Written Answers Nos. 26-43
26. Deputy Joe Carey asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Mid-Western Regional Hospital, Ennis, County Clare, and the impact of these measures; and if he will make a statement on the matter. [7560/13]
Amharc ar fhreagra30. Deputy Damien English asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Connolly Hospital, Dublin; the impact of these measures; and if he will make a statement on the matter. [7568/13]
Amharc ar fhreagra40. Deputy Paul J. Connaughton asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in University College Hospital Galway, County Galway, and the impact of these measures; and if he will make a statement on the matter. [7555/13]
Amharc ar fhreagra44. Deputy Joe McHugh asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Letterkenny Hospital, County Donegal; the impact of these measures; and if he will make a statement on the matter. [7566/13]
Amharc ar fhreagra45. Deputy Simon Harris asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Tallaght Hospital, Dublin; the impact of these measures; and if he will make a statement on the matter. [7549/13]
Amharc ar fhreagra46. Deputy Simon Harris asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in St. Colmcille's Hospital, Loughlinstown, Dublin; the impact of these measures; and if he will make a statement on the matter. [7569/13]
Amharc ar fhreagra47. Deputy Catherine Byrne asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Beaumont Hospital, Dublin; and the impact of these measures. [7562/13]
Amharc ar fhreagra58. Deputy John Paul Phelan asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in St. Luke's Hospital, Kilkenny, and the impact of these measures; and if he will make a statement on the matter. [7556/13]
Amharc ar fhreagra66. Deputy Dara Murphy asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Cork University Hospital, County Cork, and the impact of these measures; and if he will make a statement on the matter. [7554/13]
Amharc ar fhreagra70. Deputy Peter Fitzpatrick asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Our Lady of Lourdes Hospital, County Louth; and the impact of these measures. [7565/13]
Amharc ar fhreagra75. Deputy Damien English asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Our Lady’s Hospital, Navan, County Meath, and the impact of these measures; and if he will make a statement on the matter. [7552/13]
Amharc ar fhreagra77. Deputy Heather Humphreys asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Cavan General Hospital, County Cavan, and the impact of these measures; and if he will make a statement on the matter. [7553/13]
Amharc ar fhreagra86. Deputy Marcella Corcoran Kennedy asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Midland Regional Hospital, Tullamore, County Offaly and the impact of these measures; and if he will make a statement on the matter. [7557/13]
Amharc ar fhreagra89. Deputy Paul J. Connaughton asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Portiuncula Hospital, County Galway; the impact of these measures; and if he will make a statement on the matter. [7563/13]
Amharc ar fhreagra93. Deputy Mary Mitchell O'Connor asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in St. Vincent's University Hospital, Dublin, and the impact of these measures; and if he will make a statement on the matter. [7558/13]
Amharc ar fhreagra94. Deputy Brendan Griffin asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Kerry General Hospital; the impact of these measures; and if he will make a statement on the matter. [7564/13]
Amharc ar fhreagra96. Deputy Liam Twomey asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident emergency department in Wexford General Hospital; the impact of these measures; and if he will make a statement on the matter. [7547/13]
Amharc ar fhreagra99. Deputy Nicky McFadden asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Midland Regional Hospital, Mullingar, County Westmeath, and the impact of these measures; and if he will make a statement on the matter. [7559/13]
Amharc ar fhreagra104. Deputy Anthony Lawlor asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Naas General Hospital, County Kildare; and the impact of these measures. [7550/13]
Amharc ar fhreagra112. Deputy Charles Flanagan asked the Minister for Health the actions taken to tackle overcrowding and the use of trolleys in the accident and emergency department in Midland Regional Hospital, Portlaoise, County Laois; the impact of these measures; and if he will make a statement on the matter. [7548/13]
Amharc ar fhreagraI propose to take Questions Nos. 26, 30, 40, 44 to 47, inclusive, 58, 66, 70, 75, 77, 86, 89, 93, 94, 96, 99, 104 and 112 together.
Immediately following my appointment, I set out to address the issues which have been causing unacceptable delays in patients being treated in our hospitals. I established the Special Delivery Unit (SDU), as set out in the Programme for Government. The SDU is working to unblock access to acute services by improving the flow of patients through the system. Since its establishment there has been significant improvements in the waiting times for unscheduled care against a background of reduced funding for health, reconfiguration of services, a very challenging socio-economic climate and a growing number of older persons with an overall increase in life expectancy.
There was significant progress during the course of 2012 in reducing the number of patients waiting on trolleys. Over 2012 there were 20,352 less patients waiting on trolleys in comparison to 2011, representing an overall reduction of 23.6%.
