Written Answers Nos. 659-674
659. Deputy John Lahart asked the Minister for Health his plans to cut waiting times for outpatient appointments for heart failure patients, particularly in view of the high hospital readmission rates among patients with the condition; and if he will make a statement on the matter. [32613/23]
View answerHeart Failure is an important public health issue. Heart Failure is a prevalent, complex condition with increasing numbers. Across Europe, and in Ireland heart failure is a significant cause of hospital admission some of which could be avoided, placing increasing demand on our health services, a reduction in quality of life and life expectancy.
There has been notable progress in both therapeutics and structures of heart failure care improving Quality of Life and Life Expectancy. The detection and prevention of heart failure is a priority and the National Clinical Programme for heart failure is working towards , improving quality of life for people living with the syndrome. The programme (HSE) is in the process of linking in with the European Society of Cardiology who have an excellent platform to enable registry development on not only heart failure but other cardiovascular conditions. In addition, working under the guidance of Dr. Peter Kearney the programme is also aiming to initiate the EuroHeart programme database project in Ireland.
Ireland’s wider community of clinical practice in heart failure has provided leading research and innovation that continues to inform national and international practice. The STOP-HF project for example is a dedicated heart failure prevention strategy and a first-of-type concept. Ireland continues to implement pioneering innovations like the HeartCare at Home, a primary care project, which is open to all people with heart failure. To get heart failure specialist care to a wider cohort of patients ‘Virtual Consultation’ allows on-line, real-time discussion of heart failure case questions with a family doctor. This consultation results in very effective remote management, supporting hospital avoidance, avoiding unnecessary referrals and travel for the patient and facilitates the sharing of specialist expertise.
There has been significant investment in Integrated Care Programmes for Chronic Disease which includes heart failure. This investment has enabled the development of structures of care which will significantly improve all aspects of heart failure care including speed of diagnosis, access to cardiac diagnostic and therapies.
There are clear, evidence-based guidelines and excellent case studies of effective models of care in heart failure. It is recognised that progress has been made in increasing access to care, prevent unnecessary hospitalisations and deaths and maximise people’s quality of life. However, there is further access and community care required to impact waiting lists and access to care further and to understand the challenges more, a National Review of our adult Specialist Cardiac Services which includes heart failure was commissioned. The Report is now finalised and is being prepared for my consideration. The Reviews recommendations will inform the future provision of cardiac services nationally.
660. Deputy John Lahart asked the Minister for Health if he is aware of a pilot phone support programme run by an organisation (details supplied) in conjunction with the heart failure service in University Hospital Waterford that reduced the readmission rate among patients with the condition; if he believes this is a service that should now be expanded; and if he will make a statement on the matter. [32614/23]
View answerHeart Failure is an important public health issue. It is a prevalent, complex condition with increasing numbers. Across Europe, and in Ireland heart failure is a significant cause of hospital admission some of which could be avoided.
There has been notable progress in both therapeutics and structures of heart failure care improving Quality of Life and Life Expectancy. The detection and prevention of heart failure is a priority.
Ireland’s wider community of clinical practice in heart failure has provided leading research and innovation that continues to inform practice internationally. The STOP-HF project for example is a dedicated heart failure prevention strategy that is a first-of-type concept.
Ireland is also promoting pioneering innovations like the HeartCare at Home, a primary care project, which is open to all people with heart failure in Ireland. To get heart failure specialist care to a wider cohort of patients ‘Virtual Consultation’ allows on-line, real-time discussion of heart failure case questions with a family doctor. This consultation results in very effective remote management, avoiding unnecessary referrals and travel for the patient and facilitates the sharing of specialist expertise. This service was first developed along the East Coast of Ireland and Carlow and is now being rolled out nationally through the Health Service Executive Integrated Care Programme for chronic illness.
There has been significant investment in Integrated Care Programmes for Chronic Disease which includes heart failure. This investment has enabled the development of structures of care which will significantly improve all aspects of heart failure care including speed of diagnosis, access to cardiac diagnostic and therapies.
There are clear, evidence-based guidelines and excellent case studies (such as the one in University Hospital Waterford) of effective models of care in heart failure and it is recognised that there are a number of care approaches to prevent unnecessary hospitalisations and deaths and maximise people’s quality of life. While progress has been made some patients with heart failure are still waiting to access these programmes.
