Written Answers Nos. 212-223
212. Deputy Bernard J. Durkan asked the Minister for Health the degree to which he expects to be in a position to implement the recommendations of the Sláintecare report in 2019 and following years; and if he will make a statement on the matter. [21152/19]
View answerAs the Deputy is aware, a detailed Sláintecare Action plan for 2019 was completed and published on March 13th 2019. The Action Plan sets out detailed deliverables and timeframes for 239 deliverables that are to be progressed in 2019 as part of the implementation of the Sláintecare vision and firmly establishes a programmatic approach to the delivery of the Sláintecare Strategy.
In the first quarter of this year the Sláintecare Programme Implementation Office (SPIO) team has been mobilised to support and drive the implementation of these projects working in partnership with the Department units, the HSE and other partners. During the first quarter of 2019, the Sláintecare Executive Director and SPIO team have continued to engage with citizens, stakeholders and frontline staff across the health and social care service to ensure that these voices are involved in the design and delivery of the Sláintecare vision. A number of workshops, site visits and engagement events have taken place around the country with frontline clinicians. Two briefing sessions have been held with members of both the Joint Committee on Health and the former Committee on the Future of Healthcare. The Citizen Engagement and Empowerment Programme continues to be rolled out, with two regional events taking place in Quarter 1.
I refer the Deputy to the actions completed in Quarter 1 of this year, detailed in the Quarter 1 progress report published on the Department of Health website on 3rd May 2019. Detailed below is the activity of the Sláintecare Programme Implementation office to date. I'm happy to report that all deliverables for Q1 2019 are 100% on track.
Sláintecare Programme Implementation Office Activity for Q1 2019
- The Action Plan for 2019 was compiled and published on March 13th following review by the SIAC.
- The dedicated Sláintecare Programme Implementation Office (SPIO) staff of 15 have been mobilised and are now actively working with stakeholders and colleagues to progress the 2019 deliverables.
- The Sláintecare Integration Fund was published on 22nd March 2019, with applications being requested by 18th April 2019. A significant number of application have been submitted.
- The second Sláintecare Implementation Advisory Council (SIAC) meeting was held on 27th Feb. Dr Tom Keane is the Chair of the Advisory Council.
- Four stakeholder workshops were held jointly with the Chief Clinical Officer of the HSE, covering topics on chronic diseases and older persons.
- A Citizen and Staff Engagement and Empowerment Programme has been initiated to ensure the voice of service users is heard in the design of the reform programme.
- Content to support a pro-active communications programme for 2019 is in development.
- First quarter progress report 2019 completed and all 28 (100%) deliverables are on track.
Key Sláintecare Advancements since September 2018
- The DOH, the HSE and the Irish Medical Organisation (IMO) reached consensus on a major package of GP contractual reforms which will benefit patients and make general practice a more attractive career option for doctors (April 2019).
- The 2019 Healthy Ireland campaign has been announced (April 2019).
- The Smile agus Sláinte National Oral Health Policy has been launched with a commitment to elements of universal healthcare to be implemented between 2020 to 2026 (April 2019).
- The HSE Board has been appointed (January 2019) on an administrative basis and HSE Director General has been appointed (April 2019).
- A reduction in prescription charges and a decrease in the threshold for the Drugs Payment Scheme was announced (March 2019).
- The Scheduled Care Access Plan 2019 has been published (March 2019).
- The Oversight Group to implement new model of public health medicine has been established (March 2019).
- The Independent review group on the role of voluntary organisations (Catherine Day Report) has been published (February 2019).
- The joint policy statement “Housing Options for our ageing population” has been launched (February 2019).
- The Independent Patient Advocacy Service contract has been awarded (December 2018).
- The Healthy Ireland Outcomes Framework has been launched (December 2018).
- The National Patient Experience Survey 2018 was published. 86% were happy with the service they received (November 2018).
213. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the number of hospital beds throughout the public health sector needs to be augmented in keeping with demographics; the timescale for such implementation; and if he will make a statement on the matter. [21153/19]
View answerIn January 2018, I published the Health Service Capacity Review which made clear that we need additional capacity across nearly all areas of the health service over the next decade. The review acknowledged the demographic challenge facing the Irish health service in the near future due to our growing population, with our over 65 population set to increase by nearly 60% and the over 85 population set to double. These latter two groups are high users of health servicers and it is important that we invest in order to provide safe and timely care to the whole population.
It is also clear we should not plan investments in the health service as it is currently configured. Investment and reform should go hand in hand with each driving the other. The Capacity Review acknowledged the need for reform of the health service and provided projections based on reform scenarios that align with the Sláintecare vision and reform programme.
Arising from the findings of the Capacity Review, the Government committed to investing in an extra 2,600 beds in our hospitals and 4,500 more community beds in the National Development Plan over the period to 2027.
