Written Answers Nos. 12-19
12. Deputy Finian McGrath asked the Minister for Health if he will act urgently to deal with the crisis of patients being on trolleys in Beaumont Hospital in Dublin 9; and if he will make a statement on the matter. [14658/15]
Amharc ar fhreagraReducing Emergency Department overcrowding is a priority issue for me and for the Government. All hospitals, including Beaumont, have escalation plans to manage not only patient flow but also patient safety in a responsive, controlled and planned way that supports and ensures the delivery of optimum patient care.
I am informed that Beaumont Hospital has undertaken a number of initiatives to improve the patient pathway both through the ED and the hospital, in addition to working closely with the community. All available bed capacity is open and off-site capacity is also being utilised.
Three ED-experienced nurses are to join the Emergency Department at Beaumont in the next six weeks and a feasibility study in relation to the redevelopment and potential relocation of its Emergency Department is currently out to tender.
On 2 April I announced additional funding of €74m to tackle delayed discharges and provide additional community beds thus freeing up hospital beds for other patients and reducing ED overcrowding. This is on top of measures already taken in Budget 2015 when the Government provided €25m to support services to provide alternatives to and relieve pressures on acute hospitals. This funding should enable the HSE to deliver my stated objective of reducing the number of delayed discharges by one third to less than 500 and the number of patients on trolleys in EDs waiting for admission for over nine hours to fewer than an average of 70. As a hospital with significant numbers of patients who require additional supports or long term care in order to facilitate their safe discharge from acute care, Beaumont will benefit significantly from this funding.
13. Deputy Seán Kyne asked the Minister for Health the progress of the new system for providing services for school leavers with a disability; if it is providing greater choice for the school leavers and their families; if his Department is liaising with the Department of Education and Skills concerning greater third level options for persons with disabilities; and if he will make a statement on the matter. [14661/15]
Amharc ar fhreagraIn 2014 a coordinated and streamlined approach was developed to manage the process of providing services and supports to young people based on their individually expressed preferences and assessed needs. Additional funding of €7 million was allocated for this purpose. As a result, almost 1,400 young people with disabilities who finished school or rehabilitative training received placements which fully met their needs.
The Health Service Executive is committed to providing services for school-leavers again this year and is working with schools, service providers, young people and their families to identify training needs and explore suitable options for those graduating in 2015.
Planning has commenced in respect of all school-leavers and rehabilitative training graduates to ensure that needs are identified and appropriate services are provided to young people with disabilities. The HSE has confirmed that all young people and their families will be notified by the end of June of the placement that will be available to them from September. Additional funding of €6 million (at a full year cost of €12 million) has been allocated in the Social Care Operational Plan 2015 to meet the needs of over 1,400 young people who will require continuing health-funded supports.
In line with the National Disability Strategy and the Government's mainstreaming policy, responsibility for education and training for people with disabilities is a matter for my colleague the Minister for Education and Skills. Many young people with disabilities will progress to further education or vocational training funded by that Department and some young people may continue to receive health-funded supports depending on their individual needs and abilities. The Department of Health is in regular contact with the Department of Education and Skills on childrens' disability issues through the cross sectoral team arrangements that are in place.
14. Deputy Thomas Pringle asked the Minister for Health the revenue generated from the sale of estates of deceased persons on fair deal schemes since the commencement of the scheme; and if he will make a statement on the matter. [14638/15]
Amharc ar fhreagraUnder the Nursing Homes Support Scheme, where an applicant’s assets include land and property in the State, the 7.5% contribution based on such assets may be deferred. This is an optional loan element of the Scheme which can assist an applicant with the cost of their care. The purpose underpinning the loan is to ensure than an applicant does not have to sell their house during their lifetime.
The loan can be repaid at any time but will ultimately fall due for repayment upon the applicant’s death.
Under Section 26(2)(b) of the Nursing Homes Support Scheme Act 2009 the Revenue Commissioners are the appointed agents for the State in the collection of the repayable monies under the loan element of the Scheme. The Revenue Commissioners and the HSE work together in the calculation of amounts due to be repaid to the State.
