Written Answers Nos. 492-516
492. Deputy Danny Healy-Rae asked the Minister for Health the status of the provision and timeframe for the new community hospital in Killarney, County Kerry; and if he will make a statement on the matter. [30667/19]
View answerAs the Health Service Executive is responsible for the delivery of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
493. Deputy Danny Healy-Rae asked the Minister for Health the status of the provision of respite services for persons with disabilities in County Kerry; and if he will make a statement on the matter. [30668/19]
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.
494. Deputy Thomas P. Broughan asked the Minister for Health the estimated cost of increasing the number of dementia advisers by 10% and 20% in 2020; and if he will make a statement on the matter. [30669/19]
View answerThe National Dementia Strategy requires the HSE to consider the provision of dementia advisers, based on the experience of demonstrator sites. In this context, an evaluation of the Dementia Adviser Service, which was published in September 2018, recommends the continuation and expansion of the service to ensure equity of access countrywide.
There are nine Dementia Advisers working in the Dementia Adviser Service established by the Alzheimer Society of Ireland (ASI) in mid-2014. The service covers 12 counties: Cork, Kerry, Tipperary, Limerick, parts of Clare, Galway, Mayo, Sligo, Leitrim, Cavan, Monaghan and Dublin.
Seven of the 9 posts have been funded by the HSE since 2016, while the Mayo post is funded by Community Action on Dementia Mayo. €400,000 has been allocated by the HSE in each of the last 3 years towards the cost of the service and a commitment has been made to continue this funding in 2019 and in future years.
The level of funding available for the Department of Health in 2020 and the quantum of services to be provided by the HSE, including any plans to expand the Dementia Adviser service, will be considered as part of the national Estimates and budgetary process and National Service Planning.
With regard to the estimated cost of increasing the number of dementia advisers, as this is a service matter I have asked the Health Service Executive to respond directly to the Deputy.
495. Deputy Thomas P. Broughan asked the Minister for Health the number of persons with dementia here; the number of specialists working in this area; the waiting lists to access home care packages specifically for persons with dementia; and if he will make a statement on the matter. [30670/19]
View answerIt is estimated that over 55,000 people in Ireland have a form of dementia, with 4,000 new cases each year. After the age of 65, the prevalence of dementia nearly doubles every five years, but onset can occur at much younger ages. Around 4,000 people in Ireland aged under 65 have younger onset dementia. Based on population projections from the CSO, the number of people with dementia will double to 115,000 by 2036 and treble to 157,000 by 2046.
With regard to the remainder of the question, as this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
496. Deputy Thomas P. Broughan asked the Minister for Health the estimated cost of increasing the number of dementia inclusive community co-ordinators by 10% and 20% in 2020; and if he will make a statement on the matter. [30671/19]
View answerThe Dementia Community Activation Co-ordinator is a position co-funded by the HSE and the Alzheimer Society of Ireland. The Dementia Community Activation Coordinator is working with national organisations and key community stakeholders to support community dementia champions across Ireland. The Co-ordinator seeks to grow the number of champions and people within communities to take action to create sustainable dementia inclusive communities.
As the question relates to a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
497. Deputy Thomas P. Broughan asked the Minister for Health if there is a moratorium on overtime for nurses under current HSE expenditure rules; and if he will make a statement on the matter. [30672/19]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
498. Deputy Thomas P. Broughan asked the Minister for Health if he will report on expenditure profiles in the HSE at the end of the second quarter of 2019; if current expenditure guidelines are impacting on services; and if he will make a statement on the matter. [30673/19]
View answerThe HSE’s latest income and expenditure position at 30 April 2019 shows a revenue deficit of €116.2m which represents 2.3% of the available budget. The main drivers of the deficit are acute hospitals, PCRSand demand led schemes, disability services, and the treatment abroad scheme.
The HSE National Service Plan (NSP) is an important accountability instrument in use by the Department in determining how the HSE is performing against its targets as it captures in a clear and quantified way the range of health and social care services to be provided by the HSE for the allocation it has received. It establishes links between funding, staffing and services and it incorporates activity measures, outcome-based performance indicators and deliverables in key service areas, which are matched with targets and timescales.
