Written Answers Nos. 140-162
140. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will confirm that the percentage of the total health budget currently being spent on mental health is 6% and that it was 7.2% in 2006; and if he will make a statement on the matter. [22695/15]
Amharc ar fhreagraIn line with the Programme for Government, my priority as Minister has been to modernise our mental health services, notwithstanding the severe resource constraints overall in recent years, and to prioritise new resources to underpin implementation of A Vision for Change. In that regard, the Government has made available in the region of €791.8 million to the HSE for mental health services in the current year. This figure, which includes the additional funding of €35 million held by the Department of Health the details of which were finalised recently, represents 6.5% of the total health budget. In relation to the 2006 percentage figure it is difficult to carry out a precise comparison, as performance and financial reporting prior to 2014 was done on a geographic basis as opposed to the current Directorate model. However, it is estimated that it would have been approximately 7%.
A total of €125m additional ring-fenced funding has been provided by the Government for mental health since coming into office. This funding has been provided to recruit approximately 1,150 new staff for the ongoing re-configuration of community mental health teams, in particular, and to underpin the development of a recovery-focussed and community-centred service. Bearing in mind the many competing demands on both the wider Health budget and Exchequer funding generally, this represents a substantial ongoing commitment to our mental health services.
Historically, funding for the mental health services constituted a high proportion of overall health spend in Ireland. In part, this reflected the traditional emphasis on an institutional model of service delivery with a clinical care focus. While funding may have been a higher than current percentage of 6.5%, much of this funding would have been spent on what was considered a staff-intensive and relatively expensive model of service. In addition, historically other areas of the overall health budget in Ireland may not have received an adequate level of funding appropriate to a modern community-focussed health service. This has been improved in recent times with, for example, greater investment in primary and community care areas, which also benefits people with mental health issues.
In line with A Vision for Change, the HSE mental health service is now moving towards a more person-centred recovery model of care, with an increasing focus on community delivery. This model of service is widely agreed to be more focussed on the needs of the service user in the first instance. It is also considered to be more cost effective and aims for a planned greater integration of services across the primary and community care sectors over time. Therefore, while every effort will be made to maximise resources for mental health, the promotion and resourcing of positive mental health extends to a much broader range of HSE service areas.
141. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will confirm that there are 1,200 fewer mental health staff in the health services now than there were in 2006; the roles that make up this group; the full-year cost of providing a single individual member of staff in these various roles; and if he will make a statement on the matter. [22696/15]
Amharc ar fhreagraThe number of staff employed in the Mental Health Service has fluctuated in recent years due to departures for various reasons, including redundancy, retirement or staff moving to take up employment elsewhere. The HSE Mental Health Division has been actively working to improve the underlying recruitment issues largely relating to Nursing and Medical staff, with some challenges in the recruitment of Psychology staff.
Since coming into office, this Government has provided additional funding of €125 million and some 1,150 new posts to develop our mental health service and in part to ensure that at a minimum, at least one of each mental health professional discipline is represented on all Community Mental Health Teams. It is important to note that the full recurring funding 2012 to 2014 is fully available in the 2015 Mental Health Budget and the HSE is actively recruiting to fill all posts. It should also be noted that at the end of 2014, for the first time in the last couple of years, the recruitment of the new staff from the additional funding provided for mental health, is beginning to make a difference to the total numbers of staff i.e. a net gain over those leaving the services, as well as significant increases in Health and Social Care Professionals.
In relation to the particular roles of the staff who have left the service and the costs associated with this group, as this is a service issue this question has been referred to the HSE for direct reply to the Deputy. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
142. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the names and number of areas where there are no 24-7 mental health services for adults in acute mental distress; and if he will make a statement on the matter. [22697/15]
Amharc ar fhreagraAcute mental health services are delivered on a 24/7 basis. Where an individual is in distress, their first point of contact is the GP who can assess their situation and decide if referral to a specialist service is required. In the event of an emergency, an individual may present to a hospital emergency department where he/she will be assessed and may, if it is deemed clinically appropriate, be referred to the mental health service or may be admitted to an acute psychiatric unit.
A Vision for Change recommends that, as part of community secondary care provision, there should be a crisis house available in each catchment area and a number of mental health services have provided crisis houses as part of their community residential provision. In addition, as part of the Government investment in mental health, 35 posts were allocated to provide for the implementation of the Clinical Programme to address self-harm presentations in emergency departments; 24 of these posts are currently in place and the remainder are in the recruitment process. The Suicide Crisis Assessment Nurse (SCAN) is also being rolled out in a number of areas across the country. In addition, a number of voluntary organisations, funded by the National Office for Suicide Prevention such as Samaritans, Pieta House, Console provide support to individuals in crisis.