To understand the challenges more, a National Review of our adult Specialist Cardiac Services which includes heart failure was commissioned. The Report is now finalised and is being prepared for my consideration. The Reviews recommendations will inform the future provision of cardiac services nationally.
661. Deputy John Lahart asked the Minister for Health to list the hospitals that provide a clinical psychology service to heart failure patients, those treating heart failure that have no dedicated service for these patients; to set out his plans to improve these services; and if he will make a statement on the matter. [32615/23]
View answerReferring to HSE as this is an operational/services question.
662. Deputy John Lahart asked the Minister for Health in light of a survey by an organisation (details supplied) survey finding that 50% of heart failure patients did not receive adequate cardiac rehabilitation; what measures are being taken to increase access to the service for this specific patient cohort; what progress has been made to reduce an overall national waiting list for cardiac rehabilitation estimated at over 2,800 in 2021; and if he will make a statement on the matter. [32616/23]
View answerChanging Cardiovascular Health 2010 -2019 highlighted the importance of Cardiac rehabilitation. Cardiac rehabilitation is an internationally recognised standard of care for cardiac patients and considered an essential component of secondary prevention for patients with cardiovascular disease.
Cardiac rehabilitation is specifically developed for patients with established cardiovascular disease and patient positive outcomes are linked to high quality cardiac rehabilitation. Cardiac Rehabilitation is delivered through four phases, from the initial cardiac event in hospital to phase four in the community. The number of patients (5,063) accessing the service in 2019 increased by 25% from 2010. There are also increasing referrals of more complex, older and frail patients with multiple comorbidities to cardiac rehabilitation programmes.
Recent Irish Heart Attack Audit data suggest a 71% referral rate to cardiac rehabilitation programmes. There are at least 36 centres providing cardiac rehabilitation services nationally.
The National Review of Specialist Cardiac Services commenced in January 2018 with the aim to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services. This review will also recommend the optimal configuration of a national adult cardiac service in the context of the Sláintecare reform programme. In terms of scope, the National Review covers scheduled and unscheduled hospital-based services for the diagnosis and treatment of cardiac disease in adults which includes cardiac rehabilitation and heart failure services.
The Report is now finalised and is being prepared currently for my consideration. The Reviews recommendations will inform the future provision of cardiac services.
664. Deputy Fergus O'Dowd asked the Minister for Health further to Parliamentary Question No. 513 of 25 April 2023, if he can seek clarification on whether the HSE is confirming that seroquel is being prescribed to nursing home dementia patients despite the HPRA advice (details supplied) which states that it should not be taken due to increased risk of stroke and or in some cases the risk of death in elderly people with dementia; and if he will make a statement on the matter. [32638/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
665. Deputy Gino Kenny asked the Minister for Health if he has plans to progress drug availability in Ireland for rare forms of the neurological condition, spinal muscular atrophy, specifically adult types 3 and 4 (details supplied). [32647/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
666. Deputy Bernard J. Durkan asked the Minister for Health the preparedness of Ireland for the forthcoming influenza seasons with specific reference to people over 65 years of age; whether there are any plans to introduce an increased vaccine schedule to this most at-risk cohort; if there are plans to undertake health technology assessments for this cohort; when same is likely to occur; and if he will make a statement on the matter. [32651/23]
View answerThe National Influenza Vaccination Programme ensures that those most vulnerable to the effects of influenza have access to vaccination. The objective of the programme is to reduce the overall spread of influenza in the community and to protect those most at risk from influenza-related hospital admissions.
To inform decision making in relation to the current Influenza Vaccination Programme, my Department has requested that HIQA include a Health technology assessment (HTA) in its work programme, in relation to vaccination with an enhanced quadrivalent influenza vaccine for those aged 65 and older. In addition, my Department has also requested that HIQA include a HTA on the inclusion of the 50–64 year age group as an at-risk group in the influenza vaccination programme.
A HTA is a multidisciplinary research process that collects and summarises information about a health technology to provide information regarding clinical effectiveness and safety, cost-effectiveness and budget impact, organisational and social aspects, and ethical and legal issues. The information is collected and presented in a systematic, unbiased and transparent manner to inform policy decision making.
