Written Answers Nos. 30-50
30. Deputy Gino Kenny asked the Minister for Health if he is aware that an organisation (details supplied) has said the latest Department of Health/HSE-commissioned IGEES report into the public hospital system is about saving money rather than patient safety and investing in services; and if he will make a statement on the matter. [19870/24]
View answerHealthcare productivity is about maximising the benefits to the public from the expenditure authorised by the Oireachtas. The more productive we are, the more patients we treat, the less time they have to wait and the better outcomes we can achieve.
The recent IGEES publication from the Department “Hospital Performance: An Examination of Trends in Activity, Expenditure and Workforce in Publicly Funded Acute Hospitals in Ireland” shows how activity in hospitals has responded to increased funding and increases in workforce and capacity between 2016 and 2022. The paper directly facilitates the work of the Productivity Taskforce to identify where, and how, productivity can be improved within the health service. In particular, the paper establishes a baseline for acute care productivity, and highlights where activity improvements are possible in the health system based on a “whole-of-site” approach.
The paper is already guiding the work of the Productivity Taskforce in establishing areas where intervention is possible to improve the efficiency, effectiveness and equity of service delivery. Actions to be taken are outlined fully in the Productivity and Savings Taskforce Action Plan. These include the creation of a condensed set of acute key performance indicators to better understand where progress is being made. In the future, we will prioritise additional investment that are genuinely activity enhancing through the targeted elimination bottlenecks - in ICT, diagnostics, theatre availability, bed capacity and staffing. In doing so, we will improve patient outcomes and free up resources for the treatment of patients in the most appropriate clinical setting.
31. Deputy Aindrias Moynihan asked the Minister for Health the measures he is taking to address the difficulties experienced by the HSE community dental service in recruiting staff; the measures that are being taken to reduce the long wait times for children awaiting orthodontic treatment in Cork; and if he will make a statement on the matter. [19914/24]
View answerThe HSE provides orthodontic treatment for patients who are referred by a HSE dentist for assessment before their 16th birthday and who are assessed by the HSE as having the highest level of clinical need.
The HSE has been supported through sustained investment to address orthodontic treatment waiting lists through private waiting list initiatives. Last year, €10m in one-off funding was made available to support two relevant initiatives. Over 2,000 patients nationally who were suitable for care in a community setting were removed from the HSE’s orthodontic treatment waiting list, through the continuation of an existing initiative.
In addition, a new orthognathic (jaw) surgery waiting list initiative commenced in September 2023. These are complex surgeries which require a lengthy hospital stay. This year, a further €3.35m is being invested this year on a one-off basis to support both initiatives. Up to the end of March this year, 20 patients have received orthognathic surgery to date and 156 patients have been transferred into private orthodontic care nationally.
Patients in the South orthodontic region, which includes counties Cork and Kerry, have benefitted from this investment. 121 South patients were transferred to private orthodontic care last year, as were a further 15 between January and March this year. This is in addition to the 1,930 patients in active treatment in the HSE in the South at the end of last year.
My Department engages with the HSE on an ongoing basis to understand the challenges arising in the provision of oral healthcare services, including to consider the dynamics in staffing levels across the service and to examine whether there are any apparent staff retention issues. Implementation of the National Oral Health Policy is proceeding and a plan for the 2024-2026 phase of implementation is in preparation between my Department and the HSE, for targeted consultation and then publication in Q3. The plan will set out a phased approach to the reorientation of the HSE’s oral healthcare and orthodontic services and the associated strategic workforce planning elements.
32. Deputy Duncan Smith asked the Minister for Health the timeline for the appointment of a social worker for the Swords area, which is being hindered by the ongoing recruitment freeze in the HSE; and if he will make a statement on the matter. [19400/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
33. Deputy Catherine Connolly asked the Minister for Health the details of his engagement to-date in 2024 with HSE West regarding the ongoing closure of Clifden District Hospital; the steps he has taken to ensure that the hospital reopens on a permanent basis; and if he will make a statement on the matter. [19534/24]
View answerClifden District Hospital plays a vital role in providing care and support to patients and their families in the Clifden community and surrounding areas.
