Written Answers Nos. 86-108
86. Deputy John Browne asked the Minister for Health if he will confirm whether it was planned to remove more than €7 million in funding (details supplied) from the National Cancer Control Programme earlier this year and re-direct it to hospitals; and if he will make a statement on the matter. [22585/13]
Amharc ar fhreagraThe HSE Service Plan as approved by the Minister for Health on 9 January 2013 details the funding available for all services including hospitals. A core element of the Service Plan was ensuring that hospitals were provided with a 2013 budget which was, in so far as possible, linked to their 2012 costs in order to provide a more achievable financial challenge. There was insufficient funding available to fully meet hospitals' 2012 cost level and therefore hospitals on average must reduce their costs in 2013 by 3.5% and must also deal with any emerging cost pressures which are not specifically funded within the 2013 Service Plan.
As part of the allocation process outlined above, funds that were in place in hospitals for 2012 were retained in their base funding in 2013. The Cancer Programme is substantially delivered through hospitals. The bulk of the monies referred to in the question relate to colposcopy and colonoscopy screening monies in respect of work carried out by hospitals on behalf of the National Cancer Screening Service which is part of the National Cancer Control Programme.
Issues arising in relation to the change in the funding of hospitals in 2013 and the move away from historic incremental budgets to budgets more closely aligned to actual costs have now been clarified and the resources to deliver upon the funded cancer priorities identified within the Service Plan are in place.
The National Cancer Control Programme is satisfied that resources required to support cancer screening and treatment programmes have been clearly aligned to NCCP priorities.
87. Deputy Micheál Martin asked the Minister for Health the measures he is putting in place to reduce the numbers on out-patient waiting lists; and if he will make a statement on the matter. [22601/13]
Amharc ar fhreagraIn 2012 the National Treatment Purchase Fund (NTPF) initiated a national project to compile, for the first time, an Outpatient Waiting List database based on patient-level information from individual hospitals. Collaborating with individual hospitals, the SDU together with the NTPF and the HSE have developed the OP waiting list minimum dataset that allows for this data to be submitted to the NTPF from hospitals on a weekly basis. This builds on the work previously undertaken by the HSE Outpatient Data Quality Programme.
Clear data on the OPD waiting list is now being reported for the first time, and is published on www.ntpf.ie. The waiting list for outpatients is updated monthly. The data show numbers waiting over the various time-bands for a first appointment at a consultant-led clinic. In a further enhancement of the reporting, future updates will for the first time include numbers reported by specialty in addition to the breakdown by hospital. The total number of people waiting on the out-patient waiting list as at 3 May 2013 is 376,751. This is a reduction of 7,881 in comparison with the NTPF published figures to March 2013. The data also shows that of the total number of people waiting, 199,513 (52.6%) are waiting less than 6 months and almost 278,666 (74%) are waiting less than 12 months.
For 2013, a maximum waiting time target has been set of 12 months for a first time consultant-led outpatient appointment and this is reflected in the HSE Service Plan. The SDU/NTPF will work closely with hospitals towards achievement of the maximum waiting time.
Currently, the focus is on hospitals continuing the validation of waiting lists. All hospitals have been engaged in this process which is anticipated to be complete by mid-May 2013.
Reforming the delivery of outpatient services is being addressed through the Outpatient (OP) Service Performance Improvement Programme. This Programme encompasses the HSE, SDU, the NTPF and all hospitals providing outpatient services. It is a national programme being implemented between 2012 and 2015. The overall aim of the programme is to ensure timely, appropriate access to OP services so that the most appropriate member of the clinical team sees the right patient at the right time. Key elements of this large programme of reform will include on-going validation of waiting lists, the systematic and standardised management of referrals from primary care, a reduction in unacceptably high “do not attend” rates and appropriate discharging from OP services when clinically appropriate to do so.
88. Deputy Richard Boyd Barrett asked the Minister for Health if he will outline in detail the plan for health services in South County Dublin with regards to the new configuration of services at Loughlinstown, St Michael's and St Vincent's Hospitals; and if he will make a statement on the matter. [22625/13]
Amharc ar fhreagraSt. Columcille’s Hospital Loughlinstown provides joint acute hospital services with St. Vincent’s and St Michael’s, Dun Laoghaire. Together, they provide a range of services for the catchment of Dublin South-East and Wicklow, across three sites in a collaborative arrangement. The establishment of hospital groups will ensure that these hospitals have a central role in the future delivery of good quality care for patients.
Securing the Future of Smaller Hospitals: A Framework for Development offers clear information about the role of our smaller hospitals and what they will do in the future. While the Framework focusses in particular on the role of nine smaller hospitals, including St. Columcille’s, which have been the subject of particular attention from the Health Information and Quality Authority, the principles behind it will apply to all smaller hospitals. In developing the Framework, the Government is clear that (i) there is an important future role for smaller hospitals, in which they will provide services for more patients, not fewer; (ii) no acute hospital will close, and (iii) safety issues in all acute hospitals, large or small, must be fully addressed, by providing the right type of service, for the right patient in the right setting. This framework will demonstrate clearly that the future of smaller hospitals is secure. It outlines the need for smaller hospitals and larger hospitals to operate together and therefore is intrinsically linked to the on-going work regarding the development of hospital groups.
