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Thursday, 27 Jun 2013

Written Answers Nos. 246-257

Medical Card Applications

Ceisteanna (246)

Tom Fleming

Ceist:

246. Deputy Tom Fleming asked the Minister for Health if he will examine a decision to refuse a medical card following a review in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [31189/13]

Amharc ar fhreagra

Freagraí scríofa

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has recently reissued to Oireachtas members.

Hospital Appointment Delays

Ceisteanna (247, 255)

Thomas P. Broughan

Ceist:

247. Deputy Thomas P. Broughan asked the Minister for Health the steps he is taking with his Department to reduce the waiting period for patients seeking a neurology appointment here which is reportedly in the region of one year at present; if he will be bringing forward an implementation plan for the National Policy and Strategy for the Provision of Neuro-Rehabilitation Services in Ireland 2011-2015 published in 2011; and if he will make a statement on the matter. [31190/13]

Amharc ar fhreagra

Timmy Dooley

Ceist:

255. Deputy Timmy Dooley asked the Minister for Health the measures he has taken to address the long waiting lists for neurology appointments; and if he will make a statement on the matter. [31284/13]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 247 and 255 together.

The Department of Health and the Health Service Executive (HSE) have developed and published the “National Policy and Strategy for the provision of Neuro-Rehabilitation Services in Ireland 2011-2015”. In addition, the HSE is developing its Rehabilitation Medicine Programme within the Clinical Strategy and Programmes Directorate. The Report is the overarching policy on neuro-rehabilitation services and includes proposals for a framework for the future of neuro-rehabilitation services in Ireland. The aim of neuro-rehabilitation is to enable the person to achieve the highest possible level of independence. Desired outcomes range from a return to full independence in social and work situations to a person requiring long-term support and care but with a higher level of independence than in the absence of neuro-rehabilitation. Current services available include acute hospital services; the National Rehabilitation Hospital; multi-disciplinary community services; long-term assisted living supports; and rehabilitative training services. These services are provided directly by the Health Service Executive (HSE) and several non-statutory organisations.

The Rehabilitation Medicine Programme has been working in collaboration with the HSE's National Disability Unit as part of an expert Working Group planning for the implementation of the Report. The Rehabilitation Medicine Programme has incorporated key elements of the Report into its own Model of Care and adopted the Strategy’s recommendation of “hub and spoke” model for specialist rehabilitation services and is keen to progress with a comprehensive model for the continuation of such service into the community. This co-operation will continue in 2013.

Improving access to outpatient services, including neurology, is a key priority for the Government. Collaborating with individual hospitals, the SDU together with the NTPF and the HSE have developed the OP waiting list minimum dataset that allows for data to be submitted to the NTPF from hospitals on a weekly basis and, for the first time, outpatient data is available on www.ntpf.ie. 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.

Health Action Plan

Ceisteanna (248)

Nicky McFadden

Ceist:

248. Deputy Nicky McFadden asked the Minister for Health if the National Asthma Programme will be included in next year's budget and the 2014 Health Service Executive Service Plan; if the first phase of asthma patients will be given a structured asthma review in 2014; if 17 clinical nurse specialist posts will be recruited to facilitate the roll out of the National Asthma Programme; and if he will make a statement on the matter. [31194/13]

Amharc ar fhreagra

Freagraí scríofa

The National Clinical Programme for Asthma, which commenced in 2011, is one of a number of chronic disease programmes established in the HSE’s Clinical Care Directorate aimed at bringing a systematic approach to changes in how services for patients are delivered. The level of funding available for the health budget for 2014 has not yet been determined. Deliberations by the Government on the expenditure allocations for next year are likely to continue up until Budget time. The HSE is currently engaged in the estimates process. The National Clinical Programme for Asthma is included in the HSE's 2013 Operational Plan. Implementation of the Programme is ongoing and will continue in 2014. To date, different work streams of the National Clinical Programme for Asthma have resulted in the following initiative, the preparation of a Model of Care. This is currently being finalised and will be sent for stakeholder consultation after 30 June 2013. The Model of Care cannot be completed until stakeholder responses have been received and considered. The Model of Care includes a proposal to provide a standardised structured asthma review of each patient by the patient's GP at least annually. This will optimise treatment, ensure institution of inhaled corticosteroid therapy early in asthma management where appropriate, encourage medication adherence and address underlying problems with asthma care and management. This will include:

- Inhaler technique;

- Adherence to and understanding of medications;

- Self-management education including personal asthma plans and self-monitoring;

- Management of co-morbidities and triggers including allergic rhinitis; and

- Smoking cessation and/or avoidance or exposure to second hand smoke.

