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Friday, 6 Sep 2019

Written Answers Nos. 1220-1244

Mental Health Services Staff

Questions (1220)

Lisa Chambers

Question:

1220. Deputy Lisa Chambers asked the Minister for Health the number of staff vacancies at the adult mental health unit of Mayo University Hospital by post; the reason each post is vacant; the timeframe each post has been vacant; and when each post will be filled [36299/19]

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Written answers

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

Mental Health Services Provision

Questions (1221)

Lisa Chambers

Question:

1221. Deputy Lisa Chambers asked the Minister for Health the guidelines governing programmes that are put in place for patients attending a mental health facility in terms of activities, hours spent with a psychiatrist or counsellor and so on; and if he will make a statement on the matter. [36300/19]

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Written answers

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

Mental Health Services Data

Questions (1222)

Lisa Chambers

Question:

1222. Deputy Lisa Chambers asked the Minister for Health the number of patients that presented at the adult mental health unit of Mayo University Hospital in each of the years 2014 to 2018 and to date in 2019; and if he will make a statement on the matter. [36301/19]

View answer

Written answers

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

Hospital Waiting Lists Data

Questions (1223, 1227, 1228, 1229)

Lisa Chambers

Question:

1223. Deputy Lisa Chambers asked the Minister for Health the wait time for outpatient appointments at Mayo University Hospital and University Hospital Galway, respectively; and if he will make a statement on the matter. [36302/19]

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Lisa Chambers

Question:

1227. Deputy Lisa Chambers asked the Minister for Health the number of children on the waiting list to see a paediatrician in County Mayo; and if he will make a statement on the matter. [36306/19]

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Lisa Chambers

Question:

1228. Deputy Lisa Chambers asked the Minister for Health the number of children awaiting an outpatient appointment at Mayo University Hospital and University Hospital Galway, respectively, from January 2019 to date in comparison to the same period in 2018. [36307/19]

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Lisa Chambers

Question:

1229. Deputy Lisa Chambers asked the Minister for Health the number of persons on waiting lists at Mayo University Hospital and University Hospital Galway; and if he will make a statement on the matter. [36308/19]

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Written answers

I propose to take Questions Nos. 1223 and 1227 to 1229, inclusive, together.

Reducing waiting time for patients for hospital operations and procedures is a key priority for Government. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.

Budget 2019 announced that the Government has further increased investment in tackling waiting lists, with funding to the National Treatment Purchase Fund (NTPF) increasing from €55 million in 2018 to €75 million in 2019. The joint Department of Health/HSE/NTPF Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing waiting times for inpatient/day case treatment and outpatient appointments. The plan places a strong focus on ten high-volume Inpatient/Day Case procedures. When combined with HSE activity, it is projected that the NTPF will be in a position to offer treatment to all clinically suitable patients waiting more than 6 months for one of these high-volume procedures.

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 NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify outpatient waiting list proposals. While the NTPF have already approved over 38,000 outpatient appointments, they advise that the impact of these initiatives may not be seen until the end of the year. Approximately 75% of outpatient appointments approved to date relate to 4 high-volume specialties, specifically Ophthalmology, ENT, Orthopaedics, and Dermatology.

In addition, the Department of Health has established a Working Group comprised of representatives from the HSE, NTPF, and Departmental officials, to examine ways of improving access for patients waiting for scheduled care. Part of this work includes developing initiatives which will move care to the most appropriate setting, and at the lowest level of complexity.

In relation to the data requested, the latest published NTPF waiting list figures show that are 2,128 patients on the Mayo University Hospital IPDC waiting list. Of these, 65% (1,373) are waiting 9 months or less and 76% (1,613) are waiting 12 months or less. There are 8,839 patients on the Mayo University Hospital Outpatient waiting list. Of these 60% (5,265) are waiting 12 months or less.

The latest figures show that there are 8,853 patients on Galway University Hospital IPDC waiting list. Of these, 66% (5,827) are waiting 9 months or less and 75% (6,688) are waiting 12 months or less. There are 42,683 patients on the Galway University Hospital Outpatient waiting list. Of these 69% (29,598) are waiting 12 months or less.

The NTPF have advised that currently a total of 2,130 children with an area of residence in Co Mayo are waiting to see a paediatrician. In relation to the number of children waiting for an outpatient appointment at Mayo and Galway University Hospitals from January to July in both 2019 and 2018, please see the document supplied.

