Written Answers Nos 1-28
9. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will set out the reduced services to patients and the savings, if any, as a result of the reduction in planned theatre activity at Cavan General Hospital; and if he will make a statement on the matter. [40982/12]
Amharc ar fhreagraThe funding pressures now being experienced in the health services mean that the acute sector must reduce its costs in order to deliver the agreed level of activity within the resources available to it. This means that we must concentrate on maximising efficiency and getting the best possible services for patients from the budgets available to us. However, this on its own is not sufficient. Activity levels in our acute hospitals have been running ahead of the levels set in the approved HSE Service Plan and therefore it is inevitable that activity levels must also be reduced. This will be a significant challenge, and in meeting it we must be flexible and responsive to service needs, in order to ensure that essential services are protected and that patient safety and quality remain paramount.
In regard to Cavan General Hospital, I am advised by the HSE that, at the beginning of 2012, the Cavan-Monaghan Hospital Management Team, including the Clinical Director, reviewed all services provided against the approved HSE Service Plan targets and the financial allocation. From April 2012, an efficiency and cost reduction measure was implemented targeting elective surgical activity in line with the 2012 Service Plan. I am advised services have not been negatively affected given that the Cavan-Monaghan Hospital Group has nevertheless managed to provide approximately 10% more elective procedures this year to date when compared to the same period in 2011.
10. Deputy Seán Crowe asked the Minister for Health if he will address the concerns raised regarding the cutbacks to ambulance stations and services in Tallaght and Swords, County Dublin and in Maynooth, County Kildare; and if he will make a statement on the matter. [40995/12]
Amharc ar fhreagraIn relation to the ambulance stations and services in Tallaght, Swords and Maynooth, I can confirm that there will be no reduction in staffing levels. Current overtime will, however, be reduced.
Following a referral to the Labour Court under the Public Service Agreement, the HSE National Ambulance Service is currently progressing a number of efficiencies arising from LCR 20313, including the issue of removal of overtime built in to rosters. New rosters are now in place and are operating successfully.
The National Ambulance Service is not a static service. The Service deploys its resources in a dynamic manner and works on an area and national, rather than a local, basis. The dynamic deployment of ambulance resources ensures that the nearest appropriate resource is mobilised to the location of any incident, including incidents in the greater Dublin area.. In this context, any removal of overtime inefficiencies will be addressed through more efficient deployment and utilisation of resources.
11. Deputy Niall Collins asked the Minister for Health the reason he added primary care centres to the list using a particular criteria selected by the Health Service Executive; if he has had previous connections with the general practitioners involved; and if he will make a statement on the matter. [40959/12]
Amharc ar fhreagra19. Deputy Clare Daly asked the Minister for Health the way the priority list for primary care centres was approved with particular reference to the changes announced in July 2012 [40940/12]
Amharc ar fhreagra26. Deputy Dessie Ellis asked the Minister for Health if he has an up-to-date-cost-benefit analysis of the development of primary care centres by means of public-private partnership as against development by the Health Service Executive directly; and if he will make a statement on the matter. [40986/12]
Amharc ar fhreagra32. Deputy John Browne asked the Minister for Health if he has had any representations from private contractors or general practitioners involved in building primary care centres ion Swords and Balbriggan, County Dublin, the two centres which were included on a list of 35 primary care centres published by the Health Service Executive in July; and if he will make a statement on the matter. [40958/12]
Amharc ar fhreagra66. Deputy Dessie Ellis asked the Minister for Health the position regarding the development of primary care centres; the locations chosen to commence development; the criteria used for choosing priority locations; and if he will make a statement on the matter. [40985/12]
Amharc ar fhreagraI propose to take Questions Nos. 11, 19, 26, 32 and 66 together.
Early in 2012 the HSE put together a list of high priority locations for the development of primary care centres across Ireland. It is the intention of Government to develop as many centres as possible by one of three separate methods:
- by direct investment;
- by way of leasing arrangements;
- by way of Public Private Partnership.
The locations were then considered for development by way of PPP as part of the Government’s stimulus package.