Since before Christmas hospitals have seen a significant increase in the number of very sick patients needing admission. The increase in norovirus in hospitals has been well publicised; we are also seeing high levels of admissions of frail elderly people, patients presenting with respiratory illness and of patients presenting with fractures.
However, evidence from the last year, and particularly over the last ten months, has proved that the health system has the capacity to respond to these challenges more quickly and is better at managing increased demand.
The situation is being actively managed at a national level with an intensive work programme having begun between the SDU’s liaison officers, the Clinical Programmes and the hospital teams. The SDU is satisfied that hospitals are engaged in ensuring that emergency patients are seen in a timely manner, focussing on working to achieve the national targets for unscheduled care.
I will have the information requested on each hospital sent out to the Deputies as soon as possible.
27. Deputy Pearse Doherty asked the Minister for Health the products that will be delisted from the GMS scheme as outlined in the Health Service Executive national service plan 2013; and if he will make a statement on the matter. [7460/13]
Amharc ar fhreagraA Clinician Led Multi-disciplinary Medicines Management Programme has been established to provide national leadership on issues relating to quality of medicines management processes, access to medicines and cost of medicines. As part of this work, those products that are less suitable for prescribing will be identified and considered for delisting in compliance with the Health (Pricing and Supply of Medical Goods) Bill proceeding through the Dáil.
28. Deputy Charlie McConalogue asked the Minister for Health when the national positive ageing strategy will be published; and if he will make a statement on the matter. [7493/13]
Amharc ar fhreagra42. Deputy Brendan Smith asked the Minister for Health when the national positive ageing strategy will be brought forward; and if he will make a statement on the matter. [7514/13]
Amharc ar fhreagra111. Deputy John Browne asked the Minister for Health the expected publication date for the national positive ageing strategy; the reason it was not published in 2012; and if he will make a statement on the matter. [7500/13]
Amharc ar fhreagraI propose to take Questions Nos. 28, 42 and 111 together.
The Programme for Government has committed to completing and implementing the National Positive Ageing Strategy so that older people are recognised, supported and enabled to live independent full lives.
The Strategy will be a high level document outlining Ireland’s vision for ageing and older people and the national goals and objectives required to promote positive ageing. It will be an over-arching cross-departmental policy that will be the blueprint for age related policy and service delivery across Government in the years ahead.
The Strategy is being developed within the constraints of the present fiscal situation. The intention of the Strategy is not to propose new service developments. The strategy will set the strategic direction for Government policy on ageing by outlining the priority areas requiring action. It will be a matter for individual Departments/agencies to identify how best they respond to the challenges posed by an ageing population.
The Strategy was considered by the Cabinet Committee on Social Policy at its meeting on Tuesday last and will be brought to Government shortly.
29. Deputy Peadar Tóibín asked the Minister for Health the way he will achieve the charging of all private patients in public hospitals; the steps and legislation needed to achieve this; and if he will make a statement on the matter. [7461/13]
Amharc ar fhreagraAs part of Budget 2013, it was announced that provision would be brought forward to enable public hospitals to charge all private patients in public hospitals. New primary legislation will provide for an updated framework for the charging of private in-patients in public hospitals. The legislation is currently being developed by the Department. It is my intention to publish the legislation shortly during the current session of the Dáil.
31. Deputy Pádraig Mac Lochlainn asked the Minister for Health if he will detail where the cuts in disability funding outlined in the Health Service Executive national service plan 2013 will apply; the way that this will affect staffing levels; and if he will make a statement on the matter. [7464/13]
Amharc ar fhreagraThis Government currently provides funding of over €1.5 billion to the Disability Services Programme through the HSE’s National Service Plan for 2013 , and is committed to protecting front-line services for people with disabilities to the greatest possible extent.
The Minister for Health is working to ensure that protection is afforded to the disability sector, and the Social Care area as a whole.
In 2013 the HSE is seeking to maximise the provision of services within available resources and to maintaining a consistent level to that provided in 2012, by providing the following specialist disability services:
- residential services to over 9,000 people with a disability;
- day services to over 22,000 people with intellectual and physical disabilities;
- respite residential support for over 7,500 people with intellectual and physical disabilities;
- 1.68 m hours of Personal Assistant / Home Support Hours;
With regards to staffing levels the Government has decided that the numbers employed across the public service must be reduced in order to meet its fiscal and budgetary targets. The health sector must make its contribution to that reduction. This policy requires that by the end of 2013, the health service achieves a workforce of 98,955 whole time equivalents (WTEs). This is a very challenging target given the level of staff reductions that have been achieved in recent years.
