Written Answers Nos. 1440-1457
1440. Deputy Bernard J. Durkan asked the Minister for Health the areas throughout the health services in respect of which he is most concerned in respect of the ability to deliver to the public a quality service in line with international best practice; and if he will make a statement on the matter. [33785/20]
View answerAccess to services in a timely way is a priority of this Government, and waiting lists continued to grow during the past few months, as a result of the postponement of some elective care, due toCOVID-19.
The implementation of Sláintecare, the all-party Oireachtas policy to deliver a healthcare system for the population of Ireland, that offers the right care, in the right place, at the right time, by the right team, at low or no cost to the citizen, is central to the delivery to the public of a quality health service in line with international best practice.
The Government, as set out in the Programme for Government, is fully committed to the implementation of Sláintecare and has made €1.353 billion available in Budget 2021 for Sláintecare related programmes. An Interim Report updating progress in 2020 will shortly be published by the Government. This report will also point to the key focus areas for Sláintecare in the period 2021-2023, namely, (1) Keeping people well at home or near home, out of hospital and living independent lives; (2) Help achieve waiting list targets, through implementing the Department of Health’s Capacity Review 2018 plan; and (3) Devising a citizen care masterplan for universal eligibility and multiannual health funding.
1441. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he is satisfied in the context of the development of the health services in line with the objectives of Sláintecare; if there are specific areas of concern in this regard; and if he will make a statement on the matter. [33786/20]
View answerSláintecare is the all-party Oireachtas policy to deliver a healthcare system for the population of Ireland, that offers the right care, in the right place, at the right time, by the right team, at low or no cost to the citizen. A report on the implementation of the 2019 Sláintecare Action Plan, the first year of the Strategy, was approved by the outgoing Government in April 2020 and showed that a large majority of planned actions were delivered in 2019. That report is available at https://www.gov.ie/en/publication/0d2d60-slaintecare-publications/#slaintecare-action-plan-year-end-report-2019.
The Interim 2020 Report is due to be published shortly. Notwithstanding the ongoing challenge of COVID-19, the Report will show that considerable progress continues to be made. The Programme for Government reconfirmed the full commitment to Sláintecare. Budget 2021 has allocated €1.353 billion specifically to implementation of Sláintecare. Budget 2021 demonstrates a strong commitment by Government to the Sláintecare vision and will enhance the permanent capacity of the health services, substantially increase the workforce, expanding the scale and range of service to be provided in the community and introduce targeted measures to improve access to care in 2021. This will enhance the resilience of the health service in the face of the Covid-19 pandemic, but also expand and reform the health service for the future in line with Sláintecare.
1442. Deputy Bernard J. Durkan asked the Minister for Health the degree to which a waiting list exists for orthodontic services; the plans in place to address the issue; and if he will make a statement on the matter. [33787/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1443. Deputy Bernard J. Durkan asked the Minister for Health the specific and short-term measures he plans in order to address deficiencies in the mental health services including child mental health services; and if he will make a statement on the matter. [33788/20]
View answerThe development of all aspects of mental health services, including those for children and young people, remains a priority for Government. This is reflected in the current Programme for Government, the new policy Sharing the Vision - A Mental Health Policy for Everyone, and the significant additional funding given to HSE Mental Health services in Budget 2021.
I secured, in the recent Budget, an additional €50 million for Mental Health Services, thus bringing the total provision next year to €1.076 billion. In relation to the €50 million, €23 million has been allocated to commence the implementation of many of the short-term recommendations of Sharing the Vision in 2021. This will fund additional beds and the enhancement of mental health teams including in Child and Adolescent Mental Health services, Adult Crisis Resolution Teams; expansion of specialist Clinical and Dialectical Behavioural Therapy programmes; Peer Support and Bereavement Coordinators, and the Individual Placement and Support (IPS) employment approach.
In addition to the above, €15 million will assist with evolving challenges arising from Covid-19. In this context, the number of step-down beds will be increased and extra resources will be provided for community mental health teams. Reconfiguration of mental health facilities, in line with Mental Health Commission recommendations and the enhancement of digital mental health supports will also take place.