These increases have already started. Since 2017, an additional 241 beds have been opened. The Capacity Programme for 2019 provides for the following increases to capacity, as set out in the National Service Plan 2019:
- 78 additional beds, including a 40-bed modular build in South Tipperary General Hospital, and a 30-bed ward in Our Lady of Lourdes Hospital Drogheda;
- 75 acute beds and 70 community beds as part of the Winter Plan, of which 60 acute beds and 19 community beds have already opened;
- preparation of 202 beds by quarter 4 2019 with a view to bringing this extra capacity into operation in the first quarter of 2020;
- preparation of the proposed opening of a 60-bed modular build in University Hospital Limerick.
214. Deputy Bernard J. Durkan asked the Minister for Health the number of medical cards issued in 2018 and to date in 2019; the extent to which this has contributed to the overall total; and if he will make a statement on the matter. [21154/19]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
216. Deputy Bernard J. Durkan asked the Minister for Health the number of personnel engaged in the delivery of home care packages; the number of outstanding applications; and if he will make a statement on the matter. [21156/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
218. Deputy Bernard J. Durkan asked the Minister for Health the extent to which primary care centres or the upgrading of existing health centres has progressed throughout north County Kildare; the extent to which all required facilities have been put in place to facilitate the provision of required level of services to the community and the alleviation of pressure on accident and emergency departments and hospital beds; and if he will make a statement on the matter. [21158/19]
View answerAs 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.
219. Deputy Bernard J. Durkan asked the Minister for Health the extent to which orthodontic treatment continues to be made available as appropriate for children and or teenagers who require such treatment; the number of cases treated in each of the past ten years to date; and if he will make a statement on the matter. [21159/19]
View answerAs this is a service matter it has been referred to the HSE for reply to the Deputy.
220. Deputy Bernard J. Durkan asked the Minister for Health the number of new staff recruited to the public health sector in general over the past five years; and if he will make a statement on the matter. [21160/19]
View answerI have asked the HSE to respond directly to the Deputy on this question.
221. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he continues to monitor waiting lists for orthopaedic and cardiac procedures nationally; the extent to which progress is being made in this area; and if he will make a statement on the matter. [21161/19]
View answerReducing waiting time for patients for hospital operations and procedures is a key priority for Government. Budget 2019 announced that the Government has further increased investment in tackling waiting lists, with funding to the National Treatment Purchase Fund (NTPF) increasing from €55 million in 2018 to €75 million in 2019.
The joint Department of Health/HSE/NTPF Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing waiting times for inpatient/day case treatment and outpatient appointments. The plan will place a strong focus on a number of high-volume procedures, including angiograms and hip and knee replacements. When combined with HSE activity, it is projected that the NTPF will be in a position to offer treatment to all clinically suitable patients waiting more than 6 months for one of these high-volume procedures.
The latest National Treatment Purchase Fund (NTPF) Figures (April 2019), show that there were 10,099 patients on the orthopaedic inpatient and daycase waiting list. This represents a decrease of 12% on the same period last year when there were 11,483 patients waiting. Of the total number of patients waiting, 76% (7,702) are waiting 9 months or less, equating to an 8.5% (-722) decrease when compared to the same period last year. Those waiting over 9 months for an orthopaedic procedure has fallen from 3,059 to 2,397, a reduction of over 21%.
As of the end of April 2019, there were 3,788 patients on the Cardiology IPDC waiting list. This represents a decrease of nearly 6% on the same period last year when there were 4,023 patients waiting. Of the total number of patients waiting, 85% (3,221) are waiting 9 months or less, equating to a 4% (-123) decrease when compared to the same period last year. Those waiting over 9 months for a Cardiology procedure has fallen from 679 to 567, a reduction of over 16%.
More broadly, my Department has placed a particular priority on performance improvement in scheduled and unscheduled care in order to improve access for patients. At the end of 2017, a new Unit was established in my Department with a remit to work with colleagues, HSE and NTPF to provide strategic direction and drive a whole-of-Department approach to performance oversight and innovation in this area. The monitoring of waiting lists is a key activity of this Unit.
A further breakdown of the Orthopaedic and Cardiology IPDC waiting lists are provided for Deputy in the tables below.
Orthopaedics IPDC Waiting List April 2019 and 2018
|
0-3 mths |
3-6 mths |
6-9 mths |
9-12 mths |
12-15 mths |
|
|
April 2019 |
3973 |
2345 |
1384 |
912 |
480 |
|
April 2018 |
3826 |
2590 |
2008 |
1202 |
720 |
Table cntd...
|
15-18 mths |
18-24 mths |
24-36 mths |
36+ mths |
Total |
|
|
April 2019 |
330 |
366 |
268 |
41 |
10099 |
|
April 2018 |
408 |
428 |
262 |
39 |
11483 |
Cardiology IPDC Waiting List April 2019 and 2018
|
0-3 mths |
3-6 mths |
6-9 mths |
9-12 mths |
12-15 mths |
15-18 mths |
18-24 mths |
24 + mths |
Total |
|
|
April 2019 |
1871 |
887 |
463 |
212 |
101 |
70 |
114 |
70 |
3788 |
|
April 2018 |
1613 |
1034 |
697 |
289 |
154 |
76 |
119 |
41 |
4023 |
222. Deputy Bernard J. Durkan asked the Minister for Health the number of patients awaiting spinal fusion procedures; if the waiting lists have improved in recent times with a view to being in a position to offer the treatment within six months; and if he will make a statement on the matter. [21162/19]
View answerI 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 committed to improving waiting times for hospital appointments and procedures.
