Written Answers Nos. 197-204
197. Deputy Michael Healy-Rae asked the Minister for Health the position regarding funding in respect of an organisation (details supplied) in County Kerry; and if he will make a statement on the matter. [41163/12]
Amharc ar fhreagraMy Department administers a National Lottery Discretionary Fund from which once-off grants are paid to community and voluntary organisations, providing a range of health related services. If an organisation wishes to make an application for National Lottery Funding they should send in a formal application. Detailed procedures, along with the application form are set out on the Department's website - www.doh.ie
198. Deputy Bernard J. Durkan asked the Minister for Health the extent to which waiting lists for various procedures have altered over the past three years to date in 2012; if he intends to take any particular or specific initiatives to address any issues emerging; and if he will make a statement on the matter. [41170/12]
Amharc ar fhreagraThe National Treatment Purchase Fund report the number of people on waiting lists over the past three years are as follows:
- August 2010: 45,899
- August 2011: 56,870
- August 2012: 51,955.
The Special Delivery Unit (SDU) Scheduled Care Team was tasked with improving access to elective surgery and lowering waiting lists. There have been significant achievements in Scheduled Care since July 2011 when the SDU was formed. In relation to inpatient and day-case surgery, the overall waiting list numbers have decreased from 56,020 to 51,955, a drop of 7%. The number of adults having to wait more than 12 months is down from 2,732 to 408, a drop of 85% and the number of adults having to wait more than 9 months is down from 6,277 to 2,342, a drop of 63%. The number of children having to wait more than 20 weeks is down from 1,712 to 670 a decrease of 61%
The SDU began to tackle long waits for routine GI endoscopy services (i.e. scopes) in May 2012 and since May 2012 overall waiting list numbers for scopes have decreased from 13,349 to 8,904, a drop of 33%. Those having to wait longer than 3 months (the target for 2012) have decreased from 5,062 to 1,711, a drop of 66% .
The initial priority for the SDU was trolley waits and day cases. It has now begun to work on improving access to outpatient services. The SDU and National Treatment Purchase Fund (NTPF) are on trajectory to take over the reporting of outpatient waiting times from the HSE shortly. This work will involve the systematic collection of waiting time data at an individual patient level and in a standardised format from all hospitals providing a consultant-led hospital outpatient service. The collation and analysis of outpatient waiting time data in a standardised format will enable the SDU and NTPF to target their resources towards those patients who are waiting longest and ensure they are seen and assessed. It will also allow hospitals to begin to reform and standardise the manner in which it provides outpatient services to ensure that patients receive an equitable service irrespective of their geographical location.
199. Deputy Bernard J. Durkan asked the Minister for Health if he is satisfied regarding the adequacy of staff numbers throughout the various health services with particular reference to accident and emergency or other emergency services; and if he will make a statement on the matter. [41171/12]
Amharc ar fhreagraThe cumulative impact of staff reductions from this year and previous years presents a significant challenge for the health system in delivering services. The priority is to reform how health services are delivered in order to ensure a more productive and cost effective health system.
The health service faces challenges this year, both in terms of reduced staffing levels and a reduced budget. The 2012 National Service Plan sets out what actions will be taken to address these challenges.
The HSE is seeking to mitigate the impact of the reductions in overall staffing numbers on front-line services, including accident and emergency and other emergency services, by —
- using the provisions of the Public Service Agreement to bring about greater flexibilities in work practices and rosters, redeployment and other changes to achieve more efficient delivery of services;
- delivering greater productivity through the National Clinical Programmes to reduce the average length of stay, improve day of admission surgery rates, increase the number of patients treated as day cases, etc.; and
- some limited and targeted recruitment in priority areas to help limit the impact of retirements on front-line services.
202. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the GMS drugs bill has been or can be reduced; and to what extent by whatever means; the proposed schedule for any such event; and if he will make a statement on the matter. [41174/12]
Amharc ar fhreagraPublic expenditure on drugs provided to patients under the GMS and other community drugs schemes has increased significantly over the past decade in Ireland, with the year on year increase in spending on medicines being amongst the highest in Europe. In 1998 we spent just under €400 million. By 2009 expenditure had increased to just over €2 billion. However, due to action taken by my Department and the HSE, expenditure reduced in 2010 and 2011 with expenditure of approximately €1.9 billion in 2011. Cost control measures introduced in 2006 generated savings in the region of €250 million. Additional new price cuts between 2010 and 2012 resulted in a further €250 million (approximately) in savings .
Negotiations are ongoing between officials of my Department/HSE and the two bodies that represent pharmaceutical manufacturers in Ireland regarding reductions in the price of medical products supplied under State Schemes. It is expected that these negotiations will conclude shortly and provide additional savings in the cost of medicines. In addition, the Health (Pricing and Supply of Medical Goods) Bill 2012 will introduce a system of reference pricing and generic substitution for prescribed drugs and medicines. These reforms will promote price competition among suppliers and ensure that lower prices are paid for medicines resulting in savings for taxpayers and patients. The Bill is a Government priority for this Oireachtas session. It completed its passage through the Seanad on Wednesday, 19 September, and will be discussed in the Dáil shortly.
