Written Answers Nos. 54-73
54. Deputy James O'Connor asked the Minister for Health if he will provide an update on the facilities of Midleton Hospital after the devastating floods during Storm Babet; if he will provide the details of the funding available for repairs to the hospital; if he will provide a timeline for a return of the hospital; and if he will make a statement on the matter. [48224/23]
View answerAs the Health Service Executive is responsible for the management of the public healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
55. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he and his Department have identified blockages in the delivery of health services, with particular reference to addressing such issues in any way possible in order to ensure a seamless access to health services including A&Es, GPs and all public health services without restriction; if he will outline the actions already taken in this regard and any further action planned in the future in this regard; and if he will make a statement on the matter. [48152/23]
View answer70. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he and his Department continue to monitor, assess and remedy any shortcomings in the delivery of health services, whether in regard to access to homecare, general medical services, and capacity requirements in whatever area, with a view to resolution in the short term in order to make the health services in this country a more attractive place in which to work; and if he will make a statement on the matter. [48153/23]
View answerI am committed to tackling blockages in the health system and to building capacity as we move towards the goal of universal health care as envisaged by the Sláintecare programme. The Government has delivered record levels of investment over the past three years which has reduced costs for patients, improved services and speeded up access.
At community level, we have increased the number of people entitled to free GP care, reduced the threshold for the drug payment scheme and invested in the reform of primary care and community care services through the roll out of the Enhanced Community Care Programme. In the acute system, we have removed public inpatient hospital charges, delivered an additional 1,000 acute hospital beds and begun to tackle waiting lists and times through a series of Waiting List Action Plans. Additionally, there are over 23,000 more Whole Time Equivalent (WTE) staff working in our health service than there were at the beginning of 2020. This includes 6,808 nurses and midwives; 3,388 health and social care professionals; and 2,633 doctors and dentists.
I am aware that more needs to be done to meet the increasing demand for health care across community and acute services. I recently announced the completion of the extension of the GP Visit Card scheme which will see an additional 215,000 people become eligible for free GP care. 2024 will see continued implementation of the Enhanced Community Care Programme, with funding allocated to provide up to 240,000 community radiology diagnostic scans through the GP Access to Community Diagnostics programme. It is expected that the level of home support will be maintained in 2024 and the minimum proportion of new homecare hours ringfenced for people with dementia will increase to 18%. There will also be further investment in areas such as Child and Adolescent Mental Health Services, where funding will allow additional recruitment to improve access to services, drive efficiencies, and reduce waiting lists.
Reducing the numbers on waiting lists and shortening waiting times in both the acute and community areas are critical priorities for the Government. With the funding from Budget 2024 (€407 million), we are taking the next steps in the multi-annual approach towards achieving the vision of a world-class public healthcare system in which everyone has timely and transparent access to high-quality scheduled care, where and when they need it, in line with Sláintecare reforms. The HSE will also build on the work of the 2023 Urgent and Emergency Care Operational Plan to deliver a suite of targeted reform measures and initiatives to ensure appropriate and timely provision of care in Emergency Departments. More detail on the measures to be implemented in 2024 will be set out in the HSE’s National Service Plan (NSP) which is under development. My Department will monitor the performance of the HSE in delivering the NSP through an established DoH-HSE performance engagement model. The model provides for structured engagement at various levels within both organisations to identify service delivery challenges and agree and implement improvement actions.
Finally, I readily acknowledge the importance of the health workforce in delivering quality health care services. In the past number of years, the HSE has been developing its ability to attract and retain essential talent, to meet the needs of our health service now and in the future. Actions have included increases in the number of permanent contracts offered, development of career pathways and competitive international relocation packages. While workforce growth in 2024 will be lower than recently, expansion will continue in a number of targeted areas and a range of key workforce initiatives will be progressed, including the further rollout of the Safe Nurse Staffing Framework and the expansion of student nurse and medical education places. Work will continue to deliver on the recommendations of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. A number of recommendations from this Group have already been incorporated into the new and improved HSE Home Support Tender, which provides for payment for travel time for home support providers and paying carers the National Living Wage at a minimum. Work will also continue on the roll-out of the public only consultant contract in 2024, and indeed 1,000 consultants have already signed the new contract. This will extend the hours that consultants are on duty and facilitate more rapid and appropriate decision making, reduced emergency admissions, better patient flow and ultimately improved patient outcomes. I am confident that developments such as these will improve the conditions for staff working in the health service across the board.