Budget 2019 announced that the Government has further increased investment in tackling waiting lists, with funding to the National Treatment Purchase Fund (NTPF) increasing from €55 million in 2018 to €75 million in 2019. The joint Department of Health/HSE/NTPF Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing wait times for inpatient/day case treatment and outpatient appointments.
According to data provided by the NTPF, as of April 2019, there are 211 patients on the spinal fusion waiting list. This represents a decrease of 32% (-101) when compared with December 2017 and a decrease of 51% (-220) when compared to July 2017. Furthermore, in April 2019, the number of patients waiting over 9 months for a spinal fusion procedure decreased by 53% compared to December 2017 and decreased by 71% when compared to July 2017.
The data requested by the Deputy is outlined in more detail in the document attached. It should be noted that the waiting list as compiled by the NTPF is based on the collation of information for the following procedures:
- Decompression of cervical spinal cord with anterior fusion, 1 level
- Decompression of cervical spinal cord with anterior fusion, 2 or more levels
- Posterior spinal fusion, 1 or 2 levels
- Posterior spinal fusion, 3 or more levels
- Posterolateral spinal fusion, 1 or 2 levels
- Posterolateral spinal fusion, 3 or more levels
- Posterior spinal fusion with laminectomy, 1 level
- Posterolateral spinal fusion with laminectomy, 1 level
- Posterior spinal fusion with laminectomy, 2 or more levels
- Posterolateral spinal fusion with laminectomy, 2 or more levels
- Anterior spinal fusion, 1 level
- Anterior spinal fusion, 2 or more levels
Spinal Fusion IPDC Comparison
|
Row Labels |
0-3 Months |
3-6 Months |
6-9 Months |
9-12 Months |
|
Jul-2017 |
74 |
64 |
34 |
32 |
|
Children's Health Ireland |
21 |
26 |
13 |
14 |
|
Dublin Midlands Hospital Group |
16 |
22 |
10 |
11 |
|
Ireland East Hospital Group |
32 |
14 |
11 |
5 |
|
RCSI Hospitals Group |
||||
|
Saolta University Health Care Group |
5 |
2 |
2 |
|
|
Dec-2017 |
55 |
49 |
49 |
29 |
|
Children's Health Ireland |
23 |
16 |
3 |
5 |
|
Dublin Midlands Hospital Group |
6 |
8 |
21 |
15 |
|
Ireland East Hospital Group |
16 |
19 |
22 |
7 |
|
Saolta University Health Care Group |
4 |
4 |
3 |
2 |
|
South/South West Hospital Group |
6 |
2 |
||
|
Apr-2019 |
75 |
44 |
17 |
10 |
|
Children's Health Ireland |
14 |
22 |
8 |
3 |
|
Dublin Midlands Hospital Group |
31 |
9 |
3 |
2 |
|
Ireland East Hospital Group |
22 |
7 |
3 |
2 |
|
Saolta University Health Care Group |
2 |
5 |
3 |
3 |
|
South/South West Hospital Group |
6 |
1 |
Table cntd...
|
Row Labels |
12-15 Months |
15-18 Months |
18+ Months |
Grand Total |
|
Jul-2017 |
42 |
48 |
137 |
431 |
|
Children's Health Ireland |
6 |
11 |
12 |
103 |
|
Dublin Midlands Hospital Group |
30 |
33 |
101 |
223 |
|
Ireland East Hospital Group |
6 |
4 |
19 |
91 |
|
RCSI Hospitals Group |
1 |
1 |
||
|
Saolta University Health Care Group |
4 |
13 |
||
|
Dec-2017 |
31 |
16 |
83 |
312 |
|
Children's Health Ireland |
6 |
2 |
5 |
60 |
|
Dublin Midlands Hospital Group |
16 |
8 |
69 |
143 |
|
Ireland East Hospital Group |
8 |
5 |
6 |
83 |
|
Saolta University Health Care Group |
1 |
1 |
3 |
18 |
|
South/South West Hospital Group |
8 |
|||
|
Apr-2019 |
7 |
14 |
44 |
211 |
|
Children's Health Ireland |
1 |
2 |
6 |
56 |
|
Dublin Midlands Hospital Group |
4 |
5 |
18 |
72 |
|
Ireland East Hospital Group |
1 |
4 |
16 |
55 |
|
Saolta University Health Care Group |
1 |
3 |
4 |
21 |
|
South/South West Hospital Group |
7 |
223. Deputy Bernard J. Durkan asked the Minister for Health when a spinal fusion procedure will be offered in the case of a person (details supplied); and if he will make a statement on the matter. [21163/19]
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.
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.
