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Tuesday, 17 Nov 2020

Written Answers Nos. 782-801

HSE Data

Questions (782)

David Cullinane

Question:

782. Deputy David Cullinane asked the Minister for Health the agency spending per quarter in each of the years 2017 to 2019 and to date in 2020, in tabular form; and if he will make a statement on the matter. [36778/20]

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.

Ambulance Service

Questions (783)

David Cullinane

Question:

783. Deputy David Cullinane asked the Minister for Health the spend on private ambulances per quarter in each of the years 2018 and 2019 and to date in 2020, in tabular form; and if he will make a statement on the matter. [36779/20]

View answer

Written answers

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

Hospital Data

Questions (784)

David Cullinane

Question:

784. Deputy David Cullinane asked the Minister for Health the number of persons over 75 years of age left waiting over 24 hours in emergency departments for hospital beds per quarter in each of the years 2018 and 2019 and to date in 2020; and if he will make a statement on the matter. [36780/20]

View answer

Written answers

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

Home Care Packages

Questions (785)

David Cullinane

Question:

785. Deputy David Cullinane asked the Minister for Health the status of the home care waiting list for each month in 2019 and 2020; the number of hours delivered to date in 2020; the number of hours planned to be delivered in 2020; and if he will make a statement on the matter. [36781/20]

View answer

Written answers

As these are operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Hospital Data

Questions (786)

David Cullinane

Question:

786. Deputy David Cullinane asked the Minister for Health the number of delayed discharges and bed days lost in each public and voluntary hospital at the end of October 2020; the number of delayed discharges and bed days lost in each public and voluntary hospital by month in 2019 and 2020; the number to date in 2019 and 2020, in tabular form; and if he will make a statement on the matter. [36782/20]

View answer

Written answers

As the Deputy's specific questions refer to the numbers of patients with delayed transfers of care and the associated numbers of bed days lost, I have asked the HSE to respond directly with the requested information.

Hospital Waiting Lists

Questions (787)

David Cullinane

Question:

787. Deputy David Cullinane asked the Minister for Health the number of children on hospital waiting lists compared with the same period in 2018 and 2019; and if he will make a statement on the matter. [36783/20]

View answer

Written answers

It 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 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 time-critical essential 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 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 relation to the number of children on hospital waiting lists compared to the same period in 2018 and 2019, the NTPF has provided my Department with the information requested in the table attached. The NTPF has further advised that within the Public Health System, children are generally classified as those under the age of 16, while the figures in the attached table also include patients between 16 and 18 years of age, to reflect patients who were under 18 at the end of October 2018, 2019 and 2020 according to the date of birth received from the relevant hospital. 

Hospital Waiting lists for under 18's end October 2018 - 2020

Waiting List Type

End Oct 2018

End Oct 2019

End Oct 2020

GI Scope

441

487

533

IPDC

6978

7084

8160

Outpatient

92022

93124

93088

Hospital Waiting Lists

Questions (788)

David Cullinane

Question:

788. Deputy David Cullinane asked the Minister for Health the number of children on the speech and language, occupational therapy and physiotherapy waiting lists; the length of time children are waiting compared with the same period in 2018 and 2019, in tabular form; and if he will make a statement on the matter. [36784/20]

View answer

Written answers

The 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 question relates to a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Hospital Waiting Lists

Questions (789)

David Cullinane

Question:

789. Deputy David Cullinane asked the Minister for Health the cataract surgery waiting lists and wait times for September 2018, 2019 and 2020; and if he will make a statement on the matter. [36785/20]

View answer

Written answers

In 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.

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 in the reduction in the waiting times to access cataract procedures since 2018. At the end of September 2020 there were 5,013 patients waiting compared to 6,626 in September 2018.

In considering these figures 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. The HSE had to take measures to defer most routine scheduled care activity in March, April, and May. 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.

The spreadsheet below provides the requested wait times for a cataract procedure by time-band for September, in the years 2018, 2019, and 2020.

Cataract Sept 2018 2019 2020

Hospital Waiting Lists

Questions (790)

David Cullinane

Question:

790. Deputy David Cullinane asked the Minister for Health the scoliosis treatment waiting lists and wait times compared with the same period in 2018 and 2019; and if he will make a statement on the matter. [36786/20]

View answer

Written answers

It 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 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 time-critical essential 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 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.

The Orthopaedic inpatient / day case waiting list, which includes scoliosis procedures, shows that there were 9,897 patients awaiting a procedure at the end of October 2020. This is slightly lower than in the same period in 2018 and 2019 when the number waiting was 10,705 and 10,033 respectively.

In relation to scoliosis treatment waiting lists and wait times, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly with the Scoliosis Inpatient and Day case waiting lists for adults and children in all hospitals nationally at the end of October 2018, 2019 and 2020.

