Dara Calleary
Ceist:38. Deputy Dara Calleary asked the Minister for Health when the VHI will receive authorisation from the Central Bank of Ireland; and if he will make a statement on the matter. [2398/15]
Written Questions Nos. 38-45
Health Insurance Regulation
The Government agreed in December 2011 to address the European Court of Justice (ECJ) ruling of September 2011 which found that Ireland had failed to fulfil its obligations under the EU non-life Directives by exempting VHI from being regulated (i.e. holding authorisation) by the Central Bank of Ireland (CBI). Significant progress has been made since the subsequent Government Decision of 3 December 2013 towards achieving authorisation of VHI.
VHI submitted its application to the CBI on 16 May 2014. It continues to engage closely with the CBI in respect of its application, and my Department has also provided a number of clarifications to the Bank to assist it in its understanding of the interactions between the private health insurance market and the health system.
Consideration of the VHI's application for authorisation is a matter for the CBI in its role as independent financial regulator and I cannot anticipate how long that process will take, or its outcome. However, I expect that VHI will be authorised at the earliest opportunity, if approved by the Central Bank.
Disease Management
Michelle Mulherin
Ceist:39. Deputy Michelle Mulherin asked the Minister for Health the treatment that is available in the State in respect of a person who is diagnosed with Lyme disease; the tests conducted to establish such a diagnosis; and if he will make a statement on the matter. [2330/15]
Lyme Disease (also known as Lyme borelliosis) is an infection caused by a spiral-shaped bacterium called Borella burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. The infection is generally mild affecting only the skin, but can occasionally be more severe and highly debilitating. The commonest noticeable evidence of infection is a rash called erythema migrans that is seen in about 80-90% of patients.
Lyme borelliosis is diagnosed by a medical history and physical examination and can be difficult if there has been no erythema migrans rash. The infection is confirmed by blood tests which look for antibodies to B. burgdorferi produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease. The standard approach to Lyme diagnostics is a two-stage approach and involves using a sensitive enzyme immunoassay (EIA) as an initial, screening step. Screening EIA's can be insufficiently specific, giving false-positive reactions in the presence of other spirochaete infections including syphilis, and certain viral infections including glandular fever. In addition, sera from patients with autoimmune disorders and other inflammatory conditions can also lead to false-positive results. Samples giving reactive or equivocal tests in screening tests are further investigated in a second-stage immunoblot (Western blot) tests. Use of immunoblot testing greatly increases specificity. Using this outlined two stage approach will give a great degree of certainty around the diagnosis of Lyme Disease. Testing for Lyme borelliosis is currently undertaken in most of the larger hospitals in Ireland.
There is an ongoing publicity campaign regarding Lyme Disease. The Health Protection Surveillance Centre (HPSC) of the HSE is establishing a Lyme Borelliosis Sub-Committee with the primary aim to examine best practice in prevention and surveillance of Lyme Disease and to develop strategies to undertake primary prevention in order to minimise harm caused by Lyme borelliosis in Ireland. This will involve raising awareness among clinicians and the general public. It will explore ways to ensure these messages are brought to the general public with the frequency and in forms in which they can be most effective.
Each year, as part of its ongoing awareness raising regarding prevention and treatment of Lyme Disease, the HPSC holds a Lyme Disease Awareness Week in which media releases are sent out with the intention that media outlets would take up the important Lyme prevention messages. As part of last year's Awareness Week, a supply of information was made available to the public and attention was drawn to a "Tickborn Disease Toolkit", developed by the European Centre for Disease Control (ECDC). This toolkit was modified for use in Ireland and posted on the HPSC website. Indeed, the ECDC informed the HPSC that Ireland was the first European Member State to make such extensive use of this material. Following the Awareness Week, a 100% increase of web traffic to the various Lyme Disease sections of the HPSC website was noted.
Proposed Legislation
Mary Mitchell O'Connor
Ceist:40. Deputy Mary Mitchell O'Connor asked the Minister for Health his plans to publish the Public Health (Alcohol) Bill; and if he will make a statement on the matter. [2355/15]
As the Deputy is aware, the Government has approved an extensive package of measures to deal with alcohol misuse to be incorporated in a Public Health (Alcohol) Bill. These measures are based on the recommendations contained in the Steering Group Report on a National Substance Misuse Strategy, 2012. The package of measures to be implemented will include provision for minimum unit pricing, regulation of the marketing and advertising of alcohol, regulation of sports sponsorship, structural separation of alcohol from other products in mixed trading outlets and labelling of alcohol products. Work on developing a framework for the necessary Department of Health legislation is continuing and I hope to publish a General Scheme of a Bill early this year.
Hospital Waiting Lists
Niall Collins
Ceist:41. Deputy Niall Collins asked the Minister for Health his views on whether waiting times for patients needing diagnostic scans are acceptable; and if he will make a statement on the matter. [2403/15]
As this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
Hospital Staff Recruitment
Catherine Murphy
Ceist:42. Deputy Catherine Murphy asked the Minister for Health the way the current staffing situation at Naas General Hospital, County Kildare, is being addressed; if his attention has been drawn to serious shortfalls in resources and staffing capability; the long-term investment plan for the hospital in this regard; and if he will make a statement on the matter. [2389/15]
The HSE has advised that Naas General Hospital has agreed staffing levels to cover the entire hospital. When the hospital experiences surges in activity, additional staff are sourced to meet that demand. Naas General Hospital has approval to appoint 27 staff nurses and is currently in the process of appointing 10 temporary nurses. Interviews are being held next week to fill the remaining 17 posts on a temporary basis pending the permanent appointment of these posts.
