Written Answers Nos. 74-97
74. Deputy Peadar Tóibín asked the Minister for Health the reason his Department exchanged speaking notes in relation to the CervicalCheck delayed smear test results scandal with the Office of the Taoiseach on 27 March 2019; and if his attention was drawn to the speaking notes or other speaking notes on the crisis before 10 July 2019. [41157/19]
View answerMy Department regularly provides speaking points to the Department of An Taoiseach on a range of issues. This is normal practice for Government departments.
To clarify, the email in question does not concern the CervicalCheck IT issue which emerged in July this year and which related to tests undertaken at the Quest Diagnostics laboratory in Chantilly. As I have stated previously, and as is made clear in the MacCraith Report, my Department received a report in relation to this issue on the 10th of July and the first briefing on this issue was provided to me later that day.
75. Deputy Mick Barry asked the Minister for Health if he will report on the availability of hormone treatment for transgender persons through the health service; his engagement with the transgender community on this issue; and if he will make a statement on the matter. [41357/19]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
76. Deputy Marc MacSharry asked the Minister for Health the reason for the large increase in the numbers waiting more than 18 months for an outpatient appointment in Sligo University Hospital since May 2016; and if he will make a statement on the matter. [41229/19]
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.
Waiting list figures for the end of September, due to be published by the National Treatment Purchase Fund (NTPF) later this week, show that there are 16,447 people waiting for an outpatient appointment at Sligo University Hospital. Of those, 49% are waiting 6 months or less and and over 73% are waiting 12 months or less.
More broadly, Budget 2020 announced that the Government has further increased investment in tackling waiting lists, with funding to the National Treatment Purchase fund (NTPF) increasing from €75 million in 2019 to €100 million in 2020. The year-on-year increases to the National Treatment Purchase Fund since Budget 2017 reflect this Government’s priority to improve waiting times for patients to access hospital treatment.
My Department is working with the HSE and National Treatment Purchase Fund to develop the Scheduled Care Access Plan 2020. In this regard, the HSE National Service Plan 2020 will set out a planned activity level for the year ahead, while the NTPF will work with the hospital system to provide additionality to improve access to inpatient/daycase treatment and with a particular focus on hospital outpatient services.
In this regard, I would encourage all hospital groups and individual hospitals to engage with the NTPF to identify waiting list proposals for the remainder of this year and for 2020.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
77. Deputy Bobby Aylward asked the Minister for Health if he will consider implementing multi-annual budgets to support planned service for section 39 agencies such as an organisation (details supplied) in advance of budget 2020; his plans for the provision of additional funding to assist such agencies meet their deficits in respect of unmet business cases; his further plans for the provision of additional funding to assist such agencies to meet changing needs and emergency placements; the position regarding new respite services for Kilkenny; and if he will make a statement on the matter. [40862/19]
View answerSignificant resources have been invested by the health sector in disability services over the past number of years. The allocation for disability services will rise to over €2 billion in 2020, compared to the €1.904 billion allocated to the Disability Services Programme in 2019. Decisions in terms of the HSE’s Disability Programme priorities for 2020 will be made within the overall context of its annual national service planning process which is currently underway. Pending completion of this process I cannot comment further at this stage on funding allocations to specific service providers.
This Government's ongoing 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. The importance of increased respite services is acknowledged in this context.
At national level, the HSE received funding of €10 million to support the development of respite services in 2018. This funding was subsequently allocated between Community Health Organisations in the form of twelve Respite Houses and the development of local alternative respite provision. In the budget for 2020, an additional €5 million is being provided for intensive support packages for children and young people in response to the changing needs of service users and their families. A further €5 million is being provided for emergency residential services and other supports for people with priority needs.
With regard to the Deputy’s query concerning new respite services for Kilkenny, this is a service matter for the HSE and, accordingly, I have asked the Executive to reply directly to the Deputy on the matter.
78. Deputy John Curran asked the Minister for Health the number of additional homecare and transitional care beds that have been provided for in 2019; and if he will make a statement on the matter. [40900/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
79. Deputy John Curran asked the Minister for Health the number of patients in hospital nationwide that are waiting for an assessment for a homecare package; and if he will make a statement on the matter. [40899/19]
View answerDelayed transfers of care occur when patients have been deemed clinically fit for discharge from an acute bed but their discharge is delayed because they are waiting for some form of ongoing support or care following their discharge. There are many reasons for this such as a patient undertaking the application process for NHSS, awaiting assessment for a home support package, resolving legal complexity (e.g. ward of court), or awaiting the availability of rehabilitation or other resources.