The remaining €12 million, of the additional €50 million, will help address existing level of service costs, including placements for those individuals whose needs cannot, for various reasons, be met within the public mental health system.
Sharing the Vision promotes equitable access to quality, safe mental health care for all citizens. Service users and their families, carers and supporters will have more timely access to evidence-informed mental health services. Tailored measures will be put in place to ensure that individuals with complex mental health difficulties can avail of services across the State, without discrimination. This builds on the intent of A Vision for Change and Sláintecare. Sharing the Vision is expected to be implemented over a ten-year period, with associated timeframes in respect of individual recommendations detailed in the policy.
My priorities now are to ensure that the new National Implementation and Monitoring Committee (NIMC), envisaged under Sharing the Vision , commences its work as quickly as possible, and that the additional funding for mental health in Budget 2021 is progressed in the context of finalising the HSE Service Plan for next year, thus facilitating continued improvement across our mental health services.
1444. Deputy Bernard J. Durkan asked the Minister for Health when he expects to be in a position to improve the quality and extent of support services for children with special needs including the provision of maternity leave cover for speech and language therapists in order to provide continuity of services for the children in respect of whom no such cover exists at present; and if he will make a statement on the matter. [33789/20]
View answerThe Programme for Government, Our Shared Future, recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way.
The Government commits to prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1445. Deputy Bernard J. Durkan asked the Minister for Health the degree to which he expects to approve the recruitment of extra staff to various levels throughout the HSE with particular reference to areas in respect of which deficiencies in staff numbers have been identified; and if he will make a statement on the matter. [33790/20]
View answerI welcome the provisions in Budget 2021 for funding for up to 15,738 additional posts in the Health Service Executive, above what was funded for 2020.In line with statutory provisions, the National Service Plan will set out further detail on the positions, including the breakdown of the staff categories to be recruited. These staff will also enable an expansion of the capacity in our health system to ensure its resilience to future surges in demand.
In order to respond to the COVID-19 pandemic and to meet workforce demands, several initiatives were undertaken to expand the workforce to ensure adequate staffing levels. These measures have allowed the health workforce to increase by 4,292 whole-time equivalents from the end of February to the end of September this year. While this increase in the workforce was necessary to provide support to the immediate healthcare needs caused by the pandemic, a larger and more permanent expansion of the workforce is underway through the Winter Plan and Budget 2021. This expansion is necessary to support the resilience of the services in the face of COVID-19 but also to ensure that our healthcare system is resourced to meet the healthcare needs of the population far into the future.
1446. Deputy Bernard J. Durkan asked the Minister for Health if in the absence of full-time appointments, temporary or interim appointments in respect of whole-time or part-time positions can be made in the short-term rather than the postponement of making full-time appointments particularly in respect of various professionals who have answered Ireland’s call; and if he will make a statement on the matter. [33791/20]
View answerAs appointments and contracts are a matter for the Health Service Executive, I have asked them to respond to the Deputy directly, as soon as possible.
1447. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the processing of medical cards can be expedited with a view to minimising delays in which serious illness is concerned; and if he will make a statement on the matter. [33792/20]
View answerMedical cards are processed by the National Medical Card Unit (NMCU) in the HSE Primary Care Reimbursement Service. I have been assured by the HSE’s NMCU that there are currently no delays arising as part of the processing of medical card applications. However, as the processing of medical cards is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1448. Deputy Bernard J. Durkan asked the Minister for Health the extent of the waiting list for hip replacements; the plans in hand to overhaul such waiting lists; and if he will make a statement on the matter. [33793/20]
View answerIt is recognised that waiting times for scheduled appointments and procedures have been impacted as a direct result of the COVID-19 pandemic.
In response to the Covid-19 pandemic the HSE had to take measures to defer most routine scheduled care activity in March, April, and May of this year. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and urgent time-critical work. This decision was in line with the advice issued by the National Public Health Emergency Team (NPHET) in accordance with the advice of the World Health Organisation.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
The HSE continues to optimise productivity through alternative work practices such as the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.