Selecting the Primary Care Centres under PPP was not, as is generally believed, done on the basis of one criterion, the deprivation index. Three criteria were deployed:
- the deprivation index for the catchment population of the centre;
- the service priority identified by each Integrated Service Area / Local Health Office;
- an Accommodation Assessment which assessed accommodation available for the primary care team within the catchment area, the quality of the accommodation, and whether or not the accommodation was spread over more than one building.
The HSE in this new process identified 338 locations for PC centres. From this 20 were selected on the basis of accommodation availability in the locale, service priorities, and deprivation. 37 locations within the list of 338 had similar rankings.
I accepted the first list of twenty prospective centres presented by Minister Shortall, but I decided, in consultation with my Department officials and Government Ministers, to go beyond the initial mathematical model, as the number was too small and we needed at least 35 centres. Advice from the HSE/DoH based on experience of PPPs is that if only 20 were pursued, considerable slippage could arise and the health system could lose a badly needed investment. I also took into account that the track record of the HSE in delivering PCs on time is poor. In addition the €115m stimulus fund available could only be accessed by means of PPP.
I wrote to Minister Shortall on the 25 of July stating: "A very strong consensus emerged at Government level that identifying 35 locations would stimulate and encourage wider interest and participation..." In other words, if we were to identify only twenty, and stick with twenty, GPs would then be able to sit back await their completion and then enter on their terms only. If you look at what happened in an urban area where a primary care centre has been built, the process began 4 years ago with pre-contract discussions with local GPs, the building was completed in 2012, but it took several months to get the GPs to move in. A similar situation arose in a rural area. So the list was widened. In addition, new criteria were added. It was evident, for example, that consideration needed to be given to:
- Existing health facilities;
- GP to population ratio;
- Pressures on services, particularly Acute Services;
- Funding options, including exchequer funded (HSE) build or lease; and
- Implementability of a PPP (size, site and scale).
The criterion of existing health facilities was added because if they weren’t considered, you could possibly have a health centre built in the shadow of an acute hospital, while a nearby area of great need would be left without a primary care centre, which would make no sense. Under these wider criteria, 15 additions were made to the list. Some of those extra 15 had in fact been identified by the HSE as far back as 2007 as high priority (under a Fianna Fail Government). However, because of the weighting I mentioned earlier (multiplying the deprivation index by three), two of these areas – Balbriggan and Swords - both lost out. They got swept from high priority to low priority. Under the original priority system both would have been in the top 35. However, under the new system with an altered weighting system, they ended up down the list. The realities had not changed. The weighting made it look as if the realities had changed.
Here are the realities. Balbriggan is an area of high unemployment with no existing primary care centre, where the current health centre is in a very poor state. The centre in Balbriggan will, in fact, proceed under a lease arrangement. Swords has a population of 48,000, no primary care centre, and no direct public transport link to its nearest hospital, Beaumont. There can be no doubt that these two areas are high priority for primary care centres. It is my intention to further primary care developments as resources become available.
I cannot be certain of who the GPs are in the proposed Primary Care centres in Balbriggan and Swords. However, I was acquainted with all GPs in North County Dublin in my former role as an Irish Medical Organisation representative and as a GP in North County Dublin. I can confirm that since becoming Minister I have had no representations from private contractors or GPs involved in building primary care centres in Swords and Balbriggan in this regard.
12. Deputy Sandra McLellan asked the Minister for Health the position regarding the Framework for Smaller Hospitals; the location and by whom is it being drawn up; if there is consultation with the smaller hospitals concerned; if there will be public consultation; and if he will make a statement on the matter. [40993/12]
Amharc ar fhreagraThe future organisation of our acute hospitals is a major policy issue for the Government. It is essential that all hospitals provide care in the right way, at the right location, and in a manner that ensures a safe, high quality service for all.
The Government is committed to securing and further developing the role of our smaller hospitals which will see them provide more, not fewer services. The challenge is to make sure that they provide services, which can safely be delivered in these settings, in order to maximise the benefit to patients. All hospitals, irrespective of size, as well as associated GP and community services, must work together in an integrated way. There have already been very significant developments recently in healthcare delivery, particularly in the context of shifts to day surgery and ambulatory care, and the centralisation of low volume high complexity care into larger centres. In this context, it is necessary that we redefine the role of the smaller hospitals so that they continue to play a central part of the Irish Healthcare system.
