Written Answers Nos. 630-646
630. Deputy Billy Timmins asked the Minister for Health the position regarding a hospital appointment in respect of a person (details supplied) in County Carlow; if same will be expedited; and if he will make a statement on the matter. [6759/14]
Amharc ar fhreagraShould a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she would be in the best position to take the matter up with the consultant and hospital involved. In relation to the specific hospital appointment query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.
631. Deputy Bernard J. Durkan asked the Minister for Health the quality and level of support including therapeutic services available to a person (details supplied) in County Kildare; and if he will make a statement on the matter. [6762/14]
Amharc ar fhreagraAs the Deputy's question relates to service matters I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
632. Deputy Pat Deering asked the Minister for Health if he will provide a progress report on the primary care centres announced in 2012. [6774/14]
Amharc ar fhreagra633. Deputy Pat Deering asked the Minister for Health if he will provide a progress report on the primary care centre announced in 2012 for Tullow, County Carlow; when work will commence; and when he expects the centre to be in use. [6775/14]
Amharc ar fhreagraI propose to take Questions Nos. 632 and 633 together.
The development of primary care is central to the Government's objective to deliver a high quality, integrated and cost effective health care system. Supporting infrastructure, procured through a combination of public and private investment, will facilitate the delivery of multi-disciplinary primary health care.
Considerable progress has been made in progressing the primary care centre PPP project. Of the 35 primary care centre locations announced under the Infrastructure Stimulus Package in July 2012, 15 locations have been identified as being suitable for the PPP model. These are Ballymote; Boyle; Westport; Claremorris; Tuam; Limerick City; Dungarvan; Carrick-on-Suir; Wexford Town; Waterford City; Kilcock; Knocklyon/Rathfarnham; Crumlin/Drimnagh; Coolock/Darndale; and Summerhill, north inner city Dublin. In addition, the HSE has progressed Ballinrobe, which was not one of the original 35, as a suitable substitute. By year end 2013 the HSE had lodged 14 planning applications, details of which will be available on the relevant planning websites. The Limerick City planning application was submitted in January 2014 and it is expected that the Ballinrobe planning application will be submitted in February. It is expected that 10-14 sites (indicative number 12 based on affordability) from the above list will be delivered as part of a single PPP contract with the remaining centres to be delivered by the HSE using other procurement means. The National Development Finance Agency (NDFA) published a Prior Indicative Notice (PIN) / Pre-Qualification Questionnaire in the OJEU on 19 December 2013.
The location prioritisation exercise initiated by the HSE in 2012 is a dynamic process, constantly evolving to take account of changing circumstances including the feasibility of implementation. Your question has been referred to the HSE for direct reply in relation to progress on the remaining locations announced in July 2012 including Tullow / Rathvilly / Hacketstown.
634. Deputy Terence Flanagan asked the Minister for Health his views on whether the wait time for elderly persons in Beaumont Hospital has lessened since his last visit to the hospital; if additional facilities should be put in place to ensure that elderly persons are more comfortable while waiting in the accident and emergency department; and if he will make a statement on the matter. [6778/14]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
635. Deputy Clare Daly asked the Minister for Health if he will investigate the health implications arising from Professor Jacqueline McGlade's report for the European Environment Agency in terms of assessing the cost of air pollution, which the Irish Environmental Forum has put before him showing the effects emissions from the seven plants are causing to the health of people and the impact this is having on the health service. [6779/14]
Amharc ar fhreagraThe matter to which the Deputy refers relates to air quality and I do not have a function in relation to this matter.
636. Deputy Brian Walsh asked the Minister for Health the eligibility criteria for early intervention services in respect of children under the age of six who have been diagnosed with autism; if his attention has been drawn to the fact that these services have been withdrawn from such children in County Galway; and if he will make a statement on the matter. [6781/14]
Amharc ar fhreagraSignificant resources have been invested by this country in recent years in services for children with special needs, including those with autism. The Government is committed to the provision and development of services for these children, having regard to available resources.
The HSE National Review of Autism Services: Past, Present and Way Forward Report (2012) and the Progressing Disabilities Services for Children and Young People (0-18s) Programme set out the overall policy context for the provision of autism services to children and young people. The objective of the Progressing Disabilities Programme for Children and Young People is to achieve a national, unified approach to delivering disability health services for children with a disability including those with autism so that there is a clear pathway to the services for all children, regardless of where they live, what school they go to or the nature of their disability. This Programme aims to remedy the variations in service provision that currently exist around the country. In 2014, the HSE are taking a number of key steps in implementing the change programme, including rolling out a new model of assessment and intervention, in line with the Progressing Disabilities Programme for Children and Young People. An additional €4 million has been allocated, which equates to 80 additional therapy staff, for these purposes.
My Department has asked the HSE to respond directly to the Deputy in relation to the operational issues that he has raised concerning the eligibility criteria for early intervention and the provision of services in Galway.