In addition the National Treatment Purchase Fund (NTPF) is currently reviewing strategies to maximise activity and benefit for patients, to include, increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services where minor procedures are provided at the same time as outpatient consultations, funding hybrid services where public and private hospitals contribute to the treatment of patients, virtual clinics and clinical validation.
In addition to core HSE activity, the NTPF have advised my department that they have also approved 8 Hip-Replacement Insourcing initiatives and 14 Hip-Replacement Outsourcing initiatives for funding so far in 2020, which will facilitate treatment for over 1,200 patients on hip replacement waiting lists.
The data requested by the Deputy concerning the waiting list for hip replacements, is outlined in the attached document.
Total IPDC Waiters for Hip Replacement by Hospital by Wait Time Band as at 24/09/2020
|
Sum of Total |
Column Labels |
||||
|
Row Labels |
0-9 Months |
9-15 Months |
15-18 Months |
18 Months + |
Grand Total |
|
Beaumont Hospital |
12 |
10 |
22 |
||
|
CHI at Crumlin |
5 |
5 |
|||
|
CHI at Temple St |
6 |
6 |
|||
|
Connolly Hospital Blanchardstown |
21 |
21 |
|||
|
Croom Orthopaedic Hospital |
86 |
5 |
91 |
||
|
Galway University Hospitals |
101 |
43 |
18 |
45 |
207 |
|
Kilcreene Regional Orthopaedic Hospital |
85 |
10 |
95 |
||
|
Letterkenny University Hospital |
57 |
26 |
6 |
89 |
|
|
Mayo University Hospital |
36 |
9 |
5 |
21 |
71 |
|
Midland Regional Hospital Tullamore |
42 |
29 |
15 |
86 |
|
|
National Orthopaedic Hospital Cappagh |
307 |
26 |
333 |
||
|
Our Lady's Hospital Navan |
88 |
16 |
104 |
||
|
Sligo University Hospital |
43 |
13 |
56 |
||
|
Small Volume Hospitals |
7 |
14 |
21 |
7 |
49 |
|
South Infirmary Victoria University Hospital |
20 |
20 |
|||
|
St. James's Hospital |
19 |
9 |
28 |
||
|
Tallaght University Hospital |
103 |
35 |
8 |
146 |
|
|
University Hospital Kerry |
46 |
21 |
67 |
||
|
University Hospital Waterford |
8 |
8 |
16 |
||
|
Grand Total |
1086 |
265 |
44 |
117 |
1512 |
1449. Deputy Bernard J. Durkan asked the Minister for Health the extent of the waiting lists in respect of coronary procedures and heart, lung and kidney transplants; and if he will make a statement on the matter. [33794/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1450. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the HSE remains capable of dealing with further surges in Covid-19; and if he will make a statement on the matter. [33795/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1451. Deputy Bernard J. Durkan asked the Minister for Health if particular lessons have been learned from the experience to date in dealing with Covid-19; and if he will make a statement on the matter. [33796/20]
View answerAs you will be aware, the country has moved to level 5 of the Government’s medium-term strategy for dealing with COVID-19: Resilience and Recovery 2020-2021: Plan for Living with COVID-19.
This Plan sets out a Framework of 5 Levels which outline the broad measures which will apply depending on the level of the virus at any given time. The Plan is designed to help everyone – individuals, families, organisations and sectors – to better understand, anticipate and prepare for the measures that might be introduced to contain transmission of the virus.
Measures such as those introduced at level 5 are aimed at limiting the spread and damage of COVID-19, and are necessary to protect what we know are our key priorities of supporting and maintaining health and social care services, keeping education and childcare services open and protecting the most vulnerable members of our communities. The Government is committed to ensuring a balanced and proportionate response to COVID-19 in finding ways to implement public health measures in response to the pandemic in a way that is fair, reasonable and proportionate.
