National Children's Hospital

Questions (211)

Bernard Durkan

Question:

211. Deputy Bernard J. Durkan asked the Minister for Health the degree to which precise costings have been identified in respect of the new children’s hospital with particular reference to the need to ensure that the hospital when completed will be in line with best international, modern practice; and if he will make a statement on the matter. [12613/19]

View answer

Written answers (Question to Health)

The vision for the children's hospital project remains to provide modern and appropriate infrastructure to best serve the needs of children, their families and the staff who care for them.

The National Paediatric Hospital Development Board (NPHDB) has statutory responsibility for planning, designing, building and equipping the new children's hospital and outpatient and urgent care centres. The size, complexity and specialist nature of the new children's hospital project informed the decision by the NPHDB to adopt a two-stage procurement process comprised of:

Procurement Stage 1: A full tender and contract for Phase A (below ground including basement works) on the basis of a detailed design with the tendering of Phase B (the main above ground works) on a Preliminary 1st stage design with an approximate and remeasurable bill of quantities reflecting the Preliminary 1st stage design. Contract Awarded to main and specialists contractor 3rd August 2017.

Procurement Stage 2: While the basement Phase A works were under construction, the 2nd stage detailed design for the above ground Phase B works was completed with a full bill of quantities priced at the 1st stage Preliminary design tendered rates. Phase B works instructed 8 January 2019.

That procurement approach resulted in estimated 2-year saving in total project delivery time, and brought issues on cost to the fore, and to be resolved, much earlier in the life of the project than is the case where traditional procurement approaches are deployed.

Following completion of the second stage of the two-stage tender procurement process in November 2018, the capital build cost of the project is now at €1.433b. There is also additional investment from other sources associated with broader programme which is outside of these capital costs. This relates to investment in ICT and the Electronic Health Record rollout funded through the ICT capital programme, the comprehensive Children's Hospital Integration Programme which is well underway, funded through revenue, to ensure the successful clinical and operational merging of three paediatric hospitals, pre-2013 project expenditure relating to the former Mater project, and the planned construction of the Children’s Research and Innovation Centre to be funded through philanthropic funding.

In relation to cost certainty , the Guaranteed Maximum Price (GMP) procurement process agreed with the contractors requires the contractors to take all risk for quantities following completion of the GMP process, and, as per the contract, limits their recovery of additional costs incurred by them to clearly defined scope changes, in excess of 4% inflation (as per the average of three published tender price indices) which may occur post July 2019 and changes in legislation (e.g. VAT, PRSI, statutory labour rates, building regulations). Other than in respect of exclusions, the GMP ceiling cannot be exceeded with any amount in excess not recoverable by contractors.

As the Deputy will be aware, in light of the concerns over the major and sudden cost escalation associated with the finalisation of the GMP, Government also approved the commissioning of an independent review of the escalation in cost at the same time. As part of its Terms of Reference, the review will comment on the major residual risks and the robustness/completeness of the current forecasts and, where possible, quantify those risks contractually excluded from the GMP/adjusted contract sum.

Health Services Staff Data

Questions (212)

Bernard Durkan

Question:

212. Deputy Bernard J. Durkan asked the Minister for Health the number of extra nurses, doctors, consultants and all other staff employed by the public health sector in each of the past five years to date; and if he will make a statement on the matter. [12614/19]

View answer

Written answers (Question to Health)

I have asked the HSE to respond directly to the Deputy on this matter.

Hospital Waiting Lists Data

Questions (213)

Bernard Durkan

Question:

213. Deputy Bernard J. Durkan asked the Minister for Health the number of persons awaiting orthopaedic surgical appointments; the extent to which this number has fluctuated over the past five years to date; and if he will make a statement on the matter. [12615/19]

View answer

Written answers (Question to Health)

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.

The recently published National Treatment Purchase Fund (NTPF) Waiting List figures show that at the end of February 2019, there are 10,949 patients on the Orthopaedics Inpatient and Daycase (IPDC) waiting list. Of these, 62% (6,837) are waiting 6 months or less, 77% (8,402) are waiting 9 months or less and 15% (1,657) are waiting over 12 months.

