Written Answers Nos. 477-499
477. Deputy Pearse Doherty asked the Minister for Health the reason respite care allocation was cut for a person (details supplied) in County Donegal; when full respite care service will be reinstated; and if he will make a statement on the matter. [28109/19]
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.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
478. Deputy Mattie McGrath asked the Minister for Health the number of terminations of pregnancy carried out here in each of the years 2013 to 2018; and if he will make a statement on the matter. [28110/19]
View answerThe Protection of Life During Pregnancy Act 2013 was enacted on 30 July 2013 and commenced on 1 January 2014.
Section 20 of the Act 2013 required that the Minister for Health be notified of each termination of pregnancy no later than 28 days after it took place. Notifications were recorded in the form set out in the “Protection of Life During Pregnancy Act 2013 (Section 20) (Notifications) Regulations 2013” (Statutory Instrument no. 546 of 2013). Section 20 also required the Minister to prepare a yearly report by 30 June on the notifications provided to him under section 20 in the previous calendar year and lay it before the Houses of the Oireachtas. Reports excluded any identifying information on the women or doctors involved.
The following table sets out the number of terminations carried out in each of the years 2014 to 2018, the five years the Act was in operation:
|
2014 |
2015 |
2016 |
2017 |
2018 |
|
|
Total |
26 |
26 |
25 |
15 |
32 |
The Protection of Life During Pregnancy Act 2013 was repealed under section 5 of the Health (Regulation of Termination of Pregnancy) Act 2018.
479. Deputy Charlie McConalogue asked the Minister for Health further to Parliamentary Question No. 131 of 4 April 2019, his plans to introduce a three year cap on farm businesses assets in circumstances in which a family successor commits to continue to farm the asset for a period of six years (details supplied); and if he will make a statement on the matter. [28126/19]
View answerThe proposed policy change to the Nursing Homes Support Scheme (NHSS), to cap contributions based on farm and business assets at 3 years where a family successor commits to working the productive asset, has been approved by Government. My Department developed draft Heads of Bill while considering a number of complex ancillary policy and operational matters which may need to be addressed in the proposed legislation.
It is intended that this proposed policy change, the 3 year cap, will be extended to eligible existing participants in long term residential care so that they are not disadvantaged, but that there would be no retrospective recoupment of contributions for those who have paid contributions over and above the 3 year period.
The General Scheme of Bill for the NHSS was approved by Government on the 11th June 2019. The changes to the Scheme will come into effect as soon as the legislative process is successfully complete. I intend to progress this as quickly as possible, however, the timeline for completion of the legislation will also depend on how it passes through the Houses. The General Scheme has been sent to the relevant Joint Committee and I look forward to participating in pre-legislative scrutiny when scheduled by the Committee.
480. Deputy Willie O'Dea asked the Minister for Health if a person (details supplied) will be entitled to their full award of damages regardless of the outcome of an appeal in view of the appeal by the State Claims Agency against the judgment; and if he will make a statement on the matter. [28134/19]
View answerThe State Claims Agency (SCA) has a statutory remit to manage personal injury claims, including claims in respect of clinical negligence, on behalf of Delegated State Authorities (DSA’s) including the Health Service Executive.
In June 2019, Government gave approval that the Chief State Solicitor to issue, on behalf of the Minister for Health, a letter giving an undertaking to the plaintiffs to make any balancing payment that might arise as a consequence of the outcome of the Supreme Court appeal, in order to ensure that their award is maintained at the level determined by the High Court plus any legal fees incurred in the appeal. Of course, the commitment to pay is contingent on the outcome of the appeal.
481. Deputy Charlie McConalogue asked the Minister for Health when a response will issue to an interim response (details supplied); and if he will make a statement on the matter. [28135/19]
View answerThe issues involved are currently being examined by my officials and a response will issue as soon as possible.
482. Deputy Frank O'Rourke asked the Minister for Health when the needs assessment recommendations will be put in place for a person (details supplied); and if he will make a statement on the matter. [28142/19]
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.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy
483. Deputy Brendan Smith asked the Minister for Health his plans to ensure that more home supports are provided through direct employment by the HSE rather than through agencies or private companies; and if he will make a statement on the matter. [28143/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
484. Deputy Sean Fleming asked the Minister for Health when speech therapy and a device will be provided to a child (details supplied); and if he will make a statement on the matter. [28155/19]
View answerAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
485. Deputy James Browne asked the Minister for Health the number of children presenting at emergency departments here with self-harm injuries, suicide attempts and or overdoses in each of the years 2014 to 2018; the location of same in tabular form; and if he will make a statement on the matter. [28156/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
486. Deputy Seán Haughey asked the Minister for Health the number of times he has formally met with the chief executive officer and-or chairperson of a company (details supplied) in 2018 and to date in 2019; and if he will make a statement on the matter. [28159/19]
View answerThe Minister for Health did not meet with either person in 2018 or 2019. The Vhi Chairperson and Chief Executive Officer meet regularly with Department of Health officials to ensure the Minister is kept updated on important matters relating to the Vhi, and quarterly meetings are held to discuss governance issues.
