Written Answers Nos. 1-40
6. Deputy Barry Cowen asked the Minister for Health the action being taken to reduce the long waiting times for a first assessment for occupational therapy in counties Laois and Offaly; and if he will make a statement on the matter. [20912/19]
View answerI acknowledge that the current time to access Occupational Therapy services can be too long in certain locations and that this may cause anxiety for parents and patients who are currently waiting to access services.
That is why the HSE will be prioritising investment in Occupational Therapy in 2019 to reduce waiting times and improve access to services. Across the country, 40 additional OTs will be recruited by the end of the year, and there will be a focus on addressing those cases where people have been waiting over 52 weeks. In total, HSE’s National Service Plan estimates that over 350,000 primary care occupational therapy patients will be seen in 2019.
In addition, local HSE management continue to endeavour to provide the highest quality service and to prioritise referrals based on clinical need. In 2018 and early 2019, management in CHO 8 developed waiting list initiatives that were targeted at those waiting longest for OT services. As a result of this, there was decrease of 400 in the number of the longest waiting clients in Laois and Offaly, a reduction of 35%.
Further efforts to tackle access times and implement service improvement plans will be considered as resources permit. Notwithstanding the HSE's current interim financial and recruitment control measures, I believe that it is essential that we continue to invest in and develop our primary care services and infrastructure in order to reform and modernise our health system to ensure better access to care and deliver sustainability and best value for population health.
11. Deputy Mary Butler asked the Minister for Health his plans to expand the model of care homes unique to the south east that provides residential accommodation for adults that require minimal assistance of a low to medium dependency; and if he will make a statement on the matter. [20800/19]
View answerA key principle underpinning Government policy is to support older people to live in their own home as long as possible.
There will, however, always be people whose needs are best met in a residential care setting or supported housing model. There are 10 Supported Care Homes in Community Healthcare Organisation Area 5 providing accommodation and support services to older people with low to medium dependency levels. The residents cannot be maintained independently at home, but do not yet require nursing home care. The HSE acknowledges the role played by these Homes in reducing possible admission to nursing homes. The HSE will provide about €2.5 million in Section 39 funding this year towards the operational costs of the Homes. I have been assured by the HSE that it is committed to ensuring Supported Care Homes are supported while recognising that there are also strengths to services for older people in other parts of the country which also assist in reducing unnecessary admissions to nursing homes.
As people get older, their housing needs may change. The Government recently launched a Policy Statement “Housing Options for our Ageing Population” which provides a policy framework to support our ageing population through increasing the accommodation options available to them and give them meaningful choice in how and where they choose to live. It also sets out a package of key actions that will assist the development of models of supported housing that promote integration between housing and health and social care services.
An Inter-Departmental and Inter-Agency Implementation Group, with an independent Chair is being established to progress the programme of actions contained in the policy statement. This will assist in developing a menu of solutions which are available nationally to provide enhanced housing and support options for older people.
14. Deputy Catherine Connolly asked the Minister for Health the status of the options appraisal for the model 4 hospitals in Galway; when it will be published; and if he will make a statement on the matter. [20832/19]
View answerAs the Deputy is aware, in May 2017, I gave approval to Saolta University Health Care Group to conduct an options appraisal for future acute hospital needs in Galway.
As part of this, Saolta is undertaking a planning project to assess the population health needs for the Hospital’s catchment area in order to inform existing and future service needs.
The assessment will provide an options appraisal of the infrastructural requirements for Galway as a Model 4 hospital, which operates across two sites including the model 2 hospital at Merlin park.
The Galway Hospitals serve as the tertiary referral centre for complex care for patients of the Saolta Hospital Group, including cancer and cardiac care for the West and North West Region, as well as being the primary acute hospital for secondary care for patients from Galway and adjacent counties.
Saolta has advised that the options appraisal will be completed by the end of July 2019. The reason for this revised schedule was that the project had to be re-tendered as there was no successful outcome from the initial tender process which was undertaken early in 2018. In addition, the scope of the report has been revisited to incorporate interim priority infrastructural requirements.
16. Deputy Lisa Chambers asked the Minister for Health the reason for the significant overcrowding in the emergency department in Mayo University Hospital during April 2019 [20822/19]
View answerThe Winter Plan 2018/19, recognising the multiple factors across the health service that impact on Emergency Department performance, included a range of measures to support patients accessing services in the community and in hospitals. Planning for Winter 2019/20 has already commenced, with a review of performance over the Winter Period currently underway to ensure that the lessons learned from this year inform future plans.