I am advised that the HTA on the inclusion of the 50–64 year age group in the influenza vaccination programme has commenced and that the HTA related to an enhanced quadrivalent influenza vaccine for those aged 65 and older will commence thereafter.
667. Deputy Fergus O'Dowd asked the Minister for Health if he will urgently review the need for the appointment of six genomic resource associates at the department of clinical genetics at Crumlin Hospital to reduce the current unacceptable two-year waiting list with regard to rare diseases; and if he will make a statement on the matter. [32655/23]
View answerThe Government and I are fully committed to improving genetics services in Ireland. One of the key ambitions of the National Strategy for Accelerating Genetics and Genomics Medicine in Ireland, launched in December 2022, is to build a strong national genetics service. This will be a patient and family-centred service that can be accessed equitably across the country and across the lifespan of patients. In 2023, the Government allocated €2.7 million to the implementation of the National Strategy for Accelerating Genetics and Genomics Medicine in Ireland. This allocation included the establishment of a National Office of Genetics and Genomics and the appointment of front-line staff. As Children’s Health Ireland (CHI) at Crumlin is one of the current hospitals providing a genetic testing service, Crumlin was selected for allocation of some these initial posts.
This year, the following genetics/genomics posts have been allocated to CHI Crumlin:
• 2 genomic research associates
• 1 genetic counsellor
In addition to these posts at Crumlin, the following posts have been allocated to build an equitable service at a national level:
• 1 genetic counsellor to the following locations:
• RHA A - Beaumont hospital
• RHA F – Galway University Hospital
• RHA B & RHA C - St. James Hospital / St. Vincent’s University Hospital
• 1 genetic consultant to Galway University Hospital
As part of the implementation of the National Strategy, there is a plan to build a strong genetic workforce for the future. This will be achieved by not only recruiting new staff, but training and development for a future workforce, and professional development for current staff within the health service. One of the key outputs for 2023 to help inform this work is the development of a model of care for genetics and genomics. The model of care will determine where additional posts are required and outline a plan for recruitment. The Interim Director and Interim National Clinical Director of the National Office of Genetics and Genomics will be responsible for progressing this work package.
668. Deputy Brendan Griffin asked the Minister for Health for advice and clarification on a matter (details supplied); and if he will make a statement on the matter. [32660/23]
View answerProgressing women’s health is a priority for myself and for this Government. We made a strong commitment to Promoting Women’s Health in the Programme for Government and are fully committed to the continued development and improvement of women’s health services and to working with women and girls to improve their health and experiences of healthcare across the whole life cycle.
In relation to funding for postnatal care, we have seen a number of key developments in this area through the National Maternity Strategy and the Women’s Health Action Plan, with postnatal services funded and developed to provide vital care to women in the weeks after birth.
The Women’s Health Action Plan 2022-23 was published on 8 March 2022, marking International Women’s Day. The Action Plan identifies key actions to improve health outcomes and experiences for women in Ireland. Action 7(a) of the Women’s Health Action Plan 2022-23 prioritises postnatal care and commits to “exploring new ways to support postnatal women better, and closer to home, learning from the postnatal hub pilot programme."
The Women's Health Fund was established in 2021 to support the Women's Health Action Plan 2022-2023. The purpose of the Women's Health Fund is to enable the Department to respond to women's health issues raised in year. Budget 2022 allocated €10m to the fund for the progression of initiatives that align with the overall goals of the Women's Health Action Plan, to improve women's health outcomes and experiences.
In 2022, I funded the development of two community postnatal hubs, located in Tralee and Kilkenny. The objective of the establishment of these hubs is that, regardless of care pathway or length of stay post birth, all women will have access to a comprehensive range of services within the community for a period of 10- to 14 days postpartum.
In addition to the Women’s Health Fund, work is progressing as follows:
• Significant progress continues in implementing the National Maternity Strategy. Under Budgets 2021 and 2022, a total of almost €16m in new development funding was provided for maternity services to continue and accelerate this progress in line with the Programme for Government.
• This investment is providing for additional staff into maternity services, covering a variety of disciplines, including, obstetrics, neonatology, endocrinology, anaesthetics, dietetics, midwifery, physiotherapy, and occupational therapy. It is improving the infrastructure of our maternity services by providing additional home-from-home birthing suites, upgrades to theatres and wards, as well as providing additional training and supports for maternity staff.