We know that the traditional practice of providing as many services as possible in every hospital is neither sustainable nor safe. Professor John Higgins chaired a strategic board on the establishment of hospital groups and I have received his report, which is based on a comprehensive consultation process and contains almost 60 recommendations on the formation, management and governance of hospital groups, all of which are strongly endorsed by the Strategic Board. The formation of Irish acute hospitals into a small number of groups, each with its own governance and management, will provide opportunity for hospital services to be configured to deliver high-quality, safe patient care in a cost-effective manner.
I appreciate that both of the reports and the related government decision are anxiously awaited. However, this is the most radical and most fundamental modernisation of our acute health system infrastructure since the State’s foundation and I took very seriously my obligation to consider the reports closely, to assure myself and my Cabinet colleagues that they provide a robust basis to enable timely access to a high quality and sustainable hospital service for those who need it.
The Deputy will be pleased to learn that I submitted the reports to Government this morning for its consideration and decision and the reports have been accepted. Officials in my department are now in the process of making suitable arrangements for the publication of these reports as soon as possible.
89. Deputy Joan Collins asked the Minister for Health if he will ensure that the drug Pirfenidone will be made available for patients with Idiopathic Pulmonary Fibrosis despite the cost of this drug; and if he will make a statement on the matter. [22622/13]
Amharc ar fhreagra134. Deputy Catherine Murphy asked the Minister for Health if he will outline the manner in which the National Centre for Pharmacoeconomics decides on the merits of making new drugs available for public patients in the State; if there are specific guidelines in place to ensure that public health concerns are taken fully into account and the decision is not purely an economic one; if he has any direct input into any stage of the decision making process; and if he will make a statement on the matter. [22458/13]
Amharc ar fhreagra606. Deputy Michelle Mulherin asked the Minister for Health if he will reverse the decision on funding for pirfenidone, the only drug to date to be effective in the treatment of idiopathic pulmonary fibrosis; and if he will make a statement on the matter. [22307/13]
Amharc ar fhreagra640. Deputy Catherine Murphy asked the Minister for Health if, in view of the decision taken by the National Centre for Pharmacoeconomics not to fund Pirfenidone for patients with Idiopathic Pulmonary Fibrosis based on economic grounds, he will consider overturning that decision in view of the fact that the drug has significant benefits and its absence results in significant suffering for patients with the condition; and if he will make a statement on the matter. [22475/13]
Amharc ar fhreagra659. Deputy Pearse Doherty asked the Minister for Health if he will consider including Pirfenidone on the drug payment scheme for sufferers of lung fibrosis; if he will confirm that is the only drug available to treat patients with idiopathic lung fibrosis; and when the Health Service Executive will conclude its negotiations with the manufacturer [22656/13]
Amharc ar fhreagra660. Deputy Michael McNamara asked the Minister for Health if he will reconsider his decision on the drug Pirfenidone a new drug for the treatment of lung fibrosis; and if he will make a statement on the matter. [22657/13]
Amharc ar fhreagra664. Deputy Gerry Adams asked the Minister for Health if his attention has been drawn to the benefits of the drug Pirfenidone; the reason the NCPE has announced that pirfenidone will not be made available for patients with IPF based on economic grounds; and if he will make a statement on the matter. [22727/13]
Amharc ar fhreagra670. Deputy Aengus Ó Snodaigh asked the Minister for Health if he will provide details of the recent pharmacoeconomics evaluation of Pirfenidone conducted by the National Centre for Pharmacoeconomics; and if he will make a statement on the matter. [22754/13]
Amharc ar fhreagra671. Deputy Aengus Ó Snodaigh asked the Minister for Health the annual cost of treating a patient with Pirfenidone when they are suffering with idiopathic pulmonary fibrosis; the number of persons who suffer from this condition within this jurisdiction; the method by which the National Centre for Pharmacoeconomics assess if a treatment is cost effective; and if he will make a statement on the matter. [22755/13]
Amharc ar fhreagra672. Deputy Aengus Ó Snodaigh asked the Minister for Health if he will provide an update in the Health Service Executive negotiations with the manufacturers of Pirfenidione, Esbriet; and the date on which these negotiations will conclude [22756/13]
Amharc ar fhreagraI propose to take Questions Nos. 89, 134, 606, 640, 659, 660, 664 and 670 to 673, inclusive, together.
The HSE has received an application for the inclusion of pirfenidone in the GMS and community drugs schemes.
The application is being considered in line with the procedures and timescales agreed last year by the Department of Health and the HSE with the Irish Pharmaceutical Healthcare Association (IPHA) for the assessment of new medicines.
In accordance with these procedures, the National Centre for Pharmacoeconomics (NCPE) conducted a pharmacoeconomic evaluation of pirfenidone and concluded that, at the submitted price, pirfenidone is not cost-effective for the treatment of patients with mild to moderate idiopathic pulmonary fibrosis. The report is available on the NCPE's website (www.ncpe.ie).
The NCPE report is an important input to assist decision making and informs further discussions between the HSE and the manufacturer of the drug. The HSE is currently in negotiations with the manufacturers of pirfenidone and therefore it would not be appropriate to comment further while these negotiations are ongoing.
The HSE assessment process is intended to arrive at a decision on the funding of pirfenidone that is clinically appropriate, fair, consistent and sustainable. The HSE understands that patients and clinicians are very anxious that a decision be made as soon as possible.
The following information was provided under Standing Order 40A
In reply to Question No. 671, specifically "the number of persons who suffer from this condition within this jurisdiction", it is not known how many patients suffer from idiopathic pulmonary fibrosis in Ireland.