With regard to Mayo University Hospital, for the first quarter of 2019, in comparison to 2018, the number of patients attending the Emergency Department increased by 2.3% and the number of patients admitted decreased by 2.9%. The number of patients recorded on trolleys at 8am reduced by 4.2%.
Unfortunately, the improved trolley performance did not continue into April and provisional TrolleyGAR data highlights that the number of patients waiting on trolleys in Mayo University Hospital increased from 145 in 2018 to 359 in 2019.
Data in relation to attendance and admissions for April is not available at this time. However, the HSE has advised that hospitals are reporting very high levels of demand, high patient acuity and high bed occupancy, especially in the over 75-year old cohort of patients. In addition, delayed discharges are above the expected activity threshold set out in the National Service Plan and Hospitals and Community Health Organisations are reporting constrained options for supported discharges, particularly in relation to home support and long-term care.
Building upon the actions in the Winter Plan, and to meet the ongoing operational challenges, robust planning arrangements were put in place for the Easter and May bank holiday weekends by Hospital Groups and Community Health Organisations, and efforts are continuing to build upon the improved performance achieved nationally and in Mayo University Hospital in the first three months of the year.
17. Deputy Margaret Murphy O'Mahony asked the Minister for Health if he will report on his discussions with Rehab; the funding it requires to continue providing services on behalf of the HSE; and if he will make a statement on the matter. [20814/19]
View answerThis Government’s on-going priority is the safeguarding of vulnerable people in the care of the health service. We are committed to providing services and supports for people with disabilities which will empower them to live independent lives.
Significant resources have been invested by the health sector in disability services over the past number of years. Since this Government took up office, the budget for Disability Services has increased by €314 million. This year alone, the Health Service Executive has allocated €1.9 billion to its Disability Services Programme.
My primary concern is to ensure the continuity of appropriate person-centred disability services is maintained and delivered in an equitable manner consistent with the care and support needs of individuals. I want to acknowledge the important services provided by Rehab and the commitment of the staff of Rehab to people with a disability and their families.
I am informed by the HSE that the total revenue allocation provided by the HSE to Rehab for social services has increased by €8.1 million to €56.1 million in 2019 when compared with the allocation in 2016.
Rehab provides a range of services to young people and adults with physical, sensory and intellectual disabilities, mental health difficulties, autism, or acquired brain injury. Services are co-ordinated through Rehab’s three service delivery divisions, RehabCare, the National Learning Network and Rehab Enterprises.
Rehab and the HSE have committed to working intensively together with a view to making substantive progress in reaching a solution to the issues.
Rehab have agreed not to issue a notice of termination, pending the conclusion of this intensive work with the HSE. Both I and Minister Harris have committed to a further meeting with Rehab and the HSE later today, Wednesday, 15th May.
18. Deputy Mary Butler asked the Minister for Health if he will address the issue of the lack of dedicated Parkinson’s disease nurses provided by the HSE for the 12,000 patients with this disease; and if he will make a statement on the matter. [20801/19]
View answerThe HSE Model of Care for Neurology provides a framework for neurology services, including for Parkinson's Disease patients, using international best practice and describes care provision using an integrated service approach. The model is fully aligned with the objectives of Sláintecare and proposes a hub and spoke model, with services provided as close to home as possible but with access to specialist services where required.
The roles performed by Parkinson’s Disease Nurse Specialists include identifying the patient’s needs and coordinating their care; monitoring symptoms; helping with drug management; and providing emotional and lifestyle support.
The HSE has advised that there are currently 2 Advanced Nurse Practitioners in Neurology and 5 Parkinson’s Disease Nurse Specialists employed by the public health service.
Investment in treatment for Parkinson’s Disease is ongoing. In 2018, funding was allocated to the Mater Hospital to commence the service to care for Deep Brain Stimulation which is a surgical procedure aimed at providing relief of motor function symptoms that are no longer controlled by drug therapy. The funded posts include two Clinical Nurse Specialists.
The HSE has further advised that, under the model of care for neurology, it is intended that multidisciplinary services will be provided to Parkinson's Disease patients using an outreach model. Specialist nurses will be centrally involved in integrating these services.