Budget 2019 announced that the Government had further increased investment in tackling waiting lists, with funding to the NTPF increasing from €55 million in 2018 to €75 million in 2019.

I published the joint Department of Health, Health Service Executive (HSE) and National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan earlier this week. This Plan sets out a number of commitments aimed at improving access for patients waiting for hospital operations or procedures as well as patients waiting for a first Outpatient appointment.

The data requested by the Deputy is contained in the following table. These figures are published by the NTPF on their website ntpf.ie.

Orthopaedic IPDC Waiting List -Dec 2014 - February 2019

0-3 Months

3-6 Months

6-9 Months

9-12 Months

12-15 Months

15-18 Months

18 + Months

Total

February 2019

3783

3054

1565

890

518

362

777

10949

February 2018

3868

3029

1924

1277

668

496

708

11970

December 2017

4257

2784

1811

1102

637

349

593

11533

December 2016

4330

2608

1923

1164

763

333

110

11272

December 2015

4156

2479

1549

866

500

60

113

9723

December 2014

4099

2565

1564

782

546

183

103

9842

Hospital Waiting Lists Data

Questions (214)

Bernard Durkan

Question:

214. Deputy Bernard J. Durkan asked the Minister for Health the number of persons currently on public hospital waiting lists for various procedures; the length of time they have remained on these lists; when they can expect to receive treatment; and if he will make a statement on the matter. [12616/19]

View answer

Written answers (Question to Health)

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.

The latest published National Treatment Purchase Fund (NTPF) Inpatient and Daycase waiting list figures, show that at the end of February 2019 there are 71,205 patients on the IPDC waiting list. From a peak of 86,100 in July 2017, this represents a decrease of over 17% in the overall number of patients waiting for a procedure.

Since July 2017 the number of patients waiting longer than 3 months has fallen from just under 58,000 to 44,800 at the end of February 2019. This represents a reduction of 23% in the number of patients waiting.

I published the joint Department of Health, Health Service Executive (HSE) and National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan earlier this week. This Plan sets out a number of commitments aimed at improving access for patients waiting for hospital operations or procedures as well as patients waiting for a first Outpatient appointment. It includes a high level activity target from the HSE in line with the National Service Plan to deliver 1.155 million elective inpatient and day case discharges and 3.3 million outpatients appointments in 2019. While the NTPF will provide additionality through arranging treatments for 25,000 elective inpatient and day case procedures; 5,000 Gastro Intestinal Scopes; and 40,000 outpatient first appointments.

The data requested by the deputy is outlined in the tables. These figures are published by the NTPF on their website ntpf.ie

All National Hospitals - National Waiting list by Speciality.

Row Labels

 0-3 Mths

 3-6 Mths

 6-9 Mths

 9-12 Mths

12-15 Mths

Anaesthetics

80

75

50

45

55

Breast Surgery

35

15

17

16

6

Cardiology

1702

1135

423

179

102

Cardio-Thoracic Surgery

225

117

57

30

11

Clinical Immunology

67

70

35

141

27

Dental Surgery

92

63

30

34

31

Dermatology

429

160

48

17

13

Diabetes Mellitus

1

1

Endocrinology

22

7

2

2

3

Gastro-Enterology

138

60

14

5

1

Gastro-Intestinal Surgery

111

85

78

59

36

General Medicine

117

39

20

10

4

General Surgery

4213

2537

1278

651

378

Geriatric Medicine

4

8

4

10

4

Gynaecology

1875

1242

725

380

208

Haematology

8

1

0

Hepato-Biliary Surgery

20

21

13

13

9

Immunology

14

22

5

16

13

Infectious Diseases

0

Maxillo-Facial

254

207

142

61

48

Metabolic Medicine

0

0

0

1

Neonatology

0

0

0

Nephrology

26

17

11

13

2

Neurology

128

50

26

20

14

Neurosurgery

153

124

74

62

42

Obstetrics

7

1

3

0

Oncology

15

3

1

1

Ophthalmology

3344

2934

1504

552

318

Oral Surgery

101

99

92

104

50

Orthopaedics

3783

3054

1565

890

518

Otolaryngology (ENT)