In relation to the requested wait time for outpatient appointments at Mayo University Hospital and Galway University Hospital, please see table below.

Mayo University Hospital and Galway University Hospital outpatient waiting times

-

0-3 mths

3-6 mths

6-9 mths

9-12 mths

12-15 mths

15-18 mths

18-21 mths

21-24 mths

24-36 mths

36-48 mths

48+

Total

Mayo Hospital

2755

1160

698

652

662

549

289

295

940

531

308

8839

Galway Hospital

13620

7158

4778

4042

3280

2392

1701

1401

3270

865

176

42683

Number of children waiting for an outpatient appointment at Mayo and Galway University Hospitals from January to July in both 2019 and 2018

2018

2019

Galway University Hospital

Jan

4808

4567

Feb

4687

4606

Mar

4683

4676

Apr

4566

4634

May

4583

4589

Jun

4550

4560

Jul

4507

4555

Mayo General Hospital

Jan

1484

1374

Feb

1459

1430

Mar

1513

1465

Apr

1598

1499

May

1466

1540

Jun

1527

1516

Jul

1481

1429

Occupational Therapy Data

Questions (1224)

Lisa Chambers

Question:

1224. Deputy Lisa Chambers asked the Minister for Health the number of children on the waiting list for occupational therapy in County Mayo; and if he will make a statement on the matter. [36303/19]

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Written answers

As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.

Speech and Language Therapy Data

Questions (1225)

Lisa Chambers

Question:

1225. Deputy Lisa Chambers asked the Minister for Health the number of children on the waiting list for speech and language therapy in County Mayo; and if he will make a statement on the matter. [36304/19]

View answer

Written answers

As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.

Audiology Services Data

Questions (1226)

Lisa Chambers

Question:

1226. Deputy Lisa Chambers asked the Minister for Health the number of children on the waiting list for an audiology appointment in County Mayo; and if he will make a statement on the matter. [36305/19]

View answer

Written answers

As this is a service matter it has been referred to the HSE for reply to the Deputy.

Questions Nos. 1227 to 1229, inclusive, answered with Question No. 1223.

Home Care Packages Data

Questions (1230)

Lisa Chambers

Question:

1230. Deputy Lisa Chambers asked the Minister for Health the number of persons on the home care waiting list in County Mayo in comparison to the same period in 2018; and if he will make a statement on the matter. [36309/19]

View answer

Written answers

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

Child and Adolescent Mental Health Services Data

Questions (1231)

Lisa Chambers

Question:

1231. Deputy Lisa Chambers asked the Minister for Health the number of children and adolescents in County Mayo receiving counselling and services from the Child and Adolescent Mental Health Service; the number of children and adolescents on a waiting list to receive such services in County Mayo; the average wait time on this list; the number of children receiving treatment in adult mental health services in County Mayo; and if he will make a statement on the matter. [36310/19]

View answer

Written answers

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

Mental Health Services Staff

Questions (1232)

Lisa Chambers

Question:

1232. Deputy Lisa Chambers asked the Minister for Health the number of vacant mental health staff posts in County Mayo in child mental health services and adult mental health services by unit; the details of each post vacancy; the length of time each post has been vacant; when each post will be filled; and if he will make a statement on the matter. [36311/19]

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Written answers

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

Hospital Appointments Status

Questions (1233)

Niamh Smyth

Question:

1233. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) is waiting for a cataract operation; and if he will make a statement on the matter. [36312/19]

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Written answers

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

National Treatment Purchase Fund

Questions (1234)

Seán Fleming

Question:

1234. Deputy Sean Fleming asked the Minister for Health if dental and optical treatment for children will be included under the National Treatment Purchase Fund; the procedures in respect of dental and optical work that can be carried out under the scheme; if it can be used for cases in which there is a long backlog for young persons; and if he will make a statement on the matter. [36315/19]

View answer

Written answers

The 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.

Hospital Appointments Status

Questions (1235)

Niamh Smyth

Question:

1235. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) has been waiting for a knee operation since 2017; and if he will make a statement on the matter. [36316/19]

View answer

Written answers

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Nursing Homes Support Scheme

Questions (1236)

Seán Haughey

Question:

1236. Deputy Seán Haughey asked the Minister for Health if sufficient funding will be ensured for the fair deal nursing home scheme to meet the demand for the remainder of 2019; and if he will make a statement on the matter. [36317/19]

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Written answers

The Nursing Homes Support Scheme, commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost.