- The establishment of Asthma Check (Chronic Disease Watch Asthma – structured review) – this has been submitted to the Irish College of General Practitioners (ICGP) for review. It is proposed that patients with asthma would be enrolled in Asthma Check on a phased basis with clearly identified target groups.

- The preparation of Acute Emergency Asthma Guidelines for Adults - this has been submitted to the National Clinical Effectiveness Committee (NCEC) for review and feedback.

- The preparation of Acute Emergency Asthma Guidelines for Paediatrics – these have been completed.

- Asthma Control in General Practice – these guidelines have been signed off by ICGP and are being implemented.

- Asthma Educational Programme – this is available online at www. hseland.ie.

- Practical workshops have been delivered locally by Clinical Nurse Specialists to nurses in Primary and Secondary Care.

- Nurses and other health professionals have been enrolled in an asthma education module. This education module is based on the National Asthma guidelines. This supports healthcare staff in the delivery of evidenced based care and education for patients. In partnership with the Asthma Society, patient information documents have been developed to support this initiative.

The HSE has commenced the appointment of 17 Clinical Nurse Specialists (one per HSE Integrated Service Area) to support the phased roll out of the Integrated Care Diabetes Programme. When the National Clinical Programme for Asthma's Model of Care has been published an assessment can be made in relation to how it will be implemented in the acute hospital and primary care system and what resources, including nursing resources, will be required.

Home Care Packages

Ceisteanna (249)

Peadar Tóibín

Ceist:

249. Deputy Peadar Tóibín asked the Minister for Health the position regarding home care in respect of a person (details supplied) in County Kerry. [31196/13]

Amharc ar fhreagra

Freagraí scríofa

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

Departmental Staff Numbers

Ceisteanna (250)

Seán Ó Fearghaíl

Ceist:

250. Deputy Seán Ó Fearghaíl asked the Minister for Health the number of staff in his Department who availed of term time in 2012; the average duration of such in 2012; the number that will do so in 2013; and if he will make a statement on the matter. [31208/13]

Amharc ar fhreagra

Freagraí scríofa

The information requested in respect of Term Time or Shorter Working Year leave as it has been known since 2009 is detailed as follows:

-

2012

2013

No. of staff availing of Shorter Working Year

23

21*

Average duration

6.6 weeks

6 weeks

* Information supplied in respect of 2013 reflects applications on hand. It is still open to staff to apply to take leave under the Shorter Working Year Circular in 2013.

Departmental Agencies Staff Numbers

Ceisteanna (251)

Seán Ó Fearghaíl

Ceist:

251. Deputy Seán Ó Fearghaíl asked the Minister for Health the number of staff in organisations or agencies under the aegis of his Department who availed of term time in 2012; the average duration of such in 2012; the number that will do so in 2013; and if he will make a statement on the matter. [31224/13]

Amharc ar fhreagra

Freagraí scríofa

The information regarding the number of staff in organisations or agencies under the aegis of my Department availing of term time is being collated and will be forwarded to the Deputy when it becomes available.

Departmental Staff Training

Ceisteanna (252)

Seán Ó Fearghaíl

Ceist:

252. Deputy Seán Ó Fearghaíl asked the Minister for Health the number of staff in his Department who availed of study or training leave in 2012; the average duration of such leave; if all staff availing of this leave received full pay and benefits during the time; the number that will do so in 2013; and if he will make a statement on the matter. [31240/13]

Amharc ar fhreagra

Freagraí scríofa

Officers who are approved to undertake, on their own time, a course of study on a subject related to their work are entitled to a maximum of ten days study leave in respect of the final year only of a third level primary or masters degree or five days for the other years of a third level course. The information requested by the Deputy in relation to the number of staff and duration involved for 2012/13 is detailed as follows:

Study Leave

2012

To date in 2013

The No. of Staff who availed of study leave

9

7

The average duration of study leave

4.89 days

5.79 days

The Department does not award leave for training. However, officials are provided with appropriate training courses which are relatively short-term over one to five days that are generally attended during official time. The total number of staff/duration involved in 2012/13 is as follows:

Training

2012

To date in 2013

The No of Staff who attended training courses

97

12

The average duration of the training courses

1.5 days

2.5 days

Departmental Agencies Staff Numbers

Ceisteanna (253)

Seán Ó Fearghaíl

Ceist:

253. Deputy Seán Ó Fearghaíl asked the Minister for Health the number of staff in organisations or agencies under the aegis of his Department who availed of study or training leave in 2012; the average duration of such leave; if all staff availing of this leave received full pay and benefits during the time; the number that will do so in 2013; and if he will make a statement on the matter. [31256/13]

Amharc ar fhreagra

Freagraí scríofa

The information regarding the number of staff in organisations or agencies under the aegis of my Department who availed of study or training leave is being collated and will be forwarded to the Deputy when it becomes available.

National Lottery Funding Applications

Ceisteanna (254)

Finian McGrath

Ceist:

254. Deputy Finian McGrath asked the Minister for Health the funding available in respect of a project (details supplied) in Dublin 17. [31263/13]

Amharc ar fhreagra

Freagraí scríofa

My Department administers a National Lottery Discretionary Fund from which once-off grants are paid to community and voluntary organisations, providing a range of health related services. If an organisation wishes to make an application for National Lottery Funding it should send in a formal application. Detailed procedures, along with the application form are set out on the Department's website at www.doh.ie. I understand that the closing date for applications for the HSE lottery fund has now passed.

Question No. 255 answered with Question No. 247.

Hospital Consultants Recruitment

Ceisteanna (256, 267)

Timmy Dooley

Ceist:

256. Deputy Timmy Dooley asked the Minister for Health the measures he is taking to address the fact that we have the fewest rehabilitation consultants per capita in Europe; and if he will make a statement on the matter. [31285/13]

Amharc ar fhreagra

Mary Mitchell O'Connor

Ceist:

267. Deputy Mary Mitchell O'Connor asked the Minister for Health the reason persons have to wait over a year for a neurology appointment; the reason Ireland has the fewest rehabilitation consultants per capita in Europe; when the implementation plan for the neurorehabilitation strategy will be put in place; the support that is given to initiatives that can improve services for persons with multiple sclerosis and other neurological conditions; and if he will make a statement on the matter. [31364/13]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 256 and 267 together.

Neuro-rehabilitation is part of the management of most neurological and neurosurgical conditions, particularly those that cause, or have the potential to cause, ongoing disability. Neuro-rehabilitation services are presently delivered across a range of settings, from acute hospitals and specialised neurorehabilitation centres, to primary and community settings, including home. Service user neuro-rehabilitation needs range from intensive, acute treatment at tertiary level through to long-term neuro-rehabilitation at community level. Improving access to outpatient services, including neurology, is a key priority for the Government. Collaborating with individual hospitals, the Special Delivery Unit (SDU) together with the National Treatment Purchase Fund (NTPF) and the Health Service Executive (HSE), have developed the outpatient waiting list minimum dataset that allows for data to be submitted to the NTPF from hospitals on a weekly basis and, for the first time, outpatient data are available on www.ntpf.ie. 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 for 2013. The SDU/NTPF will work closely with hospitals towards achievement of the maximum waiting time. The Department of Health and the HSE have developed and published the “National Policy and Strategy for the provision of Neuro-Rehabilitation Services in Ireland 2011-2015”. In addition, the HSE is developing its Rehabilitation Medicine Programme within the Clinical Strategy and Programmes Directorate. The Report is the overarching policy on neuro-rehabilitation services and includes proposals for a framework for the future of neuro-rehabilitation services in Ireland, including key elements such as guiding principles; implementation structure; methodology for implementation; and information and communication.

