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Tuesday, 26 Nov 2019

Written Answers Nos. 329-355

Vaccine Damage Compensation Scheme

Questions (329)

Tony McLoughlin

Question:

329. Deputy Tony McLoughlin asked the Minister for Health the efforts being taken to ensure that the other 100 young persons affected by the swine influenza vaccine will not have to go through lengthy legal action to be compensated by the State in view of the recent swine influenza vaccination legal case taken against the HSE and his Department which came to a conclusion recently; and if he will make a statement on the matter. [48961/19]

View answer

Written answers

I am pleased that the mediation process was successful in the recent case relating to the administration of the Pandemrix vaccine during the 2009 H1N1 influenza pandemic and that the parties have been able to come to a resolution without the necessity to continue with legal proceedings.  

In October 2013, the Government approved (S180/46/01/0005B) the delegation to the State Claims Agency (SCA) of the management of claims in relation to individuals alleging the development of narcolepsy resulting from the administration of the pandemic vaccine. The management of the cases transferred to the SCA when the National Treasury Management Agency (Delegation of Claims Management Functions) (Amendment) Order 2013 (S.I. no 405 of 2013) was signed by the then Taoiseach on 15 October 2013.  As such, I have no role as regards the conduct of this or future cases, including as regards the issue of costs relating to them.

However, the Programme for a Partnership Government includes a commitment to “…put in place a scheme, on a no-fault basis, that will respond to the needs of people with disability arising from vaccination" and work is progressing with regard to this.  An Expert Group was established in June of last year, under Judge Meenan, to examine the law in relation to personal injuries arising in the healthcare context and to explore alternative mechanisms by which claims could be managed more effectively, particularly from the perspective of the person on whose behalf a claim has been made.  A report from this Expert Group is expected in the coming weeks, the recommendations of which will be taken into account as part of the development of a vaccine compensation scheme.

In addition, the Health Research Board recently completed a review of the evidence on vaccine injury redress programmes in other jurisdictions and this report will also be considered in conjunction with the Expert Group’s recommendations. 

Since 2012, the Department of Health, the HSE, and the Department of Education and Skills, and the Department of Employment Affairs and Social Protection have worked together to provide a wide range of services and supports for those affected.  The HSE’s Advocacy Unit acts as liaison with service and support providers and other Government Departments to facilitate access to required services.  It is in regular contact with individuals affected and regularly meets with representatives of SOUND (Sufferers of Unique Narcolepsy Disorder).  Regional co-ordinators have been appointed to assist individuals by providing advice, information and access to local services. 

The ex-gratia health supports include:

- clinical care pathways to ensure access to diagnosis and treatment;

- multi-disciplinary assessments led by clinical experts;

- counselling services for both the individuals and their families;

- discretionary medical cards for those who have been diagnosed;

- physiotherapy and occupational therapy assessments.

Treatment and individual medical needs are reassessed over time to take account of changes in their condition or circumstances.  

In conjunction with the above, a centre of excellence for narcolepsy (based in St. James’s Hospital) for treating all forms of narcolepsy in adults as well as children transitioning from paediatric services has been in development.  A sleep lab is now complete at this facility, with equipment installed and commissioned.  Additional sleep technicians have also been recruited.  The sleep lab has opened and completed its first sleep studies in July 2019.  Sleep studies are now continuing on a regular basis.  A consultant neurologist with specialist interest in sleep medicine and two consultant respiratory physicians with specialist interest in sleep medicine have been appointed.  They have all commenced their full-time positions and are seeing narcolepsy-related referrals in the clinic.  A dietician has also joined the service as part of its multidisciplinary team.

Disability Services Provision

Questions (330)

Niamh Smyth

Question:

330. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) is waiting a long time for an appointment; when they will be seen; and if he will make a statement on the matter. [48968/19]

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.