Admissions to Clifden District Hospital have unfortunately been temporarily paused due to the lack of staff availability, and prioritisation has had to be given to staffing the roster in St. Anne’s Community Nursing Unit. Local residents from the Clifden area who have required an admission to a short-stay bed have been accommodated in the HSE facility in Merlin Park, and through the use of capacity in egress beds provided in the private system in Carna nursing home.
Following a derogation that I secured, HSE Community Healthcare West are actively working to recruit HSE nursing, care, and support staff in order to safely reopen the short-stay beds available in Clifden District Hospital. Despite contacts with several recruitment agencies, the HSE have been unsuccessful in sourcing the required staffing resources to reopen the district hospital.
The HSE are committed to providing services that meet the demand in the short and longer term for people in Clifden and surrounding areas. I will continue to work alongside the HSE to ensure that services in Clifden District Hospital are fully operational again at the earliest possible time. I engage regularly with Head of Older Persons for HSE Community Healthcare West in relation to all long-term residential facilities in the area.
34. Deputy Duncan Smith asked the Minister for Health if he will commit to funding the National Cancer strategy in full in Budget 2025; and if he will make a statement on the matter. [19397/24]
View answerAs Minister for Health, I have supported the National Cancer Strategy with substantial funding of €50m on for national cancer treatment and screening. There has been over €300m in cumulative additional funding for cancer treatment services allocated to the Strategy since 2017. This funding has enabled the recruitment of more than 670 staff to our national cancer services since 2017, including an additional 200 nursing staff, 100 consultants, and 180 health and social care professionals in designated cancer centres. This means that our national cancer services have been strengthened, that more patients are receiving treatment, and that waiting times to access treatment are reduced.
We have seen significant progress on the implementation of the Strategy over the past six years, with clear evidence-based policy direction from my Department and strong implementation by the HSE's National Cancer Control Programme (NCCP).
National Cancer Registry Ireland (NCRI) data shows substantial progress being made to control the four major cancers (prostate, breast, lung and colorectal), with mortality rates falling or stabilising for each. These comprise over half of all invasive tumours (not including rarely fatal nonmelanoma skin cancers).
The implementation of the National Cancer Strategy 2017-2026 is a Government priority and continued improvements in cancer services will be driven by both my Department and the NCCP. Priorities for 2024 will include the further centralisation of cancer services which has a direct impact on positive outcomes for patients, and the implementation of models of care for areas such as medical oncology and psycho-oncology, which ensure continuity of care and support for cancer patients and their families.
As with all areas, funding for the National Cancer Strategy, is considered as part of the yearly Estimates process. Decisions on future funding of the National Cancer Strategy will be made in the context of the upcoming Estimates process for 2025.
35. Deputy Robert Troy asked the Minister for Health when the National Palliative Care Strategy will be published. [19838/24]
View answer68. Deputy David Cullinane asked the Minister for Health when he will publish a new palliative care policy for adults; and if he will make a statement on the matter. [19775/24]
View answerI propose to take Questions Nos. 35 and 68 together.
Publication of a new National Palliative Care Policy is a Programme for Government commitment. It is expected to be published in the coming months.
The new policy will consider both the needs of people with a serious illness and that of their carer. It will address service demands arising from the projected increase in Ireland’s older population, and the number of people with life limiting conditions who would benefit from palliative care.
The policy sets out a future vision for palliative care in Ireland reflecting the many developments in end-of-life care and international best practice. Our policy aligns with the aims of Sláintecare in providing equal access to high quality palliative care for everyone who needs it. We want to ensure that people do not face financial hardship as a result of their illness.
This year, the government allocated the highest ever palliative care budget of €155.5 million. My department will continue to progress developments for palliative care services in Ireland. We will work towards the highest possible quality of end-of-life care and support for people with life limiting illnesses across the country.
36. Deputy Pauline Tully asked the Minister for Health to detail the specific health supports that are available to people with long-Covid; and if he will make a statement on the matter. [19867/24]
View answerAs the Deputy will be aware, the HSE interim Model of Care for Long COVID is being implemented, building on existing service provision, in addition to establishing new services across GP, community services and acute hospitals, to ensure a national service is in place for all who need it. In 2023 €6.6m was allocated for continued development of these services.
