Robert Troy
Ceist:62. Deputy Robert Troy asked the Minister for Health if he will provide an update on the situation with regard to the new children’s hospital; and if he will make a statement on the matter. [7511/13]
Amharc ar fhreagraNational Children's Hospital Status
Ceisteanna (62, 68, 71)
Willie O'Dea
Ceist:68. Deputy Willie O'Dea asked the Minister for Health the progress that has been made in the construction of the new children’s hospital; and if he will make a statement on the matter. [7513/13]
Amharc ar fhreagra
Micheál Martin
Ceist:71. Deputy Micheál Martin asked the Minister for Health who will take the lead responsibility for the building of the new children's hospital, Dublin; and if he will make a statement on the matter. [7506/13]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 62, 68 and 71 together.
The decision to locate the new children's hospital on the St James's campus was announced on 6 November 2012. Co-location, and ultimately tri-location with a maternity hospital, on the St James's campus will support the provision of excellence in clinical care that our children deserve.
The new children’s hospital is a key commitment in the Programme for Government and the largest project within the current Capital Plan. This Government regards the building of the hospital as a priority and no effort will be spared in expediting its completion.
Following the announcement of the Government's decision, detailed consideration has been given to the project management structures and governance arrangements required to enable delivery of the project as quickly as possible and to the highest quality. In this regard I intend to restructure the National Paediatric Hospital Development Board and to establish a Children's Hospital Group which will include the three existing paediatric hospitals. The restructured National Paediatric Hospital Development Board will focus on the capital project only. The membership of the restructured Board will align with this core function and include the necessary capital development expertise.
The required legislation will, inevitably, take some time and as the terms of office of the majority of Board members expired on 5 December, I have appointed senior representatives from my Department and the HSE as an interim measure aimed at ensuring effective governance and decision-making for the project during this transitional phase.
At this important initial stage it is crucial that the project continues without delay and, in parallel with consideration of governance arrangements, work has also been progressing in relation to the site and site preparation, while a review of urgent care centre(s) configuration is underway and a time-limited review of Dublin maternity services configuration is due to commence shortly.
This Government’s priority is to ensure that the project proceeds securely to completion as quickly as possible and with optimal results. I am confident that the project management and governance structures now being put in place will enable the fastest possible delivery of this key infrastructure for children’s hospital services.
Universal Health Insurance White Paper
Ceisteanna (63)
Dara Calleary
Ceist:63. Deputy Dara Calleary asked the Minister for Health when the White Paper on Financing UHI will be published; and if he will make a statement on the matter. [7486/13]
Amharc ar fhreagraFreagraí scríofa
The Government is embarking on a major reform programme for the health system, the aim of which is to deliver a single tier health service, supported by universal health insurance (HUI), where access is based on need, not on income. Under UHI, everyone will be insured and will have equal access to a standard package of primary and acute hospital services, including acute mental health services. A new Insurance Fund will subsidise or pay insurance premiums for those who qualify for a subsidy.
The Department is preparing a White Paper on Universal Health Insurance which will provide further detail on the UHI model for Ireland in addition to the estimated costs and financing mechanisms associated with the introduction of universal health insurance. The work involved is both complex and technical, necessitating significant research and financial modelling to support analysis and costing of different design options. This, in turn, demands a wide-range of specialised expertise. The Department is engaged in a process to ensure the provision of this expertise to feed into work on the preparation of the White Paper during 2013. The White Paper will be published as early as possible within the Government’s term of office.
In advance of the White Paper, my Department has produced a Preliminary Paper on UHI, which I intend to publish very shortly.
Hospital Services
Ceisteanna (64)
Denis Naughten
Ceist:64. Deputy Denis Naughten asked the Minister for Health his plans if any to review the provision of non-planned services at Roscommon County Hospital; the proposed development in such services; and if he will make a statement on the matter. [7434/13]
Amharc ar fhreagraFreagraí scríofa
As part of reconfiguration services in Roscommon County Hospital in line with HIQA recommendations by a pass protocol, diverting ambulances to level 3 and 4 hospitals for life-threatening cardiac, respiratory and other serious conditions was put in place before the Emergency Department was closed in 2011. This is in line with national clinical care protocols for best practice and safe management of the patient with a heart attack or stroke. These protocols require such patients to be treated in a level 3 or 4 hospital as a level 2 hospital does not have a Critical Care Unit. Stabilisation of such patients is a key function of pre-hospital emergency care and is carried out by paramedics who assess, treat and stabilise patents prior to transporting them to an appropriate facility for care.
Accident victims should only be managed in a hospital with a full ED department with the necessary available acute care back-up including ICU. The essence is that patients should go to the hospital that is best able to treat them – this is particularly important for heart attack and stroke victims whose survival rate and long term prognosis is dependent on how quickly they reach an appropriate hospital.
