Written Answers Nos. 630-642
630. Deputy Terence Flanagan asked the Minister for Health the position regarding a matter (details supplied) in Dublin 5 relating to medical card patients; and if he will make a statement on the matter. [14834/15]
Amharc ar fhreagraI understand that the Minister for Public Expenditure and Reform plans to open negotiations with public sector unions on an orderly unwinding of the financial emergency measures legislation. It is intended that a similar process will be put in place involving the Department of Health, the HSE and contracted professionals, including dentists, who have been affected by these measures.
631. Deputy Dara Calleary asked the Minister for Health the proposed timescale for completion of a new national cancer strategy, the proposed membership of the review group, if he will consider including a patient advocate on the review group; and if he will make a statement on the matter. [14855/15]
Amharc ar fhreagraMy Department is developing a new Cancer Strategy for the period 2016-2025. It is envisaged that the new Strategy will be completed by the end of 2015 for implementation from 2016.
I am establishing a Steering Group to provide guidance and advice to my Department in formulating the Strategy. The Steering Group will include a range of expertise across various aspects of cancer control, including patient representation.
632. Deputy Arthur Spring asked the Minister for Health if there is an appeals process available to a medical card patient if a general practitioner removes that patient from his or her general medical services list; and if he will make a statement on the matter. [14862/15]
Amharc ar fhreagraUnder the terms of the GMS contract which general practitioners (GPs) hold with the Health Service Executive (HSE), a GP shall ordinarily accept all eligible persons, who so request, onto his or her GMS patient list. The number of persons on a GP's patient panel may not exceed 2,000, save in exceptional circumstances.
In some cases, a GP may decide not to accept an eligible person onto their list, the principal reason being where they already have a significant patient panel and coping with any additional workload would cause them difficulty.
Where a GP requests the HSE to arrange for the removal of a patient from his/her GMS list, he/she must give where requested the reason, in confidence, for such a request to a medical officer acting on behalf of the Executive. The HSE shall thereupon notify the person accordingly and supply them with information to enable them to apply for inclusion on the list of another GMS contracted GP.
The Executive has the power to assign an eligible person to a GP's GMS patient list where the person has been removed from another GP's list or refused entry onto a GP's list and the person has unsuccessfully applied to at least three GPs in the area, who are contracted to provide services under the GMS.
If the Deputy is aware of a particular case where a GP is inappropriately excluding a patient from his or her GMS panel, he may wish to refer the details to the HSE for investigation.
633. Deputy Gerry Adams asked the Minister for Health if he will provide a detailed breakdown on the cost of a packet of branded Xanax which is generic alprazolam, of branded Lipitor which is generic atorvastatin calcium and of branded Nexium which is generic esomeprazole, under the headings ex-factory price that is manufacturer's costs, distributors/wholesalers costs and retail costs; if he will provide a comparable breakdown on the costs of the same tablets, branded and generic, in all other European Union countries; and if he will make a statement on the matter. [14873/15]
Amharc ar fhreagraThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013, therefore, the matter has been referred to the HSE for attention and direct reply. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with them.
634. Deputy Tom Fleming asked the Minister for Health if he will expedite a referral to St. James's Hospital in Dublin 8 in respect of a person (details supplied) in County Kerry in view of that person's circumstances; and if he will make a statement on the matter. [14875/15]
Amharc ar fhreagraThe Deputy will appreciate that it is contrary to the Health Service Executive (Governance) Act 2013 for me to make a direction to the HSE or a hospital to benefit or prioritise any individual person or patient.
The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. Regarding the specific case raised, I have asked the HSE to respond to the Deputy directly. If he has not received a reply from the HSE within 15 working days he should contact my Private Office and my officials will follow the matter up.
635. Deputy Seán Kyne asked the Minister for Health if consideration has been given to extending the remit of registered nurse prescribers to address the needs of medical card holders in private nursing home facilities to the same extent as is currently permitted regarding non-medical card holders in such facilities; and if he will make a statement on the matter. [14890/15]
Amharc ar fhreagraThe Medicinal Products (Prescription and Control of Supply) (Amendment) Regulations, 2007 (S.I. No. 201 of 2007) and the Misuse of Drugs (Amendment) Regulations, 2007 (S.I. No. 200 of 2007) signed into law on the 1 May 2007, give prescriptive authority to nurses and midwives under specific conditions. The legislation allows a registered nurse or midwife to prescribe a range of medications within their scope of practice. The nurse or midwife must:
- have completed an approved six month education programme;
- have the appropriate three years clinical experience;
- be registered with the Nursing and Midwifery Board Ireland (NMBI) as a Registered Nurse Prescriber (RNP); and
- have authority from their health service provider to prescribe a range of medications.