In relation to the specific information requested by the Deputy, as this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
143. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will confirm that just 27 of the 46 old-age mental health teams required are in place; and if he will make a statement on the matter. [22698/15]
Amharc ar fhreagraSince coming into office, this Government has prioritised the reform of our mental health services in line with the recommendations in A Vision for Change. We are committed to reducing the stigma of mental illness, ensuring early and appropriate intervention and improving access to modern mental health services in the community. Since 2012, additional funding totalling €125 million and some 1,150 new posts have been provided for mental health. These posts have been used to strengthen Community Mental Health Teams for adults and children, to enhance specialist community mental health services for older people with a mental illness and for those with an intellectual disability and mental illness, as well as expanding forensic mental health services.
The additional funding has enabled the HSE to provide a Psychiatry of Old Age Service to areas without such a service:
- Kildare
- Wicklow
- North Lee
- North Cork
- West Cork
- Kerry
- Remaining half of Mayo
The HSE Service Plan for 2015 commits to continuing to build on the investment in mental health services for General Adult, CAMHS, Psychiatry of Old Age, Liaison, and Rehabilitation and Recovery.
In relation to the specific number of Psychiatry of Old Age teams currently in place, as this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
144. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will confirm that for persons with an intellectual disability, just 13 of the 300 posts recommended in A Vision for Change are in place; and if he will make a statement on the matter. [22699/15]
Amharc ar fhreagraSince coming into office, this Government has prioritised the reform of our mental health services in line with the recommendations in A Vision for Change. We are committed to reducing the stigma of mental illness, ensuring early and appropriate intervention and improving access to modern mental health services in the community. Since 2012, additional funding totalling €125 million and some 1,150 new posts have been provided for mental health. These posts have been used to strengthen Community Mental Health Teams for adults and children, to enhance specialist community mental health services for older people with a mental illness and for those with an intellectual disability and mental illness, as well as expanding forensic mental health services. The HSE Service Plan for 2015 commits to continue to build on the investment in community based mental health services in MHID (Mental Health in Intellectual Disabilities).
In relation to the specific question raised by the Deputy, as this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
145. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will confirm that just five of the 150 mental health intellectual disability posts for children have been filled; and if he will make a statement on the matter. [22700/15]
Amharc ar fhreagraAs this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
146. Deputy Michelle Mulherin asked the Minister for Health when a rheumatologist will be appointed to Mayo General Hospital; the reason for the delay; and if he will make a statement on the matter. [22704/15]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
147. Deputy Finian McGrath asked the Minister for Health the reason for non-payment of a retirement pension in respect of a person (details supplied) in County Longford; and if he will make a statement on the matter. [22706/15]
Amharc ar fhreagraI have asked the HSE to look into this matter and to respond to the Deputy directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
148. Deputy Terence Flanagan asked the Minister for Health if he will address a matter (details supplied) regarding accident and emergency departments; and if he will make a statement on the matter. [22709/15]
Amharc ar fhreagraReducing Emergency Department overcrowding is a priority issue for me and for the Government. All hospitals 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 convened the ED Taskforce in December 2014 to provide focus and momentum in dealing with the challenges presented by ED overcrowding. Reflecting the wide range of experience and perspectives represented on the Taskforce, the resulting action plan presented a range of time defined actions to (i) optimise existing hospital and community capacity; (ii) develop internal capability and process improvement and (iii) improve leadership, governance, planning and oversight.
The most immediate actions listed have already commenced, supported by an initial €25 million in 2014 to support services that provide alternatives to, and relieve pressure on, acute hospitals. Additional funds of €74 million have been provided in 2015 to increase the number of long term nursing home care places and reduce the waiting time for the funding of such places, as well as providing additional transitional care beds and home care packages to provide viable supports for those no longer needing acute hospital care.
All of these actions are intended to enable the HSE to deliver my stated objective of reducing the number of patients with 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 70.
149. Deputy Terence Flanagan asked the Minister for Health if he will address a matter (details supplied) regarding primary care centres; and if he will make a statement on the matter. [22710/15]
Amharc ar fhreagraTo date, there are 87 Primary Care Centres (PCCs) in operation, 44 of which have opened since March 2011. There are currently 54 locations where primary care infrastructure is under construction or at an advanced planning stage under three methods of delivery, where completion is expected by Q2, 2017:
- 15 – Direct Build;
- 14 – Public Private Partnership; and
- 25 – Operational Lease.
In November 2014, the HSE advertised an additional 73 locations for delivery of Primary Care Centres by Operational Lease. 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.