56. Deputy Marc Ó Cathasaigh asked the Minister for Health the current resources and organisational structure of the climate change unit in his Department; and if he will make a statement on the matter. [49031/23]
View answerMy Department's 2023 Climate Action Roadmap, which can be found in Publications at gov.ie, sets out the approach taken towards meeting its obligations under the whole-of-Government Climate Action Plan process, including the range of policy areas involved and their interactions.
In addition, a cross-sectoral Climate Change Oversight Group, comprising expertise across the range of policy and business areas, including medical expertise, which interact with the climate change agenda. These encompass policy areas including public health, emergency management and active lifestyles, and provide a basis for engagement with Government Departments and Agencies to support the achievement of our national climate objectives.
57. Deputy Darren O'Rourke asked the Minister for Health the level of additional core expenditure for new developments, excluding funding for carryover and otherwise maintaining existing levels of service, for CAMHS services in CHO8 in 2024; and if he will make a statement on the matter. [48937/23]
View answerImproving access to mental health services remains a commitment to me and my Department. To this end, funding to mental health has increased by 25% during the lifetime of this Government.
More specifically, around €137 million was provided by the HSE to CAMH services in 2023. In addition, around €108m has been provided to community-based mental health organisations/NGOs this year, with a significant proportion of this dedicated to supporting young people.
The total allocation for mental health services in 2024 is approximately €1.3 billion, which is the fourth year in a row in which the mental health budget has been increased. This represents a significant investment which will enable continued policy implementation and service improvement in line with Sharing the Vision. This year’s budget allocation will enhance mental health supports next year across a broad continuum from mental health promotion, prevention and early intervention, to acute and specialist mental health service delivery, with a specific focus on CAMHS.
New development funding has been secured to advance initiatives on youth mental health, and for priority groups identified under Sharing the Vision and Connecting for Life. This will be focused on increased CAMHS staffing, a new Youth Mental Health app, a referral pilot for paediatric community services including CAMHS (piloting an approach to service referrals known as ‘No Wrong Door’), and the expansion of Suicide Bereavement Liaison services.
As occurs each year following the Budget, discussions will now take place with the HSE on details relating to specific service initiatives in the context of preparing the HSE Service Plan 2024, including for Mental Health. In this context, the new National Office for Youth Mental Health in the HSE will also work to ensure that mental health services for children and young people in this country are accessible, modern, and patient-centered.
58. Deputy Brendan Smith asked the Minister for Health how the extra funding of €4.6 million in Budget 2024 will increase the provision of transitional care to make sure that older people get the care they need leaving hospital; and if he will make a statement on the matter. [48617/23]
View answerAs of 31st October, the HSE reported there were 550 Delayed Transfers of Care in hospitals of which 245 people were waiting on residential care.
It is important that people receive the care they need in the setting most appropriate for their needs. Transitional Care Funding is a significant resource in facilitating the discharge of patients from hospital to a setting appropriate to their needs. Demand for the service is high.
In Budget 2024 I secured an additional €4.6 million in core funding together with a further €17.4 million on a once of basis for next year. The temporary nature of some of the allocation will be reviewed following an update of the guidelines relating to Transitional Care Funding in 2024.
The type and quantum of services to be provided next year by the HSE, including transitional care will be considered as part of the National Service Planning process.
59. Deputy Marc MacSharry asked the Minister for Health if the HSE has provided to his Department to date the detailed costings and an implementation plan requested which will inform a decision in relation to the inclusion of the chickenpox vaccine in the primary childhood immunisation programme; when a decision on this is expected to be made; and if he will make a statement on the matter. [48926/23]
View answerThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC).
NIAC continue to revise its recommendations having regard to of the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. As the Deputy is aware, the varicella vaccine is not currently included as part of the primary childhood immunisation programme however NIAC has recommended that the vaccine is included in the programme.
My Department asked HIQA to carry out a Health Technology Assessment (HTA) on the Varicella Zoster Vaccine which was published on July 13th 2023.HIQA found that there is clear and consistent evidence that the chickenpox vaccine is both safe and effective in preventing chickenpox and its complications. It also found that adding the chickenpox vaccine to the programme is likely to be cost effective.