487. Deputy Ruth Coppinger asked the Minister for Health if he will remove charges for those with haemochromatosis attending venesection clinics; and if he will make a statement on the matter. [28169/19]
View answer488. Deputy Ruth Coppinger asked the Minister for Health the amount raised in payments by those with haemochromatosis attending venesection clinics in 2018; and if he will make a statement on the matter. [28170/19]
View answerI propose to take Questions Nos. 487 and 488 together.
Where venesection is classed as a day case procedure and is not carried out in an out-patient setting, the public in-patient charge applies.
The issue of the provision of therapeutic phlebotomy services for hereditary haemochromatosis patients, including the issue of charges, is under consideration by my Department and the HSE.
It is agreed that such services should be provided at the lowest level of complexity that is clinically and operationally feasible. In time it is envisaged that the majority of this work will be done in a primary care setting.
Meanwhile, the Irish Blood Transfusion Service is now accepting hereditary haemochromatosis patients who are eligible to donate blood at their fixed and mobile donation clinics nationwide.
Patients can attend a maximum of four times a year with a minimum of ninety days between phlebotomies. The patient's hereditary haemochromatosis will continue to be managed by their physician, including the monitoring of ferritin levels.
In respect of the question concerning the amount raised in payments by those with haemochromatosis attending venesection clinics in 2018. This is a service matter for the Health Service Executive and I have asked them to respond directly to the Deputy.
489. Deputy Mary Butler asked the Minister for Health when the national review under way of cardiac services will conclude; when the report will be published; and if he will make a statement on the matter. [28171/19]
View answerThe aim of the National Review of Specialised Cardiac Services is to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive through establishing the requirements for an appropriate configuration of specialist cardiac services throughout Ireland.
While much work has been completed in relation to informing the optimal configuration of adult cardiac services, some significant and important work remains outstanding. In order to allow this work to be completed, the work of the Steering Group will continue through the summer months. I am advised by the Steering Group that it will be in a position to confirm a completion date in September 2019.
490. Deputy Mary Butler asked the Minister for Health his plans to examine the extensive outpatient waiting list at University Hospital Waterford in relation to ophthalmological services; his views on whether the waiting lists are too long; and if his attention has been drawn to the negative impact it has on older persons waiting for treatment. [28172/19]
View answerReducing waiting times for hospital appointments and procedures is a key commitment of government. While the last 18 months have seen considerable progress in the reduction of waiting times for Inpatient and Daycase treatments, I am conscious that the Outpatient Waiting List remains a significant challenge as demand for acute hospital services continues to grow.
Budget 2019 announced that the Government had 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, and National Treatment Purchase Fund Scheduled Care Access Plan 2019 was published in March. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 1.155 million elective inpatient and day case discharges and 3.3 million outpatient appointments, of which more than 1 million will be to new patients. For its part, the NTPF will provide additionality through the provision of 25,000 IPDC appointments, 5,000 GI scopes, and 40,000 outpatient appointments.
South/South West Hospital Group has advised my Department that University Hospital Waterford is focused on the reduction of waiting lists and is actively working with the NTPF to engage in initiatives to reduce outpatient waiting times. To date this year the NTPF has approved an additional 3,600 outpatient appointments for University Hospital Waterford, and of these 890 are for the specialty of Ophthalmology. More specifically, UHW advise that they are engaging in the provision of out-of-hours clinics to provide appointments for long waiting ophthalmology patients.
University Hospital Waterford has advised that it remains committed to working in collaboration with South South-West Hospital Group, and the NTPF, on waiting list initiative supports.
491. Deputy Mary Butler asked the Minister for Health his plans to examine the extensive outpatient waiting list at University Hospital Waterford in relation to orthopaedic services; his views on whether the waiting lists are too long; if his attention has been drawn to the negative impact it has on older persons waiting for treatment; and if he will make a statement on the matter. [28173/19]
View answerReducing waiting times for hospital appointments and procedures is a key commitment of government. While the last 18 months have seen considerable progress in the reduction of waiting times for Inpatient and Daycase treatments, I am conscious that the Outpatient Waiting List remains a significant challenge as demand for acute hospital services continues to grow.
Budget 2019 announced that the Government had 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, and National Treatment Purchase Fund Scheduled Care Access Plan 2019 was published in March. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 1.155 million elective inpatient and day case discharges and 3.3 million outpatient appointments, of which more than 1 million will be to new patients. For its part, the NTPF will provide additionality through the provision of 25,000 IPDC appointments, 5,000 GI scopes, and 40,000 outpatient appointments.