The Department provides oversight of the performance of the HSE in relation to the delivery of the services set out in the NSP. The mechanism for this oversight includes the ongoing monthly performance management process in place between the Management Board in the Department and the HSE Leadership (now the HSE Executive Management Team) where the HSE reports monthly to the Department on the performance of the health system against the agreed targets set out in the NSP.
As part of the monthly performance cycle, the HSE provides an update on the application of its Performance and Accountability Framework. This includes the submission of an Escalation report which provides detail on services which are in escalation for the month in question and the actions being carried out to mitigate these. Services in escalation are those which are experiencing significant performance issues.
The latest escalation report is for April 2019 and currently the HSE are reporting 7 areas (6 in acute hospitals and 1 in social care) which have been escalated to the National Performance Oversight Group. Improvement plans and support measures are in place to monitor the ongoing performance of the different areas in escalation.
499. Deputy Margaret Murphy O'Mahony asked the Minister for Health the status of the pilot project in CHO 6 and CHO 7 to support the roll out of the National Policy and Strategy for the Provision of Neuro-Rehabilitation Services in Ireland 2011-2015. [30681/19]
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. 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.
500. Deputy Stephen Donnelly asked the Minister for Health the status of the provision of additional high dependency unit beds in the Mater Misericordiae University Hospital; and if he will make a statement on the matter. [30683/19]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to you directly, as soon as possible.
501. Deputy Stephen Donnelly asked the Minister for Health the status of the provision of additional high dependency unit beds in Cork University Hospital. [30684/19]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
502. Deputy Stephen Donnelly asked the Minister for Health the status of the provision of an additional 30 bed ward in Our Lady of Lourdes Hospital, Drogheda. [30685/19]
View answerThe Health Service Capacity Review published last year was clear on the need for a major investment in additional capacity in both hospital and community – combined with a widescale reform of the manner and the location of where health services are provided.
As set out in Sláintecare, moving care options for patients closer to their homes and into their local communities is a key part of the solution. In addition, community services are not sufficient to meet the demand, and this is placing additional pressure on hospital services.
An additional 267 acute hospital beds opened under the Winter Initiative 2017/2018, and the National Service Plan for 2019 provides for a comprehensive capacity programme.
The number of available inpatient beds is expected to increase to above 11,000 following the investment planned in the National Service Plan 2019.
In relation to the particular query raised about additional capacity at Our Lady of Lourdes Hospital Drogheda, as this is a service matter, I have asked to HSE to reply to you directly.
503. Deputy Stephen Donnelly asked the Minister for Health the status of the provision of a 40 bed modular ward block in South Tipperary General Hospital. [30686/19]
View answerAs Minister for Health, I recognise that hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged over the winter months. It is against this background that the Health Service Capacity Review 2018 recommended an increase in acute hospitals beds of over 2,600 by 2031 to support the projected increase in demand for services in the years ahead.
An additional 267 acute hospital beds opened under the Winter Initiative 2017/2018, and the National Service Plan for 2019 provides for a comprehensive capacity programme. The number of available inpatient beds is expected to increase to above 11,000 following the investment planned in the National Service Plan 2019.
Increasing capacity is therefore a priority for the Government. The opening of the modular build at South Tipperary General Hospital is included in the HSE's National Service Plan for 2019 and necessary capital funding is in place for the delivery of the project.
In relation to the particular query raised about the provision of a 40-bed modular build in South Tipperary General Hospital, as this is a service matter, I have asked to HSE to reply to you directly.
504. Deputy Stephen Donnelly asked the Minister for Health the number of bariatric surgery procedures carried out in hospitals in each of the years 2011 to 2018 and to date in 2019. [30687/19]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
505. Deputy Stephen Donnelly asked the Minister for Health the status of the establishment of a serious incident management forum for maternity services in each hospital group. [30688/19]
View answerThe National Women & Infants Health Programme is working on a range of measures to improve the quality and safety of maternity services. A key objective is the establishment of a maternity-specific Serious Incident Management Forum in each Hospital Group. I am advised that the establishment of Serious Incident Management Fora is underway across the Hospital Groups and I have therefore asked the HSE to reply directly to you with regard to the current status of this process.