19. Deputy Peadar Tóibín asked the Minister for Health if the future of the 24-hour emergency department in Navan hospital will be guaranteed. [20921/19]
View answerOur Lady’s Hospital Navan is part of the Ireland East Hospital Group. In 2013 Our Lady’s Hospital Navan was included in the list of designated Model 2 Hospitals under the Smaller Hospitals Framework. Every hospital in the Group, large and small, has a vital role to play within the Group, with smaller hospitals, such as Navan Hospital, managing routine, urgent or planned care locally and more complex care managed in the larger hospitals.
The Hospital Group is engaged in a programme of re-design work to further integrate and enhance the role of Navan Hospital within the Group and to ensure that it will provide more services safely and appropriately with better linkages to primary, continuing and social care.
There are no immediate plans to change Emergency Department services at Navan. Ireland East Hospital Group has been developing an Implementation Plan for future service configuration at Navan Hospital. Proposed changes to any Emergency Department service will only take place in the context of overall service reorganisation in the Hospital Group and will be undertaken in a planned and orderly manner.
It is intended that the Hospital Group will continue to engage closely with all interested parties to ensure that the needs of patients, staff, the local and wider community are addressed.
20. Deputy John Lahart asked the Minister for Health the reason for the significant overcrowding in the emergency department in Tallaght University Hospital during April 2019. [20819/19]
View answerThe Winter Plan 2018/19, recognising the multiple factors across the health service that impact on Emergency Department performance, included a range of measures to support patients accessing services in the community and in hospitals. Planning for Winter 2019/20 has already commenced, with a review of performance over the Winter Period currently underway to ensure that the lessons learned from this year inform future plans.
With regard to Tallaght University Hospital, for the first quarter of 2019, in comparison to 2018, the number of patients attending the Emergency Department increased by 8.9% and the number of patients admitted increased by 13.3%. However, the number of patients recorded on trolleys at 8am reduced by 48.5%. This is a very significant achievement in improving patient trolley waits in the context of an overall growth in demand.
While this level of improved trolley performance did not continue into April, provisional TrolleyGAR data highlights that the number of patients waiting on trolleys in Tallaght University Hospital decreased from 532 in April 2018 to 498 in April 2019, a 6.4% reduction.
Data in relation to attendance and admissions in April is not available at this time. However, the HSE has advised that hospitals are reporting very high levels of demand, high patient acuity and high bed occupancy, especially in the over 75-year-old cohort of patients. In addition, delayed discharges are above the expected activity threshold set out in the National Service Plan and Hospitals and Community Health Organisations are reporting constrained options for supported discharges, particularly in relation to home support and long-term care.
Building upon the actions in the Winter Plan, and to meet the ongoing operational challenges, robust planning arrangements were put in place for the Easter and May bank holiday weekends by Hospital Groups and Community Health Organisations, and efforts are continuing to build upon the improved performance achieved nationally and in Tallaght University Hospital in the first three months of the year.
21. Deputy Catherine Connolly asked the Minister for Health the physiotherapy services in Connemara; when a physiotherapist will be appointed in the Connemara region; and if he will make a statement on the matter. [20830/19]
View answerI acknowledge that challenges exist in the delivery of physiotherapy services in Connemara. However, I am assured by the HSE that efforts are being undertaken to minimise the impact on patients.
I understand that the physiotherapist post assigned to the South Connemara Primary Care Team has recently become vacant after being filled on a continuous but temporary basis since August 2018. The CHO is currently developing a staffing plan consistent with the funding levels available, and it is expected that the post will be addressed in this context.
The HSE has reconfigured services for the South Connemara area to address the challenges in this area, including centralising services to Galway city for those with an urgent clinical need.
I firmly believe that it is essential that we reposition our health services and focus on developing a strong and effective primary care system if we are to meet the challenges associated with an ageing population, the prevalence of chronic diseases and rising health care costs.
It is for this reason that the Government increased funding for primary care by more than €50m or 6.1% in 2019 compared to 2018. This investment will support the development of an accessible and comprehensive primary care system.
23. Deputy Mick Wallace asked the Minister for Health if he will consider publishing a redacted version of the contract for the national children's hospital in the interest of transparency and accountability; and if he will make a statement on the matter. [20887/19]
View answerIt is not my intention to publish the contract relating to the new children's hospital construction. However, I contacted the National Paediatric Hospital Development Board on the matter and have been provided with a redacted contract which I will make available to the Deputy.