Any future investment at Naas General Hospital must be considered within the overall acute hospital sector infrastructure programme, within the overall capital envelope available to the health service and in the context of the establishment of hospital groups. In 2015, there will be a structured integration of the Naas General Hospital into the Dublin Midlands Hospital Group and this will provide further support for Naas General Hospital in delivering high-quality, safe patient care in a cost-effective manner.
Health Insurance Regulation
Dara Calleary
Ceist:43. Deputy Dara Calleary asked the Minister for Health if he will provide an update on his plans for the VHI; and if he will make a statement on the matter. [2397/15]
The Government agreed in December 2011 to address the European Court of Justice (ECJ) ruling of September 2011 which found that Ireland had failed to fulfil its obligations under the EU non-life Directives by exempting VHI from being regulated (i.e. holding authorisation) by the Central Bank of Ireland (CBI). Significant progress has been made since the subsequent Government Decision of 3 December 2013 towards achieving authorisation of VHI.
VHI submitted its application to the CBI on 16 May 2014. It continues to engage closely with the CBI in respect of its application, and my Department has also provided a number of clarifications to the Bank to assist it in its understanding of the interaction between the private health insurance market and the health system.
Consideration of the VHI's application for authorisation is a matter for the CBI in its role as independent financial regulator and I cannot anticipate how long that process will take, or its outcome. However, I expect that VHI will be authorised at the earliest opportunity, if approved by the Central Bank.
Nursing Homes Support Scheme
Pat Deering
Ceist:44. Deputy Pat Deering asked the Minister for Health if he will provide an update on nursing home support-fair deal; the current waiting time; and his plans to reduce this. [2329/15]
The Nursing Homes Support Scheme is a system of financial support for those in need of long-term residential nursing home care. Participants contribute according to their means while the State pays the balance of the cost. To manage the available funds throughout the year, the HSE operates a national placement list in order of when the applications are approved, and funding is released in strict chronological order as it becomes available.
As of 5 January 2015 (the latest figures available) there are 1,188 people on this placement list. The current wait time for funding is approximately 11 weeks.
The budget for the Scheme in 2015 is €948.8m which reflects an increase of €10m from the 2014 position. The additional €10m was allocated to the Scheme as part of a wider initiative to alleviate the problem of delayed discharges in acute hospitals and has resulted in 300 extra approvals under the Scheme to date. In total since December 2014 funding has been released to provide for 1,200 places.
Further to this in July of 2014, the HSE allocated €5m for an initiative to improve access to appropriate care for older people. To date this has funded over 300 transitional care beds for patients in acute hospitals who are on the Nursing Homes Support Scheme national placement list.
Since the Nursing Homes Support Scheme commenced in October 2009, 56,989 applications for funding under the Scheme have been received. In 2014, 22,061 people were funded under the Scheme.
The Review of the Nursing Homes Support Scheme which is currently in progress will include consideration of the balance between community and residential services as well as the future financing and sustainability of the Scheme. Work on this Review is well advanced and will be completed in the coming months.
Care Services Provision
Caoimhghín Ó Caoláin
Ceist:45. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if cameras and other forms of monitoring will be introduced in certain care homes; his views that this would be appropriate; and if he will make a statement on the matter. [2414/15]
I welcome this opportunity to outline the progress being made by the HSE in relation to this very serious matter.
Like others, I was shocked and distressed by the revelations of extremely poor and unacceptable standards of care and mistreatment of vulnerable adults in Áras Attracta. Every person who uses our disability services is entitled to expect and receive supports of the highest standard and to live in an atmosphere of safety and care.
The safeguarding and protection of vulnerable people in the care of the health service is of paramount importance and the Director General of the HSE has written to all staff instructing them to take personal responsibility for ensuring that individuals supported by the HSE in any setting are treated with dignity and respect.
In December 2014 the HSE initiated both an expert investigation chaired by Mr Christy Lynch, and an independently chaired review of services at this facility led by Dr Kevin McCoy.
Mr Lynch’s investigation team is working independently of the HSE and will form an important input into any disciplinary process which the HSE will undertake .
Dr McCoy is undertaking an Assurance Review of the services at Áras Attracta and the final report will include an individual plan for improvement in each bungalow within the complex. The review will identify system wide learning involving engagement with relevant expertise as well as input from staff.
I welcome the fact that the Gardaí have now cleared the way so that Mr. Lynch’s investigation can commence. I have asked the HSE to keep me informed of progress.
The HSE has undertaken a number of additional initiatives to ensure that quality and safe care in residential services for people with disabilities is appropriately implemented and monitored.
A six-step plan will address this in a systematic way. These steps are:
- The establishment of a National Implementation Taskforce, including a series of National Summits to improve client safety, dignity, respect and culture;
- Implementation of the National Policy & Procedures on Safeguarding Vulnerable Persons at Risk of Abuse;
- Development of an Advocacy programme;
- Implementation of an evaluation and quality improvement programme in disability residential centres;
- Development of an implementation plan for any recommendations arising from the McCoy review of residential services in Áras Attracta when complete, and,
- Development of long term sustainable & evidence-based safeguarding practices and training programmes specific to residential settings.
The HSE is considering plans to monitor practices in social care facilities through the use of surveillance cameras, undercover persons and/or other means. However, it is very conscious of potential difficulties that could arise in relation to privacy and data protection, and given the complex issues involved, has decided to engage expert consultants to advise it on the best way to proceed. A Prior Information Notice under EU procurement rules was published in mid-December in this regard.
I can assure the Deputy that my Department will monitor progress on the initiatives and processes commissioned by the HSE in relation to Áras Attracta, to ensure that the learning from this incident is promulgated throughout our health system.