When possible, the HSE will use transitional care to accommodate the patient during the period between discharge and the finalisation of new care arrangements, but there can often be a delay, especially in cases where the patient and family are coming to terms with the new circumstances.
As of 1 October 2019, the HSE reported 141 patients nationally who are waiting to be discharged with home support. Of those, 8 have been referred to community services for assessment of their needs, and 42 have applications for home care submitted and being processed.
This year, services are being stretched more than ever, with demand consistently outstripping supply, and we have seen an increase the number of delayed transfers of care (DTOCs). While the HSE maximises the use of resources, prioritising those requiring discharge from acute hospitals, there is a growing demand for egress support. In response, and in the context of planning and preparing for the challenges of the winter period, the Department and the HSE have been considering a comprehensive approach to the current the high-level of DTOCs. However, recognising the urgency of the situation, approval was provided to the HSE to begin actions immediately to the value of €5m in 2019. As part of these measures the HSE released a significant number of funding approvals within NHSS in September, and provided additional home care and transitional care beds.
80. Deputy Stephen Donnelly asked the Minister for Health the steps being taken to address the multi-year waiting times being experienced by children with special needs in County Wicklow that have been referred for treatment to a service (details supplied) and other service providers; and if he will make a statement on the matter. [41264/19]
View answerAs the Deputy's question relates to a service matter it has been referred to the HSE for direct reply.
81. Deputy Ruth Coppinger asked the Minister for Health his plans to address the lower health outcomes in deprived areas; if extra resources will be given to these areas; and if he will make a statement on the matter. [41361/19]
View answerThe determinants of health include income and social status; employment and working conditions; education and literacy; childhood experiences; physical environments; social supports; healthy behaviours; and access to health services. Clearly, addressing such issues extends beyond the policy remit of a single government Department and requires complex cross-governmental policy solutions that seek to create the economic, social, cultural and physical environments that foster healthy living, supported by socially targeted interventions that address the specific needs of at-risk groups.
With regard to my Department, Healthy Ireland is the national framework to improve the health and wellbeing of the population, and actions to reduce health inequalities are inherent in a range of national health policies under the umbrella of the Healthy Ireland Framework. As well as raising awareness of the social and environmental determinants of health, Healthy Ireland aims to help empower communities to engage in improving their own health and wellbeing and mobilise responses to the challenges they face at local level. For example, in the first round of funding, some 70% of the €5m allocated to the Healthy Ireland Fund benefitted disadvantaged groups and communities
Furthermore, as part of the package of GP contractual reforms, it has been agreed that the GP rural practice allowance will be increased in 2020 while targeted funding of €2 million will be set aside to provide additional support to practices in deprived urban areas. It should also be noted that deprivation index scores are one factor used in determining the prioritisation of the development of Primary Care Centres, while local population needs are taken into account in the provision of primary and community services.
82. Deputy Catherine Connolly asked the Minister for Health the number, grade and title of all posts in Galway city and county in which interviews have been held, posts offered and accepted and awaiting sanction by the HSE and his Department; and if he will make a statement on the matter. [41180/19]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
83. Deputy Maurice Quinlivan asked the Minister for Health the emergency measures he is putting in place to address the severe overcrowding in University Hospital Limerick, which saw 1,405 persons on trolleys in the hospital in September 2019; and if he will make a statement on the matter. [40958/19]
View answerThe HSE TrolleyGAR count shows a 17% increase in patients waiting on trolleys in University Hospital Limerick ED for this year up to the end of September compared to the same period last year. In the month of September 2019, there were 897 patients counted on trolleys in University Hospital Limerick, which was a 28% increase compared to the previous month.
It is acknowledged that this is unacceptably high and the HSE are actively working with the University of Limerick Hospital Group to ease congestion in University Hospital Limerick with a focus on facilitating transfers to Level 2 hospitals, assistance from rehabilitation units and Community Health Organisation services, and prioritisation of diagnostics to aid inpatient discharges.
My Department is engaging extensively with the HSE this year to identify mitigating actions across the health service to bring down trolley numbers and waiting times in the ED in the face of growing demand.
Planning for winter 2019/20 has commenced and my Department is working with the HSE to finalise the Winter Plan in the coming weeks. Individual Community Healthcare Organisations (CHOs) and Hospital Groups are preparing Integrated Winter Plans that will focus on demand management and reduction, staffing availability, timely access to the most appropriate care pathway for patients as well as provide appropriate timely egress from acute hospitals. These Integrated Winter Plans will support the development of a single overarching strategic level Winter Plan for the HSE.