24. Deputy Stephen Donnelly asked the Minister for Health the measures that will be taken to reduce waiting times for children awaiting assessment by early intervention teams in County Wicklow; and if he will make a statement on the matter. [20747/19]
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.
The HSE is aware of the waiting times for the Early Intervention Teams in Wicklow. Currently staff vacancies are filled where agency staff are available or where staff from the appropriate staff panels are available. There are specific deficiencies in terms of Psychology positions and continued attempts are made to fill such positions through agency deployment and outsourcing assessments where practical.
Government approved 100 additional therapy posts nationally as part of Budget 2019. These 100 posts are dedicated posts for the assessment of need process. Community Healthcare East (which incorporates Wicklow) was allocated 3.5 posts in the first phase of allocation. These positions are being filled at present.
The national Progressing Disability Services for Children & Young People programme will change the way services are provided across the country to make it equitable and consistent for all, Community Healthcare East had an anticipated implementation date of Q3/2019, senior management within Community Healthcare East have also engaged with key partners in the voluntary disability sector to improvement co-operation towards a joint approach to assessment. It is anticipated that this will bring a substantial improvement in assessment throughout for the 3rd and 4th quarters of 2019.
25. Deputy Catherine Connolly asked the Minister for Health the timeframe for the delivery of the new radiation oncology unit in University Hospital Galway; the number of vacancies in oncology at the hospital; the number of persons on the waiting list for oncology services at the hospital; the length of time they have been on the waiting list; and if he will make a statement on the matter. [20833/19]
View answerConstruction on the new Radiation Oncology Unit at University Hospital Galway (UHG) is expected to be completed in April 2021. It will open to patients following the completion of clinical commissioning in March 2022.
UHG have made the Department aware of seven oncology-related vacancies in the Hospital, including five at staff nursing level and two within management and administration. I am advised that UHG are taking the necessary steps to recruit to these positions.
The key performance indicator for access to radiotherapy services measures the percentage of patients referred for radiation oncology treatment who were offered an appointment within 15 working days. In March of this year, 97% of these patients were offered an appointment within this timeframe, above the 90% target set out in the National Cancer Strategy 2017-2026.
UHG have advised that there are 23 patients on their oncology waiting list. An appointment date has been allocated to 22 of these patients and an appointment for the remaining person will be made shortly.
26. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he is satisfied that issues affecting long waiting lists in public hospitals, overcrowding at accident and emergency units and other contributory factors affecting the fast, efficient and effective delivery of public health services are fully addressed or are in the course of so being; and if he will make a statement on the matter. [20878/19]
View answerI am committed to tackling the key challenges our health service faces in relation to long waiting times and hospital overcrowding. Improving timely access for patients to scheduled and unscheduled care is at the heart of Sláintecare. Building upon the process made in recent years in this area, the Sláintecare Action Plan 2019 published by my Department, includes a specific workstream on Access and Waiting Lists. In addition, many of the other service reforms and enhancements included in the Action Plan and in Sláintecare will support timely access to care for patients in the coming years.
Progress has already been made in implementing the Sláintecare Action Plan Waiting List and Access actions this year.
In March, I published the Scheduled Care Access Plan 2019. The plan includes a target to reduce the overall number of patients on the waiting list for hospital operations and procedures to 60,000 by year end. It is worth recalling that the number of patients waiting was 86,000 in July 2017 and significant progress has been made over the past two years.
The Access Plan sets out the activity levels for the National Treatment Purchase Fund (NTPF) who, following an increase in funding in Budget 2019 to €75 million, will supply additionality to HSE activity in order to reduce waiting times experienced by patients for a hospital appointment, operation or procedure.
With regard to unscheduled care, the Winter Plan 2018/19 was designed to ensure that the Health system was well prepared, within existing financial and capacity requirements, to meet the increased demand for services over the Winter period. In Q1 2019 the overall number of patients attending Emergency Departments increased by 8%, admissions increased by 5%, however, trolleys reduced by 12%. The 8am trolley count, while still too high at just under 29,000 in Q1 2019, was the lowest level recorded in five years. Work has commenced on preparations for Winter 2019/20.