The Framework for Smaller Hospitals defines the role of the smaller hospitals. It outlines the need for smaller hospitals and larger hospitals to operate together. The Framework outlines the wide range of services that can be provided within the smaller hospital. It defines the need for the smaller hospital to be supported within a group of hospitals in terms of education and training, continuous professional development, the sustainable recruitment of high quality clinical staff and the safe management of patients who present with varying levels of complexity. It also sets out to address the categories of services that should transfer from the larger to the smaller hospitals and vice versa within a Hospital Group so that services are delivered in the most appropriate hospital.
Work is in progress on developing a detailed plan for service enhancements in each of the nine smaller hospitals that are covered by the Smaller Hospitals Framework. These plans are based on detailed local analysis of the services in place and what can be provided in the future.
I am determined to ensure that as many services as possible can be provided safely and appropriately in smaller, local hospitals. On this basis, the organisation of hospital services nationally, regionally and locally will be informed by the ongoing development of the HSE Clinical Programmes. With this in mind the Framework will set out what services can and should be delivered safely by these hospitals in the interest of better outcomes for patients.
The Smaller Hospitals Framework is currently being examined in the context of the overall reorganisation of the health services. The HSE is in the final stages of a consultation process to help inform the details of the service changes. This consultation process has sought feedback from all stakeholders, including local communities and health professionals in each hospital who deliver the service, and their feedback will be captured as input to the change process.
It is my intention to publish the Framework when this process has been completed.
13. Deputy Pádraig Mac Lochlainn asked the Minister for Health if his attention has been drawn to the higher price for generic medicines in this State compared to Northern Ireland and Britain; if his Department has undertaken or will undertake an investigation; if he will take action to ensure that the potential savings to the State and to patients from generic substitution is not negated by profiteering by the industry in this State; and if he will make a statement on the matter. [40991/12]
Amharc ar fhreagraThe prices of medicines vary between countries for a number of reasons. These include different prices set by manufacturers, different wholesale and pharmacy mark-ups, different dispensing fees and different rates of VAT.
Negotiations are ongoing between officials of the 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 ofmedicines.In addition, the Health (Pricing and Supply of Medical Goods) Bill 2012will 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, the 19th of September, and will be discussed in the Dáil shortly.
14. Deputy Martin Ferris asked the Minister for Health the progress made, if any, regarding the proposed development of a primary care centre at Tralee, County Kerry; and if he will make a statement on the matter. [41000/12]
Amharc ar fhreagra21. Deputy Michael Colreavy asked the Minister for Health the progress made, if any, regarding the proposed development of primary care centres at Ballymote, County Sligo, and Ballaghadereen and Boyle, County Roscommon; and if he will make a statement on the matter. [41001/12]
Amharc ar fhreagra23. Deputy Jonathan O'Brien asked the Minister for Health if he will report the progress made, if any, on the proposed development of a primary care centre at Togher, Cork City; and if he will make a statement on the matter. [40990/12]
Amharc ar fhreagra25. Deputy Aengus Ó Snodaigh asked the Minister for Health the progress made, if any, regarding the proposed developments of primary care centres in each case at Crumlin/Drimnagh, Coolock, Darndale, Rowlagh/North Clondalkin, Summerhill, Balbriggan and Swords, County Dublin; and if he will make a statement on the matter. [41003/12]
Amharc ar fhreagra68. Deputy Peadar Tóibín asked the Minister for Health the progress made, if any, in the development of primary care centres in each case at Kells, Laytown/Bettystown and Drogheda; and if he will make a statement on the matter. [41005/12]
Amharc ar fhreagraI propose to take Questions Nos. 14, 21, 23, 25 and 68 together.
The Deputies have asked about the development of primary care centres at a number of specific locations.
I can confirm that each of these locations is included in the published list of thirty-five potential locations for the delivery of primary care centres by public private partnership. The initiative is part of the Government’s Infrastructure Stimulus Package announced in July of this year.
Of the thirty-five locations identified, approximately twenty will be commissioned, subject to
a) agreement between the local GPs and the HSE on active local GP involvement in the centres; and
b) site suitability and availability.