Roscommon County Hospital is leading the way by demonstrating the range of services that can be developed in a smaller hospital. In July 2011, Roscommon County Hospital commenced a process of reconfiguring services in line with HIQA recommendations. It now has a Medical Assessment Unit that is open 9-5pm Monday to Friday for the assessment of medical patients who are referred by GPs, after initial phone triage with one of the medical consultants to ensure that the MAU is the appropriate care pathway for that patient. In addition, it has an Urgent Care Centre (UCC) open 8am-8pm, 7 days a week, which deals with minor injuries/trauma.
Developments in 2012 include: Plastic and Reconstructive Surgery, Sleep Studies, Urology Services, Radiology Upgrade, a newly developed Endoscopy Suite, Dental Service, Nurse Prescribing and re-accreditation for student nurse training.
Roscommon played a key role in Galway/Roscommon Hospital Group, with more than 520 endoscopy procedures transferred from Galway to Roscommon. Future plans for Roscommon hospital see increases in elective inpatient care, in particular in endoscopy – plans for which are well advanced with design agreed, site identified, tender documents complete, funding secured and awaiting planning permission. Roscommon is an excellent example of delivering appropriate care in the appropriate setting to maximise patient safety and resources. With regard to the Deputies specific query on reviewing the provision of "non-planned" services at Roscommon County Hospital, as this is a service matter, it has been referred to the Health Service Executive for direct reply.
Health Services
Ceisteanna (65)
Maureen O'Sullivan
Ceist:65. Deputy Maureen O'Sullivan asked the Minister for Health if he recognises the condition, X microvascular dysfunction, as a cardiac syndrome; if his attention has been drawn to the fact that in the US they have developed a new machine to diagnose the condition more effectively; the reason that some people with this debilitating condition cannot receive a statement from their cardiologists that they are unfit for work which affects their social welfare entitlements; if his Department will formulate public awareness programmes to raise awareness of this condition here; and if he will make a statement on the matter. [7633/13]
Amharc ar fhreagraFreagraí scríofa
Microvascular dysfunction is sometimes referred to as microvascular angina or cardiac syndrome X is recognised as a cardiac syndrome. This rare syndrome is difficult to diagnose and is a diagnosis of exclusion, meaning that diagnosis is reached by a process of elimination. The tests for the syndrome are the same tests carried out for coronary heart disease. Outside of research procedures, I am not aware of a new machine that is in use for treatment of the syndrome. As the carrying out of Public Awareness Campaigns is the responsibility of the HSE, I will bring this matter to their attention.
I cannot comment here on clinical related decisions by medical consultants concerned with specific cases.
Question No. 66 answered with Question No. 26.
Question No. 67 answered with Question No. 34.
Question No. 68 answered with Question No. 62.
Medical Card Eligibility
Ceisteanna (69)
Caoimhghín Ó Caoláin
Ceist:69. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will detail his proposed changes to medical card entitlements and income criteria as outlined in the Health Service Executive National Service Plan 2013; and if he will make a statement on the matter. [7446/13]
Amharc ar fhreagraFreagraí scríofa
As part of Budget 2013, it was announced that the income thresholds for medical cards for the over 70s age group are to be changed. The intention is that persons aged 70 years and over, whose gross weekly income is not more than €600 in the case of single persons and €1,200 in the case of couples, will qualify for full eligibility (medical cards); persons aged 70 years and over, whose gross weekly income is more than €600 but less than €700 in the case of single persons and more than €1,200 but less than €1,400 in the case of couples, will qualify for GP Visit Cards.
People who do not qualify for a medical card are entitled to make use of the Drugs Payment Scheme (DPS) which reimburses the cost of medication that exceeds a monthly threshold. The new rules will not take effect until later in 2013, after primary legislation has been enacted. The implementation date will be announced and publicised in advance by the Department and the HSE.
It was also announced that, in relation to eligibility for the standard medical card, the rules relating to a person’s spending that are taken into account when carrying out the means test will be tightened. The Department will first examine this proposal in more detail in consultation with the HSE. Again, the new rules and the implementation date will be announced and publicised in advance by the Department and the HSE.
Question No. 70 answered with Question No. 26.
Question No. 71 answered with Question No. 62.
Question No. 72 answered with Question No. 9.
Care of the Elderly Funding
Ceisteanna (73)
Niall Collins
Ceist:73. Deputy Niall Collins asked the Minister for Health the extent to which elder abuse is going unreported; and if he will make a statement on the matter. [7487/13]
Amharc ar fhreagraFreagraí scríofa
In 2010, the National Centre for the Protection of Older People, which is funded by the Health Service Executive, published its Report on Abuse and Neglect of Older People in Ireland. The Report found a significantly greater prevalence of elder abuse than is being reported. The under-reporting of elder abuse is a widely recognised issue internationally.