1695

1111

569

380

314

Paed Cardiology

126

78

46

42

17

Paed Endocrinology

0

1

0

0

0

Paed Gastro-Enterol

8

1

2

0

Paed Haematology

0

0

0

Paed Nephrology

1

3

0

Paed Oncology

0

0

Paediatric ENT

59

36

10

7

0

Paediatric Neurology

6

0

0

2

1

Paediatric Respiratory Medicine

81

78

63

60

29

Paediatric Surgery

19

16

4

1

1

Paediatrics

108

63

43

56

36

Pain Relief

1123

878

579

473

243

Plastic Surgery

1302

855

396

246

157

Psychiatry

0

Radiology

8

8

2

4

2

Respiratory Medicine

380

319

219

166

62

Rheumatology

146

53

27

33

15

Urology

3713

2353

1392

560

310

Vascular Surgery

608

576

368

171

111

Paediatric Radiology

0

Rehabilitation Medicine

0

1

1

Paediatric Urology

32

24

17

21

17

Paediatric Neurosurgery

3

Paed Metabolic Medicine

3

0

1

2

Paediatric Dermatology

1

0

1

Paediatric Infectious Diseases

1

Developmental Paediatrics

2

1

Grand Total

26389

18602

9954

5538

3209

Row Labels

15-18 Mths

18-24 Mths

24-36 Mths

36-48 Mths

48+ Mths

Grand Total

Anaesthetics

15

320

Breast Surgery

5

2

96

Cardiology

77

110

76

1

3805

Cardio-Thoracic Surgery

3

8

10

461

Clinical Immunology

11

351

Dental Surgery

21

20

1

292

Dermatology

17

5

3

692

Diabetes Mellitus

2

Endocrinology

2

1

39

Gastro-Enterology

1

3

1

1

224

Gastro-Intestinal Surgery

14

31

33

14

461

General Medicine

3

6

1

200

General Surgery

264

389

344

69

32

10155

Geriatric Medicine

15

45

Gynaecology

148

142

56

11

4

4791

Haematology

9

Hepato-Biliary Surgery

15

12

23

1

127

Immunology

22

41

21

154

Infectious Diseases

0

Maxillo-Facial

35

82

75

1

1

906

Metabolic Medicine

0

1

Neonatology

0

Nephrology

0

69

Neurology

10

16

26

0

290

Neurosurgery

41

75

108

2

681

Obstetrics

0

11

Oncology

20

Ophthalmology

197

198

128

8

0

9183

Oral Surgery

24

27

43

13

1

554

Orthopaedics

362

434

305

33

5

10949

Otolaryngology (ENT)