The Health Service Capacity Review published last year, highlighted the need for a major investment in additional capacity in both hospital and community. Progress has also been on the increasing capacity and the average number of open inpatient beds has increased by 3% between 2017 and Q1 2019 to 10,969 and further investment is scheduled in 2019 and 2020.
27. Deputy John Brady asked the Minister for Health if he will extend the newborn screening test pilot scheme for detecting metachromatic leukodystrophy and severe combined immunodeficiency; and if he will make a statement on the matter. [20904/19]
View answerAll newborn babies (between 3 and 5 days old) are offered newborn bloodspot screening (generally known as the ‘heel prick’) through their parents/guardians for eight very rare conditions that are treatable if detected early in life.
These include:
- cystic fibrosis
- congenital hypothyroidism
- phenylketonuria
- classical galactosaemia
- MCADD (medium-chain acyl-CoA dehydrogenase deficiency)
- homocystinuria
- maple syrup urine disease
- glutaric aciduria type 1
The most recent expansion of the programme occurred on 3rd December 2018 when screening for Medium Chain Acyl-CoA Dehydrogenase Deficiency (MCADD) and Glutaric Aciduria Type 1 (GA1) commenced.
Metachromatic leukodystrophy and severe combined immunodeficiency are not currently screened for as part of this screening programme in Ireland.
However, and as per recommendation 5, contained within the Scally Review (2018), a National Screening Committee will be established and become operational before the end of 2019. This is to strengthen the governance, transparency and oversight of any proposed new programmes or changes to existing programmes. Similar to the UK National Screening Committee, the Committee’s role will be to undertake an independent assessment of the evidence for screening for a particular condition against internationally accepted criteria and make recommendations accordingly.
Any future potential changes to the National Newborn Bloodspot Screening Programme will be incorporated as part of the Committee's work programme.
28. Deputy Alan Kelly asked the Minister for Health his plans to ease the record overcrowding in University Hospital Limerick; and if he will make a statement on the matter. [20491/19]
View answerI wish to acknowledge the distress overcrowded Emergency Departments cause to patients, their families and frontline staff working in very challenging working conditions in hospitals throughout the country.
The hospital system is currently operating at close to full capacity. The Emergency Department in University Hospital Limerick is one of the busiest in the country, with the number of patients attending growing year on year.
Limerick was identified as one of the 9 sites requiring additional investment, focus and support as part of this year's Winter Plan. The problem of overcrowding in hospitals requires a full-system, patient-focused response. Recognising this, in the Winter Plan, the HSE sought to maximise the use of existing resources across hospital groups and CHOs and to target additional investment at both hospital and community services and supports.
The range and prioritisation of measures was a matter for University Hospital Limerick and CHO Mid-West. Key measures included:
- additional home support packages and transitional care beds to support people to leave the hospital and return home;
- extended opening hours in the AMAU;
- opening of a surgical short stay unit;
- additional access to diagnostics.
The NTPF established a fund of €1m to support the HSE Winter Plan with a focus on increasing access to diagnostics in both private facilities and in-house. 6,350 vouchers had been issued to Emergency Departments for diagnostics as of 28 April 2019, including 1,050 vouchers issued to UHL.
Since 2017, an additional 25 beds have opened in Limerick, including 8 as part of this year's Winter Plan.
A capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at UHL, with funding of €10 million allocated in 2019. Enabling works commenced in March 2019, and the HSE advise that the main works are expected to start at the end of May 2019.
In addition, the National Development Plan includes a 96-bed replacement ward block in Limerick and capital funding was provided in 2018 to progress the design phase of this project.
Finally, the HSE is currently undertaking a review of performance across all Hospital Groups and Community Health Organisations over the winter period. The HSE advise that this process will include an independent expert review of clinical, analytical and management capability in University Hospital Limerick and CHO Mid West and the other 8 individual focus sites and their relevant CHOs.
29. Deputy Gino Kenny asked the Minister for Health if his attention has been drawn to the wait that families of children with SMA have been facing while the approval of Spinraza has yet to be resolved; if he will intervene on behalf of children such as a child (details supplied); if he will deliver a positive outcome for all children with SMA and their families by announcing the approval of Spinraza; and if he will make a statement on the matter. [20497/19]
View answer42. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the status of the protracted engagement between representatives of the Health Service Executive and a company (details supplied); if the most recent offer from the company presents an acceptable package to allow for approval to issue for reimbursement of Spinraza; his views on whether a further delay in reaching an agreement would be unacceptable to a caring child healthcare conscious society; and if he will make a statement on the matter. [20857/19]
View answer146. Deputy Gino Kenny asked the Minister for Health the status of the decision on the approval of Spinraza; and if he will make a statement on the matter. [20844/19]
View answerI propose to take Questions Nos. 29, 42 and 146 together.