The Integrated Winter Plan for University Hospital Limerick will be delivered by a Winter Action Team whose membership will include the CEO of UL Hospital Group and the Chief Officer of CHO Midwest.
I understand that intensive work is underway between the UL Hospital Group and CHO Midwest in the context of recent Emergency Department pressures. Delayed Transfers of Care have decreased from a peak of 30 in the last week of August 2019 to 20 in the first week of October 2019. This joint working will continue throughout the winter period and beyond.
The winter plan and associated initiatives will be supported by an additional €26m in winter funding available nationally, which I have agreed with the Minister for Public Expenditure and Reform as part of this week's Budget. This funding will support access to the Fair Deal scheme and the availability of home care, transitional care, aids and appliances and other local actions to both facilitate timely hospital discharge and reduce congestion in EDs over the winter period.
These initiatives build upon the progress that has been made on increasing capacity in University Hospital Limerick. Since December 2017, an additional 25 beds have opened in University Hospital Limerick, including 8 which opened at the start of this year as part of the 2018/2019 Winter Plan.
A capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at University Hospital Limerick, with funding of €10 million allocated in 2019. The HSE have advised that the enabling works are complete, and the main contractor is now commencing work. This important project will go some way towards addressing the acknowledged lack of bed capacity in the region.
Furthermore, the National Development Plan includes a 96-bed replacement ward block in University Hospital Limerick and capital funding was provided in 2018 to progress the design phase of the project. A design team has been appointed for this project.
84. Deputy Aindrias Moynihan asked the Minister for Health the steps he is taking to reduce the time persons are spending on ophthalmology waiting lists in counties Cork and Kerry; and if he will make a statement on the matter. [41368/19]
View answerThe Programme for Government commits to reducing waiting times for procedures in hospitals and has provided funding to the National Treatment Purchase Fund (NTPF) to deliver on this commitment. Budget 2019 announced that the Government had further increased investment in tackling waiting lists, with funding to the NTPF increasing from €55 million in 2018 to €75 million in 2019.
The joint Department of Health, HSE, and NTPF Scheduled Care Access Plan 2019 was published in March. Under the plan there has been a continued effort to improve patient access for certain high-volume procedures, including cataracts. The NTPF procures capacity for each of the procedures identified in the Action Plan, including cataract procedures, in both private hospitals or public hospitals. The Action Plan also strikes the appropriate balance between maximising the number of patients treated in both public and private capacity, as appropriate, and ensuring the best return for the taxpayer.
Under the Inpatient Day Case Access Plans for 2018 and 2019, cataracts were one of the specialties targeted by the NTPF, and by end of September 2019, the number of people waiting nationally for a cataract procedure had almost halved, from 10,024 in July 2017 to 5,074. In this same period, there has also been a reduction of 88% in the number of patients waiting over 9 months for a cataract operation.
In relation to the number of patients awaiting cataract surgery in Cork and Kerry, data provided by South South West Hospital Group (SSWHG) at the beginning of September, shows that of 499 patients waiting, 349 (70%) were waiting less than 6 months.
Furthermore, the SSWHG has advised that the NTPF has approved funding for 401 patients to receive cataract surgery with an external provider in 2019.
As part of the IPDC Action Plan 2018, a stand-alone high-volume consultant-led cataract theatre was opened by the University of Limerick Hospital Group in Nenagh Hospital, in November 2018. This initiative continues to have a positive impact in reducing waiting times for patients waiting for cataract procedures, especially in the mid-west. Given the central location of Nenagh Hospital it is envisaged that, in time, it has the potential to provide capacity for cataract surgery for patients on waiting lists in public hospitals in the surrounding geographical areas. The HSE has advised that University Limerick Hospital Group is working collaboratively with the South South West Hospital Group to review over 1,000 patients on Ophthalmology waiting lists that may be suitable for cataract procedures in Nenagh.
In addition, in line with the objectives of Sláintecare, I have asked the HSE and NTPF to work together this year with the objective of developing medium-long term improvement initiatives for patient access to hospital procedures. A Working Group comprised of representatives from the HSE, NTPF, and Departmental officials, has been established to examine ways of improving access for patients waiting for scheduled care. Part of this work included examining initiatives which would move care to the most appropriate setting, and at the lowest level of complexity, such as providing ophthalmology in the community.
Furthermore, Budget 2020 announced that the Government has further increased investment in tackling waiting lists, with funding to the NTPF increasing from €75 million in 2019 to €100 million in 2020. The year-on-year increases to the NTPF since Budget 2017 reflects this Government’s priority to improve waiting times for patients to access hospital treatment.