Disability Support Services

Questions (331)

Michael McGrath

Question:

331. Deputy Michael McGrath asked the Minister for Health his plans to give parents and legal guardians of adults with a disability a legal right to be included in the preparation of a care plan; and if he will make a statement on the matter. [48994/19]

View answer

Written answers

A wide range of disability services are provided to those with physical, sensory, intellectual disability and autism. Disability services focus on supporting and enabling people with disabilities to maximise their full potential, living ordinary lives in ordinary places, as independently as possible. Disability services strive to ensure the voices of service users and their families are heard, and are fully involved in planning and improving services to meet their needs 

Under the Health Act of 1970 (as amended) the “eligibility framework” places an obligation on the HSE to make a range of services available to people, rather than conferring on them an ‘absolute entitlement’ to access such services.  

Section 7 of the Health Act of 2004 specifies that

“The object of the Executive is to use the resources available to it in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public” 

In short, at the moment our legislation does not confer a right to particular services, instead persons have eligibility to access services while there is a finite budget of money which the HSE allocates to best fit the needs of the population as a whole. 

The overarching principle governing the planning and delivery of health services and supports for adults and children with disabilities is that they should be integrated, as much as possible, with services and supports for the rest of the population. The Government’s agenda in this regard is clearly set out in the current National Disability Inclusion Strategy (NDIS) which is based on a non-condition specific approach to the delivery of public services and the mainstreaming agenda. 

For persons with disabilities receiving support services, person-centred planning is a key process to focus the delivery of services and supports on the person and how they want to live their life.  As part of the Transforming Lives programme, a aPerson-Centred Planning Framework has now been developed.   To commence the implementation of the framework a Demonstration Project has been agreed with five provider organisations.  The five organisations participating in the implementation of the Person-Centred Planning Framework during 2019 will be evaluating their current model of person-centred planning and its alignment with the Person-Centred Planning Framework.  The experience learned through this demonstration project will inform the development of strategy and planning for the wider roll out of the framework throughout the adult disability service sector.   

The Department can confirm that the overall Budget for health funded specialist disability services in 2020 is in excess of €2 billion. This is an increase of over €490 million since 2016. The increased level of funding in 2020 will enable the Health Services to continue to provide a broad range of services aimed at improving the quality of life of people with disabilities and their families. The policy is to provide person centred services based on need rather than diagnosis.

Home Care Packages Expenditure

Questions (332)

Michael McGrath

Question:

332. Deputy Michael McGrath asked the Minister for Health the breakdown of the extra funding provided for home care supports in budget 2020; and if he will make a statement on the matter. [48995/19]

View answer

Written answers

The HSE National Service Plan 2020 has been submitted and is under consideration in my Department. The allocation of hours and targets to the Community Healthcare Organisations and Local Health Offices respectively is currently underway and I have been advised that this will be finalised in the coming weeks.

Disability Services Provision

Questions (333)

Michael McGrath

Question:

333. Deputy Michael McGrath asked the Minister for Health his plans to give adults with a disability a legal right to services; and if he will make a statement on the matter. [48996/19]

View answer

Written answers

The Health Act 1970 (as amended) provides that the Health Service Executive (HSE) makes a range of services available to persons ordinarily resident in the State on a full or limited eligibility basis. In addition, Section 7 of the Health Act 2004 provides that the object of the Executive is to use the resources available to it in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public.

Within this legislative framework, a wide range of disability services are provided to those with physical, sensory, intellectual disability and autism. Disability services focus on supporting and enabling people with disabilities to maximise their full potential, living ordinary lives in ordinary places, as independently as possible. Disability services strive to ensure the voices of service users and their families are heard, and are fully involved in planning and improving services to meet their needs.

The overarching principle governing the planning and delivery of health services and supports for adults and children with disabilities is that they should be integrated, as much as possible, with services and supports for the rest of the population. The Government’s agenda in this regard is clearly set out in the current National Disability Inclusion Strategy (NDIS) which is based on a non-condition specific approach to the delivery of public services and the mainstreaming agenda.