As the Deputies are aware, the Oireachtas put in place a strong legal framework, in the Health (Pricing and Supply of Medical Goods) Act 2013, to give full statutory powers to the HSE to assess and make decisions on reimbursement of medicines, taking account of a range of objective factors and expert opinion as appropriate.
I fully recognise that this debilitating and progressive condition places enormous strain on SMA sufferers and their families and carers, and I can understand their wish to have access to potentially beneficial drug treatments.
However, because of the significant monies involved, the HSE must ensure that the best price is achieved for all medicines, as these commitments are often multi-million euro investments on an ongoing basis. This can lead to a protracted deliberation process, where suppliers commence the negotiation process with a pricing proposal that does not reflect affordability or the evaluation of clinical effectiveness.
In the case of Spinraza, following detailed consideration of an application for reimbursement and lengthy engagement with the company, the HSE decided that it was unable to reimburse Nusinersen (Spinraza). The HSE concluded that the evidence for clinical effectiveness was still quite limited and that the price proposed by the manufacturer was not a cost-effective use of resources.
On 21 February 2019, the HSE wrote to the manufacturer involved and informed them of the proposal to refuse reimbursement at the current price offering. Under the requirements of the Health (Pricing and Supply of Medical Goods) Act 2013 the company had 28 days to respond or make representations to the HSE’s proposed decision.
I am advised by the HSE that the manufacturer submitted additional information and that the matter remains under consideration by the HSE.
30. Deputy Pat Casey asked the Minister for Health his plans to improve ambulance services in County Wicklow; and if he will make a statement on the matter. [20910/19]
View answerThe National Ambulance Service is committed to providing a safe, high quality and timely, patient centred ambulance service to people across the country, including in County Wicklow.
Overall resource availability across the North Leinster Area, which includes County Wicklow, has increased following the move towards dynamic deployment. Resources are now utilised across a region, so that if demand increases in one area, other resources from outside the immediate area can provide cover as required. In line with this practice, and using the Advanced Medical Priority Dispatch System to triage calls, the National Ambulance Service stations in Wicklow Town, Arklow and Baltinglass, together with the Rapid Response Vehicle based in Newcastle, are supported by other ambulance bases from outside the county, including from Loughlinstown, Gorey, Naas and Athy.
The Capacity Review, published in 2016, examined overall ambulance resource levels and distribution against demand and activity. The Review identified particular difficulties serving rural areas such as County Wicklow. The Capacity Review indicated that the only practical way to improve first response times in rural areas is through voluntary Community First Responder schemes. The National Ambulance Service continues to work with local Community First Responder groups across the county to enhance services, with 23 Community First Responder groups currently operating in County Wicklow.
Investment in ambulance services is guided by the Capacity Review. This year the National Ambulance Service budget has increased to an unprecedented €168.6m. This will support the National Ambulance Service to continue to deliver a high-quality service across Ireland, including County Wicklow.
31. Deputy John McGuinness asked the Minister for Health the funding being provided in 2019 for decongregation in disability services in Kilkenny city; and if he will make a statement on the matter. [20909/19]
View answerThe Report “Time to Move on from Congregated Settings – A Strategy for Community Inclusion” proposes a new model of support in the community moving people from Congregated settings to the community in line with Government policy. The Report identified around 4000 people (based on 2008 census) with disabilities in Ireland living in congregated settings, defined as a residential setting where people live with ten or more people.
The Programme for Partnership Government contains a commitment to continue to move people with disabilities out of congregated settings, to enable them to live independently and to be included in the community. The objective is to reduce this figure by one-third by 2021 and ultimately, to eliminate all congregated settings.
By the end of this year, we will have exceeded this target and under 2,100 people with a disability will remain living in congregated settings. I want to emphasise that the appropriate supports and resources are being put in place to ensure that people are supported as they move out of residential centres. The model of care for individuals will be based on a person centred plan (PCP). The PCP may change over time in line with an individual’s needs and circumstances and the model of service delivery applicable at a particular time.