South/South West Hospital Group has advised my Department that University Hospital Waterford is focused on the reduction of waiting lists and is actively working with the NTPF to engage in initiatives to reduce outpatient waiting times. To date this year the NTPF has approved an additional 3,600 outpatient appointments for University Hospital Waterford, and of these 1,100 are for the specialty of Orthopaedics. UHW advise that these extra orthopaedic appointments have been made available for the longest waiting patients.
University Hospital Waterford has advised that it remains committed to working in collaboration with South South-West Hospital Group, and the NTPF, on waiting list initiative supports.
492. Deputy Mary Butler asked the Minister for Health his plans to examine the extensive outpatient waiting list at University Hospital Waterford in relation to urologist services; his views on whether the waiting lists are too long; if his attention has been drawn to the negative impact it has on older persons waiting for treatment; his further plans to examine the fact that of the 2,757 persons waiting in the hospital 967 are waiting in excess of 18 months; and if he will make a statement on the matter. [28174/19]
View answerReducing waiting times for hospital appointments and procedures is a key commitment of government. While the last 18 months have seen considerable progress in the reduction of waiting times for Inpatient and Daycase treatments, I am conscious that the Outpatient Waiting List remains a significant challenge as demand for acute hospital services continues to grow.
Budget 2019 announced that the Government had further increased investment in tackling waiting lists, with funding to the National Treatment Purchase Fund increasing from €55 million in 2018 to €75 million in 2019. The joint Department of Health, HSE, and National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 was published in March. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 1.155 million elective inpatient and day case discharges and 3.3 million outpatient appointments, of which more than 1 million will be to new patients. For its part, the NTPF will provide additionality through the provision of 25,000 IPDC appointments, 5,000 GI scopes, and 40,000 outpatient appointments.
South/South West Hospital Group has advised my Department that University Hospital Waterford is focused on the reduction of waiting lists and is actively working with the NTPF to engage in initiatives to reduce outpatient waiting times. These outpatient initiatives are focused on those specialties that have a number of long-waiting patients. To date this year the NTPF has approved an additional 3,600 outpatient appointments for University Hospital Waterford, 500 of which are for the specialty of Urology.
In relation to urology services, UHW advise that a Locum Consultant Urologist has been appointed to focus on the longest waiting patients. An additional clinic has been established to schedule long-waiting patients, and from mid-July an additional urology clinic will also commence as part of the wider South South-West Hospital Group plans in South Tipperary General Hospital.
University Hospital Waterford has advised that it remains committed to working in collaboration with South South-West Hospital Group, and the NTPF, on waiting list initiative supports.
493. Deputy Mary Butler asked the Minister for Health the number of persons treated under the National Treatment Purchase Fund, NTPF, in each month to date in 2019; the specialties treated by percentage, in tabular form; and if he will make a statement on the matter. [28175/19]
View answerThe information requested by the Deputy is currently being collated by officials in my Department and will be provided to the Deputy directly as soon as it becomes available.
494. Deputy Mary Butler asked the Minister for Health the amount the National Treatment Purchase Fund, NTPF, has spent in the first five months of 2019 treating those on waiting lists in excess of 11 months wait; and if he will make a statement on the matter. [28176/19]
View answerThe information requested by the Deputy is currently being collated by officials in my Department and will be provided to the Deputy directly as soon as it becomes available.
495. Deputy Stephen Donnelly asked the Minister for Health if a review of newborn screening will be conducted in view of recent advances in detection and treatment of conditions and the expansion of services and screening in Italy and other countries with a view to that review providing the changes required to ensure Ireland has the best possible newborn screening services; and if he will make a statement on the matter. [28179/19]
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 03 December 2018 when screening for Medium Chain Acyl-CoA Dehydrogenase Deficiency (MCADD) and Glutaric Aciduria Type 1 (GA1) commenced.
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.
Ireland, very much like the UK has always evaluated the case for commencing a national screening programme against international accepted criteria – collectively known as the Wilson Junger criteria. The evidence bar for commencing a screening programme should and must remain high. This ensures that we can be confident that the programme is effective, quality assured and operating to safe standards.
It is correct that the number of conditions screened for by Member States (MS) in Europe does vary. This does not reflect major differences in the genetic background of populations or estimated prevalences but rather highlights different MS approaches to (1) the estimation of risks and benefits in their populations and (2) responding to the cultural demands and ethical difficulties arising from a lack of evidence to screen for many of these rare conditions. Detailed knowledge about the natural course of many rare diseases, their variants and specifically information on the medium and long term outcomes after early treatment initiation are still insufficient.
There is no doubt that newborn screening programmes has the potential to be rapidly transformed by new technologies, new therapies and ever increasing expectations but this highlights the need to continue with a robust, methodologically sound and detailed analysis of the evidence in each and every case against the Wilson and Junger criteria.