The Orphanet report in 2011 estimated the prevalence of idiopathic pulmonary fibrosis in Europe to be 1.67/10,000 which, if applied to the Irish population, would mean that there are approximately 766 people with idiopathic pulmonary fibrosis in Ireland.
90. Deputy Brian Stanley asked the Minister for Health when the small hospitals framework report will be published; and if he will make a statement on the matter. [22566/13]
Amharc ar fhreagraSecuring the Future of Smaller Hospitals: A Framework for Development offers clear information about the role of our smaller hospitals and what they will do in the future. While the Framework focusses in particular on the role of nine smaller hospitals, which have been the subject of particular attention from the Health Information and Quality Authority, the principles behind it will apply to all smaller hospitals, regardless of whether or not they are specifically referenced. In developing the Framework, the Government is clear that (i) there is an important future role for smaller hospitals, in which they will provide services for more patients, not fewer; (ii) no acute hospital will close, and (iii) safety issues in all acute hospitals, large or small, must be fully addressed, by providing the right type of service, for the right patient in the right setting. This framework will demonstrate clearly that the future of smaller hospitals is secure. It outlines the need for smaller hospitals and larger hospitals to operate together and therefore is intrinsically linked to the on-going work regarding the development of hospitals groups.
We know that the traditional practice of providing as many services as possible in every hospital is neither sustainable nor safe. The formation of Irish acute hospitals into a small number of groups, each with its own governance and management, will provide an optimum opportunity for hospital services to be configured to deliver high-quality, safe patient care in a cost-effective manner. Professor John Higgins chaired a Strategic Board on the establishment of Hospital Groups and I have received his report, which is based on a comprehensive consultation process and contains almost 60 recommendations on the formation, management and governance of hospital groups, all of which are strongly endorsed by the Strategic Board.
I appreciate that both of the reports and the related government decision were anxiously awaited. However, this is the most radical and most fundamental modernisation of our health system infrastructure since the State’s foundation and I took very seriously my obligation to consider the reports closely, to assure myself and my Cabinet colleagues that they provide a robust basis to enable timely access to a high quality and sustainable hospital service for those who need it.
The Deputy will be pleased to learn that I submitted the reports to Government this morning for its consideration and decision and the reports have been accepted. I will be publishing both the reports as soon as possible.
91. Deputy Martin Ferris asked the Minister for Health if, in relation to occupational therapists appointed in 2012 and 2013 to community mental health teams, he will indicate if these newly appointed staff are receiving supervision from a senior professional from within their discipline who is trained in the area of work being supervised in line with the Health Service Executive's Guidance Framework for Health and Social Care Professionals; and if he will make a statement on the matter. [22572/13]
Amharc ar fhreagraI have been advised by the Health Service Executive that all newly appointed Occupational Therapists to the mental health services are supervised in line with the HSE's guidance framework for Health and Social Care Professionals 2013.
92. Deputy Seán Ó Fearghaíl asked the Minister for Health the measures he will take to reduce the waiting lists for the provision of mental health services for children and adolescents; and if he will make a statement on the matter. [22612/13]
Amharc ar fhreagra99. Deputy Dara Calleary asked the Minister for Health the way he proposes to tackle the long waiting lists in the provision of mental health services for children and adolescents; and if he will make a statement on the matter. [22587/13]
Amharc ar fhreagraI propose to take Questions Nos. 92 and 99 together.
The provision of Mental Health services to children and adolescents is informed by "A Vision for Change", the Report of the Expert Group on mental health policy. This recommends the provision of 80 child and adolescent psychiatric in-patient beds nationally. There are currently 39 such child and adolescent beds nationally, which is planned to increase to 66 beds by the end of this year. The provision of additional bed capacity reflects an almost 50% decrease in admissions of children to adult units since 2008. In the context of on-going developments, planning permission has been granted to construct a 24 bed In-Patient facility at Cherry Orchard, Dublin, which will incorporate some existing beds and increase capacity overall to 76 beds. This project is scheduled to be completed by the end of this year, or early next year, with an expected opening date of 2015.
The basic approach to delivery of mental health services to children and adolescents revolves around Community Mental Health Teams. In this regard, 150 additional posts were allocated to Child and Adolescent Mental Health Teams in 2012, and a further 80 posts have been identified for allocation to this specific service area in 2013, arising from targeted Government investment of €35 million for each of these respective years.
As of 29 April last, 122 of the designated 150 posts for Child and Adolescent Mental Health Services were either filled, under offer, or awaiting appropriate clearance. The National Recruitment Service (NRS) of the HSE creates national panels in anticipation of vacancies. On occasion, however, it is difficult to fill some posts due to various reasons, such as geographical location or shortage of suitable candidates at certain times for some grades such as Clinical Psychologists. However, given the policy and service requirements identified, the NRS is currently working to ensure that remaining posts will be filled as soon as possible, subject to qualified candidates being available.
I wish to re-iterate this Government's strong commitment to enhance this year in practical terms Mental Health services for children and adolescents and I will continue to closely monitor the position over the remainder of 2013.