It is envisaged that the locations will be offered to the market in two separate bundles.
The current position is that the HSE is engaging with the NDFA as required to progress the primary care centre element of the Government’s Public Private Partnership Programme. The HSE is currently analysing the available sites in each location and engaging with the GPs to determine their interest in participating in the primary care centre development.
I would like to remind the Deputies that the PPP programme is but one method of delivering primary care centres. The HSE continues to examine options with regard to leasing and exchequer-funded HSE build.
15. Deputy Seamus Kirk asked the Minister for Health the position regarding the deficit in the health budget following the €130 million in cuts announced recently; if there will be any further cuts before Budget 2013; and if he will make a statement on the matter. [40963/12]
Amharc ar fhreagraThe financial situation in the HSE continues to be extremely challenging. In the short term, to address the 2012 position, a range of measures are being undertaken in order to achieve a balanced budget. These include the use of capital to fund revenue on a once-off basis and the transfer of Department funds to the HSE on a once-off basis. The HSE has been required to review all pay and non-pay savings targets with a view to further targeting all areas which do not compromise patient safety.
The HSE has indicated that it will achieve €130m in savings to address the deficit. Nearly 50% will come from more focused cash and stock management initiatives, savings in medical equipment (non-capital), furniture, education, training, office expenses, travel and subsistence and advertising. €6m of savings will come from the non-reimbursement of certain non-essential products. €60.5m of savings will come from specific service-related measures. These measures are now the subject of intensive discussions with the HSE and local stakeholders. I have instructed the Executive that efficiencies must be achieved in the first instance before patient services are affected and in this regard, patient safety must be paramount. It is clear that further change is required in the health sector, and at a faster pace, and the 2012 Health Sector Action Plan – prepared under the Croke Park Agreement - contains a demanding and relevant set of measures. These include a comprehensive review of rosters, changes in skill-mix, productivity improvements and a focused approach to reducing sick leave levels. Further significant cost reduction / extraction is required in 2013 and 2014. Given the need to meet unavoidable pressures such as demographics, hospital services, specialised care and the reform commitments made in the Programme for Government, initial indications are that in excess of €700m will have to be taken out of the cost base of the health sector next year. My Department is working intensively with the HSE on proposals for submission to Government to address structural expenditure issues in the context of the 2013 Estimates.
16. Deputy Richard Boyd Barrett asked the Minister for Health the reason for the medical treatment being provided in respect of a person (details supplied) in terms of rehabilitation; and if he will make a statement on the matter. [41009/12]
Amharc ar fhreagraI can confirm that the person mentioned by the Deputy was referred to the National Rehabilitation Hospital (NRH) and following assessment by the hospital's liaison service, he was placed on the waiting list for admission to the NRH. The person will be admitted to the NRH with a view to ascertaining a rehabilitation programme for him, which will be tailored to meet his individual needs. He will be admitted as soon as possible, subject to a bed in the appropriate service becoming available.
I wish to inform the Deputy that approval has been granted for extra staff at the National Rehabilitation Hospital which will open 10 new beds. A further 3 new Rehabilitation Consultants will be recruited (one each for HSE Dublin Mid Leinster, HSE Dublin North East and HSE West)
17. Deputy Jonathan O'Brien asked the Minister for Health if he will reverse the decision to cease the provision of gluten-free products on prescription for medical card patients with coeliac disease or if he will provide equivalent alternative supports or measures for coeliac patients, in view of the excessive cost of gluten-free products; and if he will make a statement on the matter. [40989/12]
Amharc ar fhreagra184. Deputy Jack Wall asked the Minister for Health the reason a person (details supplied) in County Kildare who is the holder of a medical card is no longer able to receive certain medicines under their medical card; and if he will make a statement on the matter. [41115/12]
Amharc ar fhreagra195. Deputy Ciarán Lynch asked the Minister for Health the prescription medicines that are no longer covered by the medical card following a recent decision; if treatment for certain conditions (details supplied) are now excluded; and if he will make a statement on the matter. [41153/12]
Amharc ar fhreagraI propose to take Questions Nos. 17, 184 and 195 together.