As outlined in the HSE's National Service Plan for 2019, the NHSS is expected to support 23,042 people in 2019. The NHSS budget for 2019 is €985.8m which is an increase of €24.3m over its 2018 budget.

Over the last two years, an additional €45 million has been provided to NHSS budget for the continued provision of services in line with pricing and demand. As part of normal governance and performance management arrangements The Department and the HSE maintain regular service area engagements, which also form part of ongoing collaborative work on issues relating to older persons policy and service delivery.

The HSE have noted that the number of residents in nursing homes whom are supported by the NHSS to be ahead of forecast for the year to date. The latest available performance reports indicate that there are 23,236 people supported in the Scheme at the end of July this year. This is significantly more people than forecast and this creates a challenge. The HSE has also advised that the cost of care continues to rise and the average weekly cost per bed is higher in 2019 than anticipated.

Having regard to the available budget and the demand for support, the HSE releases funding in a managed way to ensure that the operation of the NHSS remains within the budgetary allocation. The HSE cannot legally fund clients beyond the determined funding allocation, and the appropriate mechanism relating to funding allocations is through the estimates and budgetary process. To manage the available funds throughout the year, a national placement list for the release of funding is operated by the HSE, to enable it to operate within budget. Funding issues to applicants in chronological order, to ensure equity nationally. Approved applicants are placed on the national placement list in order of their approval date and funding is released to applicants in order of their place on this list. The length of time spent on the placement list depends on the number of applicants currently receiving financial support and the number of new applications. Where demand is higher, the time spent on the waiting list may increase having regard for the prudent management of the Scheme's budget.

The HSE has put in place arrangements that a monthly analysis of performance of the Nursing Homes Support Scheme continues to ensure that the maximum number of new entrants are approved with the shortest possible waiting times while remaining on track to deliver a balanced budgetary position by year end. My Department and the HSE will continue to closely engage on this matter, including with a view to improving the approval time frame for release of funding for approved cases.

Hospitals Funding

Questions (1237)

Kevin O'Keeffe

Question:

1237. Deputy Kevin O'Keeffe asked the Minister for Health if his attention has been drawn to the situation of a hospital (details supplied) in County Cork facing closure; if his attention has been further drawn to the fact patients will have to be accommodated within a directly funded HSE facility; if the appropriate funding requirement will be made available to retain the hospital; and if the current financial model of the hospital will be examined to ensure viability of same. [36318/19]

View answer

Written answers

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

Nursing Homes Support Scheme Data

Questions (1238)

Mary Butler

Question:

1238. Deputy Mary Butler asked the Minister for Health the average waiting time up to 31 August 2019 for persons that have been approved for the fair deal scheme to access a nursing home by county in tabular form; his views on whether the wait is too long and is having a negative effect on discharges from level 4 acute hospitals; and if he will make a statement on the matter. [36321/19]

View answer

Written answers

The Nursing Homes Support Scheme, commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost.

As outlined in the HSE's National Service Plan for 2019, the NHSS is expected to support 23,042 people in 2019. The NHSS budget for 2019 is €985.8m which is an increase of €24.3m over its 2018 budget.

The HSE has noted that the number of residents in nursing homes whom are supported by the NHSS is ahead of forecast for the year to date. The latest available performance reports indicate that there are 23,236 people supported in the Scheme at the end of July this year. This is significantly more people than forecast and this creates a challenge. The HSE has also advised that the cost of care continues to rise and the average weekly cost per bed is higher in 2019 than anticipated.

Having regard to the available budget and the demand for support, the HSE releases funding in a managed way to ensure that the operation of the NHSS remains within the budgetary allocation. To manage the available funds throughout the year, a national placement list for the release of funding is operated by the HSE, to enable it to operate within budget. Funding issues to applicants in chronological order, to ensure equity nationally. Approved applicants are placed on the national placement list in order of their approval date and funding is released to applicants in order of their place on this list. The length of time spent on the placement list depends on the number of applicants currently receiving financial support and the number of new applications. Where demand is higher, the time spent on the waiting list may increase having regard for the prudent management of the Scheme's budget.

The current average wait time on the placement list is at about 7 weeks which is, of course, a matter of concern for me. My Department and the HSE are working to ensure that the resources that are available are deployed in the most effective way possible and deliver the best outcomes for older people. This will require an integrated approach across community, residential and other service areas including Acute Hospitals.