93. Deputy Bernard J. Durkan asked the Minister for Health the extent to which waiting periods for various procedures have been reduced in respect of all public hospitals without exception; the extent to which the waiting period for patients to meet the consultant has been reduced in line with best practice and in comparison to the private sector; the extent to which studies and comparisons continue with the private sector in this regard; if any particular initiatives are required to address any specifically sensitive areas; and if he will make a statement on the matter. [22501/13]
Amharc ar fhreagraImmediately following my appointment as Minister for Health I established the Special Delivery Unit as set out in the Programme for Government. Its aim is to unblock access to acute services by improving the flow of patients through the system. As set out in Future Health, a key goal is to deliver faster more equitable access to hospital services.
With regard to waiting times for procedures, the target maximum wait times for inpatient and daycase treatment,as set out in the HSE Service Plan 2013, are:
|
Children awaiting an inpatient or daycase procedure |
20 weeks |
|
Routine endoscopy procedure (all) |
13 weeks |
|
Adults awaiting an inpatient or daycase procedure |
8 months |
In July 2011, when the Special Delivery Unit was set up a total of 6,277 patients were waiting more than nine months for inpatient or daycase treatment. By December last year, there were 86 adults waiting over nine months for inpatient or daycase treatment, a 98% decrease on the previous year and 89 children waiting longer than 20 weeks, a decrease of 95% on the previous year. 36 patients were waiting over 13 weeks for routine endoscopy, a 99% decrease on the previous year.
Maintaining the progress made to date and achieving the 2013 targets will be extremely challenging. The achievement to the end of 2012 has been followed, as expected, by bounceback in the figures at the start of 2013. The early months of the year have brought severe pressures on Emergency Departments which impact on waiting times - the extended winter seasonal pressures, older age profile, sicker patients etc. are all having a knock-on effect on scheduled care. However, latest available data shows that as of 2 May 2013, 88% of adults on the list were waiting less than eight months (5,392 waiting longer), 80% of children waiting were waiting less than 20 weeks (716 waiting longer), and 90% of those awaiting a GI endoscopy were waiting less than 13 weeks (917 waiting longer).
With regard to patients waiting to see a consultant, in 2012 the National Treatment Purchase Fund (NTPF) initiated a national project to compile, for the first time, an Outpatient Waiting List database based on patient-level information from individual hospitals. Collaborating with individual hospitals, the SDU together with the NTPF and the HSE have developed the OP waiting list minimum dataset that allows for this data to be submitted to the NTPF from hospitals on a weekly basis. Clear data on the OPD waiting list is now being reported for the first time, and is published on www.ntpf.ie . The waiting list for outpatients is updated monthly. For 2013, a maximum waiting time target has been set of 12 months for a first time consultant-led outpatient appointment and this is reflected in the HSE Service Plan. The total number of people waiting on the out-patient waiting list as at 3 May 2013 is 376,751. This is a reduction of 7,881 in comparison with the NTPF published figures to March 2013. The data also shows that of the total number of people waiting, 199,513 (52.6%) are waiting less than 6 months and 278,666 (almost 74%) are waiting less than 12 months.
All hospitals have been engaged in the process of validating outpatient waiting lists, which is anticipated to be complete by mid-May 2013. Reforming the delivery of outpatient services is being addressed through the Outpatient (OP) Service Performance Improvement Programme. This is a national programme, encompassing the HSE, SDU, the NTPF and all hospitals providing outpatient services, being implemented between 2012 and 2015. The overall aim of the programme is to ensure timely, appropriate access to OP services so that the most appropriate member of the clinical team sees the right patient at the right time. Key elements of this large programme of reform will include on-going validation of waiting lists, the systematic and standardised management of referrals from primary care, a reduction in unacceptably high “do not attend” rates and appropriate discharging from OP services when clinically appropriate to do so.
Neither my Department nor the HSE has a function in relation to the gathering of waiting list data for the private hospital sector. Therefore, a comparison between public and private waiting lists is not available. However, I can assure the Deputy that my Department will continue to focus its resources on reducing waiting lists in line with the Government’s commitment to deliver rapid and equitable access to health services.
94. Deputy Peadar Tóibín asked the Minister for Health the range of mental health services available for adults, adolescents and children across the Dublin/North East Region; if he will outline plans for further developments already signed off on but yet to be introduced; and if he will make a statement on the matter. [22570/13]
Amharc ar fhreagraThe HSE Dublin North East Region (DNE) covers counties Louth, Meath, Cavan, Monaghan and Dublin North City and County. Mental health services are provided directly by the HSE and by voluntary partners in a variety of settings including acute in-patient facilities, day hospitals and day centres, supported community residences and to service users in their own homes.
The total mental health budget available to HSE DNE for 2013 is €146 million. This figure includes €7.274 million from the additional €35 million funding provided for mental health services in 2013. This funding has been approved to implement the following objectives:
|
Objective |
WTE Allocation |
Full Year Cost of allocation |
|
General Adult Community Mental Health Teams |
40 |
€2,393,560 |
|
Clinical Programme addressing self-harm in Hospital Emergency Departments |
9.5 |
€568,471 |
|
Mental Health Services for Older People CMHTs |
20 |
€1,196,780 |
|
Mental Health Intellectual Disability CMHTs |
10 |
€937,500 |
|
Child and Adolescent Mental Health CMHT |
25 |
€1,626,500 |
|
National Counselling Service, Counselling in Primary Care |
0 |
€551,280 |
|
Total |
104.5 |
€7,274,091 |
The HSE has published a Regional Service Plan for DNE for 2013 which sets out the services to be provided in 2013. The priorities identified in the Regional Plan include: the provision of additional resources for developing and strengthening of the General Adult, Child and Adolescent, Mental Health Intellectual Disability and Psychiatry of Old Age Community Mental Health Teams', (CMHTs), capacity; support the implementation of the Clinical Care Programmes; review and reconfigure current supply of 206 acute in-patient beds across DNE to ensure equity of access and provision; open new 44 bedded Psychiatric Unit at Beaumount (38 Acute General Adult +6 Psychiatry of old age); relocate Regional Psychiatric Intensive Care Service from St Brendan’s to new purpose built 54-Bedded facility at Grangegorman (Phoenix Care Centre); the 12 beds in St Joseph’s Adolescent Unit, Fairview, Dublin, to become fully operational; and progress the closure of old psychiatric hospitals in the area. Details of these and other regional priorities can be found in the HSE Dublin North East Regional Service Plan 2013 at ww.hse.ie/eng/services/Publications/corporate/DNEServicePlan2013.pdf.