My Department is working with the HSE and NTPF to develop the Scheduled Care Access Plan 2020. In this regard, the HSE National Service Plan 2020 will set out a planned activity level for the year ahead, while the NTPF will work with the hospital system to provide additionality to reduce inpatient/day case waiting times, and with a particular focus on improving access to hospital outpatient services.
In 2020, the NTPF will further expand its list of targeted inpatient and daycase procedures to support further significant reductions in wait times as well as increasing funding towards supporting full packages of care for patients on the outpatient waiting lists, to include surgery or treatment where required.
85. Deputy Pearse Doherty asked the Minister for Health if an independent clinical review will be launched into recent reports of apparent failings in the care provided to a number of women at the gynaecology department, Letterkenny University Hospital, County Donegal. [41170/19]
View answerI have been advised that the Saolta Healthcare Group will conduct a review of the safety and quality of gynaecology services in Letterkenny University Hospital, led by an independent chairperson. The terms of reference and membership of the review group are being finalised at present and it is envisaged that this review will be completed in the coming months.
86. Deputy Robert Troy asked the Minister for Health his plans to address the long waiting lists for homehelp hours for countiesLongford and Westmeath. [41372/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
87. Deputy Louise O'Reilly asked the Minister for Health the reason the necessary staff have not been recruited to ensure that the paediatric outpatient department and urgent care centre at Connolly Hospital can be operational from 8 a.m. until midnight, seven days a week, as was previously committed; and when the full staff complement will be in place. [40977/19]
View answerThe new Paediatric Outpatient and Urgent Care Unit at Connolly opened on the 31st July 2019. The current hours of opening for the Outpatients Department are from 8am to 6pm Monday to Friday. The Urgent Care Unit is being opened on a phased basis and the opening hours are currently between 10am and 5pm The phased opening is in line with best practice and has allowed CHI to monitor and review their processes, provide on the job training for staff and assess and monitor patient safety.
CHI has acknowledged that there are recruitment challenges nationally and internationally in certain specialties, specifically in relation to Paediatric Radiology and Paediatric Emergency Medicine. While the initial recruitment campaign for emergency medicine has been successful there are temporary vacancies in CHI due to maternity and backfill requirements for Paediatric Emergency Medicine posts. There are 2 Paediatric Radiology posts vacant and CHI is currently recruiting for these posts and working on a pipeline for future radiologists.
CHI is continuing to actively work with Consultants to review services at the Urgent Care Unit since it opened so that it can work within existing resources towards increasing the existing opening hours at the Unit Monday to Friday and ultimately to deliver services at weekends.
89. Deputy Thomas Pringle asked the Minister for Health if the outstanding number of posts awaiting decision by the national director for Donegal CHO amounting to over 100 posts remaining vacant will be addressed; and if he will make a statement on the matter. [40875/19]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
90. Deputy Robert Troy asked the Minister for Health the status of discussions between the HSE and South Westmeath Hospice regarding the retention of the facility. [41371/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
91. Deputy Thomas Pringle asked the Minister for Health if there is a recruitment embargo or freeze within the HSE and specifically for the north west CHO1 area; and if he will make a statement on the matter. [40874/19]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
92. Deputy Denis Naughten asked the Minister for Health his priorities in the capital plan to address the delays in accessing elective surgery; and if he will make a statement on the matter. [41172/19]
View answerProject Ireland 2040, incorporating the National Development Plan 2018-2027, provides for funding of €10.9 billion over the decade to develop infrastructure, equipment and additional service capacity for the public health sector, in an ambitious plan to improve our health services and modernise how we deliver services through the implementation of Sláintecare.
The Sláintecare Action Plan for 2019 includes a commitment to develop criteria for new dedicated ambulatory elective-only hospital facilities. Detailed policy analysis to underpin this very significant health capital development is required to guide service and operational specifications for the new facilities.
The Health Service Executive recently published its Capital Plan for 2019-2021 outlining the projects to be progressed over the three-year period across a range of investment programmes, including the development of additional capacity.
Project Ireland 2040 and the National Development Plan are long-term plans which will provide the capital funding to develop dedicated ambulatory elective-only hospital facilities. However, we must ensure that we carefully plan the use of this capital funding to meet the populations health needs and achieve value for money.
Project Ireland 2040 includes provision for new dedicated ambulatory elective-only hospital facilities will be introduced in Dublin, Galway and Cork. These facilities will provide high volume, low complexity procedures on a day and outpatient basis, together with a range of ambulatory diagnostic services. The high volume of demand for such services in these major urban centres is sufficient to justify the construction of dedicated ambulatory centres.