The model of care recommended the establishment of six Long COVID clinics across the country representing each hospital group, with appropriate staffing support. All Long COVID clinics are now established and receiving patients. Long COVID clinics are established in Beaumont University Hospital, St James’s University Hospital, St Vincent’s University Hospital, Cork University Hospital, University Hospital Limerick and Galway University Hospital.
Clinics operating under the Model of Care are supported by interdisciplinary teams with range of expertise including clinicians in the areas of infectious disease, respiratory medicine, psychiatry, cardiology and neurology. Allied health professionals, including occupational therapy, physiotherapy and clinical psychologists also form part of these interdisciplinary teams. The HSE continue to develop the service and are actively recruiting clinicians into these teams.
There is currently a neurology clinic at St James’ Hospital that receives referrals for patients with neurological symptoms that may be attributed to Long COIVD. This clinic accepts referrals from Long COVID clinics around the country.
Additionally, to further inform the continued development of post-acute and Long COVID services, the HSE have launched a Follow-up After Disease Acquisition (FADA) Survey to help increase understanding around how people are recovering from prolonged symptoms of COVID-19. Preliminary results of the survey are expected to be available later this year.
37. Deputy Pádraig O'Sullivan asked the Minister for Health the number of children in CHO4 that are waiting for a medical appliance, for example, wheelchair, orthotics and shower chair, in tabular form; and if he will make a statement on the matter. [19420/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
38. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 51 of 29 February 2024, for an update on the development of the SAR/PBC by the project team and the Galway University Hospitals Capital Programme Oversight Board for the new emergency department, women and children's block in UHG; the expected timeline for it to move to pre-tender stage; and if he will make a statement on the matter. [19533/24]
View answerGalway University Hospitals (GUH) is proposing a number of projects of significant scale on its University Hospital Galway (UHG) campus, including the new emergency department, women and children’s block. In order to ensure that capital investment works do not adversely impact the delivery of healthcare on the congested campus, a programmatic approach for the delivery of these projects is required.
To address this need, a Capital Programme Oversight Board was established by Saolta in September 2023. This Board has been tasked with developing a master plan from which all individual proposals on the UHG campus will flow, including the development of the new emergency department, women and children’s block.
In line with the requirements of the new Infrastructure Guidelines, which replaced the Public Spending Code, a Strategic Assessment Report (SAR)/ Preliminary Business Case (PBC) for the ED, women and children’s block must be developed. The first step in this process, the completion of the SAR, has been completed and the Department has provided its feedback to the HSE and the project team to inform the development of the SAR/PBC.
Saolta’s Capital Programme Oversight Board has been tasked with developing that SAR/PBC into a more integrated and strategic plan, incorporating the work of the Capital Programme Oversight Board master planning, from which all individual proposals will flow and be developed.
The submission of the SAR/PBC is dependent on the completion of the master planning for the UHG campus by Saolta’s Capital Programme Oversight Board and the sequencing of projects and works to unlock the necessary capacity on the campus.
Any SAR/PBC submitted must be subject to a Departmental review and independent external validation, including an external assurance process and presentation to D/PENDPDR’s Major Project Advisory Group, in line with Infrastructure Guidelines requirements. Satisfactory completion of this review process will enable Government consent to be sought to proceed to the next stage of the project development process- completion of the design, development of the pre-tender business case, and the statuary planning processes.
39. Deputy Paul Murphy asked the Minister for Health the recommendations he will make to the Cabinet Committee on Health in respect of the legislative changes needed to implement the abortion review; and if he will make a statement on the matter. [19877/24]
View answer58. Deputy David Cullinane asked the Minister for Health the progress in implementing the recommendations of the termination of pregnancy review; and if he will make a statement on the matter. [19776/24]
View answerI propose to take Questions Nos. 39 and 58 together.
The Independent Review of the Health (Regulation of Termination of Pregnancy) Act 2018 made a range of recommendations most of which are operational in nature.