• A framework for the development of five postnatal hubs has been finalised by the HSE's National Women & Infants Programme (NWIHP); this includes the two hubs funded through the Women’s Health Fund. The HSE has advised that recruitment is underway for all five postnatal hubs, which will be located in Kilkenny, Kerry, Cork, Portiuncula and Sligo. These hubs will support women for up to 14 days post birth by addressing many of the gaps identified by women in postnatal care including education, breastfeeding, physiotherapy, emotional and physical supports.
Implementation of the services listed above represents significant development and advancement for women's health nationwide, but this remains a work in progress. I am committed to the full implementation of the Women's Health Action Plan 2022-23 and will continue to drive progress in all areas of women's health to fulfil its mandate into the future.
669. Deputy Joan Collins asked the Minister for Health if he will respond to research (details supplied), published on 6 June 2023, which reveals that services for over-8s are based on a geographic lottery to access children’s eye care with very little access in some areas, particularly in the north west and parts of the greater Dublin region; if the HSE will fast-track the roll-out on a standardised optometrist-led eye care programme for over-8s and a timeframe to introduce same; to provide a breakdown nationally of where this care is now; and the plans for the future. [32661/23]
View answerSight testing, eye examinations and optical appliances are provided to medical card holders by ophthalmologists, optometrists and dispensing opticians through the Community Ophthalmic Services Schemes (COSS). Patients may access these services following a referral by a healthcare professional such as their general practitioner.
All children, including those not covered by a medical card, receive a vision screen while in national school from a Public Health Nurse. The Health Service Executive (HSE) provides optical services free of charge to preschool children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate consultant for treatment. In such circumstances, these services will continue to be provided until the child has reached the age of 16.
The HSE Primary Care Eye Services Review Group Report, published in June 2017, highlighted the limitations of the current model of service delivery and set out the way forward for a significant amount of eye services to be delivered in a primary care setting. The Report estimated that 60% of existing outpatient activity could be moved to primary care thus enabling hospital services to focus on patients who require more specialist diagnostics or treatments.
The National Clinical Programme for Ophthalmology has developed a model of care which details how the realignment of eye services from the acute hospitals to the community will be undertaken. Included in current priorities is transferring the care of children aged 8+ years to the care of local private optometrists.
A project team with a wide-ranging membership was established in late 2019 / early 2020 to progress this initiative. The work of the team was paused due to the requirement to focus resources on the COVID 19 pandemic. However, the project team has been reconvened and is progressing matters in relation to this initiative.
As this also involves a service matter, I have asked the HSE to respond to the Deputy directly in regards to progress made, as soon as possible.
670. Deputy Róisín Shortall asked the Minister for Health if current trainee counselling psychologists in second and third year of their doctorate programme will receive funding; the timeline he is working towards in announcing the details of this funding, given that students who are currently enrolled in counselling psychology doctorate programmes fees are due in the coming months; and if he will make a statement on the matter. [32664/23]
View answerAs the Deputy will be aware, €750,000 has been provided in Budget 2023 to support counselling psychology training places. This funding demonstrates the Government’s commitment to strengthen access to psychology training.
I am focused on supporting counselling psychology students in an equitable way and that delivers value for money. The structure of this funding is still being finalised by officials in the Department. The approach will be based on best practice and knowledge gained from other health and social care funded training models.
Further detailed discussions are required between the Department and HSE to progress this. I hope to be in a position to announce the details shortly for academic year 2023-2024.
672. Deputy Catherine Murphy asked the Minister for Health the number of WTE consultant in emergency medicine-based in the accident and emergency department of Naas General Hospital in the years of 2022 and to date in 2023, in tabular form. [32677/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
673. Deputy Catherine Murphy asked the Minister for Health the full-year cost to reduce the waiting list for cancer genetic screening by 50%. [32678/23]
View answerAs this is a service matter, I have asked the HSE to respond to the Deputy directly, as soon as possible.
674. Deputy Catherine Murphy asked the Minister for Health the number of patients that have attended cardiology risk clinic at Tallaght University Hospital in 2022 and to date in 2023, in tabular form. [32679/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