506. Deputy Stephen Donnelly asked the Minister for Health if he will provide a report on the pilot anaesthetics model of care for general hospitals with maternity services. [30689/19]
View answerOne of the priorities set out in the HSE National Service Plan 2019 is to pilot an anaesthetics model of care for general hospitals with maternity services. As this work is being led by the National Women & Infants Health Programme, I have asked the HSE to respond to you directly.
507. Deputy Stephen Donnelly asked the Minister for Health the status of the implementation of a phased national plan for benign gynaecology; and if he will make a statement on the matter. [30690/19]
View answerOne of the priorities identified in the HSE National Service Plan 2019 is the implementation of a phased national plan for benign gynaecology. As this work is being led by the National Women & Infants Health Programme, I have asked the HSE to respond to you directly.
508. Deputy Stephen Donnelly asked the Minister for Health if the HSE has identified the suite of clinical guidelines required in maternity services; and the gaps identified in terms of the development and-or review of new or existing clinical guidelines. [30691/19]
View answerThe National Clinical Effectiveness Committee (NCEC) is a Ministerial committee whose role is to prioritise and quality assure, to the level of international methodological standards, a suite of national clinical guidelines and national clinical audit prioritised as important for the Irish health system.
To support the National Maternity Strategy 2016-2026, the NCEC is prioritising and quality assuring a set of National Clinical Guidelines for maternity services. For example, the National Clinical Guideline No. 4. Irish Maternity Early Warning System, first published in 2014, was updated and republished by the Department of Health in February 2019.
Guidelines on Intrapartum Care are also in development as a priority to support a risk-based approach to maternity care. The clinical guideline "Risk in Pregnancy" is nearing completion and will undergo quality assurance by the NCEC in the coming months. It is expected that the NCEC will recommend it to the Minister for Health for endorsement as a National Clinical Guideline soon after.
Regarding the specific information requested by the Deputy, I have asked the HSE to reply to you directly.
509. Deputy Stephen Donnelly asked the Minister for Health if the HSE has defined the detailed care pathways to be made available to women in all maternity services based on the mode of care proposed in the national strategy thereby enabling a standardised and consistent planning approach. [30692/19]
View answerIreland’s first National Maternity Strategy, ‘Creating A Better Future Together, 2016 – 2026’, was published in January 2016. The Strategy aims to ensure that appropriate care pathways - Supported, Assisted and Specialised - are in place in order that mothers, babies and families get the right care, at the right time, by the right team and in the right place. It recognises that, while all pregnant women need a certain level of support, some will require more specialised care. Accordingly, it proposes an integrated model that delivers care at the lowest level of complexity and encompasses all the necessary safety nets in line with patient safety principles.
The National Women & Infants Health Programme has been established in the HSE to lead the management, organisation and delivery of maternity, gynaecology and neonatal services across primary, community and acute care. As the phased implementation of the Strategy is being led by the Programme, I have asked the HSE to reply to your query directly.
510. Deputy Stephen Donnelly asked the Minister for Health if the HSE has prepared a detailed implementation plan for the recommendations set out in the report on the use of transvaginal mesh. [30693/19]
View answerAs Minister for Health, I requested Dr Tony Holohan, Chief Medical Officer (CMO) to draft a report on the use of Uro-Gynaecological Mesh in the surgical treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) in women. The report covers the clinical and technical issues involved in ensuring both:
1. the safe and effective provision of mesh procedures in urogynaecology and
2. an appropriate response to women who suffer complications as a result of undergoing such procedures.
This report was published on the Department of Health website on 21 November 2018.
In advance of the report’s completion, the HSE was requested in May 2018 to begin work immediately on the development of national standardised patient information and informed consent materials and the clarification and development of treatment pathways and appropriate referral services for women suffering serious complications.
The HSE was also asked by the Chief Medical Officer on 24 July to pause all mesh procedures where clinically safe to do so, until a number of key recommendations are implemented.
A Synthetic Mesh Devices Advisory Group was convened by the HSE, to advise on and progress all of the recommendations which included three patient representatives, as well as representatives of the HPRA, the IOG, the RCSI, the CFI and all Hospital Groups to advise on and action all of the recommendations above.