95. Deputy Derek Keating asked the Minister for Health the current statistics in relation to accident and emergency waiting times; and if he will make a statement on the matter. [22124/13]
Amharc ar fhreagraImmediately 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 have been significant improvements in the waiting times for unscheduled care against a background of reduced funding for health, reconfiguration of services and a very challenging economic climate.
By the end of 2012, the INMO reported 20,000 fewer people waiting on trolleys in Irish hospitals when compared to 2011 – an improvement of almost 24%. Progress has continued into 2013, as of 3 May 2013, the INMO reported 2,081 fewer patients on trolleys compared to the same period in 2012 – an improvement of 7.6%.
During the early months of 2013, the acute hospitals experienced unprecedented admission rates from their Emergency Departments. The Special Delivery Unit remains focussed on this issue and all systems, both hospital and community based, have been activated to prioritise care for those most in need.
96. Deputy Jonathan O'Brien asked the Minister for Health if he will provide an update on the roll out of the promised 20 primary care centres at different locations across the State; the number and details of the additional primary care centres that are being provided by direct capital expenditure; and if he will make a statement on the matter. [22557/13]
Amharc ar fhreagraApproximately 20 of the 35 primary care centres locations announced under the infrastructure stimulus package in July 2012 will be offered to the market 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.
The HSE is working with the National Development Finance Agency (NDFA) as required to progress the Primary Care Centre Public Private Partnership project. The NDFA as a centre of expertise will be responsible for the delivery of the PPP project on behalf of the HSE, including the management of the procurement phase and the provision of financial advice including a Value for Money assessment. It has been reviewing the processes involved in procurement of PPP projects with a view to streamlining the process and delivering projects more quickly. The preparatory work for the primary care centre project which precedes the signing of any PPP agreements is well underway.
While it is not possible, at this time, to give start and completion dates for any of the individual 20 potential locations, the best estimate is that these primary care centres will be completed by late 2016.
The Minister for Health has approved the HSE's Capital Plan 2013-2017. The consent of the Minister of Public Expenditure and Reform is awaited after which the HSE will publish the details on its website.
97. Deputy Barry Cowen asked the Minister for Health the way he will ensure that the quality of life of persons with disabilities is enhanced; and if he will make a statement on the matter. [22590/13]
Amharc ar fhreagra123. Deputy Willie O'Dea asked the Minister for Health his proposals to ensure that the quality of life of persons with disabilities is enhanced; and if he will make a statement on the matter. [22614/13]
Amharc ar fhreagraI propose to take Questions Nos. 97 and 123 together.
The Government’s policy on disability services is based on a mainstreaming approach to the provision of services and supports, whereby people with disabilities have access to the same services as the general population, and in addition receive appropriate supports and interventions to address individual needs. This is embodied in the National Disability Strategy,which is the Government’s overarching policy on the most effective combination of legislation, policies, institutional arrangements and services to support and reinforce equal participation for all people with disabilities.
The National Disability Strategy Implementation Group, which I am chairing, is in the process of drawing up an Implementation Plan specifying actions across a number of departments, including the Department of Health. The National Disability Authority is at an advanced stage in the development of Disability Indicators which will allow real measurement of how the actions contained in the Plan translate into an enhanced quality of life for people with disabilities.
With regard to services and supports which are under the aegis of the Department of Health, the implementation of the recommendations set out in the Value for Money (VFM) and Policy Review of Disability Services in Ireland and the VFM National Implementation Framework will enhance the quality of life of people with disabilities in the following ways: people with disabilities and their families will have more choice and flexibility in the services they receive and will have more control over how they access these services; services and supports will be tailored to meet individual need and will support greater independence and social inclusion; the move to individualised budgeting will be underpinned by a standardised needs assessment to ensure fairness and transparency in the way in which funding is allocated; supports and services will be delivered with greater equity, transparency and accountability and will be more cost effective.
During 2013 the HSE will manage and direct migration towards a person-centred supports model through demonstration projects initiated by service providers as proof of concept, which will run in parallel with current services. Their suitability for wider application will then be evaluated. The implementation processes underway in respect of the Congregated Settings Report and the New Directions (Adult Day Services) Report also fit within the overarching VFM implementation framework and will significantly enhance the lives of people with disabilities.
A HSE-led National implementation Group is developing a national plan and change programme to progress the recommendations of the Congregated Settings Report and transfer the 3,600 people with disabilities who live in these settings into the community over the next 7 years. As part of this process €1m has been transferred from the Health Vote to the Housing Vote to provide for the social housing costs of up to 150 people leaving institutions in 2013.