The HSE provides a comprehensive Elder Abuse Service aimed at tackling and preventing elder abuse. The Service is comprised of dedicated Senior Case Workers for the Protection of Older People (social workers), Dedicated Officers for the Protection of Older People, (regional coordinators), unified data collection, national and regional oversight committees, a national research facility, awareness raising and training programmes. Because of the nature of referrals to this service, all cases are prioritised and responded to as a matter of urgency upon receipt of referral. I urge anybody with concerns about elder abuse to contact the HSE.
Obesity Levels
Ceisteanna (74)
Mick Wallace
Ceist:74. Deputy Mick Wallace asked the Minister for Health his views on the need to introduce a sugar tax on soft drinks or a so called fat tax in order to combat obesity here; and if he will make a statement on the matter. [7540/13]
Amharc ar fhreagraFreagraí scríofa
The prevalence of overweight and obesity has risen steadily in recent times, with 61% of Irish adults now overweight or obese. The problem has been exacerbated as a result of our changing social, economic and physical environment and by a dramatic reduction in physical activity, and changing dietary patterns. Alone, no single initiative will reverse the trend, but it is hoped that a combination of actions against obesity will help. As Minister for Health, I have made overweight and obesity a public health priority and have established a Special Action Group on Obesity (SAGO) with whom I meet regularly to progress the obesity agenda.
The Special Action Group on Obesity is concentrating on a range of measures including actions such as calorie posting in restaurants; as a means of educating the general public on the calorie content of food portions; revision of this Department's Healthy Eating Guidelines, including the Food Pyramid, which were launched last year to help inform people about the food and drink choices required for a healthy lifestyle and set out in plain and simple language the food servings the Irish population need to consume to maintain health and well-being. Work is also being progressed in such areas as treatment algorithms which have been agreed and will inform primary care staff of the steps to be taken with regard to managing obesity. The Special Action Group on Obesity has been considering opportunistic screening and monitoring with the HSE with a view to earlier detection of overweight and obesity in children. Research is underway in association with the Department of Children and Youth Affairs to establish the use and types of foods and drinks stocked in vending machines in post primary schools. The HSE has also developed a Physical Activity Plan for Ireland to give clear direction for the promotion of physical activity in Ireland and address the risk of developing health problems associated with sustained inactivity.
A sugar sweetened drinks levy is just one of a range of actions that have been under consideration. A Steering Group was established to oversee the carrying out of a Health Impact Assessment on the health and economic aspects of introducing a Sugar Sweetened Drinks tax. The Institute of Public Health facilitated the Department of Health with this assessment. I intend to publish this assessment in the near future.
The Special Action Group on Obesity is now looking at ways of reducing food consumption from the top shelf of the food pyramid, in accordance with this Department's Healthy Eating Guidelines.
Question No. 75 answered with Question No. 26.
Question No. 76 answered with Question No. 16.
Question No. 77 answered with Question No. 26.
Health Services Staff Remuneration
Ceisteanna (78)
Robert Dowds
Ceist:78. Deputy Robert Dowds asked the Minister for Health if he will explain the way he is addressing the issue of the continuing non-payment of a training allowance for full-time clinical placement to student medical scientists registered with Dublin Institute of Technology; and when students may expect to be paid this allowance. [7435/13]
Amharc ar fhreagraFreagraí scríofa
The HSE has in the past confirmed to all health sector employers that Student Medical Scientists on placement must be paid the monthly training allowance as set out in my Department's consolidated salary scales.
This allowance was approved for continued award to new beneficiaries, following the review of public sector allowances conducted in 2012. The HSE has recently reiterated in clear terms to hospitals that this allowance should be paid to all Student Medical Scientists on work placement. I have asked the HSE to seek confirmation from the hospitals concerned that the necessary amounts are being paid.
Hospital Consultants Remuneration
Ceisteanna (79)
John McGuinness
Ceist:79. Deputy John McGuinness asked the Minister for Health the savings that could be made if consultants’ pay was reduced to the EU average; and if he will make a statement on the matter. [7510/13]
Amharc ar fhreagraFreagraí scríofa
It is not possible to calculate a precise figure in this regard, given the range of variables that would have to be taken into account. The average salary for a consultant working in the public health service was approximately €170,000 in 2012. Including allowances, the average salary was about €185,000.
My immediate priority is to achieve more effective implementation of the existing consultants contract and to reform how services are delivered to patients. The terms of the agreement reached with the consultant representative bodies at the Labour Relations Commission in September 2012 provide for significant changes in working practices and more cost-effective delivery of services. A number of further matters were addressed by the Labour Court in LCR 20403 of 6 November 2012. Health service management is proceeding with implementation of the changes arising from the industrial relations process.