Any opportunity for residents to live in smaller settings in the community will come after considerable planning and discussion with those residents and their families. It will be on the basis that it will enhance their life, and anyone who moves will continue to access the services they require.
The HSE has prioritised the transition of a further 160 people from congregated settings in 2019 under its Service Plan, and I am informed that 49 people have moved into their homes in the community to the end of March this year.
The HSE is responsible for leading out on the recommendations of "Time to Move on from Congregated Settings - A Strategy for Community Inclusion". I am informed that the total budget to St Patrick's Centre Kilkenny is €16.94m. St. Patrick's has submitted funding proposals related to decongregation to the HSE and a validation of these requirements is underway. In the context of same, it is not appropriate to comment further on this process until the matter concludes.
32. Deputy Niamh Smyth asked the Minister for Health the steps he is taking to deal with the ongoing respite crisis; and if he will make a statement on the matter. [20712/19]
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.
The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.
Annalee View Respite Centre was closed in February, 2019 following an oil leak. An Oil Remediation Specialist company was contracted to carry out an inspection of the site visit. Following completion of the inspection, the HSE was advised to vacate the Centre and the premises was closed with immediate effect.
I have been informed that HSE Disability services are awaiting the full detailed report of the damage caused and the amount of necessary works required to re-open the centre and that the HSE is actively seeking an alternative premise in order to continue the provision of residential respite Services. This endeavour will target available rental or lease suitable properties in the Cavan Monaghan area that can meet the needs of service users who avail of respite and meet HIQA standards.
33. Deputy Maureen O'Sullivan asked the Minister for Health his plans for a project (details supplied) that is providing a valuable service for those in addiction. [20854/19]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
35. Deputy Éamon Ó Cuív asked the Minister for Health the reason for the significant overcrowding in the emergency department in University Hospital Galway during April 2019 [20823/19]
View answerThe Winter Plan 2018/19, recognising the multiple factors across the health service that impact on Emergency Department performance, included a range of measures to support patients accessing services in the community and in hospitals. Planning for Winter 2019/20 has already commenced, with a review of performance over the Winter Period currently underway to ensure that the lessons learned from this year inform future plans.
With regard to University Hospital Galway, for the first quarter of 2019, in comparison to 2018, the number of patients attending the Emergency Department increased by 8.4% and the number of patients admitted decreased by 0.3%. The number of patients recorded on trolleys at 8am reduced by 7.9%.
Unfortunately, the improved trolley performance did not continue into April and provisional TrolleyGAR data highlights that the number of patients waiting on trolleys in University Hospital Galway increased from 643 in April 2018 to 783 in April 2019.
Data in relation to attendance and admissions for April is not available at this time. However, the HSE has advised that hospitals are reporting very high levels of demand, high patient acuity and high bed occupancy, especially in the over 75-year-old cohort of patients. In addition, delayed discharges are above the expected activity threshold set out in the National Service Plan and Hospitals and Community Health Organisations are reporting constrained options for supported discharges, particularly in relation to home support and long-term care.
Building upon the actions in the Winter Plan, and to meet the ongoing operational challenges, robust planning arrangements were put in place for the Easter and May bank holiday weekends by Hospital Groups and Community Health Organisations, and efforts are continuing to build upon the improved performance achieved nationally and in Galway University Hospital in the first three months of the year.
36. Deputy Darragh O'Brien asked the Minister for Health his plans to increase the number of home support hours available for older persons in north Dublin; and if he will make a statement on the matter. [20906/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
37. Deputy Gino Kenny asked the Minister for Health the date for the commencement of the cannabis access programme; and if he will make a statement on the matter. [20843/19]
View answerGood progress is being made in establishing the Medical Cannabis Access Programme:
1. clinical guidelines have been drawn up and published,
2. secondary legislation is being drafted,
3. cannabis products for use under the Programme, once reviewed as suitable for medical use, will be published on an ‘approved list’.
The Programme aims to facilitate access to certain ‘acceptable’ cannabis products which have not been authorised as medicines by a statutory Medicines Competent Authority. Such products are not subject to the same rigorous safety, quality and efficacy standards that are in place for medicines, nor are the producers subject to the same responsibilities as the marketing authorisation holders for authorised medicines.
Availability of cannabis products that are of an appropriate quality standard and are affordable to patients is critical in establishing the access programme. Officials in my department are working intensively on finding solutions to the supply of appropriate products for Irish patients.