The recommendations in New Directions, the Report of the National Working Group for the Review of HSE-funded Adult Day Services,is guiding the reconfiguration and modernization of HSE funded adult day services from a largely segregated group-delivered service to a personally chosen and socially inclusive model of supports. A National Implementation Working Group established by the HSE to oversee the implementation of the recommendations has developed a draft interim Quality Standards Framework for Day Services with a consultation process to commence in Quarter 3, 2013.
One of the key commitments in the Programme for Government in relation to children and adults with disabilities is to put the National Standards for Residential Services for People with Disabilities on a statutory footing and ensure that the services are inspected by the Health Information and Quality Authority (HIQA). The standards outline what is expected of a provider of services and what a person with a disability, his or her family, and the public can expect to receive from residential care services. They seek to ensure that vulnerable people with disabilities in residential services are safeguarded and protected, and their quality of life is enhanced.
Each section of the National Standards outline the specific standards for adults and children which aim to enhance the potential of people living in residential services in addition to ensuring that their living space is of an appropriate standard. The Standards focus on outcomes which empower people with disabilities at the different stages of their lives to participate in, and contribute to, activities which help them realise their full potential. I am pleased to say that I formally launched these standards earlier today.
Work is also continuing in the Department of Health on both the Registration and Inspection and Care and Welfare regulations required to bring the standards into law. These are being developed taking into account the lessons learned from the introduction of similar regulations for nursing homes. HIQA's additional staffing requirements have been approved and discussions on the resources required to commence the regulatory regime are well advanced. It is expected that the proposed registration and inspection regime will commence in Quarter 3 this year.
98. Deputy Brendan Smith asked the Minister for Health his policy for reducing suicide rates; and if he will make a statement on the matter. [22615/13]
Amharc ar fhreagra108. Deputy Seamus Kirk asked the Minister for Health the measures he is putting in place to tackle suicide; and if he will make a statement on the matter. [22597/13]
Amharc ar fhreagra644. Deputy Michael Healy-Rae asked the Minister for Health his plans to set up a media campaign, similar to that of the road safety with the Road Safety Authority, targeting the prevention of suicide; and if he will make a statement on the matter. [22527/13]
Amharc ar fhreagra691. Deputy Tom Fleming asked the Minister for Health if he will strategically coordinate his Department, the Health Service Executive and the various suicide organisations, for example, Console, Pieta House, Aware, Mental Health Awareness, South West Counselling, Living Links and many other proactive organisations regarding the prevention of suicide; if he will take immediate action to organise these various groups into a single cohesive unit in conjunction with the HSE whilst these groups still maintain their own identity and ownership of their specific organisation; if he will assist with funding and resources to ensure that the potential of this strategic coordination is harnessed, directed and targeted effectively to deal with the spiralling phenomenon of suicide; and if he will make a statement on the matter. [22886/13]
Amharc ar fhreagraI propose to take Questions Nos. 98, 108, 644 and 691 together.
Suicide 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 supporting their families, friends and peers in recognising and responding appropriately to signs of emotional distress and suicidal thoughts.
Funding for suicide prevention is provided to the NOSP by the HSE from its overall budget for mental health. The annual budget for suicide prevention increased this year to over €13 million. Over €8 million of this is provided to the NOSP to fund voluntary and statutory agencies delivering services in the area of prevention, intervention, postvention and research. The remaining €5 million for suicide prevention is available regionally to fund HSE Resource Officers for Suicide Prevention, Self-Harm Liaison Nurses in Hospital Emergency Departments and local suicide prevention initiatives.
The NOSP is reviewing its current activities to make the most of our available resources, including looking at best practice internationally to inform evidence-based policy decisions. This will result in a revised strategic approach for 2013 and will inform the final phase of the Reach Out Strategy, which runs until 2014. I expect that the HSE will approve the revised approach in the very near future.
A key part of the work of the NOSP is to create an awareness within the community of positive mental health and suicide prevention. NOSP commissions major national media campaigns and also sponsors non-statutory partners in their health promotion work. The major NOSP campaigns include ‘Your Mental Health’ and ‘Let Someone Know’. It also funds campaigns targeted at specific groups within the community e.g. the farming community through Farm TV. These programmes have been well evaluated in terms of impact. The focus of these national campaigns is to assist the individual to understand the importance of looking after their mental health and to seek help at times of stress.
The NOSP is also involved in media monitoring to ensure that safe messages are communicated through print media and has facilitated national standards on the reporting of suicide. The NOSP has recently established a communication advisory group to assist with the development of a new communications strategy for suicide prevention and to promote positive mental health.
Another function of the NOSP is to coordinate the activity of the many voluntary and statutory agencies that are engaged in suicide prevention activities. Currently the NOSP funds 26 non-statutory agencies working in this area. The relationship between NOSP and the non-statutory groups is framed in Service Level Agreements.
It is vital that we ensure that this work is connected/interlinked and avoids duplication, is evidence and needs based and offers value for money. In order to get maximum benefit from the investment in suicide prevention and ensure a coordinated response to the needs of those at risk of or affected by suicide, the NOSP will continue to coordinate the work of the many different voluntary, statutory and non-statutory organisations working in this area. By promoting cross-organisational collaboration, the development of networks and partnerships, skills sharing and service development, the NOSP hopes to maximise the impact of a suicide prevention and support network in Ireland, to ensure it reaches and responds effectively to people who are vulnerable. The NOSP is currently working to integrate current programmes so as to reduce duplication within the sector, and provide a strategic framework for the coordination of the extensive range of actions in this area.
