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Tuesday, 26 Nov 2019

Written Answers Nos. 304-328

Home Care Packages

Questions (304)

Gerry Adams

Question:

304. Deputy Gerry Adams asked the Minister for Health if there is a person here in receipt of a direct payment from his Department or the HSE for the purchase of home care under the intensive home care package. [48796/19]

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Written answers

I would like to advise that officials from the Department of Health sought to liaise with the Deputy's office in order to seek clarification around the matters raised in order to provide a satisfactory answer. On this occasion, we were not able to obtain the information we sought. If the Deputy would like to raise the matter again and also provide additional information, the Department would be happy to provide an answer to his question.

Primary Care Centres Provision

Questions (305)

Robert Troy

Question:

305. Deputy Robert Troy asked the Minister for Health the timeframe for works to complete a primary care health centre at Church Street, Moate, County Westmeath, (details supplied); and if this work will be completed within the coming months. [48797/19]

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Written answers

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Occupational Therapy Staff

Questions (306)

Brendan Griffin

Question:

306. Deputy Brendan Griffin asked the Minister for Health when the moratorium on the recruitment of occupational therapists in County Kerry will be lifted; and if he will make a statement on the matter. [48798/19]

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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.

Psychological Services

Questions (307)

Niamh Smyth

Question:

307. Deputy Niamh Smyth asked the Minister for Health the status of the future of the HSE assistant psychologist scheme aimed at children and adolescents in primary care psychology; his plans to further extend the scheme past March 2020; his views on the success of the scheme in counties Cavan and Monaghan; and if he will make a statement on the matter. [48807/19]

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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.

Hospital Facilities

Questions (308)

James Browne

Question:

308. Deputy James Browne asked the Minister for Health the position regarding the catheterisation laboratory development in University Hospital Waterford; and if he will make a statement on the matter. [48823/19]

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Written answers

In 2016, the Herity Report concluded that the needs of the effective catchment population of University Hospital Waterford (UHW) could be accommodated from a single cath lab and recommended that the operating hours of the existing cath lab should be extended. Approval and funding has been provided for the additional staff required to facilitate this service and recruitment is progressing.

A mobile cath lab has been deployed at UHW since October 2017 to conduct diagnostic cardiac procedures pending the recruitment of the additional staff required to extend the opening hours of the existing cath lab.  

I remain committed to the provision of a second cath lab in University Hospital Waterford.  The project has been included in the HSE’s Capital Programme 2019, the Design Team was appointed in June 2019 and the application for planning permission was lodged on 29 October.

The Herity Report also recommended that the current 9 to 5 provision of emergency pPCI services should cease to allow the hospital focus on the much larger volume of planned work. I asked my Department to address the implications of this recommendation by arranging for a National Review of Specialist Cardiac Services.

The aim of this Review is to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive by establishing the need for an optimal configuration of a national adult cardiac service.

Work is ongoing on finalisation of the Review and drafting of its recommendations has commenced.

Home Help Service Provision

Questions (309, 310)

Aengus Ó Snodaigh

Question:

309. Deputy Aengus Ó Snodaigh asked the Minister for Health the reason a person's (details supplied) home help hours have been reduced from two hours per week to only one hour a week. [48827/19]

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Aengus Ó Snodaigh

Question:

310. Deputy Aengus Ó Snodaigh asked the Minister for Health if the home help hours of a person (details supplied) will be reinstated back to two hours per week. [48828/19]

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Written answers

I propose to take Questions Nos. 309 and 310 together.

As these are service matters they have been referred to the Health Service Executive for direct reply.

Medical Aids and Appliances Provision

Questions (311)

Frank O'Rourke

Question:

311. Deputy Frank O'Rourke asked the Minister for Health if he will reconsider approving the funding for a specialised bed for a person (details supplied); and if he will make a statement on the matter. [48903/19]

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Written answers

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

Disability Services Provision

Questions (312)

Kathleen Funchion

Question:

312. Deputy Kathleen Funchion asked the Minister for Health the reason for the delay in a person (details supplied) receiving a day service in view of the fact the person has a personalised budget and should have no issues receiving the service. [48908/19]

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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.

Mental Health Services Staff

Questions (313)

James Browne

Question:

313. Deputy James Browne asked the Minister for Health the number of mental health whole-time equivalents to be recruited as of November 2019 for the full implementation of A Vision for Change taking account of demographic changes in each CHO; the teams and specialities in which the additional staff are required by CHO in tabular form; and the estimated full year cost of providing the additional staff. [48909/19]

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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.

National Children's Hospital Expenditure

Questions (314)

Barry Cowen

Question:

314. Deputy Barry Cowen asked the Minister for Health if he has received an update on the cost of the national children’s hospital; the estimated amount it will cost in 2020, 2021 and 2022; the way in which it will be paid for from the Exchequer; and if he will make a statement on the matter. [46968/19]

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Written answers

I advised Government in December 2018 that the final cost of the design, build and equipment programme for which the National Paediatric Hospital Development Board is responsible was estimated to be €1,433 million. There has been no change to this figure advised to Government.