Having considered the findings of the HTA, the Department has asked to HSE to provide detailed costings and an implementation plan which will inform a decision in relation to the inclusion of the chickenpox vaccine in the primary childhood immunisation programme. These costings and plan have not yet been received by the Department.
60. Deputy Pearse Doherty asked the Minister for Health what further plans are being considered to deal with the ongoing crisis at Letterkenny University Hospital; and if he will make a statement on the matter. [48213/23]
View answer61. Deputy Pearse Doherty asked the Minister for Health if he is aware of the ongoing situation with Letterkenny University Hospital where GPs and consultants continue to voice their concerns about the future of the service; if any further resources will be provided to the hospital to help it deal with the crisis; and if he will make a statement on the matter. [48220/23]
View answerI propose to take Questions Nos. 60 and 61 together.
As Minister for Health I am committed to the ongoing development of regional hospitals, such as Letterkenny University Hospital. Letterkenny is a large, busy hospital and this Government has allocated significant resources in order to meet the needs of patients using the hospital.
• There has been significant investment in services in LUH in recent years. Capital projects completed in the last two years include:
• the expansion of gynaecology services
• the opening of the acute stroke unit
• the provision of an additional endoscopy theatre and a new maternity theatre
• Since the end of 2019, 49 additional acute beds have been delivered to LUH.
There are several capital projects underway which will add additional capacity in services for patients. Projects planned and underway include the expansion of the Renal Department, the expansion of the Oncology Day Unit and the Electrical Infrastructure Upgrade.
I am concerned with the issues raised in recent correspondence from GPs and consultants working in Letterkenny and the wider Donegal area and I hope to meet with representatives of GPs working in County Donegal at the earliest available opportunity.
Following a meeting that I had with the HSE CEO in October, it has been agreed that the Performance Management and Improvement Unit would travel to Letterkenny University Hospital last week to visit the hospital.
I have also been informed of an issue regarding a locum consultant radiologist employed in radiology services in Letterkenny. This was notified to my Department via the HSE Patient Safety Protocol on 31 October. A full review of the work undertaken by this doctor during the period in question is being carried out. The review will be conducted by suitably qualified clinicians using the relevant HSE guidance and will include an examination of all of the radiological images reported on by the locum consultant radiologist. In the event that any issues of patient safety are identified, appropriate remedial actions will be instigated and full open disclosure will be arranged with patients and/or their families.
62. Deputy Brian Stanley asked the Minister for Health what extra capacity has been added to the local health services to provide for the additional 950 asylum seekers in Stradbally and for the local population; who will provide these services; and if they are now in place. [47529/23]
View answerThe Department of Health is providing access to healthcare services for Ukrainian refugees under the temporary protection directive. To-date, over 98,000 individual health identifiers has been allocated, along with over 60,000 medical cards, to beneficiaries of temporary protection.
The HSE has developed and implemented a primary care service delivery model (Migrant Health Model) to address unmet health needs among Ukrainian refugees which takes into account capacity issues in the health system. The model provides for a range of services including health needs assessments, migrant health teams, GP sessional clinics, psycho-social supports and catch-up immunisation.
The Government has allocated an additional €50m in non-core funding to meet the health needs of Ukrainian refugees in 2024. This funding continues the investment in healthcare services provided in 2023.
The PQ has been referred to the HSE to provide additional information on healthcare services for refugees in the location mentioned.
63. Deputy Gino Kenny asked the Minister for Health if he is aware that an organisation (details supplied) recently stated that the Budget 2024 capital allocation for Health will not result in the opening of the 1,500 additional rapid build hospital beds, six surgical hubs and four elective hospitals promised by him; and if he will make a statement on the matter. [49023/23]
View answerThe Budget 2024 capital allocation for Health is based off the NDP ceilings. A 5-year allocation to 2025 of €5.657bn has been allocated to the Department of Health as part of the review of the National Development Plan (NDP). An 11% increase in funding year on year to 2025 this will support the strategic direction of health capital investment in the period.
The number of projects competing for inclusion in the Capital plan each year invariably exceeds available funding. This is the case in 2024 and a balanced approach to progressing the pipeline of projects across the sector must be applied.
The 1,500 acute bed rapid-build programme, surgical hubs and elective hospitals will be progressed under Capital Plan 2024.