I am informed that an ongoing work programme for the clarification and development of treatment pathways and appropriate referral services for women suffering from mesh-related complications is being progressed by the HSE. This work includes identifying the appropriate specialist clinical expertise and facilities required at hospital group level and nationally to provide comprehensive aftercare services. Pending the completion of this work, the HSE is also examining options to address service requirements for patients with immediate or urgent needs.
As was requested by the Secretary General of my Department in November 2018, the HSE has prepared an Implementation Plan for the complete set of recommendations set out in the CMO’s Report, which was approved by the Leadership Team in the HSE and published on the HSE website on 26 April 2019, which I hope provides further clarity on this issue.
I am informed that the HSE has advised that a detailed progress report on implementation of the recommendations will be provided to my Department and this report is awaited.
At my meeting with the Mesh Survivors Ireland Group on 7 March 2019 I agreed to continue engagement with them on a pathway forward, to ensure that the ongoing clinical management of this patient group is in line with international best practice and emerging evidence.
511. Deputy Stephen Donnelly asked the Minister for Health if he will provide a report on the assessment of midwifery workforce levels against the 2016 birth rate plus methodology in the context of the new model of care. [30694/19]
View answerThe HSE Midwifery Workforce Planning Project Report modelled on Birthrate Plus methodologies was published in April 2016. This Report recommended a range of midwifery staffing ratios across the 19 maternity hospitals/units taking into account the variability in working arrangements and clinical practices between the different sites and services. This Report also acknowledged that the implementation of the National Maternity Strategy 2016 – 2026 would have a significant impact to the way midwifery services are delivered and will consequently have a further impact on workforce requirements. The National Women & Infants Health Programme in the HSE, is leading on the implementation of the National Maternity Strategy, which includes identifying and resolving requirements in relation to staffing.
As this is an operational issue, I have asked the HSE to reply to your query directly.
512. Deputy Stephen Donnelly asked the Minister for Health if the HSE has developed a national suite of KPIs for maternity services including the model of care. [30695/19]
View answerA multidisciplinary Steering Group has been established by the HSE National Women & Infants Health Programme to oversee the implementation of the new Model of Care. One of the areas of work identified by the Steering Group is the development of key performance indicators for maternity services. Accordingly, I have asked the HSE to reply to your query directly.
513. Deputy Stephen Donnelly asked the Minister for Health if the HSE has identified and defined the educational supports and training programmes required by staff to ensure a safe, competent and supported maternity workforce. [30696/19]
View answerOne of the priorities set out in the HSE National Service Plan 2019 is to identify and define the educational supports and training programmes required by staff to ensure a safe, competent and supported maternity workforce. As this work is being led by the National Women & Infants Health Programme, I have asked the HSE to respond to you directly.
514. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in the determination of an application for assistance under the fair deal scheme in the case of a person (details supplied); when payment will issue; and if he will make a statement on the matter. [30698/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
515. Deputy Anne Rabbitte asked the Minister for Health the average annual cost of providing a medical card under the redress for women resident in certain institutions scheme. [30714/19]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
516. Deputy Anne Rabbitte asked the Minister for Health the status of the work to develop a scheme to support survivors of mother and baby home institutions; the supports being considered under the remit of the scheme; and if he will make a statement on the matter. [30715/19]
View answerThe matters raised by the Deputy are more appropriate to my colleague at the Department of Children and Youth Affairs. The Deputy may wish to refer her query to my colleague the Minister for Children and Youth Affairs for further information on work to develop supports for former residents of Mother and Baby homes. Minister Zappone published the recommendations of the First Report of the Collaborative Forum of Former Residents of Mother and Baby Homes on 16 April, 2019. The Report contains 43 recommendations in total, including 21 health and well-being recommendations relating to healthcare provision and health assessment and screening.
Given the range and complexity of the relevant recommendations, I established an Interdepartmental Working Group to undertake an assessment of the Collaborative Forum's health and well-being related recommendations, The Working Group will develop proposals for a package of health and well-being supports, including access to any necessary health and social care measures for former residents of relevant institutions. The group comprises representation from my Department, the Department of Children and Youth Affairs and the Health Service Executive. It is currently examining the scale and scope of healthcare supports which may be provided and is due to report back to Government in September 2019.