196

295

314

38

2

4914

Paed Cardiology

16

7

7

1

340

Paed Endocrinology

0

0

1

2

Paed Gastro-Enterol

0

0

11

Paed Haematology

0

Paed Nephrology

0

4

Paed Oncology

0

Paediatric ENT

0

2

1

115

Paediatric Neurology

9

Paediatric Respiratory Medicine

11

322

Paediatric Surgery

0

0

41

Paediatrics

34

98

85

13

536

Pain Relief

189

114

27

1

3627

Plastic Surgery

158

247

225

27

0

3613

Psychiatry

0

Radiology

2

3

29

Respiratory Medicine

48

21

1

1216

Rheumatology

26

11

1

312

Urology

170

239

218

32

1

8988

Vascular Surgery

95

111

55

4

2099

Paediatric Radiology

0

0

Rehabilitation Medicine

2

Paediatric Urology

3

7

1

122

Paediatric Neurosurgery

3

Paed Metabolic Medicine

6

Paediatric Dermatology

2

Paediatric Infectious Diseases

1

Developmental Paediatrics

3

Grand Total

2248

2758

2191

270

46

71205

National Waiting List by Hospital

Row Labels

 0-3 Mths

 3-6 Mths

 6-9 Mths

 9-12 Mths

12-15 Mths

15-18 Mths

Bantry General Hospital

110

7

Beaumont Hospital

2271

1800

830

519

217

102

Cappagh National Orthopaedic Hospital

633

596

186

57

8

3

Cavan General Hospital

374

210

42

0

0

Cork University Hospital

483

276

169

113

50

51

Cork University Maternity Hospital

170

120

57

39

16

10

Croom Orthopaedic Hospital

161

40

8

Ennis Hospital

268

193

176

64

9

0

Lourdes Orthopaedic Hospital Kilcreene

172

69

7

0

0

Louth County Hospital

257

82

23

1

Mallow General Hospital

45

34

21

6

5

3

Mater Misericordiae University Hospital

1994

1692

885

395

264

181

Mercy University Hospital

464

210

100

54

37

35

Midland Regional Hospital Mullingar

155

131

52

5

0

Midland Regional Hospital Portlaoise

161

120

78

54

34

28

Midland Regional Hospital Tullamore

477

368

226

136

71

69

Naas General Hospital

88

44

16

10

6

2

Nenagh Hospital

620

487

253

66

27

7

Our Lady of Lourdes Hospital Drogheda

258

230

115

12

1

Our Lady's Hospital Navan

371

204

115

38

10

2

Royal Victoria Eye and Ear Hospital

824

533

233

66

34

6

South Infirmary Victoria University Hospital

1236

755

316

107

53

41

South Tipperary General Hospital

89

50

2

0

St. Columcille's Hospital

213

178

115

16

18

18

St. James's Hospital

1148

944

511

388

236

171

St. John's Hospital Limerick

430

242

147

102

40

23

St. Luke's General Hospital Kilkenny

304

189

95

58

27

6

St. Vincent's University Hospital

1008

538

333

167

88

82

University Hospital Limerick

825

505

257

125

105

64

University Hospital Waterford

1689

1356

926

515

333

240

Wexford General Hospital

172

48

6

0

Tallaght University Hospital

1045

756

490

364

308

173

Letterkenny University Hospital

853

510

266

99

48

35

Connolly Hospital Blanchardstown

494

334

219

105

40

10

CHI at Crumlin

721

562

288

250

158

134

Galway University Hospitals

2722

2228

1265

830

480

405

Sligo University Hospital

985

650

388

248

179

131

CHI at Tallaght

164

122

75

97

47

39

CHI at Temple St

340

230

117

90

53

35

University Hospital Kerry

139

74

22

11

Portiuncula University Hospital

119

55

35

31

7

2

Mayo University Hospital

625

513

359

240

177

109

St. Michael's Hospital

345

133

85

50

10

13

Roscommon University Hospital

367

184

45

10

13

18

Grand Total

26389

18602

9954

5538

3209

2248

Row Labels

18-24 Mths

24-36 Mths

36-48 Mths

48+ Mths

Grand Total

Bantry General Hospital

117

Beaumont Hospital

94

110

2

5945

Cappagh National Orthopaedic Hospital

4

2

0

1489

Cavan General Hospital

626

Cork University Hospital

70

69

11

1292

Cork University Maternity Hospital

20

10

2

444

Croom Orthopaedic Hospital

209

Ennis Hospital

1

711

Lourdes Orthopaedic Hospital Kilcreene

248

Louth County Hospital

363

Mallow General Hospital

3

0

117

Mater Misericordiae University Hospital

326

279

56

5

6077

Mercy University Hospital

27

33

2

962

Midland Regional Hospital Mullingar

0

343

Midland Regional Hospital Portlaoise

23

2

500

Midland Regional Hospital Tullamore

108

94

2

1551

Naas General Hospital

1

167

Nenagh Hospital

5

2

1467

Our Lady of Lourdes Hospital Drogheda

0

0

616

Our Lady's Hospital Navan

0

740

Royal Victoria Eye and Ear Hospital

6

1

1703

South Infirmary Victoria University Hospital

35

9

2

2554

South Tipperary General Hospital

141

St. Columcille's Hospital

11

8

12

5

594

St. James's Hospital

275

225

0

1

3899

St. John's Hospital Limerick

18

0

1002

St. Luke's General Hospital Kilkenny

0

679

St. Vincent's University Hospital

94

69

33

19

2431

University Hospital Limerick

71

48

1

2001

University Hospital Waterford

283

185

6

5533

Wexford General Hospital

226

Tallaght University Hospital

210

182

16

1

3545

Letterkenny University Hospital

49

25

0

1885