100. Deputy Thomas P. Broughan asked the Minister for Health if he will report on the current situation in the accident and emergency department of Beaumont Hospital, Dublin 9 in view of the fact that some citizens have been left waiting for more than 24 hours in accident and emergency for admission; and if he will make a statement on the matter. [22187/13]
Amharc ar fhreagraOn my appointment as Minister for Health, I set out to address the issues which cause unacceptable delays in patients being treated in our hospitals. I established the Special Delivery Unit (SDU), which is working to unblock access to acute services by improving patient flow through the system, including Beaumont hospital. An intensive work programme is underway between the SDU's liaison officers, the Clinical Programmes and Beaumont hospital teams. The SDU is satisfied that there is increased engagement at all levels in the hospital ensuring that emergency patients are seen in a timely manner, focussing on working to achieve the national targets for unscheduled care. There has been some improvement in reducing the number of patients waiting on trolleys. Up to the beginning of May there were 248 less patients waiting on trolleys in comparison to 2012, representing an overall reduction of 8.9%.
In relation to the particular query raised by the Deputy in relation to additional immediate steps being taken to reduce waiting times at the hospital, as this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy in this matter.
101. Deputy Éamon Ó Cuív asked the Minister for Health the way the cost of procedures in public hospitals here compares to the rest of the OECD; and if he will make a statement on the matter. [22611/13]
Amharc ar fhreagra107. Deputy Billy Kelleher asked the Minister for Health if it is the case that the cost of procedures in Irish public hospitals is the highest of all countries surveyed in the OECD; and if he will make a statement on the matter. [22583/13]
Amharc ar fhreagraI propose to take Questions Nos. 101 and 107 together.
In relation to the particular queries raised by the Deputy, as these are service matters, I have asked the Health Service Executive to respond directly to the Deputy in these matters.
102. Deputy Mary Lou McDonald asked the Minister for Health the additional resources that will be made available to existing children’s hospitals, including Temple Street, in view of the further delay in the delivery of the National Children’s Hospital; and if he will make a statement on the matter. [22577/13]
Amharc ar fhreagra115. Deputy Aengus Ó Snodaigh asked the Minister for Health the additional resources that will be made available to existing children’s hospitals, including Crumlin, in view of the further delay in the delivery of the National Children’s Hospital; and if he will make a statement on the matter. [22578/13]
Amharc ar fhreagra117. Deputy Seán Crowe asked the Minister for Health the additional resources that will be made available to existing children’s hospitals, including Tallaght, in view of the further delay in the delivery of the National Children’s Hospital; and if he will make a statement on the matter. [22568/13]
Amharc ar fhreagraI propose to take Questions Nos. 102, 115 and 117 together.
The HSE National Service Plan which was submitted to me in December, and which I approved, sets out the quantum and type of health services to be provided in 2013 within the overall level of funding provided. The HSE has responsibility for the delivery of services, set out in the Regional Plans, and to ensure that services are delivered within budget.
The three children's hospitals referred to, which will all transfer to the new children's hospital when built, have expressed their commitment to becoming a single service well before then. They are already working closely together, with a single Clinical Director across the three sites, to ensure optimisation of resources and facilities.
The establishment of a Children's Hospital Group, which I announced last November, is an important further step towards that single service. The Group will have a non-statutory Board of Direction which will oversee the integration of services across the three hospitals. Dr Jim Browne has been appointed as its Chair, and will work closely with the Chairs of the three existing hospitals, who have welcomed his appointment.
103. Deputy Seán Crowe asked the Minister for Health in relation to the filling of the 414 posts for community mental health services committed to in the Health Service Executive National Service Plan 2012, the number of these positions that have been filled by existing HSE staff members; the position regarding the back-filling of the positions these staff members have vacated; and if he will make a statement on the matter. [22569/13]
Amharc ar fhreagra585. Deputy Terence Flanagan asked the Minister for Health if he will outline the progress being made in appointing new staff for community mental health services in 2013; and if he will make a statement on the matter. [22191/13]
Amharc ar fhreagra587. Deputy Terence Flanagan asked the Minister for Health if there were delays in spending the budget allocated for community health services in 2012; if every effort will be made to ensure that the same delays are not experienced in 2013; and if he will make a statement on the matter. [22193/13]
Amharc ar fhreagra600. Deputy Thomas P. Broughan asked the Minister for Health if the additional staff funded in 2013 for mental health services have been recruited yet; if not, at what stage is their recruitment; and if the full funding for this project will be spent in 2013 [22270/13]
Amharc ar fhreagra601. Deputy Joanna Tuffy asked the Minister for Health if he will provide an update on the promised additional community mental health staff; and if he will make a statement on the matter. [22272/13]
Amharc ar fhreagraI propose to take Questions Nos. 103, 585, 587, 600 and 601 together.
In 2012, a special allocation of €35m was provided for mental health to be used primarily to further strengthen Community Mental Health Teams in both adult and children’s mental health services, to advance activities in the area of suicide prevention, to initiate the provision of psychological and counselling services in primary care, and to facilitate the transfer of mental health service users from institutional to community based care. 414 posts were approved to implement this €35m package of special measures.
Candidates for these new posts were asked on application to include details of their current employer. However, at the appointment stage this data may not be current and cannot be validated. Accordingly, it is not possible to indicate the number of the successful candidates who were already employed by the HSE.