The first Nurse and Midwife Prescribers in Ireland were registered with An Bord Altranais now the NMBI, in January 2008. To date, only a small number of nurses from private nursing homes have undertaken the Certificate in Nursing for Nurse/Midwife Prescribing.
Professional guidance is already in place with regard to nurse and midwife medicinal product prescribing from the Nursing and Midwifery Board of Ireland and from the HSE for its services. The HSE has developed a robust governance process for the safe implementation of nurse and midwife prescribing. This governance process has been shared with Nursing Homes Ireland. However, issues concerning governance, risk management and patient safety need to be addressed and appropriate protocols and procedures put in place by the nursing home sector to support and facilitate the extension of this important initiative for medical card patients.
In this regard, the Office of the Chief Nursing Officer of the Department of Health, the Office of the Nursing and Midwifery Services Director of the HSE and the Nursing and Midwifery Board of Ireland met with Nursing Homes Ireland in 2014 to progress this initiative. Nursing Homes Ireland was given guidance on the best approach to the implementation and governance arrangements required to be in place to support the safe prescribing of medicines by nurses in the nursing homes.
Further engagement has been arranged between the parties to progress the development of the necessary governance arrangements and adapt the national framework for the nursing home sector. These issues are the subject of current discussions between Nursing Homes Ireland, the HSE Office of the Nursing and Midwifery Services Director and the Chief Nursing Officer’s Office of the Department of Health.
636. Deputy Seán Kyne asked the Minister for Health his views on the concept of a minor ailment scheme involving Irish pharmacies; if he is aware of the high success rate of such schemes in other jurisdictions; and if such a scheme has been, or is being, considered by the Health Service Executive and his Department. [14891/15]
Amharc ar fhreagraThe development of primary care services is an essential component of the health reform process. In a developed primary care system up to 95% of people's day to day health and social care needs can be met in the primary care setting. Pharmacy services are well placed within the community to provide essential health advice and to support effective care at the lowest level of complexity and in a cost-effective manner.
As we continue to experience increased pressure and demand on the resources within the health system it is necessary to consider new and innovative ways to provide the services we require. Expanding the role of the community pharmacist to include provision of services such as a Minor Ailments Scheme is worth exploring as we seek to further expand and develop the primary care sector. It is important that such proposals generate real savings on existing public expenditure since the health service continues to operate within tight budget constraints.
The Department is examining this issue having regard to the evidence-base for such a service including the application of such schemes in other countries and any contractual or funding implications.
637. Deputy Billy Timmins asked the Minister for Health if an eight-year waiting time for access to a dermatologist in counties Carlow and Waterford is the exception rather than the rule; his plans to reduce such times; and if he will make a statement on the matter. [14894/15]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to the Deputy directly. If he has not received a reply from the HSE within 15 working days he should contact my Private Office and my officials will follow the matter up.
638. Deputy Billy Timmins asked the Minister for Health the estimated completion cost of the children's hospital; if he will provide a breakdown of this; when the planning application will be lodged; and if he will make a statement on the matter. [14895/15]
Amharc ar fhreagraThe National Paediatric Hospital Development Board is the statutory body responsible for planning, designing, building and equipping the new children's hospital. The new hospital will be co-located with St James's Hospital, and ultimately tri-located with a maternity hospital to be developed on campus. In addition to the main hospital, the project includes two satellite centres at the campuses of Tallaght and Connolly Hospitals.
A design team is working on detailed design development with planning submission scheduled for June 2015. Subject to planning, work is scheduled to commence at the main site at St. James's, and at satellite centre sites at Connolly and Tallaght, in January 2016.
The Minister for Public Expenditure and Reform, Deputy Howlin, has committed to making €200 million available from the sale of the National Lottery for the new children's hospital, adding to the existing €450m Exchequer funding and underlining the Government's commitment to the project. Current estimates are that the core hospital, including both satellite centres, will be delivered within this envelope. For reasons of commercial sensitivity, I do not intend to provide a detailed breakdown of costs at this stage but I can confirm that this estimate includes provision for inflation, VAT and contingencies; it does not include equipment or ICT which can be purchased, licensed or leased separately. Philanthropic and commercial funding streams will be targeted as appropriate for supporting elements of the project to include car parking, academic and research facilities, and estimates will be reviewed and refined at each stage of the project.
