any such instance must be addressed in accordance with the appropriate grievance and disciplinary policies and procedures. Any employee who experiences or witnesses work place bullying or harassment should be aware that they can report these instances under the Dignity at Work Policy for the Health Service.
The NAS is also developing anti bullying work place initiatives in line with the Positive Workplace Programme and bespoke sessions for the NAS are currently in development. Staff Health & Wellbeing initiatives and programmes are ongoing in the NAS as part of Healthy Ireland including significant focus on staff health initiatives such as mental wellbeing, physical activity, health checks and improving the workplace environment.
There are a number of other ongoing programmes and initiatives being undertaken and supported by the National Ambulance Service. For example, a number of NAS managers across the country have undertaken Leadership Development Programmes including Continuous Quality Improvement courses using the Lean Sigma process.
The NAS has also established a National Staff Engagement Forum as well as local Engagement Networks. The role of the Forum is to create a space for conversations about what matters to staff in terms of engagement and to gather suggestions on how to improve it by building on existing approaches and continually looking for new ways to engage staff.
In addition, the NAS has strengthened representative bodies and increased the number of NAS staff representation in order to provide further regular and scheduled discussion around areas such as improvement in internal and upward communication, raising awareness around dignity at work issues, and health and wellbeing initiatives.
353. Deputy Niall Collins asked the Minister for Health his views on whether there may be a culture of bullying and-or harassment within the National Ambulance Service; and if he will make a statement on the matter. [9363/19]
View answer382. Deputy Peadar Tóibín asked the Minister for Health his views on whether there may be a culture of bullying and-or harassment within the National Ambulance Service; and if he will make a statement on the matter. [9507/19]
View answerI propose to take Questions Nos. 353 and 382 together.
I am clear that bullying or harassment in any workplace must not be tolerated and any such instance must be addressed in accordance with the appropriate grievance and disciplinary policy and procedures.
The Health Service, including the National Ambulance Service, recognises the right of all employees to be treated with dignity and respect and is committed to ensuring that all employees are provided with a safe working environment which is free from all forms of bullying, sexual harassment and harassment. Workplace bullying and harassment adversely affect the quality of patient/client care by undermining employee morale and can result in absenteeism, stress-related illnesses and higher turnover of staff.
A Dignity at Work Policy for the Health Service is in place. This policy was produced on a partnership basis by a Working Group comprising representatives from the HSE, Voluntary Hospitals and Intellectual Disability sectors, HSE-Employers Agency, IBEC and the health sector trade unions.
This Policy covers sexual harassment and harassment as outlawed by the Employment Equality Acts 1998 to 2008 and workplace bullying and reflects the experiences of both employers and union representatives in dealing with complaints of bullying and harassment.
I can advise that the National Ambulance Service (NAS) is developing anti bullying work place initiatives in line with the Positive Workplace Programme and bespoke sessions for the service are currently in development. Staff Health & Wellbeing initiatives and programmes are ongoing in the NAS as part of 'Healthy Ireland' including significant focus on staff health initiatives such as mental wellbeing, physical activity, health checks and improving the workplace environment.
354. Deputy Niall Collins asked the Minister for Health the action he plans to take to prevent the upcoming ambulance dispute strikes on 28 February and 1 March 2019; and if he will make a statement on the matter. [9364/19]
View answer355. Deputy Niall Collins asked the Minister for Health if his attention has been drawn to the fact that the HSE continues to decline an invitation from a union (details supplied) to attend the WRC to find a solution to the ongoing dispute contrary to his preference for negotiation in relation to the matter; and if he will make a statement on the matter. [9365/19]
View answer383. Deputy Peadar Tóibín asked the Minister for Health his plans to prevent the upcoming ambulance dispute strikes on 28 February and 1 March 2019; and if he will make a statement on the matter. [9508/19]
View answer384. Deputy Peadar Tóibín asked the Minister for Health if his attention has been drawn to the fact that the HSE continues to decline an invitation from a union (details supplied) to attend the WRC to find a solution to the ongoing dispute contrary to his indication that he would prefer negotiation in relation to the matter; and if he will make a statement on the matter. [9509/19]
View answerI propose to take Questions Nos. 354, 355, 383 and 384 together.
SIPTU is the main union recognised by the HSE and has negotiating rights for frontline ambulance grades employed by the Executive. Unite and FORSA also represent some ambulance grades. As a result, the HSE deducts subscriptions at source for those ambulance staff that are members of those unions. However, the National Ambulance Service Representative Association (NASRA) is not recognised by the HSE and, therefore, does not have negotiating rights.
Whilst individuals have a right to membership of any trade union, if they choose to join an association which is not recognised by their employer, such membership is not facilitated by their employer. This means that the HSE does not facilitate the deduction of union subscriptions for this particular Association.
While it is regrettable that the PNA has taken industrial action, it is not possible to negotiate with a union which is not recognised as having negotiating rights for ambulance grades. I have asked my Department to engage with the HSE to explore ways forward and see if we can progress a resolution to this dispute.
356. Deputy Niall Collins asked the Minister for Health his views on the fact that only 4% of staff have confidence in senior management within the National Ambulance Service; and if he will make a statement on the matter. [9366/19]
View answerAs this is a service issue, I have asked the HSE to reply to you directly.
357. Deputy Niall Collins asked the Minister for Health the action he plans to take in relation to the fact that 5% of staff agree that communication between senior management and staff is effective in the National Ambulance Service; and if he will make a statement on the matter. [9367/19]
View answerAs this is a service issue, I have asked the HSE to reply to you directly.