In the current financial environment the Health Service Executive (HSE) is facing a challenge to deliver services in a way that will minimise any adverse impact on patients and continue to protect, as far as possible, the most vulnerable citizens. Unfortunately, it has become necessary for the HSE to suspend certain products from its list of reimbursable items. These include glucosamine, omega-3 triglyceride products, and gluten-free products.
Glucosamine is indicated for the management of symptoms of osteoarthritis. The National Centre for Pharmoeconomics (NCPE) have assessed the cost-effectiveness of glucosamine on two occasions and concluded that it did not offer value for money to the HSE. However, glucosamine products are available over the counter without prescriptions.
Omega-3 triglyceride products have been identified both nationally and internationally as not being cost effective or being of lesser benefit to patients. However, these products are also available over the counter without prescriptions.
Gluten-free products have become more widely available in supermarkets in recent years and tend to be significantly cheaper than products sold through community pharmacies. A Supplementary Welfare Allowance Adult Diet Supplement may be awarded by the Department of Social Protection to eligible persons. Persons wishing to apply for this allowance can do so by completing an application form which can be downloaded at the following link: http://www.welfare.ie/EN/Forms/Documents/swa9.pdf . Separate application forms are available for children. For persons who are not awarded a Diet Supplement, monies spent on gluten-free foods can be taken into account for tax purposes.
18. Deputy Willie O'Dea asked the Minister for Health following the recent agreement with consultants, if he has abandoned plans for a new grade of hospital doctor which it was hoped would provide a more clear career path for NCHDs; the action he will take to address this issue; and if he will make a statement on the matter. [40969/12]
Amharc ar fhreagraAs the Deputy is aware I was examining the introduction of a new entry level consultant post that would provide an opportunity for clinicians to work autonomously with clinical responsibility for all aspects of their patients’ care. This initiative was in response to concerns about the large numbers of qualified Irish doctors travelling abroad, the career structure for doctors and the recent difficulties in filling non consultant hospital doctor (NCHD) posts in our hospitals.
As part of my deliberations I consulted, in the first instance, with the medical schools via the Forum of Irish Postgraduate Medical Training Bodies. I met with representatives of the Forum last May concerning the proposal at which the NCHD representatives outlined their concerns regarding the proposed new grade. A survey of Higher Specialty trainees indicated that 75% of respondents did not agree with the proposal and 80% considered it would not incentivise them to return from abroad to work in Ireland. Last July the Forum Trainee Subcommittee, which includes trainee representatives from across all the postgraduate training bodies, formally responded to me indicating their strong opposition to the introduction of a new consultant grade on the grounds that it would not address the issue of doctor retention and has the potential to exacerbate the problem. They also considered that it would under utilise the trainees potential contribution to the Irish Healthcare System.
As an alternative to the introduction of a new entry level consultant post it has been decided to introduce new salary arrangements for future consultant appointments involving a 30% reduction in salary for future consultant appointees.
The new salary arrangements for future consultant appointments will facilitate the continuing appointment of consultants, which will benefit patients as well as offering job opportunities for NCHDs.
20. Deputy Timmy Dooley asked the Minister for Health when he was informed of findings in the Health Service Executive July performance report which was published on 20 September 2012; and if he will make a statement on the matter. [40961/12]
Amharc ar fhreagraThe draft HSE performance report for July was received in my Department on the 7th of September. The figure reported therein of 339,441 patients waiting for an outpatient appointment is unacceptably high. However the reported increase is not due to a sudden large increase in the numbers waiting but rather to more accurate data which presents a more accurate picture of the problem.
That this more accurate reporting procedure in relation to outpatient waiting lists would show an increase in the numbers has been public knowledge for some time now. In April this year a HSE report indicated that based on unvalidated interim results, not including all hospitals, nearly 178,000 patients were waiting for an outpatient appointment. That HSE report related to 30 hospitals and indicated that the figures were likely to rise once figures became available from all hospitals.
In a press briefing on 21 June this year the Special Delivery Unit (SDU) reported that its best estimate at that time was that the total national outpatient waiting list was likely to be approximately 350,000 patients. The major problem for patients was the number having to wait an inordinate amount of time for a consultation.