Child and Adolescent Mental Health Services

Questions (791)

David Cullinane

Question:

791. Deputy David Cullinane asked the Minister for Health the CAMHS waiting lists and wait times compared with the same period in 2018 and 2019; and if he will make a statement on the matter. [36787/20]

View answer

Written answers

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

Departmental Projects

Questions (792, 793)

David Cullinane

Question:

792. Deputy David Cullinane asked the Minister for Health the capital projects under way which fall under his remit; the additional capacity they will add; the timeline for delivery of same; and if he will make a statement on the matter. [36789/20]

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David Cullinane

Question:

793. Deputy David Cullinane asked the Minister for Health the planned capital projects which fall under his remit; the additional capacity they will add; the timeline for delivery of same; and if he will make a statement on the matter. [36790/20]

View answer

Written answers

I propose to take Questions Nos. 792 and 793 together.

As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to the deputy directly in relation to this matter.

Hospital Data

Questions (794)

David Cullinane

Question:

794. Deputy David Cullinane asked the Minister for Health the number of wards under construction or planned to commence within the next six months; and if he will make a statement on the matter. [36791/20]

View answer

Written answers

As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to the deputy directly in relation to this matter.

Health Services Provision

Questions (795, 796, 797)

David Cullinane

Question:

795. Deputy David Cullinane asked the Minister for Health the measures taken in 2020 to improve ehealth and ICT systems; and if he will make a statement on the matter. [36792/20]

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David Cullinane

Question:

796. Deputy David Cullinane asked the Minister for Health the measures to be taken in 2021 to improve ehealth and ICT systems; and if he will make a statement on the matter. [36793/20]

View answer

David Cullinane

Question:

797. Deputy David Cullinane asked the Minister for Health the estimated timeline and cost of completing upgrading and modernisation of HSE ICT and procurement systems; and if he will make a statement on the matter. [36794/20]

View answer

Written answers

I propose to take Questions Nos. 795 to 797, inclusive, together.

As a result of the Covid-19 pandemic, there has been an increased focus in 2020 on deployment of eHealth initiatives to support both acute and community care. Within weeks of the first wave of the pandemic, solutions such as telehealth and electronic transfer of prescriptions were implemented, followed shortly afterwards by the COVID Tracker app, designed to support contact tracing.

The COVID Tracker App was developed to provide people with information about the rate of spread of infection, to enable them to self report symptoms and to alert them of close contacts with others who have since been diagnosed Covid positive. The app was the result fo close collaboration and joint development between the  Department of Health, the Office of the Government Chief Information Officer, the HSE, the innovation unit at An Garda Síochána, Science Foundation Ireland and academia, working closely with technical partners from the private sector including Nearform (a Waterford based app development company), Apple and Google.  By international comparison, it has been very successful with over 2 million downloads and more than 1.3 million active users.

The HSE developed an enterprise wide CRM solution to manage and track COVID patients as they move through the COVID care pathway. This is the 'radar' system that enables the health system to manage patient calls to the call center and interactions at test centres, assessment hubs and other covid related facilities.

The clinical management of COVID care has been assisted by the implementation of:

- electronic ordering of COVID tests and electronic tracking and reporting of results;

- remote working on a large scale by non-patient facing staff;

- provision of electronic aids to nursing homes and hospitals to help with restricted visiting regimes and enabling patients to stay connected to their families and friends;

- system and technology deployments to support acute ICU care and community-based services for COVID-19;

- communication system upgrades. 

The Department of Health and the Health Service Executive (HSE) are currently examining the role eHealth and ICT will have to support post-2020 COVID health management activities.  Of immediate priority is the need for systems to support the administration of the Covid vaccine when it becomes available but there will be many other ICT enabled covid actions to be addressed.

Whilst non-COVID eHealth and ICT supportive projects and programmes are also being examined, many of those activities complement the COVID response and the Sláintecare reform programme. 

eHealth and ICT Initiatives for 2021 are currently being factored into the HSE service plan for 2021, that is scheduled to be submitted the Department by the end of November.

National Children's Hospital

Questions (798)

David Cullinane

Question:

798. Deputy David Cullinane asked the Minister for Health the position regarding the national children’s hospital; the estimated timeline for delivery; the estimated cost to date; the estimated final cost; and if he will make a statement on the matter. [36795/20]

View answer

Written answers

Under the contract, the new children's hospital is due to be completed by the end of 2022 and handed over to Children's Health Ireland to open in 2023 after a period of commissioning.  There will be delays associated with the requirement to cease works on the site of the new Children’s Hospital due to Covid-19 restrictions. As of March 2020, when the site closed due to Covid-19, the NPHDB was of the view that the Main Contractor was behind schedule on the construction   works. 