It is currently the responsibility of the HSE Regional Directors of Operations (RDO) to decide within the context of their current resources, whether to fill vacancies that may arise as a result of the appointment of an individual to the mental health development posts from 2012. Each RDO has been asked to consider favourably the backfilling of posts vacated by the appointment of individuals to new mental health development posts to ensure that the objective of enhancing General Adult and Child and Adolescent Community Mental Health Teams will be maintained.
As at 30th April, 2013, 383 of the 414 posts approved in 2012 have either been filled, are under offer or awaiting clearance. The National Recruitment Service (NRS) of the HSE creates national panels in anticipation of vacancies. On occasion however, it is difficult to fill some posts for various reasons including geographical location, international shortage of some grades, most notably clinical Psychologists etc. The NRS is currently working to ensure that the remaining posts will be filled as soon as possible, subject to appropriately qualified candidates being available.
Budgetary pressures within the HSE delayed the full utilisation of the 2012 funding, but this sum is available again this year along with a further additional €35m which was provided in Budget 2013 for the continued development of mental health services across a range of headings, including the further ongoing development of community services. 477 posts have been approved to implement these measures.
Discussions took place within the HSE, and in consultation with the Department of Health, to finalise the allocation of these resources and commence recruitment. In March, each of the four HSE regions were asked to submit a business case against each of the identified objectives detailing how the funding is to be spent and the type and number of WTE to be recruited. The business cases were submitted to the Office of the Assistant National Director Mental Health and examined to ensure that they were within the scope of the agreed objectives approved by the HSE Senior Management Team; the funding came within the allocation to the Region; the WTEs were within the allocation; there was clarity about the types of post to be recruited.
Approval has issued to two of the Regions, HSE Dublin North East and HSE South and it is expected that approval will issue to the remaining two HSE Regions shortly. When the Approval Letters issue, the Regional Directors of Operations will ensure that the necessary paperwork is submitted to the NRS and the recruitment process will commence. I have received assurances from the HSE that the recruitment process for the new posts being funded in 2013, and any outstanding posts from the 414 approved in 2012, is being given priority within the HSE.
104. Deputy Derek Keating asked the Minister for Health the current figures in relation to accident and emergency waiting times and patients who are required to remain on trolleys before admission; and if he will make a statement on the matter. [22125/13]
Amharc ar fhreagraImmediately 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 have been significant improvements in the waiting times for unscheduled care against a background of reduced funding for health, reconfiguration of services and a very challenging economic climate
By the end of 2012, the INMO reported 20,000 fewer people waiting on trolleys in Irish hospitals when compared to 2011 – an improvement of almost 24%. Progress has continued into 2013, as of 3 May 2013, the INMO reported 2,081 fewer patients on trolleys compared to the same period in 2012 – an improvement of 7.6%
During the early months of 2013, the acute hospitals experienced unprecedented admission rates from their Emergency Departments. The Special Delivery Unit remains focussed on this issue and all systems, both hospital and community based, have been activated to prioritise care for those most in need.
105. Deputy Clare Daly asked the Minister for Health if he will assist a person (details supplied) whose spouse died 40 years ago giving birth in the Coombe Hospital, Dublin 8, and whose death was recorded as avoidable and the hospital responsible but nobody was ever held to account. [22385/13]
Amharc ar fhreagraThe HSE has a well established procedure for managing feedback and complaints in relation to experiences of individuals and their families in our hospitals. The details of the formal complaints policy, are available on the HSE website, at www.hse.ie/eng/services/ysys/Complaint. In addition, advice and instructions for making complaints and feedback about a service or an individual may be found at www.healthcomplaints.ie. In accordance with this procedure, a complaint must be made in the first instance to the hospital in which the incident causing the complaint occurred.
The HSE also has a National Advocacy Unit, their role includes promoting clear communication between health care providers and patients following an adverse event in health services, and mediation and facilitation for complaints handling. The Advocacy Unit also has a national role in liaising with the Office of the Ombudsman. If an individual is not satisfied with the way their complaint was dealt with, a review can be sought from the HSE Director of Advocacy and the Ombudsman, whose details are set out below.
HSE Director of Advocacy, Oak House, Millennium Park, Naas,Co Kildare - Tel 1890 424 555.
If an individual is not happy with the outcome of the review they may request an independent review from the Office of the Ombudsman or Ombudsman for Children, whose details are set out below.
Office of the Ombudsman, 18, Lower Leeson Street, Dublin 2, Tel 1890 223 030, Email: ombudsman@ombudsman.gov.ie.
In relation to this specific query, I have asked the HSE to respond to you directly regarding the assistance that their National Advocacy Service may be in a position to provide in relation to the queries you have raised.
106. Deputy Mary Lou McDonald asked the Minister for Health if he will confirm that all publicly funded hospitals, regardless of their form of patronage or nominal religious denomination, are and will be required to provide treatments permissible under the law and that it will be unlawful for such hospitals, as institutions, to deny such treatments as required for the lives, health and well-being of patients; and if he will make a statement on the matter. [22576/13]
Amharc ar fhreagraThe Deputy may wish to note Head 12 of the General Scheme of the Protection of Life during Pregnancy Bill 2013 which provides a right to conscientious objection to health professionals. However, this right does not extend to institutions. It is the intention of the legislation that women will be able to access treatments permissible under the law.