639. Deputy Billy Timmins asked the Minister for Health the number and location of public maternity hospitals; the capital funding that was allocated to these since 1990 to date in 2015; and if he will make a statement on the matter. [14896/15]
Amharc ar fhreagraCurrently there are 19 public maternity maternity hospitals located at:
- Dublin North East - the Rotunda; OLOL Drogheda; Cavan General Hospital;
- Dublin Midlands - Coombe Women's and Infants' Hospital; Midland Regional Hospital Portlaoise;
- Ireland East - National Maternity Hospital Holles Street; Midland Regional Hospital Mullingar; St Luke's Hospital Kilkenny; Wexford General Hospital;
- South / South West - Cork University Maternity Hospital; Kerry General Hospital; Waterford University Hospital; South Tipperary General Hospital;
- Mid-West - University Maternity Hospital Limerick;
- Saolta Hospital Group - Galway University Hospital; Portiuncula Hospital; Mayo General Hospital, Sligo General Hospital; Letterkenny General Hospital.
Records of the capital grants paid to all hospitals including maternity hospitals prior to 01/07/1994 are paper based and the files are archived. The following limited electronic data is available for the Coombe, Rotunda and National Maternity Hospitals for the period 01 July 1994 to 29 February 2000.
|
Hospital |
Construction etc |
ICT |
Total |
|
Coombe |
€2,305,605.32 |
€450,988.74 |
€2,756,594.06 |
|
Rotunda |
€3,059,823.71 |
€1,407,264.07 |
€4,467,087.78 |
|
NMH |
€4,069,908.75 |
€1,160,008.68 |
€5,229,917.43 |
From the establishment of the Eastern Regional Health Authority (ERHA) in March 2000, block capital grants for all hospitals including maternity hospitals were paid to the ERHA for distribution as authorised to the hospitals in its area. Prior to the establishment of the HSE, a similar regime applied to the other maternity hospitals; capital grants were paid to the Health Boards for distribution as authorised to the hospitals in their areas.
Other than the information above, the detailed data requested by the Deputy is not available in my Department. As it would require considerable staff resources to extract the required data from the relevant archived files, it is not proposed to do this extensive search.
The Deputy's question has been referred to the HSE in relation to capital grants made to maternity hospitals since its establishment in January 2005.
640. Deputy Billy Timmins asked the Minister for Health if all the recommendations outlined in a report (details supplied) have been implemented in all maternity hospitals; and if he will make a statement on the matter. [14897/15]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to the Deputy directly. If he has not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
641. Deputy Billy Timmins asked the Minister for Health the position regarding the primary care list of 35 centres published in 2012; the cost to date; the estimated time of completion; and the estimated total completion cost; and if he will make a statement on the matter. [14898/15]
Amharc ar fhreagraThe 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.
Primary care infrastructure at thirteen of the 35 locations will be delivered using the Public Private Partnership (PPP) mechanism. These are Coolock / Darndale - Dublin north city; Summerhill, north inner city Dublin; Kilcock; Wexford Town; Waterford City; Dungarvan; Carrick-on-Suir; Limerick City – Ballinacurra/Weston; Tuam; Boyle; Ballymote; Claremorris, and Westport. The HSE included Ballinrobe as a suitable substitute for PPP. Considerable progress has been made in developing this project. Planning permission has been awarded at all locations. The pre-selected bidders submitted their tender documentation in early February. These tenders are being assessed and evaluated. Construction is scheduled to begin in early 2016 and it is expected that the primary care infrastructure will be delivered by early 2017. As the tender process is still underway it is not possible, for reasons of commercial sensitivity, to set out the total estimated total completion cost of this project. Crumlin/Drimnagh and Knocklyon/Rathfarnham recently completed the planning process but not within the timeframe to be included in the PPP project.
As regards the remaining locations, the mechanism and timescale for delivery of primary care infrastructure is dependent on a number of factors. Regardless of the delivery mechanism, all potential primary care infrastructure is subject to suitable locations being offered/provided/available, to successful planning processes and GP commitment to sharing accommodation and delivering health care services with HSE staff. In addition the operational lease mechanism is subject to market pressures such as the developers' access to adequate financing. Delivery of primary care infrastructure is a dynamic process, constantly evolving to take account of changing circumstances including the feasibility of implementation.
The following locations have been included in the HSE Capital Plans to be delivered by direct/own-build - Rathdrum; Tullow/Rathvilly/Hacketstown; Dungloe; Laytown/Bettystown and Rowlagh/North Clondalkin.