I will shortly be announcing the name of the incoming Chair of the National Screening Committee. Recruitment of the remaining membership will continue over the summer months. Any future potential changes to the National Newborn Bloodspot Screening Programme will be incorporated as part of the Committee's immediate work programme.
496. Deputy Michael Harty asked the Minister for Health his views on the consultant recruitment and retention difficulties experienced by the HSE; and if he will make a statement on the matter. [28193/19]
View answerThe issue of new entrant consultant pay has been examined by the Public Sector Pay Commission. The Commission found that evidence of recruitment campaigns with very low levels of applications was indicative of on-going difficulties in regard to recruitment of consultants. Research undertaken on its behalf identified a number of relevant factors including relative pay, training opportunities and the lack of attractiveness of specific posts, particularly in smaller hospitals.
The Commission acknowledged that the difference in pay between the pre-existing and new entrant consultants is greater than for other categories of public servants. It did not view the measures announced last September for new entrant public servants generally, as being sufficient to address the degree of pay differential which exists for Consultants. Given its analysis, the Commission proposed that the Parties to the Public Service Stability Agreement jointly consider what further measures could be taken, over time, to address the pay differential.
The Government accepted the Report of the Commission and recognises that there are significant recruitment and retention challenges in relation to consultant posts. The proposal of the Commission does need to be addressed. The next step is to engage with the representative organisations of medical consultants.
It should also be noted that while pay has an impact in recruitment and retention of consultants, a number of other factors are also important, including, inter alia, opportunities for career development, training opportunities and location. The Commission stated it was strongly supportive of the full implementation of the recommendations of the Strategic Review of Medical Training and Career Structures, the 'MacCraith' recommendations, as they have the potential to resolve many of the issues raised with the Commission relating to recruitment and retention. The Department continues to monitor progress on implementation of these recommendations.
Notwithstanding the current recruitment challenges, the number of consultants working in the public health service continues to grow year on year. It increased by 125 whole time equivalents or just over 4 per cent in the year to the end of May 2019. In the five years to the end of May 2019 the number of consultants has increased by 533 - over 20 per cent - and now stands at 3,121 WTE's.
497. Deputy Michael Harty asked the Minister for Health the reason the waiting time for first-time ophthalmic appointments in University Hospital Limerick is now 18 months; and if he will make a statement on the matter. [28194/19]
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, the Government is committed to improving waiting times for hospital appointments and procedures.
The joint Department of Health/HSE/National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care this year by reducing waiting times for inpatient/day case treatment and outpatient appointments.
The Access Plan sets out the activity levels for the NTPF and the HSE. The NTPF will supply additionality to HSE activity in order to reduce waiting times experienced by patients for a hospital appointment, operation or procedure.
A key element of the Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments. For its part the NTPF will aim to deliver 40,000 first Outpatient appointments. The HSE and the NTPF will focus in particular on a number of specialties with a high volume of referrals, which include ophthalmology. The NTPF is engaging with the HSE and public hospitals to seek solutions for very long waiting patients. NTPF funded treatment is provided in private hospitals or in public hospitals where there is available capacity.
In addition, my Department is working with the HSE and NTPF, under the Access Plan, with the objective of developing medium-long term improvement initiatives for patient access to hospital procedures. This will include moving care to more appropriate settings and providing care at the lowest level of complexity such as providing ophthalmology in the community; maximising the use of Advanced Nurse Practitioner led clinics; and physiotherapists to manage orthopaedic clinics.
The latest published waiting list figures show that at the end of May 2019 there were 4,408 patients awaiting a first Ophthalmology outpatient appointment at University Hospital Limerick. Of this number, 1,184 (27%) were waiting 18 months or longer.
With regard to the specific issue raised by the Deputy in relation to first time Ophthalmology outpatient appointments in University Hospital Limerick, I have asked the HSE to respond to the Deputy Directly.
498. Deputy Bernard J. Durkan asked the Minister for Health the extent to which orthodontic services are readily made available by all possible means; the extent to which the school medical examinations identifies the need for such services; if the existence of waiting lists impedes the delivery of the service; and if he will make a statement on the matter. [28236/19]
View answerAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
499. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the need for oral hygiene remains an important part of health service information; the extent to which Ireland complies with best practice in that regard; and if he will make a statement on the matter. [28237/19]
View answerOral hygiene, particulary toothbrushing advice in line with best evidence, is central to oral heath promotion programmes in Ireland and internationally.
Smile agus Sláinte, the National Oral Health Policy, which was published in April 2019 aims to enable people to achieve their personal best oral health. The Policy has three strategic strands. The first strand, "Health and oral Health promotion and protection programmes" will embrace national, community and individual prevention and protection programmes supported by appropriate regulation. It will address the risk factors for oral health, including poor oral hygiene, and put in place oral health promotion and protection programmes to combat such risk factors.