Since the Scheme commenced in 2009 and until the end of 2014 almost 10% of applicants who received support under the Scheme have availed of the loan. The HSE have advised Revenue that at the end of February 2015 €37.3m fell to be recouped from loans due for repayment, of which Revenue have recouped €22.1m.
15. Deputy Thomas Pringle asked the Minister for Health in view of the recent meeting with Saolta health group and other stakeholders, including Oireachtas Members, and the recent retirements in Letterkenny General Hospital in County Donegal, the number of general surgeon positions that will be filled in the hospital; and if he will make a statement on the matter. [14637/15]
Amharc ar fhreagraFollowing the retirement of Mr Kevin Moran, Consultant Urologist, from Letterkenny General Hospital, the Saolta University Health Care Group has put in place a locum consultant surgeon pending approval to fill this post on a permanent basis. In addition, the appointment of a further permanent general surgeon at Letterkenny General Hospital is planned.
16. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the latest status of the existing agreement between the State and the Irish Pharmaceutical Healthcare Association on pharmaceutical prices, signed in 2012; his plans to further reduce the cost of medicines to patients and the taxpayer; if the Government’s legislative powers to impose a price cut on pharmaceutical firms will be employed; the savings it is envisaged this will provide; the effect of employing the lowest price of medications in reference countries rather than the average price in these countries; and if he will make a statement on the matter. [14712/15]
Amharc ar fhreagraIn 2012 the State entered into a new three year price reduction Agreement with the Irish Pharmaceutical Healthcare Association. This Agreement remains in place until 31st October this year.
As the end of the current Agreement approaches consideration is being given to a range of options available to the State in seeking to deliver further savings on the cost of drugs. Such options include entering into a new Agreement with the Irish Pharmaceutical Healthcare Association as well as the possibility of using the legislative powers afforded to the HSE under the Health (Pricing and Supply of Medical Goods) Act 2013 to review and alter prices.
An important objective in any new arrangement will be to secure significant savings on the projected cost of drugs, as well as continued access to cost effective treatments. Since such savings may be the subject of negotiations with industry, I do not wish to place the State's detailed position or estimated savings into the public domain in advance.
17. Deputy Finian McGrath asked the Minister for Health if he will prioritise funding for disability services, in line with the Taoiseach's pre-election commitments regarding disability; and if he will make a statement on the matter. [14656/15]
Amharc ar fhreagraThe Government is committed to protecting frontline health and personal social services needs for people with disabilities. The Government currently provides funding of approximately €1.5 billion to the Disability Services Programme through the Health Service Executive's National Service Plan for 2015.
The HSE works with voluntary disability service providers to ensure that available resources are used in order to be responsive to the health and personal social services needs of people with a disability.
In 2015, the HSE is seeking to maximise the provision of services within available resources and to maintaining a consistent level to that provided in 2014, by providing the following specialist disability services:
- residential services to around 9,000 people with a disability;
- day services to over 22,000 people with intellectual and physical disabilities;
- respite residential support of 190,000 overnights for people with intellectual and physical disabilities;
- 3.9 million hours of Personal Assistant / Home Support Hours.
Additional funding of €6 million has been allocated in the HSE National Service Plan in 2015 to provide day places for an estimated 1,400 young people finishing school and rehabilitative (life-skills) training. €4m in additional funding has also been allocated in the Plan to deliver an increase in the services for children with disabilities and reduce waiting lists under the Progressing Disability Services for Children and Young People (0-18s) Programme.
A total of 150 people will be facilitated to move from institutions to homes in the community in line the recommendations of the HSE's report "Time to Move on from Congregated Settings - A strategy for Community Inclusion' (2011). This report proposes a new model of support in the community by moving people from institutional settings to the community, over a seven year time frame.
In order to maintain current service levels while supporting people with disabilities to achieve their full potential, including living as independently as possible, a significant change programme involving a realignment and reconfiguration of existing resources is being undertaken by the HSE. The reconfiguration will be in line with the recommendations in the Value for Money and Policy Review of Disability Services and will see new and sustainable models of service being implemented to meet the changing needs of service users, increased demographic pressures and individuals wish for more choice and control.