In relation to the estimated amount that this project will cost in 2020, 2021 and 2022, the projected cash flow projection for this period is detailed as follows.

Year

Estimated amount

2020 

€327,203,776

2021

€359,651,055

2022

€249,168,409

With regard to the way in which it will be paid for from the Exchequer, the amount allocated to Health each year follows an extensive process of engagement between my Department and the Department of Public Expenditure and Reform. The Department of Public Expenditure and Reform have responsibility for allocating public expenditure across all the relevant votes within the overall envelope set by the Government.

Disabilities Assessments

Questions (315)

Jackie Cahill

Question:

315. Deputy Jackie Cahill asked the Minister for Health when he expects assessments of need under the Disability Act 2005 in County Tipperary to be provided within the statutory timeframe; and if he will make a statement on the matter. [48883/19]

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Written answers

As this is a service issue the Deputy's question has been referred to the HSE for direct reply. 

Hospital Waiting Lists

Questions (316)

Barry Cowen

Question:

316. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment. [48924/19]

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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.

Medical Card Administration

Questions (317)

Michael Healy-Rae

Question:

317. Deputy Michael Healy-Rae asked the Minister for Health if laser eye surgery is covered by the medical card; and if he will make a statement on the matter. [48925/19]

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Written answers

The Health Act 1970 (as amended) provides for two categories of eligibility for persons ordinarily resident in the country, i.e. full eligibility (medical cardholders) and limited eligibility (all others).  Full eligibility is determined mainly by reference to income limits.  Determination of an individual's eligibility status is the responsibility of the Health Service Executive.

The HSE provides, or has provided on its behalf, a range of services including all in-patient public hospital services, including consultants services, all out-patient public hospital services including consultants services, dental, ophthalmic and aural services and appliances and a maternity and infant care service.  Persons with full eligibility (medical card holders) are entitled to receive these services free of charge. 

As the provision of the particular procedure mentioned is a service matter for the HSE I have referred the matter to the HSE for direct reply to the Deputy.

Hospital Discharges

Questions (318)

Louise O'Reilly

Question:

318. Deputy Louise O'Reilly asked the Minister for Health the number of delayed discharges to date in 2019 by month and hospital; and the reason for delayed discharge in tabular form. [48933/19]

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Written answers

Delayed transfers of care (previously referred to as delayed discharges) 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, homelessness, ward of court application, and the availability of 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.

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. 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.

In addition, the HSE Winter Plan was launched on Thursday 14 November. The aim of the Winter Plan is to ensure that service providers are prepared for the additional external pressures associated with the winter period, including the prolonged holiday period, severe winter weather, seasonal influenza, and the spread of norovirus and other healthcare associated infections.

Nine Winter Action Teams, each aligned to a Community Healthcare Organisation and associated acute hospitals and Hospital Groups, have prepared Integrated Winter Plans. These plans 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 HSE Winter Plan is supported by an additional €26m in winter funding nationally. This winter funding will support access to the Fair Deal scheme, and will provide additional home support and transitional care to facilitate timely hospital discharge and reduce congestion in EDs over the winter period.

With regard to the Deputy's specific question, I have asked the HSE to respond to the Deputy directly with the requested information.

Primary Care Centres

Questions (319)

Louise O'Reilly

Question:

319. Deputy Louise O'Reilly asked the Minister for Health his plans to provide parking for disabled persons using the primary care centre in Balbriggan, County Dublin; and if he will make a statement on the matter. [48934/19]

View answer

Written answers

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Cancer Awareness

Questions (320, 321, 322, 324, 325)

Louise O'Reilly

Question:

320. Deputy Louise O'Reilly asked the Minister for Health the number of women issued letters by the HSE regarding their risk of breast implant associated anaplastic large cell lymphoma. [48935/19]

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Louise O'Reilly

Question:

321. Deputy Louise O'Reilly asked the Minister for Health if supports have been put in place for women that were issued with letters by the HSE regarding their risk of breast implant associated anaplastic large cell lymphoma. [48936/19]

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Louise O'Reilly

Question:

322. Deputy Louise O'Reilly asked the Minister for Health when the attention of the HSE was drawn to the risk to women of breast implant associated anaplastic large cell lymphoma. [48937/19]

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Louise O'Reilly

Question:

324. Deputy Louise O'Reilly asked the Minister for Health his views on whether issuing letters instead of face-to-face dialogue with a clinician was the best way to deliver news to women that they are at risk of breast implant associated anaplastic large cell lymphoma. [48941/19]

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Louise O'Reilly

Question:

325. Deputy Louise O'Reilly asked the Minister for Health the seriousness of the risk of breast implant associated anaplastic large cell lymphoma for women who are affected by implants (details supplied). [48942/19]

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Written answers

I propose to take Questions Nos. 320 to 322, inclusive, 324 and 325 together.

Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA ALCL) is a new and emerging issue and while more specific to highly textured breast implants and tissue expanders, the risk exists for all types of textured breast implants and tissue expanders.

BIA-ALCL is not breast cancer, but a type of non-Hodgkin’s lymphoma – a cancer of the immune system.

BIA- ALCL is a relatively new form of cancer and was given provisional recognition as a type of ALCL by the World Health Organisation (WHO) in 2016. As research has developed, there has been more awareness of this condition over the past number of years. When diagnosed and treated early, it has a very good recovery rate. It has been diagnosed in only a small number of people worldwide.

Most cases of BIA-ALCL have been diagnosed in patients who have implants, or have had tissues expanders manufactured by Allergan, with a specific textured surface called "BIOCELL." These implants and expanders have not been used in Ireland since December 2018.

The Health Products Regulatory Authority (HPRA) has been updating my Department on this matter as further research is published and as evidence continues to emerge at both a European and international level and while the risk of developing BIA-ALCL has been shown to be more common than first thought, it still remains an uncommon condition.

The Health Service Executive (HSE) has decided to communicate publicly on this matter in order to increase general awareness of BIA ALCL, ensure that women in Ireland are fully informed on this issue and are given the appropriate advice and follow up as required. My Department has been and continues to work alongside the HSE in this regard.

The 8 national cancer centres are writing directly to their patients who have had breast implants or tissue expanders, including those who received Allergan ‘BIOCELL’ and patients without Allergan ‘BIOCELL’ breast implants/ tissue expanders. The distribution of these letters is an ongoing process, with letters being sent directly by the 8 cancer centres to their patients. As this is an ongoing communication process, I cannot inform the Deputy how many letters have issued.

The letters and the information on the HSE’s website, advise all individuals to be breast aware; describing the signs and symptoms to be aware of and monitor for and what to do if a patient finds a swelling or lump. It is important to note that for patients without any symptoms- no further action is needed apart from routine follow-up.

Dedicated telephone lines have been set up in the 8 cancer centres to provide assurance, encourage women to be breast aware and when necessary allocate clinical review. The phone numbers are included in each patient’s letter.

In December 2018, a French medical device notified body (which evaluates the conformity of products) decided not to renew the CE Certificates for certain breast implants and tissue expanders produced by the company Allergan. The HPRA made information available publicly when the product was withdrawn. The HSE advisory was issued in response to increased understanding of the incidence of the condition based on International studies over the past year.

This current HSE patient advisory programme was initiated in August last based on the evolving understanding of the disease internationally. Since then, my Department has been engaging with a range of national stakeholders, including the HSE, HPRA, clinical representatives and the private hospital sector on this issue to ensure that appropriate action is been taken.

Treatment Abroad Scheme

Questions (323)

Seán Haughey

Question:

323. Deputy Seán Haughey asked the Minister for Health if there is a delay by the HSE in reimbursing claimants availing of surgery under the cross-border directive; his plans to ensure that a person (details supplied) is paid as soon as possible; and if he will make a statement on the matter. [48938/19]

View answer

Written answers

The HSE is responsible for the operation of the Cross-Border Directive and has a dedicated CBD office for this purpose. Since being introduced in 2014, awareness of the provisions of the Directive has grown steadily. In 2015, the first full year of operation of the scheme, 150 reimbursements were made at a cost of €585,863. In 2018, these figures had risen to 3,886 reimbursement claims processed, at a value in excess of €12m.

The significant growth in use of the scheme, and volume of applications submitted, has placed additional demands on the CBD office and given rise to a build-up of applications. over recent months.  I have been advised by the HSE that additional resources are now being allocated and specific initiatives implemented to urgently address the backlog and delays in reimbursement.

Regarding the specific application referred to, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.

Questions Nos. 324 and 325 answered with Question No. 320.

Departmental Funding

Questions (326)

Michael McGrath

Question:

326. Deputy Michael McGrath asked the Minister for Health the position regarding an application for funding for a feasibility study (details supplied) for second level school on-call therapeutic counselling; and if he will make a statement on the matter. [48945/19]

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.

Health Services Provision

Questions (327)

Michael McGrath

Question:

327. Deputy Michael McGrath asked the Minister for Health his plans to establish dedicated, free, drop in sexual and mental health clinics in Cork city; and if he will make a statement on the matter. [48953/19]

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 Staff

Questions (328)

James Browne

Question:

328. Deputy James Browne asked the Minister for Health the steps that have been taken to recruit staff for CAMHS in south County Wexford; and if he will make a statement on the matter. [48954/19]

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.

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