Kells is to be delivered by the operational lease mechanism and the HSE's NSP 2015 indicates that its construction will be completed later this year. The operational lease mechanism is also the preferred delivery option for the following locations - Drogheda north; Balbriggan, Swords and Tralee.
In its November 2014 advertisement for primary care infrastructure to be delivered by the operational lease mechanism the HSE advertised the following locations - Carrickmacross; Kilkenny city; Cork city for Togher; Clonmel; Thurles; Ennis; Gort and Ballaghadereen. The closing date for receipt of Expressions of Interest was mid-January 2015. Currently, the HSE is reviewing all Expressions of Interest received to determine which are suitable for more detailed consideration and progression to the next stage of the process.
The following parts of your question have been referred to the HSE for direct reply:
- The costs incurred to date on the 14 PPP locations;
- The costs incurred to date for the remaining locations and where possible estimated total completion costs.
If he has not received a reply from the HSE within 15 working days he should contact my Private Office who will follow up.
642. Deputy Billy Timmins asked the Minister for Health the status of the hospital grouping lists; the person who is the chief executive officer of each group; when the appointments took place; and if he will make a statement on the matter. [14899/15]
Amharc ar fhreagraSeven hospital groups, including the Children's Hospital Group, have been established on a non-statutory administrative basis are set out in the table following
|
No. |
Composition |
|
i |
RCSI (Dublin North East): Beaumont Hospital; Our Lady of Lourdes Hospital, Drogheda; Connolly Hospital; Cavan General Hospital; Rotunda Hospital; Louth County Hospital; Monaghan Hospital. (Academic Partner: RCSI). |
|
ii |
Dublin Midlands: St James's Hospital; The Adelaide & Meath Hospital, Dublin, including the National Children's Hospital; Midlands Regional Hospital, Tullamore; Naas General Hospital; Midlands Regional Hospital Portlaoise; the Coombe Women & Infant University Hospital. (Academic Partner: TCD). |
|
iii |
Ireland East (Dublin East): Mater Misericordiae University Hospital; St Vincent's University Hospital; Midland Regional Hospital Mullingar; St Luke's General Hospital, Kilkenny; Wexford General Hospital; National Maternity Hospital; Our Lady's Hospital, Navan; St Columcille's Hospital; St Michael's Hospital, Dun Laoghaire; Cappagh National Orthopaedic Hospital; Royal Victoria Eye and Ear Hospital. (Academic Partner: UCD). |
|
iv |
South/South West: Cork University Hospital/CUMH; Waterford Regional Hospital; Kerry General Hospital; Mercy University Hospital; South Tipperary General Hospital; South Infirmary Victoria University Hospital; Bantry General Hospital; Mallow General Hospital, Lourdes Orthopaedic Hospital, Kilcreene. (Academic Partner: UCC). |
|
v |
Saolta University Health Care (West / North West): University Hospital Galway; Merlin Park University Hospital; Sligo Regional Hospital; Letterkenny General Hospital; Mayo General Hospital; Portiuncula Hospital Ballinasloe; Roscommon Hospital. (Academic Partner: NUIG). |
|
vi |
UL Hospitals (Midwest): University Hospital Limerick; Ennis Hospital; Nenagh Hospital; St John's Hospital Limerick; University Maternity Hospital Limerick; Croom Orthopaedic Hospital. (Academic Partner: UL). |
|
vii |
Children’s Hospital Group: The acute paediatric services in Dublin; Our Lady's Children's Hospital - Crumlin, Children's University Hospital Temple Street, and the paediatric service in AMNCH – Tallaght. (Academic Partner: All Universities) |
The seven Hospital Group CEOs are as follows:
-Ms Mary Day – Ireland East Hospitals Group;
-Mr Bill Maher – RCSI Hospitals Group, Dublin North East;
-Dr. Susan O’Reilly – Dublin Midlands Hospitals Group;
-Ms Colette Cowan – University of Limerick Hospitals;
-Mr Gerry O’Dwyer – South/South West Hospitals Group;
-Mr Maurice Power (Acting) – Saolta University Healthcare Group;
-Ms Eilis Hardiman - Children's Hospital Group.
As the HSE is responsible for the recruitment of the Hospital Group CEOs, I have asked the HSE to respond to the Deputy directly regarding appointment dates. If he has not received a reply from the HSE within 15 working days he should contact my Private Office and my officials will follow the matter up.