Since the beginning of this crisis, the Government has developed a greater understanding the transmission of COVID-19, gained insight into the people that it poses the greatest risk to, developed testing and tracing protocols, and become part of a worldwide effort to generate vaccines and drug therapies to counter the virus.
We know that COVID-19 spreads when individuals and groups come into close contact with one another, enabling the virus to move from one person to another. We also know that COVID-19 is infectious in a person with no symptoms, or for the period of time before they develop symptoms.
Therefore the most important way to stop the spread of Covid-19 is for everyone to adhere to the current public health measures, such as good hand hygiene, physical distancing, cough and sneeze etiquette, wearing a face covering, avoiding crowded situations, and not attending work when symptoms appear.
Throughout the course of the pandemic, testing and contact tracing has been and continues to be a key component of the Government’s response. The development of a comprehensive, reliable and responsive testing and tracing operation has been central to our public health strategy for containing and slowing the spread of COVID-19 since the outset.
Personal Protective Equipment (PPE) is another key part of the response, and the health service responded quickly to a worldwide shortage and developed guaranteed supply lines to ensure adequate PPE was available throughout 2020, along with ensuring the stock levels were increased for the future.
As new scientific evidence becomes available, the Health Protection Surveillance Centre and the HSE continues to publish and update guidance documents for managing potential cases of COVID-19 in both healthcare and non-healthcare settings, which are available at the following link:
https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/
As I am sure you can appreciate, the evidence relating to the SARS-CoV-2 virus and the decisions necessary to protect everybody living in Ireland from its effects is constantly evolving. The public health advice relating to Covid-19 is kept under continuing review by the National Public Health Emergency Team (NPHET), by the Department of Health and by the Government. The measures in place and the public health advice have been adapted to the changing circumstances and this will continue to be the case for the foreseeable future.
1452. Deputy Bernard J. Durkan asked the Minister for Health the degree to which efforts are being made to fill the various consultant positions throughout the HSE with a view to ensuring the provision of available and accessible services nationally without exception; and if he will make a statement on the matter. [33797/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible. I do wish to advise that the number of consultants employed in the health services continues to increase year on year. In the 12 months to the end of August 2020 the number has increased by 254 to 3,411 (wte's), with an increase of 715 in the past 5 years.
1453. Deputy Bernard J. Durkan asked the Minister for Health the number of orphan or new drugs currently awaiting approval to qualify for reimbursement; and if he will make a statement on the matter. [33798/20]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a 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).
The NCPE conducts health technology assessments (HTAs) for the HSE and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess whether a drug is cost-effective as a health intervention.
I am advised by the HSE that there are currently 81 applications for reimbursement (including new medicines and new uses of existing medicines) undergoing assessment.
The Committee for Orphan Medicinal Products (COMP) is the European Medicines Agency's (EMA) committee responsible for recommending orphan designation of medicines for rare diseases. This designation is for medicines to be developed for the diagnosis, prevention or treatment of rare diseases that are life-threatening or very serious. The European Commission decides whether to grant an orphan designation for the medicine based on the COMP's opinion.
The HSE has advised that the appropriate repository of the information relating to designated orphan drugs is the EMA website. The status for any medicine could change in the event that a medicine is removed from the Community Register of designated Orphan Medicinal Products and therefore it will be appreciated that these figures are not readily available as the status of a medicine can change at any stage.
As of 30 October 2020, 25 of the medicines under consideration for reimbursement in Ireland had orphan designation.
1454. Deputy Bernard J. Durkan asked the Minister for Health the steps being taken to ensure the availability of access to Covid-19 vaccines here as soon as such vaccines are approved; and if he will make a statement on the matter. [33799/20]
View answerA COVID-19 Immunisation Strategy Group, chaired by the Department of Health, has been convened. The purpose of the Group is to advise on and assist in the development of national policy relating to COVID-19 vaccines. In addition, a COVID-19 Immunisation Programme Implementation Team has been established in the HSE.
Work is ongoing in both the Department of Health and the HSE to ensure the timely implementation of the COVID-19 immunisation programme.