I can confirm that the overall Budget for health funded specialist disability services in 2020 is in excess of €2 billion. This is an increase of over €490 million since 2016. The increased level of funding in 2020 will enable the Health Services to continue to provide a broad range of services aimed at improving the quality of life of people with disabilities and their families. The policy is to provide person centred services based on need rather than diagnosis.

Questions Nos. 334 and 335 answered with Question No. 284.

Hospital Waiting Lists

Questions (336)

Pat Deering

Question:

336. Deputy Pat Deering asked the Minister for Health further to Parliamentary Question No. 138 of 23 October 2019, if it is standard practice that a person (details supplied) would be waiting in excess of three and a half years to have a MRI; and if so, the reason therefor; and if he will make a statement on the matter. [49021/19]

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.

Medical Card Eligibility

Questions (337)

Anne Rabbitte

Question:

337. Deputy Anne Rabbitte asked the Minister for Health if a child with chronic recurrent multifocal osteomyelitis is entitled to a medical card regardless of the income of the parents in view of the fact it is a rare disorder; and if he will make a statement on the matter. [49026/19]

View answer

Written answers

The HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility.  The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card.  This position remains unchanged.

Nevertheless, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines.  The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness.

Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting documentation to fully take account of all the relevant circumstances that may benefit them in the assessment including medical evidence of cost and necessary expenses.

Psychological Services

Questions (338)

Niamh Smyth

Question:

338. Deputy Niamh Smyth asked the Minister for Health if he will review the case of a person (details supplied); his views on whether it is acceptable that child psychology services would be stretched as a result of adult appointments; and if he will make a statement on the matter. [49032/19]

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.

Question No. 339 answered with Question No. 284.

Disease Incidence

Questions (340)

John Curran

Question:

340. Deputy John Curran asked the Minister for Health the number of measles cases in each of the years 2015 to 2018 and to date in 2019; and if he will make a statement on the matter. [49093/19]

View answer

Written answers

I have asked the Health Service Executive to respond to the Deputy directly.

Legislative Programme

Questions (341)

John Curran

Question:

341. Deputy John Curran asked the Minister for Health his plans to introduce similar legislation relating to the promotion of unhealthy, sugary and junk foods to children in view of the new advertising laws which came into effect recently regarding the promotion of alcohol in the proximity of children; and if he will make a statement on the matter. [49094/19]

View answer

Written answers

Three sections of the Public Health (Alcohol) Act 2018 came into effect on 12 November 2019.  From that date:

- Alcohol advertising in or on public service vehicles, at public transport stops or stations and within 200 metres of a school, a crèche or a local authority playground is prohibited; 

- Alcohol advertising in a cinema is prohibited except around films with an 18 classification or in a licensed premises in a cinema;  

- Children’s clothing that promotes alcohol is prohibited. 

The question of introducing similar measures in relation to the types of foods proposed by the Deputy is complex.  There are issues around defining the precise types of foods which would be included under such a measure.  Furthermore, the forms of advertising that are prohibited under the Public Health (Alcohol) Act are only part of the problem in relation to the advertising and marketing of unhealthy food to children.  There is a particular difficulty with digital marketing which can be sophisticated, targeted and difficult to regulate. 

'A Healthy Weight for Ireland’, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland agenda.  The OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy.  Childhood obesity is a key priority under the Policy, as is reducing the inequalities seen in obesity rates, where children (and adults) from lower socioeconomic groups have higher levels of obesity.  The OPAP is based on the best available evidence in the Irish and international literature, and is informed by established international models and frameworks.  Evidence-based actions are being progressed under the Plan on a number of fronts, including the introduction of the Sugar Sweetened Drinks Tax and work underway in relation to the reformulation of unhealthy food and drink. 

Issues relating to marketing and advertising of unhealthy foods are being progressed under the Obesity Policy and Action Plan, including through the Voluntary Codes of Practice on Non-Broadcast Media and the revision of the Broadcasting Authority of Ireland’s Children’s Commercial Communications Code.  The possibility of introducing legislative measures remains under consideration, but any such measures would need to have a strong evidence base in favour of legislation, and to address the difficulties inherent in introducing such measures.

