Michael Healy-Rae
Question:406. Deputy Michael Healy-Rae asked the Minister for Health if an appointment for a person (details supplied) will be expedited; and if he will make a statement on the matter. [17255/22]
View answerHospital Appointments Status
Questions (406)
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.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Services Staff
Questions (407, 428)
David Cullinane
Question:407. Deputy David Cullinane asked the Minister for Health if his attention has been drawn to training and pay inequalities between educational psychologists and clinical psychologists; if his Department has engaged or will engage with the Department of Further and Higher Education, Research, Innovation and Science to address same; and if he will make a statement on the matter. [17260/22]
View answerDavid Cullinane
Question:428. Deputy David Cullinane asked the Minister for Health if additional funding will be made available for implementation of the Report of the National Psychology Project Team and in particular, a recommendation in relation to funding of counselling psychologists along the same lines as clinical psychologists; and if he will make a statement on the matter. [17304/22]
View answerWritten answers
I propose to take Questions Nos. 407 and 428 together.
The Report of the Psychology Review Implementation Group in 2017 expanded the care group employment available to counselling and educational psychologists. The report’s recommendation led to the establishment of a Project Team to implement this recommendation.
In February 2019, HSE Community Operations convened a Project Team, chaired by Dr Cathal Morgan, comprised of representatives from Clinical, Counselling and Educational Psychology; Social Care, Disability, and Mental Health services; Community and Acute services; Operational and National HR; and the Health and Social Care Professions office.
The Project Team was tasked with, inter alia, considering the preparation of a workforce plan for psychological services in the HSE, including an examination of the current framework for training psychologists for the health service, and the type, and skill-mix, required for the future. The work of the Project Team was informed by a thorough stakeholder consultation process.
Clinical Psychology Trainees, on the doctoral programme, are HSE employees and are in receipt of partial funding (60%) of HEI fees each year. Traditionally the educational and counselling psychologists’ courses have not been funded by the HSE. The HSE does not employ or contribute to HEI fees for Counselling and Educational Psychologists during their doctoral training.
The Report of the National Psychology Project Team, Establishment of a National Psychology Placement Office and Workforce Planning, was completed in January 2021. The Report contains a plan to address a range of matters in relation to psychology through establishment of a placement office and workforce planning. Implementation of the report’s recommendations and the creation of a National Psychology Placement Office are a matter for the HSE in the context of available health resources.
The Deputy may wish to note that the rates of pay for the grades of Clinical Psychologists and Educational Psychologists are as set out in the Department of Health’s Consolidated Salary Scales which are available to view online here: www.gov.ie/en/publication/b556a-application-of-1-october-2021-pay-adjustments/. As is evidenced within the pay scales document, no disparity exists between these two grades.
Hospital Waiting Lists
Questions (408)
Bernard Durkan
Question:408. Deputy Bernard J. Durkan asked the Minister for Health the extent to which it is expected to overhaul long waiting lists for various procedures in respect of scoliosis and spina bifida with particular reference to availing of every opportunity to reduce these waiting lists and to show results on a weekly basis; and if he will make a statement on the matter. [17263/22]
View answerWritten answers
I sincerely regret that children can experience a long waiting time for orthopaedic treatment, and I remain conscious of the burden that this places on them and their families. One of the central priorities for me as Minister for Health is that waiting times for hospital appointments and procedures are improved, and that children receive the care that they need and deserve in a timely and appropriate fashion. In particular, a special area of focus for me and my Department is that of paediatric orthopaedics.
In January I asked the HSE to develop a dedicated plan to tackle scoliosis waiting lists this year. In February I met with senior officials of Children’s Heath Ireland (CHI) and the HSE, as well as senior orthopaedic clinicians from Temple Street, Crumlin and Cappagh, to discuss the finalisation of the proposals to increase orthopaedic activity at CHI. The plan proposes ambitious additional activity levels which will work to reduce the number of children waiting for spinal orthopaedic procedures (scoliosis and spina bifida) by year end.
This latest initiative is further evidence of this Government’s commitment to address the issues facing these children. Both current and capital funding has been provided to a value of €19 million in 2022 to support this initiative.
More specifically, €3.4 million has been committed to support additional activity at Cappagh Orthopaedic hospital. This is the full year requirement associated with the €1.65 million that was provided from the Access to Care Fund in 2021 to support CHI paediatric orthopaedic activity at Cappagh. Furthermore, €4.7 million has been provided on a recurring basis since 2021 to fund an additional 24 beds at Crumlin and Temple street, and 2 high dependency unit beds at Crumlin. These beds will facilitate the increase in activity needed to reduce paediatric orthopaedic waiting times. A further €4 million has been committed for a theatre expansion programme across CHI sites to focus on paediatric orthopaedics.