As the HSE has responsibility for the provision, maintenance and operation of Primary Care Centres, I have asked the Executive to reply directly to the Deputy about PCCs that are due to open in the coming months. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
150. Deputy Brendan Griffin asked the Minister for Health if he will include bowel disease in the long-term illness scheme; and if he will make a statement on the matter. [22714/15]
Amharc ar fhreagraThe Long Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act, 1970 (as amended). Regulations were made in 1971, 1973 and 1975 specifying the conditions covered by the LTI Scheme, which are as follows: Acute Leukaemia; Mental handicap; Cerebral Palsy; Mental Illness (in a person under 16); Cystic Fibrosis; Multiple Sclerosis; Diabetes Insipidus; Muscular Dystrophies; Diabetes Mellitus; Parkinsonism; Epilepsy; Phenylketonuria; Haemophilia; Spina Bifida; Hydrocephalus; and conditions arising from the use of Thalidomide. There are no plans to extend the list of conditions covered by the LTI Scheme.
Under the Drug Payment Scheme, no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines.
Under the provisions of the Health Acts, medical cards are provided to persons who are, in the opinion of the HSE, unable without undue hardship to arrange GP services for themselves and their dependants. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family.
151. Deputy Seán Kyne asked the Minister for Health the staffing numbers, by type and grade, working at University Hospital Galway; the number of patients, both inpatient and outpatient, treated in 2014; the way the staffing levels at the hospital compare with other acute hospitals; and his plans to increase staffing numbers at the hospital in 2015. [22719/15]
Amharc ar fhreagraI have asked the HSE to look into this matter and to respond to the Deputy directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
152. Deputy Paul Murphy asked the Minister for Health the steps that are being taken to make patients aware of their right to avail of publicly funded health care in other European Union and European Economic Area states under Directive 2011/24/EU; if he will provide, in tabular form, the number of Irish patients who have availed of this mechanism in other states, by year, since the directive came into force; and if he will provide, in tabular form, the categories of different procedures availed of. [22720/15]
Amharc ar fhreagraThe EU Directive on the application of patient's rights in cross-border healthcare seeks to ensure a clear and transparent framework for the provision of cross-border healthcare within the EU. It is designed to clarify patients' rights to access safe and good quality treatment across EU/EEA Member States.
The Health Service Executive operates the EU Directive on Patients' Rights in Cross Border Healthcare in Ireland. In line with practice in other EU Member States, the HSE, through the National Contact Point (NCP) office, provides information for patients on the Cross-Border Directive on its website - http://www.hse.ie/eng/services/list/1/schemes/cbd/ - and also by phone. The principal function of the NCP is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost and the procedures for accessing and determining those entitlements. The NCP also has a responsibility to ensure that all enquirers are informed of the right to healthcare, if any, that they may have through the European legislation on the coordination of social security schemes (EU Regulation 883/04) and which may be more beneficial to them. The NCP is able to inform patients what the cost of their treatments would be in Ireland to allow them make a comparison with the costs they are being quoted for comparable treatment in another Member State.
The Health Service Executive has been asked to examine the matter of the data requested and to reply to the Deputy as soon as possible. If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them.
153. Deputy Brendan Griffin asked the Minister for Health when a motorised wheelchair will be provided in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [22723/15]
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 (HSE) for direct reply to the Deputy. If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and they will follow the matter up with the HSE.
154. Deputy Ruth Coppinger asked the Minister for Health if he will undertake a review of wheelchair policy in order to greatly improve the quality of the service. [22729/15]
Amharc ar fhreagra155. Deputy Ruth Coppinger asked the Minister for Health if he is aware of the research by a person (details supplied) on wheelchair provision and maintenance; if his Department will be implementing changes to policy regarding the provision and maintenance of wheelchairs in order to address the concerns raised in the report; and if he will make a statement on the matter. [22730/15]
Amharc ar fhreagraI propose to take Questions Nos. 154 and 155 together.
The provision and maintenance of aids and appliances, including wheelchairs, is a service matter for the Health Service Executive. Accordingly, I have arranged for the Deputy's questions to be referred to the Health Service Executive (HSE) for direct reply to the Deputy. If the Deputy has not received a reply from the HSE within 15 working days, she can contact my Private Office and they will follow the matter up with the HSE.
156. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal will receive an ear, nose and throat appointment in Letterkenny General Hospital, County Donegal. [22732/15]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
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. In relation to the specific case raised, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
157. Deputy Ruth Coppinger asked the Minister for Health if he is aware of the case of persons (details supplied) in County Wicklow who have been experiencing difficulties in securing adequate wheelchair resources from the Health Service Executive; and the steps he will take to ensure that their needs are met. [22733/15]
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 (HSE) for direct reply to the Deputy. If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and they will follow the matter up with the HSE.
158. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the number of patients in Cavan Monaghan Hospital waiting for scans for over six months, 12 months and 18 months; the way this compares with the national average; the action being taken to address this; and if he will make a statement on the matter. [22734/15]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
159. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the current status of the Mental Health (Amendment) Bill 2008 [Seanad]; if there is any other legislation relating to mental health planned; and if he will make a statement on the matter. [22735/15]
Amharc ar fhreagraIn March this year, I published the Expert Group Review of the Mental Health Act 2001. This report contains 165 recommendations and sets out to promote the rights of persons with severe mental illness in addition to, importantly, promoting access to the most appropriate and highest achievable standard of mental health treatment, care and support. I will shortly seek Government approval for the preparation of a General Scheme of a Bill to reflect all of the recommendations of the Expert Group in revised mental health legislation.
In addition, I have prioritised an early amendment to the legislation in respect of Electro-convulsive Therapy (ECT) to ensure it cannot be administered to an involuntary patient who has capacity and refuses such treatment and a similar amendment regarding treatment over three months to involuntary patients who have capacity and refuse such treatment. I intend to use the Mental Health (Amendment) Bill 2008 to bring about these important changes to the existing legislation. This Bill while it has been passed by the Seanad contains inconsistencies and I will also shortly seek Government approval for revised heads and the rescheduling of the Bill on the Dáil order paper.
Once rescheduled, the amendments proposed by the revised Mental Health (Amendment) Bill 2008 will be progressed as soon as possible.
160. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his plans further to assist the extension of automated external defibrillator coverage; and if he will make a statement on the matter. [22747/15]
Amharc ar fhreagra165. Deputy Mary Mitchell O'Connor asked the Minister for Health if funding has been allocated for the provision of defibrillators on foot of the publication of Health Technology Assessment of Public Access Defibrillation by the Health Information and Quality Authority on 1 December 2014; and if he will make a statement on the matter. [22808/15]
Amharc ar fhreagraI propose to take Questions Nos. 160 and 165 together.
The Health Information & Quality Authority conducted an economic evaluation of various Automated External Defibrillators (AED) national deployment programmes in designated places, such as hospitals, places of worship, hospitality and entertainment venues, sports clubs, transport stations, retail premises and public buildings. It reported that none of the Public Access Defibrillation programmes evaluated would be considered cost-effective using conventional willingness to pay thresholds.
One of the means to help improve health outcomes in this area is through the expansion of the National First Response Network. Community first responder groups comprise this national network. These are people from local communities who are trained in basic life support and the use of defibrillators that attend a potentially life threatening emergency in their area. They are then able to provide an early intervention in situations such as heart attack or cardiac arrest by providing, among other things, resuscitation and defibrillation.
Cardiac First Responders (CFR) Ireland, launched earlier this year, is the national umbrella organisation for Community First Responders Groups. CFR Ireland is supported by the National Ambulance Service, Pre-Hospital Emergency Care Council and the Centre for Emergency Medical Science UCD. Each group is linked to the National Ambulance Service control and despatch system. If there is a cardiac 999 call in an area, the on-duty CFR member gets a text from the National Ambulance Service at the same time that an ambulance is despatched with location and call details. The First Responder then goes straight to the site and administers initial care (defibrillation if required) until the National Ambulance Service and Rapid Response vehicle arrives.
This national initiative provides an opportunity to extend care for cardiac events. The prospect for a pilot programme on defibrillator availability in a local area will also be explored and will address the practical issues relating to the use of AEDs in the community. In addition, the development of a national AED register is under consideration.
161. Deputy Barry Cowen asked the Minister for Health if he will provide an update on the case of a person (details supplied) in County Offaly; and when the person can expect an appointment with the consultant orthopaedic surgeon in the Midland Regional Hospital in Tullamore, County Offaly. [22783/15]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
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. In relation to the specific case raised, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
162. Deputy Eamon Gilmore asked the Minister for Health if he will provide, in tabular form, the number of persons who have applied to register with the Nursing and Midwifery Board of Ireland; the number of applicants who have successfully registered with the board and details of the longest, shortest and average length of time it has taken these applicants to complete the application to registration stage, and from the registration stage to obtaining their personal identification number from An Bord Altranais, for the years 2013, 2014 and 2015 to date; and if he will make a statement on the matter. [22788/15]
Amharc ar fhreagraI wish to thank the deputy for the matter raised.
Given that this is an operational matter, it is appropriate that it should be dealt with by the Nursing and Midwifery Board of Ireland (NMBI). Therefore, I have referred the Deputy's question to the NMBI for attention and direct reply.
If you have not received a reply from the NMBI within 15 working days, please contact my Private Office and they will follow up the matter with them.