The final Report of the Review made a number of recommendations in relation to increasing access to services.
The Government asked the HSE to establish an implementation group to progress the operational recommendations. An action plan for the implementation of the recommendations has been developed. Ten work-streams have been identified, they are as follows:
Early Pregnancy Ultrasound
Section 12-Early Pregnancy TOP
Surgical TOP and MVA
Audit & Data Collection
Education & Training
Foetal Medicine Protocols
National Prenatal Screening Programme
Maternal Health - Section 9
HSE Workplace Policies
Leadership Models
Significant progress has already been made in this regard, for instance six additional hospitals started providing termination services in 2023, an increase of 55%.
Increased service provision is largely down to the huge increase in funding for women’s healthcare under this government, as well as the dedicated work of our healthcare leads.
Termination services in early pregnancy (up to 12 weeks) are currently provided in 17 of the 19 maternity hospitals, with the remaining two expected to come onboard in 2024.
There has also been a small but sustained increase in community providers, approximately an additional 20 in the last 12 months alone.
Furthermore, the revised model of care introduced in response to the Covid pandemic has been approved as the enduring model of care. Under this blended approach, it is possible for one of the two consultations required for termination in early pregnancy to take place remotely. This will alleviate the time and expense involved in travelling to the doctor’s surgery twice.
The cumulative effect of these measures, now in place, will substantially reduce barriers and increase access to services for those who need it.
Safe Access Zones legislation is at an advanced stage in its progress through the Houses of the Oireachtas, with Report Stage in the Seanad scheduled for 1st May.
The proposals recommending legislative changes were referred to the Joint Committee on Health for consideration. Further consideration of this issue will take place at the Cabinet Committee on Health.
40. Deputy Brendan Griffin asked the Minister for Health the up-to-date breakdown of all staffing types at West Kerry Community Hospital; the net recruitment progress that has been made in each category in each year since 2019; the current bed complement; the breakdown of bed types; how many people are currently waiting for a bed in the hospital; what recruitment efforts are being made for each category of staff, including healthcare assistants and nurses; and if he will make a statement on the matter. [19820/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
41. Deputy Frankie Feighan asked the Minister for Health when a medical officer will be appointed to the Plunkett Home, Boyle, County Roscommon, given this position was advertised and approved at the end of 2023. [11712/24]
View answer42. Deputy Paul Donnelly asked the Minister for Health when the regulation in respect of selling vape products to minors will be fully enacted; and the repercussions for retailers if found to be in breach. [12315/24]
View answer43. Deputy Darren O'Rourke asked the Minister for Health the number of GPs currently practicing in Meath; the number of new GPs who have taken up work in each of the years 2021, 2022, 2023 and to date in 2024; if he plans to increase this; and if he will make a statement on the matter. [19726/24]
View answerGPs are self-employed practitioners and therefore may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. As of the start of April, there are 2,526 GPs contracted to provide services under the GMS Scheme, and a further 602 GPs hold some other contract with the HSE for the provision of health services such as services under the Primary Childhood Immunisation Scheme or National Cancer Screening Service.
In relation to the numbers of HSE contacted GPs practicing in Meath, and those who have taken up contracts annually since 2021, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
The Government is working to increase the number of GPs practicing throughout the country and thereby to improve access to GP services.
Under the 2019 GP Agreement additional annual expenditure provided for general practice was increased by €211.6m. This provided for significant increases in capitation fees for participating GMS GPs, and new fees for additional services and increased practice supports. The GP Agreement 2023 further increased GP capitation fees, increased the existing subsidy rates for practice staff, and introduced a grant support for additional staff capacity as well a practice staff maternity leave support.
The number of doctors entering GP training has been increased significantly in recent years, with 286 new entrants in 2023 and 350 places planned for new entrants for this year. Annual intake to the GP training scheme has been increased by over 80% from 2015 to 2023, and the number of new entrant places to be available this year is a 22% increase on last year's intake alone.