My Department is working in conjunction with the HSE to develop the Capital Plan 2024. Once finalised it will be submitted to me for approval in my capacity as Minister for Health, prior to publication in line with established procedures.
There is a strong track record of delivery of infrastructure in the health sector. Every allocated euro in the current NDP provision is invested to ensure we deliver on our core goal of universal healthcare and this is underpinned by a strong pipeline of capital projects being progressed by the HSE and Department of Health.
64. Deputy Eoin Ó Broin asked the Minister for Health to provide an update regarding wait times for both adult and child occupational therapy services in Clondalkin, Lucan, Palmerstown, Rathcoole, Newcastle, Saggart and Brittas; what efforts are being made to increase staff in the services and to reduce waiting times in the areas outlined; and if he will make a statement on the matter. [48923/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
The Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
65. Deputy Maurice Quinlivan asked the Minister for Health the progress that has been made regarding the establishment in Limerick of the trial 24/7 mental health de-escalation unit; and if he will make a statement on the matter. [49008/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
66. Deputy Patricia Ryan asked the Minister for Health the level of additional core expenditure for new developments, excluding funding for carryover and otherwise maintaining existing levels of service, which has been allocated to the Cancer Strategy for 2024; and if he will make a statement on the matter. [48995/23]
View answerCancer services are a top priority for this Government, and this is shown by the unprecedented funding allocated to the National Cancer Strategy in recent years. Over 2021 and 2022 I secured €40 million in funding for the Strategy, supporting the recruitment of approximately 360 staff to date in cancer services, and €30 million in funding for new cancer drugs.
What this means is that more patients are being seen and waiting times are down. For Rapid Access Clinics for breast, lung and prostate cancer, waiting times for patients are down by 14 to 57 weeks across the clinics, and over 40,000 patients have been seen so far this year, 2,000 more than the same period in 2019. There have been over 10,000 cancer surgeries performed so far this year, 700 more than the same period for 2019. Over 75,000 chemotherapy and other systemic anti-cancer therapies have been administered, 6,500 more than the 2019 figure.
In Budget 2024, I have allocated €3m in funding to the National Cancer Control Programme's Alliance of Community Cancer Support Centres. This funding will help these voluntary and charity organisation centres to deliver services directly to cancer patients and their families. The work of the centres emphasises the importance of quality of life during and after cancer treatment.
67. Deputy Gino Kenny asked the Minister for Health if he is aware that an organisation (details supplied) recently stated that the planned HSE NCHD recruitment freeze is “in breach of NCHD contract”, that NCHDs are suffering unprecedented levels of work-related stress and burnout, and that the freeze will lead to even more dangerous conditions for patient care; and if he will make a statement on the matter. [49024/23]
View answerOn October 13th, the HSE CEO announced a recruitment pause on all Grades that have grown beyond their recruitment targets for 2023. This is an extension of the pause on the recruitment of new and replacement staff in all grades in the Management and Administration category, announced a number of weeks ago.
The recruitment pause is part of a suite of control measures, including an instruction to reduce expenditure on agency staff and management consultants across the HSE and Section 38 organisations.
Many areas of the HSE have been recruiting more staff than they are funded for. If this level of growth, in excess of budgeted targets, was allowed to continue uncontrolled, it would have significant financial implications for 2023 and following years, and adversely impact on the HSE’s ability to recruit essential patient facing staff next year.
In September the total workforce stands at 122,274 WTE. This is an increase of 592 WTE from August’s figures. The workforce has grown by 4,905 WTE year-to-date or 4% over end 2022.
There has been significant and ongoing growth in NCHD numbers . As of September 2023, the total NCHDs workforce stands at 8,579 WTE. This is an increase of 583 WTE year-to-date. Since 2019, NCHDs have grown by 1,803 WTE or 27%.
The Government recognises NCHDs' grievances and accepts that they need to be addressed. The Government is committed to reviewing and changing the working conditions for NCHDs and is actively working towards reform as well as making posts in Ireland more attractive for them. NCHDs are a critical part of the health service. We must recognise their importance and work to ensure that they achieve a better work/life balance.
Following engagement with the Department, HSE and the IMO an agreement was agreed pertaining to grievances and issues raised by NCHDs following a vote in favour of industrial action. This agreement came into effect from 1st January 2023. The HSE is prioritising the full implementation of the Agreement.