18. Deputy Sandra McLellan asked the Minister for Health the holistic and alternative therapies that are being incorporated into the treatment of children's mental health within State services; and if the Government is actively promoting the use of these types of therapies for children. [14463/15]
Amharc ar fhreagraThe agreed HSE Service Plan 2015 aims to support the population, including children, to achieve optimal mental health, and otherwise promote positive mental health as detailed in the Executive's Operational Plan for this care programme. In particular, a key priority is to progress integrated, evidence-based and recovery focussed models of care for mental heath services.
The Executive supports timely access to appropriate services to address the mental health needs of all children from a preventative care model and early intervention perspective. It should be noted, however, that mental health problems are not the sole remit of Child and Adolescent Mental Health Services (CAMHS). Like adults with mental health problems, most children and adolescents will have these problems responded to at primary care level.
The Vision for Change policy recommends a consultation/liaison model between primary care and mental health services to improve communication and coordination between the two. The Mental Health Division of the HSE has actively progressed communication and integration between primary and secondary mental health services through the use of a “Stepped Care” approach. Psychological and other relevant supports are accessed in primary care in the first instance, with CAMHS providing a secondary care service to those referred to it.
A number of other important service improvements are also being progressed by the HSE Mental Health Division with a view to promoting, encouraging and fostering the development of robust preventative initiatives and quality mental health services for all children and adolescents, including;
- A proposal to support and enhance further access to psychological therapies (psychology and counselling) in primary care for young people who would otherwise be referred to CAMHS.
- In partnership with Túsla, co-sponsoring research with NUI Maynooth which is aimed at developing innovative research, building capacity, promoting inter-agency integration, with a view to developing family-focused mental health services.
It should also be noted that the provision of health and personal social services by the HSE are, by their nature, holistic to varying degrees and the concept of a holistic approach across many services is well embedded in HSE provision. In this context, the issues raised by the Deputy would also be a matter for consideration by the health professionals involved at operational level, taking account of matters such as quality and safety, the assessed need of individuals or other relevant therapeutic requirements. Such consideration is undertaken on an individual basis as part of an overall approach tailored to the affective care and treatment of an individual.
19. Deputy Thomas P. Broughan asked the Minister for Health further to Parliamentary Question No.725 of 24 March 2015, if he will outline the business case put by Beaumont Hospital in Dublin 9 for the cystic fibrosis service, which includes a 20-bed unit; and if he will make a statement on the matter. [14636/15]
Amharc ar fhreagraOfficials from my Department met with the Cystic Fibrosis Hopesource Foundation, hospital management, clinicians and nursing staff to discuss proposals for an in-patient unit for Cystic Fibrosis patients at Beaumont Hospital within the last week. The meeting was a positive engagement, with preliminary discussions on future service needs.
It was acknowledged that the population of adults with Cystic Fibrosis served by Beaumont Hospital has more than doubled since service provision commenced. A dedicated CF Outpatient facility allows for the provision of a comprehensive range of multi-disciplinary services for approximately 150 patients. The consultation and treatment rooms have specialist air filtration to assist with infection control. Seven single in-patient rooms are reserved for elective CF admissions for prophylactic antibiotic therapy (or other treatment as required). This ensures that adults with CF are rarely admitted as in-patients via the Emergency Department. However in the longer term, demographic factors, coupled with the increase in patient longevity resulting from improved treatment and pharmaceuticals, will increase service provision requirements further. As a result, it is estimated that a future requirement will arise for up to 20 in-patient beds.
Beaumont Hospital and the HSE are engaging in relation to the overall infrastructural requirements to best meet growing service demands. An initial business case for the future development of additional CF services at Beaumont Hospital has been submitted by the CEO of the hospital to the RCSI Hospital Group Chief Executive and is under review. The views and ideas exchanged between my officials, hospital staff and patient advocates will inform the further development of this business case in the run up to the 2016 Service Plan.