I am determined to address outpatient waiting lists. Improving outpatient services is the next priority for the SDU. The collation and analysis of outpatient waiting time data in this standardised format will enable the SDU and NTPF to target their resources towards those patients who are waiting longest and ensure that they are seen and assessed. It will also allow hospitals to begin to reform and standardise the manner in which they provide outpatient services to ensure that patients receive an equitable service irrespective of their geographical location.
22. Deputy Derek Keating asked the Minister for Health the options in place to deal with the medical consultants pay and their unwillingness to support his plans; and if he will make a statement on the matter. [40792/12]
Amharc ar fhreagra28. Deputy Micheál Martin asked the Minister for Health if his Department was involved in the recent negotiations on the consultants contract; and if he will make a statement on the matter. [40092/12]
Amharc ar fhreagra33. Deputy John Halligan asked the Minister for Health the reason the issue of private practice was not on the table for negotiations with the consultants; and if he will make a statement on the matter. [41011/12]
Amharc ar fhreagra40. Deputy Michael McGrath asked the Minister for Health the amount the €200 million in savings expected from the agreement reached with the hospital consultants will contribute towards bridging the deficit in the health budget this year; when he expects to see the savings from this agreement; and if he will make a statement on the matter. [40965/12]
Amharc ar fhreagra52. Deputy Derek Keating asked the Minister for Health the options he has to deal with the position taken by the Irish Hospital Consultants Association (details supplied); if he will consider recommending to the Department of Finance the introduction of a super tax in such circumstances; and if he will make a statement on the matter. [40791/12]
Amharc ar fhreagra63. Deputy John McGuinness asked the Minister for Health if he will outline the terms agreed with consultants at the Labour Relations Commission; the aspects of the deal that have yet to be agreed; his views on whether these changes will begin from 1 October; and if he will make a statement on the matter. [40966/12]
Amharc ar fhreagraI propose to take Questions Nos. 22, 28, 33, 40, 52 and 63 together.
Following a request on 13 September by senior health service management on behalf of the Government, intensive discussions between health service employers and the two consultant representative bodies commenced immediately at the Labour Relations Commission and concluded on 17 September 2012. These dealt with a range of matters, including measures to ensure that the relevant parts of the Health Sectoral Agreement within the Public Service Agreement 2010-2014 can be given effect. The management team comprised officials from the HSE, my Department and the Department of Public Expenditure and Reform.
The outcome of this engagement is that detailed proposals have been agreed between the parties. Amongst the key provisions of this agreement are that:
- Consultants will be available for rostering for any five days out of seven as opposed to weekdays as at present;
- There can be rostering of consultants where required on a 16/7 (8 a.m. to midnight) or 24/7 basis in services where this is required;
- Clinical Directors will have a much strengthened management role in respect of consultants;
- Consultants will cooperate with a range of measures to support improved Community and Mental Health services;
- Consultants commit to expeditious processing and signing of claims for submission to private health insurers;
- There will be more cost-effective arrangements for funding of continuing medical education.
In addition, the proposals agreed include provisions regarding compliance with the contractual requirements regarding private practice These include a commitment by consultants to measures that ensure that public patients waiting for elective care of any type are seen within clinically appropriate timeframes and that the entirety of the Consultant’s private activity, including in-patient, day-patient and out-patient activity, is within contractual limits. Also, the parties agreed that the current methodology and process for private practice measurement will be accepted as a minimum base for the purpose of determining compliance with contractual commitments on private practice and the parties are committed to developing the system to include the appropriate range of clinical activity.
The agreement also puts on a formal basis consultants' co-operation with a range of productivity flexibilities, which will allow for considerable efficiencies in the use of hospital beds, with the potential to deliver a saving of 220,000 bed days annually. Given that these flexibilities are centred on enhancing productivity on an ongoing basis, they are not expected to deliver immediate monetary savings. A range of other measures are in train to address the current deficit.
Separately, Government will apply a 30% reduction in salary for future consultant appointees. Management proposals to reduce the “rest day” arrangements that currently apply and to eliminate the fee to consultant psychiatrists for giving a second opinion under the Mental Health Act 2001 will be referred to the Labour Court, in line with the procedures provided for in the Public Service Agreement. The issue of “historic rest days” will be referred to the Labour Court in line with normal procedures.