It is envisaged that these facilities will be sited adjacent to acute hospitals. The aim is to both increase capacity in the hospital system and provide a better separation of scheduled and unscheduled care, in line with the recommendations of the Sláintecare Report. They will provide increased, protected capacity for elective treatment and free up capacity in major hospitals to address higher complexity and emergency care.
93. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 95 of 13 March 2019 the precise location of the helipad of Galway University Hospital; if the helipad has been relocated to the grounds of the hospital from its temporary location in the community park in Shantalla, Galway; and if he will make a statement on the matter. [41182/19]
View answerAs this is an operational matter, I have asked the HSE to reply to you directly.
94. Deputy Jackie Cahill asked the Minister for Health when the changes to the nursing home support scheme for farmers will take place; and if he will make a statement on the matter. [41228/19]
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. The 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.
The General Scheme of Bill for the NHSS was approved by Government on the 11th June 2019 and subsequently published. The changes to the Scheme will come into effect as soon as the legislative process is successfully complete. The Department will 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 the Department will participate in pre-legislative scrutiny when the Committee sets a date in the coming months.
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.
95. Deputy Jack Chambers asked the Minister for Health the degree to which he is incorporating demographic changes into budgetary planning; and if he will make a statement on the matter. [41304/19]
View answerDemographic change, in terms of both the age structure and health status of the population (including factors such as morbidity, disability or dependency ratios), is fully considered by my Department and the Health Service Executive when undertaking budget planning.
Meeting demographic need within the fiscal resources available to Government is a major policy challenge for both Irish and international Governments. The significant increases in health funding year on year reflects the consideration given by my Department and the HSE to the growing needs for health and social care services year on year and the commitment by Government to address this recognised policy challenge.
96. Deputy Louise O'Reilly asked the Minister for Health if the establishment of a day hospital in Swords, County Dublin will be considered. [40979/19]
View answerThe National Development Plan 2018-2027 outlines that new dedicated ambulatory/elective-only hospital facilities will be delivered in Dublin, Cork and Galway to tackle waiting lists and provide access to diagnostic services.
The Sláintecare Action Plan 2019 includes a commitment that the criteria for ambulatory/elective sites will be determined during the course of this year. This will involve policy development to determine the services to be delivered, the facilities required and the relationship with existing hospitals in the catchment area.
This work will be directed by an Elective Hospital Oversight Group, and draw upon international evidence, including the merits of stand-alone facilities or dedicated facilities on the site of a general hospital. In advance of the development of the criteria for site selection, it is not possible to evaluate the merits of the particular proposed location at this stage.
97. Deputy Jackie Cahill asked the Minister for Health the measures being taken to alleviate overcrowding in the South Tipperary General Hospital in which the figures recorded in September 2019 were the worst recorded for September since an organisation (details supplied) commenced keeping records; and if he will make a statement on the matter. [41227/19]
View answerAccording to provisional HSE TrolleyGAR data, there was a 39% increase in patients waiting on trolleys year to date in South Tipperary General Hospital (STGH) ED in September 2019 compared to the same period last year. In the month of September 2019, there were 574 patients counted on trolleys in STGH, which was a 23.7% increase compared to the previous month.
My Department is engaging extensively with the HSE this year to identify mitigating actions across the health service to bring down trolley numbers and waiting times in the ED in the face of growing demand.
Planning for winter 2019/20 has commenced and my Department is working with the HSE to finalise the Winter Plan in the coming weeks. Individual Community Healthcare Organisations (CHOs) and Hospital Groups are preparing Integrated Winter Plans that will focus on demand management and reduction, staffing availability, timely access to the most appropriate care pathway for patients, and appropriate timely discharge from acute hospitals. The Integrated Winter Plans will support the development of a single overarching strategic level Winter Plan for the HSE. These Integrated Winter Plans will support the development of a single overarching strategic level Winter Plan for the HSE.
The Integrated Winter Plan for STGH will be delivered by a Winter Actions Team that will include the CEO of the South South West Hospital Group and the Chief Officer of CHO 5.
The 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 wide scale reform of the manner and the location of where health services are provided.
As part of the 2017/2018 Winter Initiative, funding was allocated for the provision of a 40-bed modular unit in STGH in Clonmel. HSE Estates have advised that the contract programme is now 85% complete and that substantial completion is anticipated in November. Equipment has been delivered to the site and the equipping programme is underway. The final commissioning will take place once the contractor hand-over is completed.