Furthermore, GP recruitment is ongoing under the joint International Medical Graduate Rural GP Programme between the HSE and ICGP. 112 non-EU GPs were recruited last year under the training programme and it is planned to recruit up to 250 more GPs from outside Ireland to the country this year. The placement of GPs under the programme is targeted to rural and underserviced areas.
Finally, my Department and the HSE have commenced a Strategic Review of General Practice. The review, with input from key stakeholders, is examining the broad range of issues affecting general practice including issues related to GP capacity. When completed, the review will set out the measures necessary to deliver a more sustainable general practice into the future.
44. Deputy Pearse Doherty asked the Minister for Health if funding will be made available to provide for a dedicated consultant neurologist at Letterkenny University Hospital; and if he will make a statement on the matter. [19818/24]
View answerThe Government has allocated €22.5 billion to the health budget for 2024 with the Department of Health's additional allocation in budget 2024 being nearly €2 billion. This additional allocation includes an increase of €808 million in core current funding, €1,032 million in non-core current funding and an additional €120 million in capital funding. The number of consultants HSE will aim to recruit in 2024 is subject to confirmation in the Pay and Number Strategy when it is finalised later this year
The HSE has confirmed that a review of Neurology Services in the North West is currently underway by the Saolta Medical Managed Clinical Academic Network (MCAN). It is expected that this review will be completed towards the end of Q2 2024 and will inform the potential development of Neurology Services in the North West and Donegal. Any development of services will require a business case by the hospital through the normal HSE processes to access additional resources.
45. Deputy Duncan Smith asked the Minister for Health if he will increase statutory funding for an organisation (details supplied) due to data that shows that stroke incidence in Ireland could increase by 60% by 2030; and if he will make a statement on the matter. [19399/24]
View answerThanks to continued investment in Health Services, Ireland has seen a decline in the number of deaths from cardiovascular disease (CVD). Since 2012, the mortality rate from heart disease has been reduced by 38%, mortality from stroke has been reduced by 48%.
• However, CVD remains a significant challenge claiming 9,000 lives annually.
• The Government acknowledges the vital support, education, and advocacy offered by the Irish Heart Foundation and other patient support groups.
• Many patient services are embedded in policy, including the National Stroke Strategy 2022-2027 for which the government has provided over €7m to date.
• Partnerships and collaboration are and will continue to be, enablers of our commitment to promoting the cardiovascular health of our nation.
• In 2022 and 2023, the HSE's National Heart Programme, supported through the Enhanced Community Care Programme, sponsored two CVD risk prevention projects with the IHF.
• The State, via the HSE, provides funding to the IHF, and other cardiovascular support agencies of approximately €530,000 through Service Level Agreements and Grant Aid Agreements of which €380,000 was allocated to IHF in 2024.
• In 2024, the HSE advise that an additional once-off sum of €400,000 has been allocated to the Irish Heart Foundation's for a High-Risk CVD Prevention Programme which has demonstrated its effectiveness by enhancing healthcare provision, clinical outcomes, and health behaviours in patients living in deprived communities.
46. Deputy Peadar Tóibín asked the Minister for Health the longest length of time any child has been waiting for scoliosis or spinal surgery in Temple Street or Crumlin Children’s Hospitals. [18648/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
47. Deputy Thomas Gould asked the Minister for Health the reason funding has not been provided to reopen a service (details supplied). [19710/24]
View answerAs this refers to a service matter, I have sent this PQ to the HSE for direct response. 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.
48. Deputy Richard Bruton asked the Minister for Health if he has considered broadening the scope of screening programmes to address more effectively the undetected treatable conditions, which if caught earlier would enhance health lives and reduce health costs; and if he will make a statement on the matter. [19862/24]
View answerI am fully committed to supporting our population screening programmes, which are a valuable part of our health service, enabling early treatment and care for many people, and improving the overall health of our population.
It is important to be aware that any decisions about changes to or expansion of our screening programmes will be made on the advice of the National Screening Advisory Committee (NSAC). This is an independent expert group that considers and assesses evidence in a robust and transparent manner, and against internationally accepted criteria. It is important that we have rigorous processes in place to ensure our screening programmes are effective, quality assured and operating to safe standards and that the benefits of screening outweigh the harms.