The current overall capital build cost of the project is €1,433 m.  This includes all of the capital cost for the main hospital at St James's Hospital campus which will house the school and third level educational spaces, the two Outpatient Department and urgent care centres at Connolly and Tallaght Hospital campuses, equipment for the three sites, and the construction of the carpark and retail spaces.

The € 1.43bn figure on capital cost as set out above does not take account of the impact of COVID on the construction sector, including the NCH.

In addition to the capital project there is a broader programme of activity associated with the integration and transfer of the services of the three children’s hospitals to the new sites under development. This includes investment in ICT, an Electronic Health Record system, the Children's Hospital Integration Programme (the merging of three paediatric hospitals), pre-2013 project expenditure relating to the former Mater project, and the planned construction of the Children’s Research and Innovation Centre to be funded through philanthropic funding. The inclusion of these elements alongside the capital build account for a total overall project cost of €1.73 billion.

The PwC report makes clear that the Guaranteed Maximum Price established through the two-stage tender process does not provide a contractual ceiling on cost and significant residual risks remain of further cost.  The residual risks, for which there cannot be cost certainty, include items such as construction inflation, claims and certain uncontrollable risks, such as potential costs relating to Brexit. 

The NPHDB is continuing to engage with the Main Contractor to obtain an updated programme of works that is in line with its contractual commitments.  At this point it is still too early to fully assess the final time or costs impact of the pandemic on the project.

National Maternity Hospital

Questions (799)

David Cullinane

Question:

799. Deputy David Cullinane asked the Minister for Health the position regarding the new national maternity hospital; the estimated timeline for delivery; the estimated cost to date; the estimated final cost; and if he will make a statement on the matter. [36796/20]

View answer

Written answers

The project to co-locate relocation of the National Maternity Hospital on the St Vincent’s University Hospital Campus is progressing.  Site preparatory and enabling works, required to support the relocation of the new National Maternity Hospital, are underway at present and consists of Aspergillus prevention works, campus infrastructural upgrade works, enabling works / site preparation works, and the construction of a new Pharmacy and multi storey car-park extension. 

The preparatory works commenced on the campus in early 2018 with a programme of Aspergillus prevention works. Construction of the new pharmacy and the multi-storey car-park will conclude in 2021. The budget for these works is €51.7m, of which €33.4m has been expended to date. A further series of the Advance works will be undertaken through to mid-2022 and will be subject to a future procurement process.

With the exception of the construction works which are contractually committed as listed above, no further contractual commitments have been entered into with respect to works to the new National Maternity Hospital project.

The new National Maternity Hospital project is required to progress through a number of approval stages, in line with the Public Spending Code, before a firm timeline or funding requirement can be established.

Primary Care Centres

Questions (800)

David Cullinane

Question:

800. Deputy David Cullinane asked the Minister for Health the status of primary care centre delivery; and if he will make a statement on the matter. [36797/20]

View answer

Written answers

The development of Primary Care Centres (PCCs) is a key building block in enabling the vision of Sláintecare to become a reality.

The latest report from the HSE indicated that there are 135 Primary Care Centres fully operational nationwide. Six of these have become operational so far in 2020, and a further six are expected to open by the end of the year. This represents good progress and almost a doubling of the 70 operational PCCs at the end of 2012. In addition, a  further 67 sites are at various stages of development.

 As the Deputy may be aware, the HSE has primary responsibility for both the provision and the maintenance and operation of PCCs, and the Executive has been asked to reply directly to the Deputy in this regard.

PCPU proposed reply

Health Services Reform

Questions (801)

David Cullinane

Question:

801. Deputy David Cullinane asked the Minister for Health the status of the restructuring and reform of the HSE; when this will recommence; the new timeline for delivery; and if he will make a statement on the matter. [36798/20]

View answer

Written answers

The Programme for Government commits to ongoing implementation of the Sláintecare vision at the highest levels through the “Cabinet Committee on Health, chaired by the Taoiseach, giving overall strategic direction, and overseeing the implementation of Sláintecare”. The Government recognises the need for enhanced governance and accountability in the health service, including through the formal appointment of the Health Service Executive (HSE) Board in June 2019 and the introduction of a new HSE Chief Executive Officer.

The new Regional Health Areas geographies were announced in summer 2019.  A work programme for rolling out the regions was developed pre-COVID in early 2020, but work was put on hold as a result of the pandemic.  In accordance with the Programme for Government, which states “Bring forward detailed proposals on the six new regional health areas to deliver local services", a business plan for the establishment of these health areas is expected to be brought to Government for its approval in due course.

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