In order to mitigate the impact on front-line services of the reduction in employment numbers, the priority is to reform how health services are delivered in order to ensure a more productive and cost effective health system. Therefore, the HSE is 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.
Staff reductions will be pursued throughout 2013 through natural turnover (retirements and resignations) and such other targeted measures or initiatives as may be determined by Government in relation to the health sector or the wider public service.
The HSE National Service Plan provides for investment of an additional 1,025 WTEs in a number of key prioritised areas, as well as the completion of the 2012 mental health investment programme (400+) posts. Also, a graduate nurse employment programme will be implemented, involving the recruitment of up to 1,000 nurses on two-year contracts. This will provide additional nursing capacity at service level.
In relation to the specific queries raised by the Deputy, as these are service issues they have been referred to the HSE for direct reply.
32. Deputy Richard Boyd Barrett asked the Minister for Health if, in view of changes to ambulance services across the country over the last two years, he will confirm that the response time target of 19 minutes for ECHO and DELTA calls is being reached; if not, the effect this is likely to have on health and safety issues; and if he will make a statement on the matter. [7436/13]
Amharc ar fhreagraThe National Ambulance Service is not a static service. The NAS deploys its emergency 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 within a region is mobilised to the incident.
For dynamic deployment of emergency resources within a region to be effective, those resources must be available to be used as efficiently as possible. Following a referral to the Labour Court under the Public Service Agreement, the NAS is progressing a number of efficiencies arising from the Court's ruling, including more efficient rostering and the removal of overtime built in to rosters. New rosters are now in place and are operating successfully. The Health Information and Quality Authority (HIQA) has developed key performance indicators (KPIs) for pre-hospital emergency care, which classify 999 emergency calls by clinical status. Clinical Status 1 Echo calls involve life-threatening emergencies of cardiac or respiratory origin, while Clinical Status 1 Delta calls involve life-threatening emergencies other than cardiac or respiratory. The target times for responding to Echo and Delta calls are 7 minutes 59 seconds by a first responder (a person trained in minimum basic life support and use of a defibrillator) and 18 minutes 59 seconds for a patient-carrying vehicle. With effect from January 2012, HIQA set the target for first responders to meet the response time (7 minutes 59 seconds) in 75% of cases. From January 2013 the target for patient-carrying vehicles is to meet the Clinical Status 1 ECHO incidents response time (18 minutes 59 seconds) in 85% of cases.
The NAS has been taking a number of steps to improve emergency responses. These include development of a Performance Improvement Action Plan, an intermediate care service for non-emergency patient transfers, to release emergency resources for emergency use, the national control centre reconfiguration project and a trial emergency aeromedical service.
In light of the above, and following a review of the validity of time-based KPIs, it is considered, in line with international views, that clinical outcomes would be more appropriate as performance indicators. Accordingly, work has begun on their development. I also welcome the fact that use of clinical indicators will enable a focus on Clinical Status 1 (Echo and Delta) calls.
In relation to the specific queries raised by the Deputy, as these are service matters, they have been referred to the HSE for direct reply.
33. Deputy Mary Lou McDonald asked the Minister for Health when the full and completed Walsh report into the practice of symphysiotomy will be published; and if he will make a statement on the matter. [7453/13]
Amharc ar fhreagraAs the Deputy is aware, my Department has commissioned an independent research report in relation to the practice of symphysiotomy in Ireland. The Research included a consultation process involving patient groups, health professionals and in particular the women who have experienced symphysiotomy. The researcher is currently finalising the report based on the consultation and it is also planned to have a peer review process. It is hoped that the report will be published early in 2013.
My first priority is to ensure that the women who have had this procedure have their health needs comprehensively and professionally met. In this regard, the HSE provides a range of services to women who continue to suffer the effects of having had this procedure. These services include the provision of medical cards, the availability of independent clinical advice and the organisation of individual pathways of care and the arrangement of appropriate follow-up.
34. Deputy Micheál Martin asked the Minister for Health the action he is taking to reduce outpatient waiting lists; and if he will make a statement on the matter. [7516/13]
Amharc ar fhreagra67. Deputy Anthony Lawlor asked the Minister for Health the actions taken to reduce the waiting times for adults awaiting inpatient and day case surgery; the impact of these measures; and if he will make a statement on the matter. [7543/13]
Amharc ar fhreagra110. Deputy Tom Hayes asked the Minister for Health the actions taken to reduce the waiting times for adults awaiting inpatient and day case surgery; the impact of these measures; and if he will make a statement on the matter. [7542/13]
Amharc ar fhreagraI propose to take Questions Nos. 34, 67 and 110 together.