Minister Harris met recently with the Irish Heart Foundation to explore some of the issues relevant to the regulation of marketing and advertising of unhealthy foods to children. 

The current legislative priority relevant to these issues is the development of a General Scheme for a Public Health (Calorie Postings and Workplace Wellbeing) Bill. The primary purpose of the proposals in relation to calorie postings is to ensure that calorie information is available at the point of choice for food sold in restaurants, takeaways and other food service businesses. Its objective is to ensure that consumers will be empowered to make an informed choice about the food they consume and will have the information they need to manage their calorie intake. An industry consultation will be initiated shortly and it is intended that the draft General Scheme will be finalised in early 2020.

Primary Care Centres Provision

Questions (342)

John Curran

Question:

342. Deputy John Curran asked the Minister for Health the status of the development of a primary healthcare centre in Lucan, County Dublin; and if he will make a statement on the matter. [49096/19]

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.

Misuse of Drugs

Questions (343)

John Curran

Question:

343. Deputy John Curran asked the Minister for Health the funding that will be allocated to the HSE to commence a targeted national campaign to raise awareness of the risks associated with drug use; and if he will make a statement on the matter. [49097/19]

View answer

Written answers

The Government is committed to a health-led approach to drug use and to developing harm reduction interventions for at risk groups, as set out in  the national drugs strategy Reducing Harm, Supporting Recovery, a health-led response to drug and alcohol use in Ireland 2017-2020.

The Department of Health works with the HSE to raise awareness of the dangers associated with drugs through the Drugs.ie website. The site provides a comprehensive range of information and supports related to substance use. The site also houses the National Directory of Drug and Alcohol Services which allows the person to locate information, support or treatment in their own area. 

In 2019, the HSE developed and promoted two national campaigns aimed at students and the festival goers, who may not present at traditional addiction services.

I, along with the Minister for Health and the Minister for Justice  and Equality, recently announced the introduction of a health diversion programme for persons in possession of drugs for personal use. This is a hugely important step in developing a health-led approach and in delivering on a key commitment in the national drugs strategy.

However, we cannot be complacent about the dangers of drugs. Therefore, the Department of Health is providing funding of €100,000 to the HSE in 2020 to develop a national harm reduction campaign to raise awareness of the risks associated with drug use. This will include information about club drugs, festival drug use, newer drugs as well as cannabis.

I am strongly supportive of measures that will reduce harm for people who take drugs.

Question No. 344 answered with Question No. 54.

Hospital Appointments Status

Questions (345)

Michael Healy-Rae

Question:

345. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [49136/19]

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.

Disability Services Provision

Questions (346)

Niamh Smyth

Question:

346. Deputy Niamh Smyth asked the Minister for Health the status of the case of a person (details supplied); and if an urgent appointment will be scheduled. [49140/19]

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.

Hospital Waiting Lists

Questions (347)

Michael Healy-Rae

Question:

347. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [49144/19]

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.

Question No. 348 answered with Question No. 54.

Medicinal Products Availability

Questions (349)

Bernard Durkan

Question:

349. Deputy Bernard J. Durkan asked the Minister for Health the extent to which patients here have ready access to modern drugs in line with their availability throughout the European Union; and if he will make a statement on the matter. [49147/19]

View answer

Written answers

The HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.  The Act specifies the criteria for decisions on the reimbursement of medicines. 

In line with the 2013 Act and the national framework agreed with industry, if a company would like a medicine to be reimbursed by the HSE, the company must submit an application to the HSE to have the new medicine added to the reimbursement list. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).

As a country, we invest heavily in medicines, to the tune of almost €2 billion annually. In 2019 to date, the HSE has approved 36 new drugs and newly licensed indications for existing drugs for reimbursement in the public healthcare system. 