358. Deputy Niall Collins asked the Minister for Health the actions that have been taken by the National Ambulance Service in relation to the finding in the national staff survey that only 3% of staff agree that senior managers act on staff feedback; and if he will make a statement on the matter. [9368/19]
View answerAs this is a service issue, I have asked the HSE to reply to you directly.
359. Deputy Louise O'Reilly asked the Minister for Health the tender process which was undertaken before it was agreed that a company (details supplied) would be hired to compile the report into the national children’s hospital overspend; and if he will make a statement on the matter. [9371/19]
View answerThe HSE commissioned the review by PwC into the cost escalation relating to the new children's hospital project. Accordingly, I have asked the HSE to respond to you directly.
360. Deputy Stephen S. Donnelly asked the Minister for Health the number of cervical smear tests provided by the national screening service in each of the years 2012 to 2018. [9392/19]
View answerIn relation to the specific data requested, I have asked the HSE to respond directly to the Deputy.
362. Deputy Michael Healy-Rae asked the Minister for Health if matters (details supplied) will be addressed regarding the National Ambulance Service; and if he will make a statement on the matter. [9401/19]
View answer377. Deputy Mattie McGrath asked the Minister for Health if his attention has been drawn to the findings of the health sector national staff survey 2016 and the National Ambulance Service report January 2017 carried out by a company (details supplied) that found 31% of respondents claimed discrimination in relation to their trade union activity in addition to other significant workplace difficulties; and if he will make a statement on the matter. [9496/19]
View answer397. Deputy Maureen O'Sullivan asked the Minister for Health if his attention has been drawn to the health sector national staff survey 2016, National Ambulance Services report January 2017 undertaken by a company (details supplied); if so, his views on the fact that 31% of respondents that claimed discrimination in relation to their trade union activity; and the way in which he plans to address the continued refusal by the HSE to attend the Workplace Relations Commission with a union to find a solution to the ongoing dispute. [9560/19]
View answerI propose to take Questions Nos. 362, 377 and 397 together.
The Deputies have raised a number of issues in relation to a Health Sector National Staff Survey which was carried out in 2016. The purpose of the survey was to measure employee sentiment and engagement within the publicly funded Health Sector. I understand that within the National Ambulance Service there was a 50% response rate.
As with all surveys, it raised a number of both positive and negative results. These results have prompted the National Ambulance Service to take a range of measures to address the areas where improvements could be made.
There are a number of ongoing programmes and initiatives being undertaken and supported by the National Ambulance Service. For example, a number of NAS managers across the country have undertaken Leadership Development Programmes including Continuous Quality Improvement courses using the Lean Sigma process.
The NAS is also developing anti bullying work place initiatives in line with the Positive Workplace Programme and bespoke sessions for the NAS are currently in development. Staff Health & Wellbeing initiatives and programmes are ongoing in the NAS as part of Healthy Ireland including significant focus on staff health initiatives such as mental wellbeing, physical activity, health checks and improving the workplace environment.
I will now move to discuss the PNA/NASRA dispute. As I have stated before, SIPTU is the main union recognised by the HSE and has negotiating rights for frontline ambulance grades employed by the Executive. Unite and FORSA also represent some ambulance grades. As a result, the HSE deducts subscriptions at source for those ambulance staff that are members of those unions. However, the National Ambulance Service Representative Association (NASRA) is not recognised by the HSE and, therefore, does not have negotiating rights.
Whilst individuals have a right to membership of any trade union, if they choose to join an association which is not recognised by their employer, such membership is not facilitated by their employer. This means that the HSE does not facilitate the deduction of union subscriptions for this particular Association.
While it is regrettable that the PNA has taken industrial action, it is not possible to negotiate with a union which is not recognised as having negotiating rights for ambulance grades. I have asked my Department to engage with the HSE to explore ways forward to see if we can progress a resolution to this dispute.
363. Deputy Stephen S. Donnelly asked the Minister for Health if he or his officials received advice from the national screening service between 25 and 28 April 2018 that recommended against the introduction of out-of-cycle smear tests prior to his decision to approve out of cycle smear tests. [9410/19]
View answerOn 28 April 2018, I made the decision to provide for a free out of cycle smear test for any woman who was concerned, where her GP felt she should have a further test as part of her reassurance.
My Department's advice in this regard was reflected in the press statement issued on the 28 April which said that, “for any woman who has had a CervicalCheck smear test and where her GP feels she should have a further test as part of her reassurance, the Minister has asked CervicalCheck to make the necessary arrangements, including payment provision. These arrangements will be confirmed next week."
A fee to provide for this free repeat smear was subsequently agreed with the Irish Medical Organisation, and welcomed by TDs across the Dáil and by GP representative bodies.
Neither I nor my officials received advice that recommended against these tests in advance of the decision. I understand that, subsequent to the decision, on foot of contact by the Department, concerns were raised by the National Screening Service, but these failed to recognise the circumstances of the unfolding crisis in the programme. Were it not for these circumstances, it would never have been necessary to contemplate such a step in the ordinary course of the operation of the screening programme. The decision cannot be separated from the reality that general practitioners, in difficult circumstances, were dealing with large numbers of worried patients as a result of the issues which came into the public domain over the course of Thursday and Friday, 26th and 27th of April. It was important that GPs be supported while they awaited supporting information to be developed and disseminated by CervicalCheck. The alternative, i.e. that the State failed to recognise the reality of patients presenting in this way to GPs or the State refused to pay for such smears, would have been untenable in the circumstances.
364. Deputy Noel Rock asked the Minister for Health his plans to create a community transport service for those with disabilities needing to attend services which are a substantial distance from their home; and if he will make a statement on the matter. [9434/19]
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.
I understand that the Deputy's question relates, specifically, to the provision of transport for individuals with disabilities attending a day service and as this is a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