Capital funding of €4 million has been designated to support this initiative, which is included within the 2022 Capital Plan due to be approved shortly. Finally, €2 million has been provided for outsourcing initiatives for both inpatient and daycase procedures, as well as to meet radiology needs. Plans are currently being finalised by CHI in this regard.
Healthcare Policy
Questions (409, 418)
Bernard Durkan
Question:409. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he proposes to co-ordinate the introduction of Sláintecare with the need to meet the ongoing and various needs of the health services and to ensure the introduction of Sláintecare continues and that the general quality of health services is improved in line with Sláintecare expectations; and if he will make a statement on the matter. [17264/22]
View answerBernard Durkan
Question:418. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the quality and structure of the health services continues to be supported given the higher level of demand; and if he will make a statement on the matter. [17274/22]
View answerWritten answers
I propose to take Questions Nos. 409 and 418 together.
We acknowledge that our health service has experienced pressures given the impact and duration of the pandemic. The health service continues to be overseen by my Department in its current form. The HSE sets out the type and volume of services that will be provided within its financial allocation in its annual National Service Plan. Oversight of HSE performance in relation to the delivery of services and the implementation of initiatives under the Plan is maintained throughout the year by way of the DoH-HSE performance engagement model.
Under the model, performance delivery is considered across the four equally important domains of access to services, quality and patient safety, finance and workforce. The model provides for monthly meetings at operational level between my Department and HSE counterparts, as well as high-level meetings between senior management in both organisations, to discuss on-going or emerging performance issues and determine actions to improve areas of concern. This model also provides me the opportunity to have quarterly meetings with the Board Chair and an annual meeting with the full HSE Board to review and discuss performance, reform and governance issues.
However, we accept that aspects of the current model of healthcare delivery are in need of reform. Delivering Sláintecare remains a priority for Government and my Department is actively progressing with its implantation in partnership with the HSE. The Sláintecare Implementation Strategy and Action Plan 2021-2023 was approved in May of last year and two subsequent progress reports have been published:
- Sláintecare Implementation Strategy and Action Plan 2021-2023 - www.gov.ie/en/publication/6996b-slaintecare-implementation-strategy-and-action-plan-2021-2023/
- Sláintecare Progress Report 2021 published on 15 February 2022 - www.gov.ie/en/publication/9652b-slaintecare-progress-report-2021/
- Sláintecare mid-year Progress Report for 2021 published on 10 September 2021 - www.gov.ie/en/publication/cce45-slaintecare-mid-year-progress-report-for-2021/
My Department has strengthened the governance around Sláintecare with responsibility for the implementation of Sláintecare projects now devolved to a senior leadership team. To ensure that implementation is fully embedded across the Department and that the drive for universal healthcare across both the Department of Health and the HSE, a new Programme Board has been established and has met three times (15 December 2022, 14 February 2022 and 29 March 2022). Reporting to me, the Board is co-chaired by the Secretary-General of the Department and the Chief Executive Officer of the HSE and will also comprise senior members of the Department’s Management Board and the HSE’s Executive Management Teams.
Health Services
Questions (410)
Bernard Durkan
Question:410. Deputy Bernard J. Durkan asked the Minister for Health the steps that are being taken to ensure that delays in the provision of various health services are eliminated, having particular regard to the need for continued improvement in the services and greater awareness of the patient's circumstances; and if he will make a statement on the matter. [17265/22]
View answerWritten 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 Waiting Lists
Questions (411)
Bernard Durkan
Question:411. Deputy Bernard J. Durkan asked the Minister for Health the full extent of the waiting lists for each procedure among the major general hospitals; when it is expected to address these issues; and if he will make a statement on the matter. [17266/22]
View answerWritten answers
It is recognised that waiting times for scheduled appointments and procedures have been affected by the COVID-19 pandemic. While significant work continues to positively impact on waiting times and improve pathways to elective care, acute hospitals have been impacted by operational challenges arising from surges in cases related to Omicron variants.
As a response to the recent surge in both ED attendance and COVID-19 cases the CEO of the HSE has written to the CEOs of all hospital groups advising them of the need to prioritise unscheduled COVID-19 care and urgent time sensitive work for a 14 day period. The resulting curtailment of elective care( and associated staff shortages) will negatively impact on achieving waiting list reduction targets.
The HSE has confirmed to the Department that 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 Department of Health continues to work with the HSE and the National Treatment Purchase Fund (NTPF) to identify ways to improve access to care, including through increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services, providing virtual clinics, and increasing capacity in the public hospital system.