Delayed Transfers of Care continue to represent a significant challenge to the Health Service as a whole, and for some hospital patients their ultimate destination will be into transitional care or long term residential care supported by the NHSS. However, there are a number of challenges apart from those related to NHSS, that lead to delayed transfers of care. The Delayed Discharges Implementation Group has been established to address these challenges through the implementation of the recommendations emanating from the Report of the Independent Expert Review of Delayed Discharges.

In relation to the operational matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Home Care Packages Data

Questions (1239)

Mary Butler

Question:

1239. Deputy Mary Butler asked the Minister for Health the number of persons up to 31 August 2019 waiting for a home care support package by county in tabular form; and if he will make a statement on the matter. [36322/19]

View answer

Written answers

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

Home Care Packages Expenditure

Questions (1240)

Mary Butler

Question:

1240. Deputy Mary Butler asked the Minister for Health his views on whether the most cost-effective way to deliver care for older persons is a home care support package at an average cost of €165 weekly; his further views on whether the current waiting lists are not facilitating a timely delivery of home care supports; and if he will make a statement on the matter. [36323/19]

View answer

Written answers

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

Hospital Appointments Delays

Questions (1241)

Niamh Smyth

Question:

1241. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) is waiting for a high-resolution manometry 24-hour PH study at St. James's Hospital to diagnose the cause of their incapacity to swallow; and if he will make a statement on the matter. [36327/19]

View answer

Written answers

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Autism Support Services

Questions (1242)

Lisa Chambers

Question:

1242. Deputy Lisa Chambers asked the Minister for Health the number of children in County Mayo on the waiting list for an autism assessment; and if he will make a statement on the matter. [36333/19]

View answer

Written answers

The 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.

Cross-Border Health Services Provision

Questions (1243)

Mary Butler

Question:

1243. Deputy Mary Butler asked the Minister for Health the turnaround times in the primary care reimbursement service specifically through the cross-Border treatment scheme; his views on the adequacy of the service being delivered; his plans to reduce the waiting times for persons that have applied and been approved; the way in which he plans to deal with waiting times which can be up to six months; and if he will make a statement on the matter. [36342/19]

View answer

Written answers

The HSE is responsible for the operation of the Cross Border Directive and the management of the HSE Cross Border Directive (CBD) office is an operational matter for the HSE. Officials of my Department recently met with the HSE to discuss this matter and have requested the Executive to examine current resourcing of the CBD office, and to identify necessary actions to mitigate waiting times arising from current demands for the Scheme. As the HSE have operational responsibility for the CBD office I have also referred the Deputies question to them for direct reply.

Addiction Treatment Services

Questions (1244)

Michael McGrath

Question:

1244. Deputy Michael McGrath asked the Minister for Health his plans to allow general practitioners administer a drug (details supplied) to help patients combat addiction; and if he will make a statement on the matter. [36343/19]

View answer

Written answers

The Misuse of Drugs (Supervision of Prescription and Supply of Methadone and Medicinal Products containing Buprenorphine authorised for Opioid Substitution Treatment) Regulations 2017 came into effect on 22 November 2017. The purpose of these Regulations is to provide access to certain buprenorphine-based medicinal products for Opioid Substitution Treatment (including buprenorphine/naloxone (suboxone) and buprenorphine only) on the same statutory basis as methadone.

The phased rollout of suboxone commenced on 01 May 2018 and allowed for prescribing of this product by trained Doctors working in HSE Addiction service and specifically approved Level 1 and Level 2 GPs outside the Dublin region. This rollout then extended to suitably trained Level 1 and 2 GPs within the Dublin region in October 2018.

The HSE Addiction services have provided training to HSE Addiction staff and community based GPs in relation to buprenorphine containing products to include the prescribing and dispensing of suboxone on seven separate occasions since October 2017. In addition, the ICGP in conjunction with the HSE provided training to community based GPs in relation to buprenorphine and buprenorphine/naloxone in October 2018.

This has resulted in an increase in the number of patients receiving treatment for Opioid Dependence with suboxone from 118 in 2014 to 254 in 2019 (January to July).

The provision and expansion of buprenorphine/naloxone (suboxone) prescribing is in line with one of the key actions under the National Drug and Alcohol Strategy Reducing Harm, Supporting Recovery - to improve the availability of Opioid Substitution Treatments (2.1.14).

The provision of this medication is expected to continue to expand over the coming year and GPs are continually being encouraged to become trained to prescribe this medication. Further training of Community GPs will come under the remit of the ICGP who have the expertise and responsibility to provide training to GPs.

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