203. Deputy Bernard J. Durkan asked the Minister for Health if in the context of the current economic situation, he directly or through the Health Service Executive has managed to identify areas wherein efficiencies or accelerated patient throughput can be achieved; and if he will make a statement on the matter. [41175/12]
Amharc ar fhreagraI take it that the Deputy is referring to efficiencies within the acute hospital sector. In the current economic climate, the acute hospital sector must reduce its costs in order to deliver the agreed level of activity within the resources available to it. In terms of service delivery, we must concentrate on getting the best possible services for patients from the budgets available to us. This means we need to focus on how beds are used, on the throughput of patients, on reducing length of stay to international norms and on having as many procedures as possible carried out as day cases rather than inpatient work, thus maximising also the efficient usage of operating theatre facilities.
Measures aimed at achieving greater efficiency in the use of existing resource include prudent management of high-cost drugs (eg oncology and rheumatology) as well as a range of measures related to better use of bed-days and staffing, including bed capacity. The Reduction in Average Length of Stay (ALOS), from the performance to date this year of 7.2 days to the target in the HSE Service Plan of 5.8 days. The reduction in ALOS will be achieved by full implementation of the HSE National Clinical Care Programmes, in particular the Acute Medicine Programme, the Surgery Programme and the Frail Elderly Programme. As an example, approximately 121,000 bed days nationally have been saved to date through the implementation of the Acute Medicine Programme.
The Clinical Care Programmes provide a national, strategic and co-ordinated approach to a wide range of clinical services. They have three main objectives – to improve the quality of care, to improve access and to improve cost-effectiveness. Their primary aim is to modernise the way hospital services are provided across a wide range of clinical areas. This is being done through standardising access to and delivery of high quality, safe and efficient hospital services, and maximising linkages to primary care and other community services.
Funding of €23.4m is being provided in 2012 to hospital budgets to recruit staff to progress the implementation of the Acute Medicine Programme, the Emergency Medicine Programme, the Stroke Programme, the Surgery Programme and other clinical programmes. Currently there are 29 Clinical Care Programmes in different stages of development/implementation. There are also initiatives underway for Retrieval, Medications Management, Perspective Funding and Productive Wards. Many of the programmes have now produced models of care and guidelines which have been jointly agreed and endorsed for implementation with/by the colleges.
204. Deputy Bernard J. Durkan asked the Minister for Health if he is satisfied regarding the adequacy of ambulance service cover in all regions throughout the country; and if he will make a statement on the matter. [41176/12]
Amharc ar fhreagraThe HSE National Ambulance Service (NAS) provides pre-hospital emergency care and emergency and some non-emergency patient transport. The Service has undergone significant change and modernisation, in order to ensure quality, safety and value for money.
Before the NAS was established, each health board had its own ambulance service. There was little co-ordination of activities across board boundaries and no clear national leadership on pre-hospital care. Supported by my Department, the Pre-Hospital Emergency Care Council and HIQA, the NAS is providing national management and integration of ambulance services.
In particular, the following are being addressed: ongoing reduction to two ambulance control centres nationally; appointment of a medical director for the NAS; introduction of advanced paramedics who can provide more complex life-saving care on-site care; modernisation of communications and control infrastructure; and development and implementation of new performance indicators for pre-hospital care.
In addition, and in line with the Croke Park Agreement, the Labour Court issued a binding recommendation, directing the National Ambulance Service (NAS) and the unions with negotiation rights for paramedic staff to address a number of overtime inefficiencies in rostering arrangements. Up to recently, a number of ambulance stations had worked in isolation from each other, with built in overtime for staff resulting in duplication of service. The amount of overtime involved was 24 hours per station per week.
The National Ambulance Service and recognised unions have concluded discussions on roster changes at approximately 30 ambulance stations around the country, to eliminate such arrangements and improve operational efficiencies. New rostering arrangements have begun in a large number of stations. Following discussions with staff and based on activity and demand levels, a number of stations have additional cover under the new arrangements.
Where necessary, emergency cover is supported by advanced paramedics in rapid response vehicles and by resources dynamically deployed from adjacent stations on a rolling basis. The NAS has also introduced a new Intermediate Care Service to address routine inter-hospital transfers and to release emergency ambulances for emergency service work. The net effect of these changes is improved efficiency and increased resource availability across the area.
The NAS is a dynamic service. It responds to calls on a prioritised basis, through the Advanced Medical Priority Dispatch System (AMPDS), which is in operation in all NAS Command and Control Centres. The NAS has established that 10% of all 999 calls are inappropriate for an emergency ambulance and a further 50% are neither life threatening or serious. This data is in line with international experience.