Notwithstanding the significant progress on drug costs achieved from price reductions under the IPHA Agreement and commercial negotiations conducted by the HSE, the Health Service is still facing very significant challenges in relation to the affordability of medicines.  The industry continues to develop very expensive products, particularly in the high-tech medicines area and the costs involved are a challenge for health systems even in countries with much greater resources than Ireland. The Government wants new and innovative medicines to be available to our citizens as quickly as possible but this can only be achieved if medicines are priced by the pharmaceutical industry in a viable and sustainable manner.  

My Department and the HSE are working on making greater efficiencies in medicines usage through a range of initiatives both domestically and internationally to ensure the greatest possible access to new treatments for patients in Ireland.   

The HSE’s Medicines Management Programme (MMP), incorporating the Preferred Drugs initiative, is overseeing the implementation of a number of actions to bring about greater value for the taxpayer through cost-effective provision of medicines. Among the initiatives being pursed are improvements in practices for the procurement of drugs in hospitals and the designation of preferred products with a focus on high-cost prescribing areas, in particular optimising the use of biosimilars.  

Department officials and I have also been engaging over the past number of years, with a number of voluntary EU forums.  In June 2018, I signed the Beneluxa Initiative on Pharmaceutical Policy. This Agreement is in line with my objective to work with other European countries to identify workable solutions, in an increasingly challenging environment, to secure timely access for patients to new medicines in an affordable and sustainable way.  In June 2019, Ireland became a Founding Member of the International Horizon Scanning Initiative which is being established as part of the work programme of Beneluxa.

HSE Planning

Questions (350)

Bernard Durkan

Question:

350. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he expects the proposed winter action plan to deal with likely eventualities arising in the public hospital sector over the winter months; and if he will make a statement on the matter. [49148/19]

View answer

Written answers

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. The 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 help reduce congestion in EDs over the winter period.

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. Each Action Team has set out a range of initiatives it will undertake within its area to implement the Plan. 

The funding which has been allocated to the WATs will support initiatives at local level including:

- Additional medical, nursing, therapies support, pharmacy and lab staff to improve patient experience time, improve senior clinical decision making, reduce length of stay, and facilitate weekend discharges;

- Additional Aids and Appliances to facilitate timely discharge;

- Additional home support hours to facilitate early hospital to community transfers;

- Communications to facilitate hospital avoidance and public health awareness;

- Implementing Frail Intervention Therapy Teams for admission avoidance and reduced admissions of patients over - 75;

- Additional Flu testing kits to improve PET.

In addition to the immediate measures being undertaken in the Winter Plan the Government through the Sláintecare Strategy is addressing the issues of access to healthcare. The Sláintecare Action Plan for 2019 has a specific workstream on access and waiting lists. The Government is also increasing investment in health infrastructure and capacity in the system in line with Project Ireland 2040.

I am confident that together with the more immediate measures being undertaken under the Winter Plan and the strategic approach undertaken by the Government under Sláintecare that progress will be made in addressing the difficulties in the emergency departments.

Cancer Screening Programmes

Questions (351)

Bernard Durkan

Question:

351. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the women involved in the cervical smear test issues have had their cases dealt with to their satisfaction; and if he will make a statement on the matter. [49149/19]

View answer

Written answers

I understand that the Deputy is referring to the Independent Clinical Expert Panel Review of cervical screening, which is being carried out by the Royal College of Obstetricians and Gynaecologists (RCOG).

The purpose of the review is to provide women, or their next of kin, with independent clinical assurance about the timing of their diagnosis and treatment. In addition, an aggregate report by the Royal College will make recommendations, where appropriate, with the aim of improving care for women.

I am happy to report that the RCOG review is nearing completion. The overriding focus throughout this process has been to ensure that review results are communicated to women and families in the most appropriate and sensitive way possible.