637. Deputy Brian Walsh asked the Minister for Health the funding allocated for autism services provided through CAMHS teams since 2011; and the way increases in funding have been utilised to benefit service users. [6782/14]
Amharc ar fhreagra638. Deputy Brian Walsh asked the Minister for Health if he will provide an update in relation to the establishment of a new autism spectrum disorder team within CAMHS in the Health Service Executive western area; if he will identify the members of a steering committee formed to oversee the establishment of the ASD team; and if he will make a statement on the matter. [6783/14]
Amharc ar fhreagraI propose to take Questions Nos. 637 and 638 together.
The HSE National Review of Autism Services: Past, Present and Way Forward Report (2012) and the Progressing Disabilities Services for Children and Young People (0-18s) Programme set out the overall policy context for the provision of autism services to children and young people. The objective of the Progressing Disabilities Programme for Children and Young People is to achieve a national, unified approach to delivering disability health services for children with a disability including those with autism so that there is a clear pathway to the services for all children, regardless of where they live, what school they go to or the nature of their disability. This Programme aims to remedy the variations in service provision that currently exist around the country. In 2014, the HSE are taking a number of key steps in implementing the change programme, including rolling out a new model of assessment and intervention, in line with the Progressing Disabilities Programme for Children and Young People. An additional €4 million has been allocated, which equates to 80 additional therapy staff, for these purposes.
It is also recognised that Child and Adolescent Mental Health Services in policy terms will have a role in the area of autism in relation to consultation on difficult diagnoses and in terms of specialist episodic treatment of acute mental disorders as set out in A Vision for Change: Report of the Expert Group on Mental Health Policy.
My Department has requested the HSE to respond directly to the Deputy in relation to the specific operational issues that he has raised in his questions.
639. Deputy Joan Collins asked the Minister for Health if he will investigate the situation of a family (details supplied). [6786/14]
Amharc ar fhreagraThe 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 issued to Oireachtas members.
640. Deputy Sean Fleming asked the Minister for Health the eligibility criteria for the provision of dietician services by the Health Service Executive; if these vary across the State; and if he will make a statement on the matter. [6805/14]
Amharc ar fhreagraThere is no statutory obligation on the HSE to provide dietician services.
There are currently approximately 80 community dieticians working within the HSE. These dieticians work mainly in primary care, long stay residential care units for older people and nutrition health promotion in the treatment, management and prevention of nutrition related diseases. Dieticians aim to provide early intervention to those with existing nutritional problems, including disease related malnutrition, diabetes, those on nutritional support and clients with chronic diseases, including obesity.
Dieticians also provide a dietetic service to paediatric clients and their families for the treatment of faltering growth, childhood obesity, food allergies and other nutrition related issues. They also provide a public health nutrition role, improving infant feeding practices through their public health nurse colleagues, supporting community cooking classes and other nutrition prevention programmes across the schools and community setting.
As nutrition related illnesses are on the increase, the need for these services is also increasing. Dietetic services accept referrals from both General Medical Services (GMS) and non GMS clients. Referrals are accepted from general practitioners (GPs) and all members of the Primary Care Team and other network colleagues. They accept self-referrals only from clients wishing to avail of the Diabetes X-pert structured patient education programme and group weight management programmes in the community. They also accept referrals from their hospital colleagues when transferring clients' care to the community. A prioritisation system is in place with malnutrition (adult and faltering growth in infants), home enteral tube feeding, diabetes and paediatric patients being prioritised. However, due to varying staffing levels around the country and the increasing demand in nutrition related diseases, access to dietetic services varies in some parts of the country.
The Dietetic service to the long stay residential units for older people is delivered as part of the primary care service in some areas with a prioritisation system in place. Nutrition Training on malnutrition screening is provided to front line staff by the dieticians. A clinical dietetic service is provided to the units, usually to high priority patients, including those who are malnourished and those on PEG feeding. Access to dietetic services varies across the country with some residential units getting a visit monthly/bi-monthly and some weekly by the dietician, depending on bed numbers and dietetic services locally. HSE dieticians do not currently provide a service to private nursing homes. However, these patients, if mobile, will be seen by the dietician in their clinic.
641. Deputy Sean Fleming asked the Minister for Health if he will reverse the decision to increase the prescription charge for persons on the State pension who are holders of medical cards; and if he will make a statement on the matter. [6808/14]
Amharc ar fhreagraAs announced in Budget 2014, it has become necessary to increase the prescription charge due to the very difficult and challenging economic environment which requires the Government to achieve additional savings in health expenditure with €666 million of savings targeted in 2014. The increase in prescription charges will account for €43 million of this target. The Government is committed to achieving these savings while protecting front line services to the most vulnerable to the greatest extent possible.
Medical card holders are required to pay a €2.50 charge per item for medicines and other prescription items supplied to them by community pharmacists, subject to a cap of €25 per month for each person or family. These new rates are effective from 1 December 2013.
642. Deputy Éamon Ó Cuív asked the Minister for Health if he will provide details of all official engagements by him or the Ministers of State in his Department that have taken place in Northern Ireland since he took office; and if he will make a statement on the matter. [6820/14]
Amharc ar fhreagraMinisterial Diaries for my Department are currently being reviewed to provide a list of official engagements as requested. I will forward the list directly to the Deputy as soon as it becomes available.