All NCHDs are entitled to reasonable working conditions, to their annual leave and to be allowed take it. In response to this the Minister established The National Taskforce on the Non-Consultant Hospital Doctor (NCHD) Workforce was established by the Minister for Health in September 2022.It’s primary goal is enhancing working conditions for NCHDs in Ireland.
68. Deputy Robert Troy asked the Minister for Health for an update on the three new elective hospitals in Cork, Galway and Dublin, as promised under the National Development Plan; when he expects work to begin on the development of these hospitals; when he expects them to be operational; and if he will make a statement on the matter. [48986/23]
View answerThe Government is committed to establishing new standalone national Elective Hospitals in Cork, Dublin and Galway. This will enable the delivery of high-quality and timely elective care services to address the known demographic changes to 2035 (up to a 40% increase in day-case surgeries) with significant additional service delivery capacity.In December 2022 and following Public Spending Code Gate 1 approval, the Government approved the next stage of the Enhanced Provision of Elective Care Programme and progression of the development of new Elective Hospitals in Cork and Galway. The preferred sites recommended to be brought forward are St Stephen’s Hospital in Cork and Merlin Park, University Hospital in Galway. The planning phase requires the HSE to develop detailed project briefs, a procurement strategy and pre-tender business cases for the hospitals that will then be submitted for Government approval to proceed to tender. The appointment of the Design team is currently underway and will be in place in early 2024.In relation to Dublin, a site identification and assessment process for the delivery of additional elective capacity, including engagement with necessary stakeholders, has been completed. A Memorandum on preferred site options will soon be brought to Government for consideration.Whilst it is difficult to be definitive about timelines due to the many complexities to delivery – both in terms of infrastructure and resourcing of the new facilities – the Department of Health and HSE will work to ensure the expedient development and delivery of the new Elective Hospitals. We expect the new Elective Hospitals to see their first patients in 2027 and be fully operational from 2028.
69. Deputy Ruairí Ó Murchú asked the Minister for Health the level of additional core expenditure for new developments, excluding funding for carryover and otherwise maintaining existing levels of service, which has been allocated to eating disorder residential and community support services in the State for 2024; and if he will make a statement on the matter. [48975/23]
View answerThe total allocation for mental health services in 2024 is approximately €1.3 billion, which is the fourth year in a row in which the mental health budget has been increased. This increase in funding for mental health services represents a significant investment which will enable continued policy implementation and service improvement in line with our national mental health policy, Sharing the Vision. This year’s budget allocation builds on the investment this Government has made over the last number of years to deliver the policy priorities of Sharing the Vision through the provision of mental health supports across a broad continuum from mental health promotion, prevention and early intervention, to acute and specialist mental health service delivery, and enabling us to continue to deliver our vital services to as many people as possible, as we move into 2024.
As occurs each year following the Budget, discussions will now take place with the HSE on details relating to specific service initiatives in the context of preparing the HSE Service Plan 2024, including that for Mental Health.
71. Deputy Emer Higgins asked the Minister for Health if he will respond to reports of high and unmanageable stress levels amongst CAMHS staff; and if he will make a statement on the matter. [49010/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
72. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 46 of 21 September 2023, the status of the examination by the HSE of the completed SAR/PBC for the new emergency department, women and children’s block at University Hospital Galway; if the HSE has completed the examination to date; the timeline for the delivery of the new emergency department; and if he will make a statement on the matter. [48434/23]
View answerThe Department of Health carried out a review of the Strategic Assessment Report (SAR) for the New Emergency Department, Women and Children’s Block at University Hospital, Galway. The output of this review has been shared with the HSE to ensure that the SAR/Preliminary Business Case (PBC) document, as now required under the updates to the Public Spending Code (PSC) of March 2023, is as robust as possible.
The Department understands that the new SAR/PBC has now been submitted by the Project Team to the HSE for approval. If approved by the HSE, the SAR/PBC will be subject to further external reviews and Government consent before it can proceed to the pre-tender stage, as required by the PSC. The timeline for this will be determined by when the SAR/PBC is received by the Department.
73. Deputy David Stanton asked the Minister for Health his plans, if any, for the further development and expansion of South Lee Mental Health Services; and if he will make a statement on the matter. [47766/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