On 9 September, the HSE sent a letter to all 1,038 participants in the review to provide them with options about how they may choose to receive their report. The process of communicating individual reports to women or next of kin has been ongoing since the 23 September. This has been a large-scale process and, although it has taken longer than originally planned, is expected to complete in the coming days.  

A core principle underpinning this process has been to ensure that individual participants would have had an opportunity to receive their results in advance of publication of the Expert Panel’s Aggregate Report. In keeping with this principle, the Minister for Health will bring the aggregate report to Government, and publish it, once he has received assurance that all women or next of kin have had the opportunity to receive their individual report.

While the aggregate report has not yet been received, the Royal College in a letter to the Minister for Health in September advised that, based on the provisional findings of its Review, the performance characteristics of the CervicalCheck Screening Programme that fall within the scope of the Review appear to be broadly in line with experience in the UK.

It has always been expected that a significant proportion of women in this review will receive results which disagree with their original review result. This is in line with international experience. For example, in one review of the English Cervical Screening Programme, 45% of slide reviews disagreed with the original review result.

This reflects the reality that no matter how closely a review panel tries to reproduce the original screening conditions, the conditions of a review are different – the fact that a review includes records of a patient known to have a serious condition, such as cancer, will heighten vigilance and increase reports of abnormality. Finding discrepancies on review does not imply that the same findings should have been made under routine conditions.

Primary Care Centres

Questions (352)

Bernard Durkan

Question:

352. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he expects the provision of primary care centres nationwide to alleviate the congestion at general hospitals; and if he will make a statement on the matter. [49150/19]

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.

Medical Card Data

Questions (353)

Bernard Durkan

Question:

353. Deputy Bernard J. Durkan asked the Minister for Health the number of full medical card holders nationwide; the extent to which this number has fluctuated in the past three years; and if he will make a statement on the matter. [49151/19]

View answer

Written answers

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

Hospital Procedures

Questions (354)

Bernard Durkan

Question:

354. Deputy Bernard J. Durkan asked the Minister for Health the number of children or other patients who have undergone scoliosis procedures on a monthly basis in the past two years; and if he will make a statement on the matter. [49152/19]

View answer

Written answers

Reducing waiting times for patients to access scoliosis services is a key priority of Government. Increased investment in paediatric orthopaedics and scoliosis services has improved access to surgery and outpatient appointments in recent years. Furthermore, Children’s Health Ireland (CHI) is working to ensure that children in Ireland who require scoliosis surgery and ongoing treatment can be seen and treated within a clinically appropriate time.  

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

Hospital Beds Data

Questions (355)

Bernard Durkan

Question:

355. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the need for extra beds is being addressed at hospitals nationwide; if progress is being achieved; and if he will make a statement on the matter. [49153/19]

View answer

Written answers

The Health Service Capacity Review published last year indicated that there was a need for a major investment in additional capacity in both hospital and community beds, combined with 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, there is a need to further develop community services to meet the increasing demand, which is placing additional pressure on hospital services.

Steady progress is being made in increasing bed capacity with the number of available inpatient beds expected to increase to above 11,000 following the investment planned in the National Service Plan 2019.

The Capacity Programme for 2019 provides for the following increases in capacity, as set out in the National Service Plan 2019:

- The provision of 75 acute beds and 70 community beds under the Winter Plan 2018/19;

- 47 additional beds, including the 40-bed modular build in South Tipperary General Hospital (STGH), 3 HDU beds in the Mater Hospital and 4 HDU beds in Cork University Hospital. The 40-bed modular in STGH is due to be completed in November 2019 and operational in Quarter 1 2020.

- Preparation of 202 beds, of which 16 are critical care, during 2019, with a view to bringing this extra capacity into operation in Q1 of 2020;

- Commencement of works on a 60-bed modular ward in University Hospital Limerick. The enabling works are completed, the main contractor is currently on site, and construction is anticipated to be completed in mid-2020. Commissioning and equipping are scheduled to be completed in Quarter 3 2020.

The National Service Plan for 2020 is currently under consideration by the Department.

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