The 2022 Waiting List Action Plan, which was launched on the 25th of February, allocates €350 million to the HSE and NTPF to reduce waiting lists. Under this plan the Department, HSE, and NTPF will deliver urgent additional capacity for the treatment of patients, as well as investing in longer term reforms to bring sustained reductions in waiting lists.The plan builds on the successes of the short-term 2021 plan that ran from September to December last year. The 2021 plan was developed by the Department of Health, the HSE and the NTPF and was driven and overseen by a senior governance group co-chaired by the Secretary General of the Department of Health and the CEO of the HSE and met fortnightly. This rigorous level of governance and scrutiny of waiting lists has continued into this year with the oversight group evolving into the Waiting List Task Force. The Task Force will meet regularly to drive progress of the 2022 plan and to monitor the impact of COVID-19 on waiting list reduction targets.
This is the first stage of an ambitious multi-annual waiting list plan, which is currently under development in the Department of Health. Between them, these plans will work to support short, medium, and long term initiatives to reduce waiting times and provide the activity needed in years to come.
Information concerning waiting lists for specialities for each major general hospital, including Planned Procedures and TCI’s are available on the NTPF website at: www.ntpf.ie/home/nwld.htm.
Hospital Services
Questions (412)
Bernard Durkan
Question:412. Deputy Bernard J. Durkan asked the Minister for Health the extent to which ready access to treatment for patients requiring cardiovascular, endoscopy and oncology is expected; and if he will make a statement on the matter. [17267/22]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Healthcare Infrastructure Provision
Questions (413)
Bernard Durkan
Question:413. Deputy Bernard J. Durkan asked the Minister for Health the current position in regard to whether proposed extensions to various hospitals throughout the country, including Naas General Hospital, are being advanced; and if he will make a statement on the matter. [17268/22]
View answerWritten 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 Data
Questions (414)
Bernard Durkan
Question:414. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the number of incidents of the various forms of cancer has been identified throughout the country, with particular reference to identifying the areas of greater or lesser incidence; and if he will make a statement on the matter. [17269/22]
View answerWritten answers
The National Cancer Registry Ireland (NCRI) is charged with collecting and classifying information on all cancer cases that occur in Ireland. NCRI data is used widely in the development of cancer services, service planning and in monitoring progress being made under the National Cancer Strategy. While the NCRI produces reports on the incidence of cancer by HSE region, this operates a number of years in arrears as diagnoses need to be validated to assure completeness and accuracy.
The NCRI has currently published information on incidence rates for invasive cancers (excluding non-melanoma skin cancer) as a whole, and for 25 major cancer types, for 1994-2017 at county scale. This data is provided on the NCRI website via maps for each county and cancer type, which provide the average numbers of cases diagnosed annually, and express this visually as a comparison between the number of cases observed and the number of cases that would be expected (based on average national rates) given the size and age/sex breakdown of the population in each county.
For invasive cancers as a whole (excluding non-melanoma skin cancer) in the 2006-2017 period, the annual average number of cases observed was highest in Co. Dublin, while Co. Cork was highest against the Standardised Incidence Ratio.
The data on cancer incidence rates can be found on the NCRI's website at the following link: www.ncri.ie/data/maps and the breakdown of the total number of cases for each county from 2013-2017 is as follows:
|
Region |
Cases 2013-2017 |
|
Co Dublin |
29,573 |
|
Co Cork |
13,463 |
|
Co Galway |
5,969 |
|
Co Limerick |
4,714 |
|
Co Kildare |
4,182 |
|
Co Tipperary |
4,107 |
|
Co Kerry |
3,938 |
|
Co Donegal |
3,930 |
|
Co Mayo |
3,802 |
|
Co Meath |
3,717 |
|
Co Wexford |
3,592 |
|
Co Wicklow |
3,368 |
|
Co Waterford |
2,972 |
|
Co Louth |
2,934 |
|
Co Clare |
2,819 |
|
Co Kilkenny |
2,072 |
|
Co Westmeath |
2,067 |
|
Co Sligo |
1,791 |
|
Co Offaly |
1,745 |
|
Co Cavan |
1,723 |
|
Co Roscommon |
1,699 |
|
Co Laois |
1,639 |
|
Co Monaghan |
1,334 |
|
Co Carlow |
1,329 |
|
Co Longford |
970 |
|
Co Leitrim |
901 |
|
TOTAL |
110,350 |
National Children's Hospital
Questions (415)
Bernard Durkan
Question:415. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the new children’s hospital is progressing; and if he will make a statement on the matter. [17270/22]
View answerWritten answers
The new Children’s Hospital (NCH) project comprises the main hospital on a shared campus at St James’s, the Outpatient and Urgent Care Centre at Connolly Hospital, Blanchardstown, and the Outpatient and Emergency Care Centre at Tallaght University Hospital.