In July 2011, I announced the establishment of the Special Delivery Unit as a key part of my plans to radically reform the health system in Ireland. The Unit’s purpose is to improve access to the emergency and elective care system. Since it was established last year, it has been working to unblock public access to acute services by improving patient journeys through the system and by streamlining public hospital waiting lists. I am pleased to be able to say that very significant progress has been made by the SDU in relation to scheduled care waiting times. The initial focus for the Special Delivery Unit's Scheduled Care Team has been on waiting times for in-patient and daycase elective surgery.
The HSE Service Plan 2012 set a target that no adult should have to wait longer than nine months for in-patient or daycase surgery. By the end of December 2012, the number of adults having to wait more than 9 months for in-patient and day case surgery was down to 86 from 3,706 in December 2011, a 98% decrease.
This is a significant achievement which shows what can be done to tackle access to in-patient and daycase services. The progress made in 2012 does not mean all problems are solved, and 2013 will remain very challenging against a target waiting time for this year of eight months. However, the improvement reflects my commitment, and that of this Government, to ensuring patients can access the acute hospital services they need, when they need them.
Access to outpatient waiting times is also a key priority and a maximum waiting time target has now been set that no-one should be waiting longer than 12 months for a first-time outpatient appointment. The setting of this target has been made possible by the considerable work done by the HSE and the National Treatment Purchase Fund (NTPF) working in conjunction with the SDU. For the first time, clear and comprehensive data on outpatient waiting times is available (www.ptr.ie). The collation and analysis of outpatient waiting time data in a standardised format reveals the distribution of long waiters across all hospitals. In the first instance, this allows resources to be targeted towards those patients who are waiting longest, to ensure that they are seen and assessed. In parallel with reducing the numbers of longest waiters, the SDU will this year work with the HSE National Clinical Care Programmes to reform the structure, organisation and delivery of outpatient services to ensure that the right patient is seen and assessed by the right health professional at the right time.
36. Deputy Mick Wallace asked the Minister for Health if he will provide an update on his plans to implement the judgement of the European Court of Human Rights in A, B and C v Ireland case by way of legislation with regulations, within the parameters of Article 40.3.3 of the Constitution as interpreted by the Supreme Court in the X case; if he will comment on media reports that he plans to have the threat to the life of a woman where these is a risk of suicide examined by up to five doctors when deciding whether abortion should be allowed; and if he will make a statement on the matter. [7539/13]
Amharc ar fhreagraAs the Deputy is aware, last December the Government approved the implementation of the judgment of the European Court of Human Rights in the A, B and C v Ireland case by way of legislation with regulations, within the parameters of Article 40.3.3 of the Constitution as interpreted by the Supreme Court in the X case. They also agreed to make appropriate amendments to the criminal law in this area.
Since then, the Joint Oireachtas Committee on Health and Children held three days of oral hearings on the issue, from 8th to 10th of January this year. Officials from my Department attended to provide background, and the Committee heard contributions from a range of interested groups in public session, including experienced medical practitioners, legal experts, representative of churches and religious groups, and advocacy groups. On the 31st of January, the Committee furnished a report to the Government summarising the contributions received during the consultative process. This report is being used by my officials in examining the issues involved and in formulating a legislative response that will stand up to public and parliamentary scrutiny. The Government has committed to engage further with the Oireachtas Committee when Heads of a Bill have been developed.
I do not propose to comment on media reports concerning the content of the draft legislation at this time. Intensive work is currently underway in my Department on drafting this legislation and it is the Government’s intention that the Heads of a Bill will be published in the next few months.
37. Deputy Éamon Ó Cuív asked the Minister for Health the way he plans to increase the number of general practitioners here; and if he will make a statement on the matter. [7497/13]
Amharc ar fhreagraSeparate reports in 2009 by FÁS, ESRI and the Competition Authority and in 2010 by the Joint Oireachtas Committee on Health and Children referred to the General Practitioner (GP) manpower issue and stated that 120 training places per year were not sufficient to meet the demands of a growing and ageing population. They recommended that the number of GP training places be increased to 150. In July 2010, the GP trainee intake increased from 120 to 157 training places per year. The Department commissioned research in 2011 to develop a model of demand for and supply of GP and practice nurse services. The outcome is a functional and adaptable Excel spreadsheet model which can be used in assessing future GP manpower needs.