Connolly Hospital Blanchardstown

1

1203

CHI at Crumlin

195

152

20

0

2480

Galway University Hospitals

479

470

77

15

8971

Sligo University Hospital

176

154

21

2932

CHI at Tallaght

48

25

1

618

CHI at Temple St

36

11

1

913

University Hospital Kerry

0

246

Portiuncula University Hospital

249

Mayo University Hospital

61

15

5

2104

St. Michael's Hospital

4

1

641

Roscommon University Hospital

24

10

0

0

671

Grand Total

2758

2191

270

46

71205

Hospitals Capital Programme

Questions (215)

Bernard Durkan

Question:

215. Deputy Bernard J. Durkan asked the Minister for Health the position in regard to the upgrading and extension of facilities as Naas General Hospital, County Kildare; and if he will make a statement on the matter. [12617/19]

View answer

Written answers (Question to Health)

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 Naas General Hospital, County Kildare.

Nursing Home Services

Questions (216)

Bernard Durkan

Question:

216. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he can extend the lifespan of a nursing home (details supplied) having particular regard to the high quality service and care provided there, the presence of a dedicated staff and the locally supported proposal to provide extra care facilities for the region there; and if he will make a statement on the matter. [12618/19]

View answer

Written answers (Question to Health)

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

Primary Care Centres Data

Questions (217)

Bernard Durkan

Question:

217. Deputy Bernard J. Durkan asked the Minister for Health the number of primary care centres operating throughout County Kildare; the extent to which it is expected to provide more throughout the county or in lieu thereof provide upgraded health centres to meet the needs of the various communities; and if he will make a statement on the matter. [12619/19]

View answer

Written answers (Question to Health)

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.

Hospital Staff Data

Questions (218)

Bernard Durkan

Question:

218. Deputy Bernard J. Durkan asked the Minister for Health the extent to which staffing levels in all categories at Naas General Hospital are adequate to ensure the effective, efficient and safe operation of the hospital; the number of positions available waiting to be filled; and if he will make a statement on the matter. [12620/19]

View answer

Written answers (Question to Health)

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

General Practitioner Services Provision

Questions (219)

Bernard Durkan

Question:

219. Deputy Bernard J. Durkan asked the Minister for Health the action he has taken or can take to ensure the availability of a ready supply of general practice doctors nationally in both urban and rural settings; and if he will make a statement on the matter. [12621/19]

View answer

Written answers (Question to Health)

The Government is aware of workforce issues generally facing general practice, including the influence of demographic factors, and has implemented a number of measures to improve recruitment and retention in general practice.

These include changes to the entry provisions to the GMS scheme to accommodate more flexible/shared GMS/GP contracts, and to the retirement provisions for GPs under the GMS scheme, allowing GPs to hold GMS contracts until their 72nd birthday. Enhanced supports for rural GP practices have also been introduced. 257 GP practice units encompassing 347 individual GPs are now in receipt of financial supports under this framework, a significant increase on the 167 GPs who received a rural practice allowance prior to the introduction of this measure. These steps should help to address the future demand for GPs by enticing GPs who may have ceased practicing for family or other reasons back into the workforce, facilitating GPs to work past the standard retirement age and encouraging more GPs to work in rural areas.

There has been a huge expansion in the number of training places on GP training programmes in recent years. In 2009, there were 120 GP training places available and in 2018 193 places were filled, an increase of around 60% over this nine year period.

It is acknowledged that there are many challenges in general practice. That is why Government remains committed to engaging with GP representatives on the development of a package of measures and reforms to modernise the current GMS contract.

Talks between the Department of Health, the HSE and the Irish Medical Organisation are continuing. 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.

Hospital Appointments Status

Questions (220)

Robert Troy

Question:

220. Deputy Robert Troy asked the Minister for Health if an appointment will be expedited for a person (details supplied). [12622/19]

View answer

Written answers (Question to Health)

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.