643. Deputy Brendan Griffin asked the Minister for Health the position regarding the provision of vital services for a child (details supplied) in County Kerry, who has suffered a serious deterioration in personal service under reconfigured services. [6831/14]
Amharc ar fhreagraAs the particular issue raised by the Deputy relates to an individual case, this is a service matter for the Health Service Executive. Accordingly, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.
644. Deputy Róisín Shortall asked the Minister for Health if he will provide details of any special arrangements that exist with regard to the employment of consultants in St. Vincent's Hospital outside the terms of the standard consultant contracts; and if he will make a statement on the matter. [6832/14]
Amharc ar fhreagraMost hospital consultants are employed under the Consultant Contract 2008. Over 85% of consultants hold this contract, as Type A, B or B* contract holders.
Type A contract holders have no access to private practice. Type B contract holders are subject to a cap of 20% private activity on-site, if newly appointed, or a cap of up to 30% on-site in the case of certain existing consultants. Type B* contract holders may engage in private practice on-site and off-site.
A minority of consultants hold Consultants Contract 1997, Category 1, Category 2 or Geographical Wholetime without fees. Category 1 consultants are permitted to engage in private practice on-site. Category 2 consultants may engage in private practice on-site and off-site.
The right of Type B* (2008 Contract) and Category 2 (1997 Contract) consultants to engage in private practice off-site is subject to certain conditions. These conditions include such private practice being confined to periods outside the aggregate hourly weekly commitment and other scheduled commitments to the public service.
My Department has written to the HSE requesting that it satisfies itself that all hospitals are enforcing consultants' contractual provisions regarding private practice, specifically drawing its attention to assertions made concerning academic teaching hospitals in Dublin not being compliant with the contractual provisions.
The following information was provided under Standing Order 40A
Further to the reply provided, the HSE has now provided the following additional supplementary information to more explicitly clarify the position as follows:
There are no special employment arrangements applying to Consultants employed by St Vincent’s University Hospital or St Michael’s Hospital (the two public hospital components of the St Vincent’s Hospital Group). Under the Health 2004 the HSE has statutory responsibility for the regulation of consultant posts in the public health system. As part of the delivery of that regulatory function, the HSE determines the location, contract type, hours, qualifications and other aspects of each consultant post. The HSE has not sanctioned any special employment arrangement in relation to consultant posts under St Vincent’s University Hospital.
Guidance to HSE and HSE-funded agencies regarding the extent to which Consultants employed in posts approved by the HSE can engage in private practice is set out in the document, forwarded to the Deputy, issued in September 2009 (entitled ‘Public and private patients in Public hospitals - Guidance to health service management on the treatment of public and private patients’).
The Guidance noted (at Section 8) that Consultant Contract 2008 provides that Type B Consultants who took up posts for the first time under Consultant Contract 2008 may only engage in private practice “in hospitals or facilities operated by the Employer, as part of such activities that arise as part of the employment contract (e.g. home visits) and in colocated private hospitals on public hospital campuses”.
Arising from information provided to the HSE by St Vincent’s Hospital Group, the HSE is satisfied that Consultants employed by St Vincent’s University Hospital or St Michael’s Hospital do not share an employer with St Vincent’s Private Hospital and are employed separately to employees of St Vincent’s Private Hospital. St Vincent’s Private Hospital is not a co-located private hospital as determined by the Department of Health or the HSE. In this regard Type B Consultants who took up post for the first time under Consultant Contract 2008 have no entitlement to private practice in St Vincent’s Private Hospital.
645. Deputy Gerry Adams asked the Minister for Health if the €3.22 million set aside in the Health Service Executive's service plan for a bilateral simultaneous and sequential cochlear implant programme has been allocated yet to the national cochlear implant programme at Beaumont Hospital; if recruitment and training has begun in the specialised unit in Beaumont for the roll-out of the programme; when he anticipates that the first operations will commence; and if he will make a statement on the matter. [6838/14]
Amharc ar fhreagraBeaumont Hospital is the centre for delivering Ireland’s national cochlear implant programme, with surgical provision for patients under six years being carried out in the Children’s University Hospital Temple Street. Since the programme commenced in 1995, over 700 patients have received cochlear implants. The HSE developed a proposal, in liaison with Beaumont Hospital, to introduce a bilateral cochlear implant programme in Ireland. Introduction of bilateral cochlear implantation will involve additional staff, equipment and capital works and in this context €3.22m has been provided in the HSE's National Service Plan 2014 for this service development.
In regard to the specific detail requested by the Deputy, as this is a service matter I have asked the HSE to reply directly to him.
646. Deputy Michael Healy-Rae asked the Minister for Health the position regarding braces in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [6844/14]
Amharc ar fhreagraThe HSE provides orthodontic treatment to patients based on their level of clinical need. An individual's access to orthodontic treatment is determined against a set of clinical guidelines and priority is given to patients with greatest needs. The HSE has been asked to examine the specific query raised by the Deputy and to reply to him as soon as possible.