NSAC is an independent expert group that considers and assesses evidence in a robust and transparent manner, and against internationally accepted criteria. Its role is crucial in ensuring that Ireland has rigorous processes in place to ensure our screening programmes are effective, quality assured and operating to safe standards, and that the benefits of screening outweigh the harms.
Significant progress has been made on the expansion of the NBS Programme since I became Minister for Health. As the Deputy will be aware, last year I approved recommendations from the National Screening Advisory Committee (NSAC) for the addition of Severe Combined Immunodeficiency (SCID) and Spinal Muscular Atrophy (SMA) to the NBS programme, which will bring the number of conditions screened for in Ireland to 11, once the implemented. I would highlight that this will represent a 37% increase achieved under the lifetime of this Government.
NSAC is conscious of the constantly changing landscape regarding screening and holds regular Calls for Submissions, which invite all stakeholders, including members of the public, HSE and other medical professionals, to make proposals for the introduction of new population-based screening programmes or changes to existing programmes in Ireland. The third and most recent Call for Submissions closed on 1 March 2024. All submissions are carefully considered by the Committee as per its work programme.
49. Deputy Danny Healy-Rae asked the Minister for Health for an update on services in a local hospital (details supplied); and if he will make a statement on the matter. [13599/24]
View answer50. Deputy Duncan Smith asked the Minister for Health the reason a chief pharmaceutical officer has yet to be appointed; if he will support such an appointment considering the consistent shortage in various medicines worldwide; and if he will make a statement on the matter. [19398/24]
View answerI want to thank the deputy for their question.
The pharmacy profession is an important part of the healthcare service. Pharmacists working across primary and secondary care heavily contribute to the safe supply of medicines, amongst their other roles. I believe pharmacists can do more in our healthcare service.
As you will be aware, in July 2023, I established the Expert Taskforce to Support the Expansion of the Role of Pharmacy with the aim of identifying and supporting the delivery of specific objectives, which will serve to align services and practices that can be delivered by pharmacists, and pharmacies, with the needs of the health service and patients.
This Taskforce has been very successful so far. The first report and set of recommendations were published in early November 2023, with the Taskforce recommending a change to the maximum validity of prescriptions. A prescriber is now empowered to write a prescription for 12 months, if they feel it is appropriate for their patient. From September, for prescriptions written after March 1st , 2024, pharmacists will be enabled to extend certain prescriptions originally written for six months for a further six months if they deem it appropriate.
The Taskforce continue to work together on their second phase of work, which is to empower pharmacists to prescribe within their scope of practice. I am expecting that report in June of this year.
I understand that the pharmacy profession has advocated for the role of a Chief Pharmaceutical Officer for several reasons over the last few years. Many of these are being addressed by the Taskforce. The CPO role in other jurisdictions often has an input in managing medicines shortages.
Medicine shortages are, unfortunately, a feature of modern health systems worldwide and a global health problem. Issues surrounding security of medicines supply have been increasingly well characterised, both nationally and internationally, in recent years. The causes of such supply issues are multifaceted, ranging from pandemics to geopolitical events and perennial shortages of raw materials.
I understand that recurring shortages of medicines can cause concern and I would encourage any patient with concerns about their medicine to speak to their healthcare professionals.
Managing and mitigating against medicines shortages are the subject of several workstreams in my department.
Currently, Ireland has a multi-stakeholder Medicines Shortages Framework, operated by the Health Products Regulatory Authority (HPRA), which aims to prevent the occurrence of shortages and reduce their impact as they do arise.
Additionally, my department is progressing several workstreams for management of shortages via the Health (Miscellaneous Provisions) Bill 2024, including primary legislative amendments to make regulations to enhance the security of medicines supply and for the better management of shortages, via Medicines Substitution Protocols and a reporting requirement for actors in the medicines supply chain.
There are several pharmacists working in the Department of Health tasked with addressing the growing issue of medicines shortages and expanding. Currently, there is currently no Chief Pharmaceutical Officer role in the Department of Health.