The medical representative organisations have agreed to present the agreed proposals on reforms to their members for consideration. I expect this to be done in a timely manner having regard to the relevant provisions in the Public Sector Agreement.
I believe that the proposals which have been agreed between the parties, when implemented, will allow for very significant reforms in how health services are delivered and ultimately will lead to improved outcomes for users of the services.
24. Deputy Joe Higgins asked the Minister for Health in relation to kidney transplant operations in Beaumont Hospital, Dublin, where the waiting time for the procedure has increased from three to six months to 14 months, his views on the 70 patients who as of 31 May 2012 are at an advanced stage of work-up to have this procedure done with live donors; the number of those 70 patients thart are pre-emptive patients; and the difference in waiting times for those patients having the same procedure done privately at the same hospital [37887/12]
Amharc ar fhreagraI am advised by the HSE that the ‘work up’ of patients for the live donor programme involves clinical assessment of both recipients and potential donors. Clinical criteria are defined for all renal patients to be placed on the renal transplant list. Pre-emptive live donor transplantation is a possibility for patients; however, this number is not possible to define as while some patients may be pre-emptive at initial stages of work up, the process and time to completion of work-up may require patients to commence other forms of renal replacement therapy prior to transplantation. The HSE have advised that they do not monitor the private or public status of any of the patients as it is not relevant to either the live donor work-up or transplant operation date.
Members of the National Renal Transplant Programme as well as members of the senior management team at Beaumont Hospital are actively working with the Department of Health, the HSE and the National Transplant Office to increase the rate of kidney transplantation by ensuring that the appropriate resources are in place to do so. Approximately 30 live donors will be performed in 2012 and Beaumont Hospital have developed plans and outlined resources to increase this to 100 live donor transplants per annum.
27. Deputy Sean Fleming asked the Minister for Health if he and the HSE are committed to maintaining the full range of services at the South Infirmary Victoria Hospital following reconfiguration of the health services in the Cork area; and if he will make a statement on the matter [40962/12]
Amharc ar fhreagraThe creation of hospital groups and trusts is at the heart of the Government’s reforms of the acute hospital sector. It is an important stepping stone towards the introduction of universal health insurance which is the ultimate destination of the Government's reform programme. As a first step on that journey, hospitals will be aligned within groups on an administrative basis. Each Group will have a single consolidated management team with responsibility for performance and outcomes, within a clearly defined budget and employment ceiling.
Hospitals in Cork and Kerry have already undertaken a significant amount of work in this respect, through the ongoing reconfiguration program, which has received wide support through its comprehensive consultation process. Hospitals in the region have cooperated with a range of changes in the services they provide, in order to optimise patient care. South Infirmary Victoria University Hospital has seen a number of changes in the past twelve months, such as the relocation of services from the St Mary’s’ Orthopaedic /HSE to the SIVUH which includes the orthopaedic services. The transfer of this service coupled with the development of the paediatric orthopaedic services on the SIVUH site will greatly benefit the children of the Cork and Kerry region and reduce significantly the need for children and their parents to travel to Dublin based hospitals as heretofore. The transfer of these services has been supported through the appointment of three additional consultant orthopaedic surgeons.
The profile of the hospital is changing from an acute general hospital to a specialist tertiary referral hospital for the Cork and Kerry region; e.g. Orthopaedic surgery, Ear Nose and Throat (including head and neck surgery) and, in the near future, Ophthalmology. In the next number of weeks the additional services of Pain Medicine and elective Plastic Surgery are planed to move to the SIVUH from Cork University Hospital.
It is envisaged that the introduction of hospital groups will provide further opportunities for inter-site co-operation, on the basis of parity of esteem for the hospitals and teams within their hospital groups. Budgets for specialist and tertiary services will be set nationally. It is very important that services are provided by a hospital group working together as a cohesive entity. The provision of services should be planned and facilitated across the group so as to ensure effective, efficient and safe services in the most appropriate location, to achieve the best possible outcomes for patients and their families.