1455. Deputy Bernard J. Durkan asked the Minister for Health the number of children suffering from mental health issues hospitalised throughout the HSE in each of the past ten years to date; the degree to which treatment has been made readily available in sufficient scale to address the issue; and if he will make a statement on the matter. [33800/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1456. Deputy Bernard J. Durkan asked the Minister for Health the extent to which cataract treatments are available in all areas nationally without exception; and if he will make a statement on the matter. [33801/20]
View answerIn recent years, my Department has worked with the HSE and the National Treatment Purchase Fund (NTPF) to improve access for patients waiting for high volume procedures, including cataracts. Ophthalmology services are provided throughout all hospital groups in the country, with cataract removal one of the key procedures carried out as part of this specialty. Waiting list data collated by the NTPF is one indicator of the level of demand for hospital services, including ophthalmology appointments and cataract procedures. The NTPF have advised my Department that at the end of September there were 5,013 patients waiting for a cataract procedure across more than 10 central sites. The attached spreadsheet provides detailed information on the sites that currently hold a cataract waiting list, as well as the number of patients waiting for the procedure by time-band.
A key development in improving access to Ophthalmology services was the opening of a stand-alone high-volume consultant-led cataract theatre by the University of Limerick Hospital Group in Nenagh Hospital in 2018, with the intention that it would facilitate patients from surrounding geographical areas to avail of their treatment there. The impact of such initiatives can be seen the reduction in the waiting times to access cataract procedures since 2017, with the number of patients awaiting a procedure down 68% since July 2017. At the end of September 2020 there were 1,380 patients waiting over 9 months compared to July 2017, when there were 4,371 waiting over 9 months.
My Department continues to work with the HSE and NTPF to monitor waiting times for scheduled care and identify areas where access to services can be improved. In this context it is important to recognise that waiting times for scheduled appointments and procedures have been impacted as a direct result of the COVID-19 pandemic this year. In response to the Covid-19 pandemic the HSE had to take measures to defer most routine scheduled care activity in March, April, and May of this year. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and urgent time-critical work. This decision was in line with the advice issued by the National Public Health Emergency Team (NPHET) in accordance with the advice of the World Health Organisation.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols. The HSE continues to optimise productivity through alternative work practices such the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.
In addition the NTPF is currently reviewing strategies to maximise activity and benefit for patients, to include, increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services where minor procedures are provided at the same time as outpatient consultations, funding hybrid services where public and private hospitals contribute to the treatment of patients, virtual clinics and clinical validation.
Cataract Waiters by Hospital
|
Sum of Amount |
Column Labels |
||||
|
Row Labels |
0-9 Months |
9-15 Months |
15-18 Months |
18+ Months |
Grand Total |
|
Galway University Hospitals |
472 |
76 |
548 |
||
|
Letterkenny University Hospital |
8 |
9 |
5 |
5 |
27 |
|
Mater Misericordiae University Hospital |
1118 |
231 |
24 |
30 |
1403 |
|
Nenagh Hospital |
94 |
7 |
101 |
||
|
Royal Victoria Eye and Ear Hospital |
1026 |
103 |
23 |
7 |
1159 |
|
Sligo University Hospital |
338 |
294 |
74 |
30 |
736 |
|
Small Volume Hospitals |
9 |
9 |
7 |
13 |
38 |
|
South Infirmary Victoria University Hospital |
108 |
13 |
121 |
||
|
St. Vincent's University Hospital |
165 |
38 |
12 |
215 |
|
|
University Hospital Limerick |
164 |
112 |
22 |
30 |
328 |
|
University Hospital Waterford |
131 |
95 |
18 |
93 |
337 |
|
Grand Total |
3633 |
987 |
185 |
208 |
5013 |
1457. Deputy Bernard J. Durkan asked the Minister for Health the extent to which services are readily available for children suffering from eating disorders nationally; the plans to improve the quality and extent of such services; and if he will make a statement on the matter. [33802/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