In September 2021, the main contractor on the NCH project, BAM Ireland, substantially completed and handed over the paediatric outpatient and emergency care centre at Tallaght, in line with the contractor's schedule, and the facility opened on 15 November 2021, following a period of operational commissioning. The new facility will accommodate up to 17,000 outpatient and 25,000 emergency care attendances per year.
Together with the Outpatient and Urgent Care Centre at Connolly Hospital, which opened in July 2019, these new facilities will improve access to urgent, emergency and outpatient care for a significant number of children. In 2021, there were over 13,300 outpatient attendances at Connolly and almost 11,400 patients presented for urgent care as per updated CHI figures.
Work on the St James’s site is ongoing and progressing well with major milestones reached in 2021, including the completion of the concrete frame with over 150,000 cubic metres of concrete poured, the topping out of the building (where the highest point on the building was completed- a significant milestone in any construction project), the infill concrete slabs over the steelwork frame, the closing in of the concourse and approximately 17,000 square metres of glazing and 5,800 square metres of external façade installed.
To date, 86,000 square metres of internal partitions have been installed, with the equivalent of over 26 kilometres installed in 2021, and the fit out of most internal areas is now underway, including the south fingers comprising Outpatients, Cardiology Wards, and Therapies spaces, and the ‘Hot Block’ comprising Emergency Department, Critical Care and Theatres. Work in 2022 will be focused on the progression of the internal fit-out of the over 6,000 internal spaces. Internal fit out ranges from first fix in some areas, whereas others are much further progressed, with ceilings and joinery being fitted.
The NCH was connected to a permanent supply of power from the ESB network recently, which is another important milestone in the project.
The National Paediatric Hospital Development Board (NPHDB) has advised that the main contractor’s current schedule outlines completion can be achieved by December 2023 which would mean the NCH at St James’s could open in the second half of 2024, after the necessary commissioning period. The NPHDB is working to ensure that contractor will meet its own schedule.
Question No. 416 answered with Question No. 53.
Healthcare Policy
Questions (417)
Bernard Durkan
Question:417. Deputy Bernard J. Durkan asked the Minister for Health the degree to which the health services throughout the regions can expect a universal level of investment and attention with a view to ensuring that every patient throughout the country can expect to receive a high level of service; and if he will make a statement on the matter. [17273/22]
View answerWritten answers
As the Deputy may be aware, the introduction of the Regional Health Areas (RHAs) will ensure the alignment of hospital, community, and primary healthcare services at a regional level, based on defined populations and their local needs. This is key to delivering on the Sláintecare vision of an integrated health and social care service where all patients can access high-quality services in a timely manner, as close to home as possible. The 2020 Programme for Government committed to bring forward detailed proposals on the six Regional Health Areas to enable delivery of local services for patients that are safe, of high-quality, and fairly distributed.
In partnership with the HSE and other key stakeholders, my Department is developing a work programme for their implementation. I intend to bring a memorandum on RHA implementation to Government for decision very shortly.
Senior Department and HSE officials are leading this work. The Department of Children, Equality, Disability, Integration and Youth is also involved, given the transfer of disability policy to Minister O’Gorman’s Department. This team of officials is on track to finalise a detailed implementation plan by the end of this year. This will cover how RHAs will impact on workforce and HR planning, funding allocation, capital infrastructure, and governance lines. The team reports on their progress to the Sláintecare Programme Board which reports directly to me. The work programme will provide for substantial levels of staff engagement and of public engagement in autumn of this year to ensure broad-ranging input to the design of our health and social care services.
Funding for regions will be determined by a population-based resource allocation formula which will take into account a variety of demographic and geographical factors. This will provide for equitable and transparent funding allocation throughout the country as well as providing greater clarity and oversight of expenditure.
The completion of population-based profiling and the design of the resource allocation model to determine how resources are allocated to each RHA will be key. The implementation plan will examine the current allocation of resources to each RHA including budget, staff, and infrastructure and will produce reports on these in the current year.
The implementation plan will review the current budgeting and financial management process and detail new processes to set up RHAs as operational delivery units to enable service planning and funding. In order to enable population-based approaches, new financial reporting structures are required as well as ensuring that financial management systems are fit for purpose. In this regard, the rollout of the Integrated Financial Management System is taking into account the move to RHAs. In addition to population-based funding, activity-based funding will also be progressed to facilitate services provided nationally and between regions.
The regions will have a “one budget, one system” approach to ensure equitable resource allocation based on local need, with a view to ensuring that every patient in every region can expect to receive a high level of service, no matter where in the country they live.