In the meantime it is open to a medical practitioner wishing to prescribe cannabis for medical purposes for an individual patient under their care, to apply to the Minister for Health for a licence, under Section 14 of The Misuse of Drugs Acts 1977 to 2016 and the Regulations made thereunder.
It should be noted that it is the decision of the clinician, in consultation with their patient, to prescribe or not prescribe a particular treatment for a patient under their care.
The Department of Health website contains detailed information on medical cannabis, including clinical guidance on the use of medical cannabis. It is continuously updated.
38. Deputy Dara Calleary asked the Minister for Health if health service recruitment in CHO 2 is being curtailed; and if he will make a statement on the matter. [20816/19]
View answerI have asked the HSE to respond directly to the Deputy on this question.
39. Deputy Niall Collins asked the Minister for Health the reason for the significant overcrowding in the emergency department in University Hospital Limerick during April 2019 [20826/19]
View answerThe Winter Plan 2018/19, recognising the multiple factors across the health service that impact on Emergency Department performance, included a range of measures to support patients accessing services in the community and in hospitals. Planning for Winter 2019/20 has already commenced, with a review of performance over the Winter Period currently underway to ensure that the lessons learned from this year inform future plans.
With regard to University Hospital Limerick (UHL), for the first quarter of 2019, in comparison to 2018, the number of patients attending the Emergency Department increased by 2.5% and the number of patients admitted decreased by 7%. The number of patients recorded on trolleys at 8am increased by 17.9% in UHL, despite a national decrease of 12.3% in this period.
Provisional TrolleyGAR data highlights that the number of patients waiting on trolleys in UHL increased from 723 in April 2018 to 862 in April 2019.
The Emergency Department in UHL is one of the busiest in the country, with the number of patients attending growing year on year. UHL was identified as one of the 9 sites requiring additional investment, focus and support as part of this year's Winter Plan. The problem of overcrowding in hospitals requires a full-system, patient-focused response. Recognising this, in the Winter Plan, the HSE sought to maximise the use of existing resources across hospital groups and CHOs and to target additional investment at both hospital and community services and supports.
Since 2017, an additional 25 beds have opened in UHL, including 8 as part of this year's Winter Plan.
A capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at UHL, with funding of €10 million allocated in 2019. Enabling works commenced in March 2019, and the HSE advise that the main works are expected to start at the end of May 2019.
In addition, the National Development Plan includes a 96-bed replacement ward block in Limerick and capital funding was provided in 2018 to progress the design phase of this project.
Finally, the HSE have advised that the review of the Winter Plan currently underway will include an independent expert review of clinical, analytical and management capability in University Hospital Limerick and CHO Mid-West and the other 8 individual focus sites and their relevant CHOs.
40. Deputy Richard Boyd Barrett asked the Minister for Health the details of the plans for a private clinic as part of the national children’s hospital; if the funding of this clinic is included in the latest budget for the hospital; and if he will make a statement on the matter. [20881/19]
View answer77. Deputy Richard Boyd Barrett asked the Minister for Health the rationale for the co-location of a private clinic at the national children’s hospital in view of the fact that space at this site is at a premium; the cost of this part of the project; and if he will make a statement on the matter. [20882/19]
View answerI propose to take Questions Nos. 40 and 77 together.
The vast majority of services in the new children’s hospital will be public services. However, as part of the National Contract for Consultants negotiated in 2008, some consultants holding specific contracts are entitled to engage in private outpatient practice outside of their public commitment and this commitment must be conducted on site, that is, in the hospital they are contracted with. As a result, private outpatient clinics may be held on the public hospital campus but these clinics must be held outside contracted hours. The new children's hospital is obliged to provide such facilities for consultants holding such contracts. The proposal is for consultants to pay a fee for use of the rooms and other operational costs.
Within the plan for the hospital, an area has been planned which carries the designation of "private clinic". Within the ‘private clinic’ area the following has been drawn:
- 1 x reception desk area x 7m2
- 1 x feeding room x 4m2
- 1 x wait area x 16m2
- 1 x play area x 8m
- 8 x consult/examination rooms x 16m2
- 1 x WC x 3m2
- 1 x clean utility x 9m2
- 1 x dirty utility x 7m2
Total area: 180m2
This work is planned to proceed at the building commissioning stage in the year before the building opens.
