Thursday, 27 Sep 2012

Written Answers Nos. 53-60

Hospital Staff Issues

Ceisteanna (54, 59, 201, 215)

Joan Collins

Ceist:

54. Deputy Joan Collins asked the Minister for Health if he will confirm that all agency workers in hospital are being paid the agreed rates; and if he will make a statement on the matter. [41010/12]

Gerry Adams

Ceist:

59. Deputy Gerry Adams asked the Minister for Health if his Department and the Health Service Executive have carried out an impact assessment of the effect on patient care of the further restrictions on overtime and use of agency staff; and if he will make a statement on the matter. [40998/12]

Bernard Durkan

Ceist:

201. Deputy Bernard J. Durkan asked the Minister for Health the extent to which agency nursing or other staff are now employed throughout the health services; the extent to which such positions could be filled by part-time or whole-time temporary staff; the extent to which cost comparisons have been made in such circumstances; and if he will make a statement on the matter. [41173/12]

Bernard Durkan

Ceist:

215. Deputy Bernard J. Durkan asked the Minister for Health the extent to which cost comparisons have been made between the use of temporary, whole or part-time staff with agency staff costs; the current number of agency staff employed at all grades; the number of temporary staff, part-time or whole time; the extent to which efforts are being made to ensure non-interference with core or front-line services in the course of meeting budgetary cutbacks arising from the decisions of his predecessors; and if he will make a statement on the matter. [41212/12]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 54, 59, 201 and 215 together.

The 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 and to mitigate the impact of the reductions in overall staffing numbers on front line services. These actions include a target for reductions in agency costs.

Agency staff may be used only in the most exceptional of circumstances and when all alternative avenues have been exhausted. Such staff may only be engaged when signed off by identified senior management. In the light of the current serious budgetary situation in the HSE, further instructions concerning reductions on the use of agency staffing were issued by senior management in August this year.

The HSE has provided the following information, as at the end of July 2012, on the average number of staff engaged each week from contracted agencies. This does not included agency staff who are engaged other than through national contracts.

Nursing - 711 WTE

Health Care Assistants - 486 WTE

Doctors 138 WTE

Allied Health Professionals - 261 WTE

Social Care Workers - 115 WTE

Following the enactment of the Protection of Employees (Temporary Agency Work) Act this year, the HSE provided guidance to public service employers on the Act, including the fact that the equal pay provisions of the Act have retrospective effect to 5th December 2011. All agency staff employed through agencies contracted by the HSE have now had their basic pay adjusted in accordance with the Act. The HSE and the contracted agencies are currently making arrangements for the calculation and payment of back money due to agency staff.

The health service must operate with the employment targets set by Government, in line with the Government's commitment to reduce public expenditure. The HSE has also implemented a general pause on recruitment in order to deal with the serious budgetary situation. Decisions on the filling of positions, including whether posts should be filled by directly recruited staff or by agency will be made by the HSE in the context of the need to meet employment reduction targets and cost containment targets. This would include the cost effectiveness of the direct recruited staff compared to agency staff. However, such cost comparisons will depend on the individual grade and the differing costs of using agency staff in that grade, such as the fee to be paid to the contracting agency and VAT.

Hospital Waiting Lists

Ceisteanna (55)

Seán Fleming

Ceist:

55. Deputy Sean Fleming asked the Minister for Health if the special delivery unit has achieved its target of a nine month maximum wait time for inpatient and daycase surgery by September 2012; and if he will make a statement on the matter. [40975/12]

Freagraí scríofa

Minister for Health

The target for 2012, as set in the Health Service Executive (HSE) Service Plan 2012, is that no adult shall be waiting more than 9 months for an elective procedure. At the start of 2012 there were a total of 53,513 people who had to be treated by the 30 September 2012 to ensure that nobody was waiting more that 9 months for surgery. As of the 20 September 2012, 51, 637 (96%) had been treated. The Special Delivery Unit (SDU) and National Treatment Purchase Fund (NTPF) intends to issue an end of Quarter 3 progress report against the 2012 access targets in early October on all hospitals. This will be based on the waiting list numbers submitted by each hospital to the NTPF at the end of September 2012. The SDU Scheduled Care Directorate together with the NTPF will continue to support individual hospitals towards reaching access targets before the end of 2012.

Health Services Reform

Ceisteanna (56)

Michael Moynihan

Ceist:

56. Deputy Michael Moynihan asked the Minister for Health the areas in the health service he plans to privatise; and if he will make a statement on the matter. [40967/12]

Freagraí scríofa

Minister for Health

I have no plans to privatise health services. The question of external models of delivery is being examined by my Department at present as part of the broader public service reform programme.

Hospitals Building Programme

Ceisteanna (57)

Caoimhghín Ó Caoláin

Ceist:

57. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide details of the planned refurbishment works at St. Mary's Hospital, Castleblayney, County Monaghan; if restoration of respite services is an integral part of the promised major capital investment programme at the hospital; when the refurbishment and capital investment works will get underway; and if he will make a statement on the matter. [40981/12]

Freagraí scríofa

Minister for Health

The management and delivery of the health capital programme is a service matter. Therefore your question has been referred to the Health Service Executive for direct reply.

Health Services Provision

Ceisteanna (58)

John Halligan

Ceist:

58. Deputy John Halligan asked the Minister for Health the position regarding surgical equipment in respect of a person (details supplied) in County Wexford; and if he will make a statement on the matter. [40793/12]

Freagraí scríofa

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for direct reply.

Question No. 59 answered with Question No. 54.

Hospital Services

Ceisteanna (60)

Gerry Adams

Ceist:

60. Deputy Gerry Adams asked the Minister for Health if his attention has been drawn to the fact that a senior clinician at Our Lady of Lourdes Hospital, Drogheda, County Louth has written to the Health Service Executive stating that proposed cuts to intensive care and operating theatres could lead to increased morbidity and mortality of critically ill patients; if he will immediately instruct the HSE not to proceed with these and other threatened cuts at the hospital; and if he will make a statement on the matter. [40997/12]

Freagraí scríofa

Minister for Health

The 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.

For the Louth-Meath Hospital Group cost-containment measures will include:

- Reduction in spending on agency and overtime

- Closure of some beds, the effect of which will be mitigated in so far as possible by the commissioning of transitional care beds for clinically discharged patients

- Reduction in activity to bring it into line with approved levels

This will be a significant challenge, and in meeting it the focus is on ensuring that essential services are protected and that patient safety and quality remain paramount. In particular, emergency services, oncology services and obstetrics are being prioritised and the focus is on protecting these.

The Senior Management Team in the Louth Meath Hospital Group have already met with staff and staff union representatives to advise on the range of cost containment measures being introduced in Louth Meath Hospitals. All measures proposed to date have been risk assessed and the Senior Management Team in Louth Meath Hospital Group are satisfied that the risk assessment is a reasonable and comprehensive assessment of potential risks, and their mitigation and control and is compliant with national policies and HSE guidelines. The risk register will be managed by senior managers and clinicians within the hospital group.

It is important to note that across the acute hospital sector as a whole, reduction in costs will come from greater efficiencies where possible, including shorter average length of stay which in turn reduces the number of bed days needed. For example, the implementation of the HSE’s Acute Medicine Clinical Care Programme has saved 121,000 bed days to date this year. Similarly, the HSE’s transitional care initiative is shortening the average length of stay in acute beds by putting in place 190 transitional care beds and 150 rehabilitation beds this year, to which patients can move when appropriate.