The Report recognises that given the current economic climate, the focus in the short to medium term has to be on re-configuration of services, structures and resources and the enhancement of the skills and competencies required to meet the changing context. The recruitment of additional consultants in rehabilitation medicine can only be considered in this context i.e. reconfiguring current services and available resources. The key priority areas, as identified in the HSE’s National Operational Plan for 2013 are to map and develop Integrated Service Area level rehabilitation networks and implement the model of care for rehabilitation services within the networks with a focus on community rehabilitation. Current provision for people requiring neuro-rehabilitation services, including those with multiple sclerosis, range from acute hospital services; the National Rehabilitation Hospital; multi-disciplinary community services; long-term assisted living supports; and rehabilitation training services. These services are provided directly by the HSE and several non-statutory organisations, including MS Ireland. The HSE provided over €2.6m to MS Ireland in 2012 towards the provision of services and supports. Neuro-rehabilitation services can be accessed through HSE local health offices.

Ambulance Service Provision

Ceisteanna (257, 259)

Tom Fleming

Ceist:

257. Deputy Tom Fleming asked the Minister for Health further to Parliamentary Question No. 1778 of 18 September 2012, if he will immediately consider reinstating the existing ambulance control centre at Kerry General Hospital even on a temporary basis as a back-up service in view of the fact that the local knowledge by staff in this control centre and the local knowledge at the community hospital bases is invaluable in the introduction of the new ambulance control centre in Dublin; if he will now accept the fact that there is no longer an input from local staff, that this is having very serious repercussions for the health and safety of the general public in County Kerry and throughout the country; and if he will make a statement on the matter. [31286/13]

Amharc ar fhreagra

Martin Ferris

Ceist:

259. Deputy Martin Ferris asked the Minister for Health if he will restore local ambulance control to Tralee following the recent error in directing an ambulance to the home of a young child who died. [31306/13]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 257 and 259 together.

A tragic event occurred in Kerry last week which was widely reported. Firstly, I wish to extend my deepest sympathies to the family of the child involved. The loss of a loved one is hard for family and friends at any time, but the sudden and unexpected death of a young child is particularly difficult. In relation to this incident, the facts are that, at 1.16 a.m. on 18 June 2013, an emergency call was received for a baby who was reported as not breathing. The National Ambulance Service (NAS) was initially unable to obtain sufficient details of where help was needed, which led to a delay in reaching the incident. The first emergency resource arrived at the scene 30 minutes after the initial 999 call. The patient was subsequently pronounced dead. The incident has been the subject of a systems analysis, as is routine in cases where a death occurs, to ascertain whether call-taking protocols were followed. Following an examination of the facts, the HSE is satisfied that systems and processes operated correctly and there are no plans to carry out any further review. However, interrogation has been strengthened to try and mitigate the impact of a call where the incident location cannot be identified. In addition, HSE Communications has been requested to run a publicity campaign to improve public awareness of the need to communicate precisely the locations of incidents. In the interest of respecting the dignity and grief of the family, I wish to make no further comment on the specific incident.

A significant reform programme has been underway to totally reconfigure the way the HSE manages and delivers pre-hospital care services, to ensure a clinically driven, nationally co-ordinated system, supported by improved technology. The National Control Centre Reconfiguration Project, which is endorsed by HIQA and which represents international best practice, will reduce the number of ambulance control centres to a single national control system, with significant investment in new voice, data and mapping technologies. The project is also a key element of Future Health: A Strategic Framework for Health Reform in Ireland 2012-2015. Both HIQA and the NAS have had concerns over control and dispatch structures at some control centres leading up to the development of the national control system. Accordingly, the NAS moved the Cork and Tralee centres to its Townsend Street centre on an interim basis in May, to mitigate such concerns pending completion of the national centre. Detailed preparations took place to ensure the safety of services during the move of the Cork and Kerry operations. The NAS provided additional staff, training, technology and equipment to assist this process. 112/999 calls from those areas are now answered in Dublin using improved technology. The NAS is satisfied that Townsend St, while not appropriate to the needs of the overall reconfiguration project, is nevertheless suitable and infrastructurally sound for the interim accommodation of these centres.

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