The Health (Provision of General Practitioner Services) Act 2012 came into effect on 12 March 2012. This legislation eliminates restrictions on fully qualified and trained GPs wishing to obtain contracts to treat public patients under the GMS contract. It will encourage more young GPs to remain in Ireland and to establish their practice here and will make it more attractive for GPs to move here from overseas. As of 31st November 2012, a total of 97 GPs had obtained a GMS contract since the new legislation came into effect and a further 33 applications are being processed/awaiting Garda clearance, etc. On 31st December 2012, there were over 2,800 GPs, 2,368 of whom are GMS contract holders.
38. Deputy Michael McGrath asked the Minister for Health the key measures he is taking to tackle suicide; and if he will make a statement on the matter. [7494/13]
Amharc ar fhreagraSuicide is a tragedy that we are constantly working to prevent and also working to give more support to the families affected. Dealing with the current high levels of suicide and deliberate self harm is a priority for this Government. Reach Out our National Strategy for Action on Suicide Prevention makes a number of recommendations in relation to fast track referrals to community-based mental health services, effective response to deliberate self harm, training, stigma reduction, etc. Consequently, the HSE's National Office for Suicide Prevention (NOSP) has developed a range of initiatives to support people who are suicidal and also supports their families, friends and peers in recognising and responding appropriately to signs of emotional distress and suicidal thoughts.
Key initiatives progressed by the NOSP in 2012 include the provision of a wide range of awareness and training programmes including safeTALK and ASIST (Applied Suicide Intervention Training) which trains participants to become more alert to the possibility of suicide in their community, the continuation of the National Awareness Campaigns which, last year, specifically targeted men and young men, the funding of partner agencies and projects and the development of the recently launched Guidance for Post-Primary Schools on Mental Health & Suicide Prevention developed with the Department of Education and Skills.
The annual budget for suicide prevention increased this year to over €13m, with €8.1m available to NOSP to fund voluntary and statutory agencies delivering services in the area of prevention, intervention, postvention and research and the remaining €5m available regionally to fund Resource Officers for Suicide Prevention, Self-Harm Liaison Nurses in Hospital Emergency Departments and local suicide prevention initiatives.
The NOSP is currently working to integrate current programmes within the sector and to provide a strategic framework for the coordination of the extensive range of actions in this area. Priority initiatives identified for this year include:
- The further development of existing National Mental Health Awareness campaigns to promote help seeking.
- Increased training for GPs and practice staff.
- Building the capacity of communities to respond to suicide.
- Implementation of the clinical care programme for self harm. This will include the funding of nursing posts within Hospital Emergency Departments, training of acute hospital staff on suicide and self harm intervention and the development of the SCAN (Suicide Crisis Assessment Nurse) model which allows for crisis interventions at primary care.
- Investment in voluntary agencies providing front-line services.
43. Deputy Dessie Ellis asked the Minister for Health the reason the new epilepsy monitoring unit at Cork University Hospital and the redevelopment unit at Beaumont Hospital, Dublin, remain unopened, in view of the completion of the units in the autumn of 2012 at an estimated spend of €900,000; if he will address this situation in the interest of epilepsy patients here; the timeframe for the opening of these facilities; and if he will make a statement on the matter. [7452/13]
Amharc ar fhreagraCork and Beaumont are two of six regional centres which have been identified by the HSE's Clinical Care Programme for Epilepsy for the provision of specialist epilepsy services. Developments so far under the Programme include the opening of Rapid Access Clinics at four of these centre, including Beaumont, St James’s, Galway and Limerick. The Rapid Access clinics are led by Advanced Nurse Practitioners (ANPs). Under the Programme, 10.5 (WTE) Advanced Nurse Practitioners (ANPs) have been recruited to lead these clinics so that a total of 12 ANPs are now in place across the four centres, delivering services on site and on an outreach basis.
The two Epilepsy Monitoring Units (EMUs) planned for Cork and Beaumont under the Programme will increase pre-surgical evaluation capacity. Monitoring is required for those patients with the worst effects of epilepsy, and patients at these units will require 24/7 care.
The staffing requirements to enable the units to be safely opened have been identified. In regard to the planned EMU at Beaumont, I am advised that Beaumont Hospital and the HSE are working jointly to fill the posts necessary to support the service development. The recruitment of the necessary nursing personnel is a key element to facilitate phased opening of the unit, commencing Quarter 1, as nursing staff come into post. With regard to Cork, the HSE has advised that the Service Plan for 2013 for CUH is being drawn up currently and will be finalised in the coming weeks, and that the provision of additional staff for the Epilepsy Monitoring Unit is being considered as part of that process.
