Written Answers Nos. 391-413
391. Deputy Ruth Coppinger asked the Minister for Health if he will report on the Health Service Executive scheme that was launched in July 2015, the aim of which was to recruit nurses who had been trained here to return here for employment. [40288/15]
Amharc ar fhreagraWith a recovering economy, the Health Service Executive is now in a position to offer a wide range of challenging career opportunities for nurses and midwives. There are many initiatives currently under way to improve nursing staff levels throughout the country. These include the retention of 2015 degree programme graduates, offering full time permanent contracts, and an international recruitment campaign.
In July, the HSE launched an International Staff Nurse Recruitment Campaign which focused on the UK to attract Staff Nurses to jobs in Ireland. In this campaign, there was a particular emphasis on targeting Irish Nurses who have left Ireland in recent years and want to return home. It is envisaged that the HSE will be expanding this recruitment initiative outside the UK and Europe shortly in order to fill service vacancies.
I have asked the HSE to respond to the Deputy directly on this matter. 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.
392. Deputy Jim Daly asked the Minister for Health his views on correspondence (details supplied) in County Cork regarding funding for people with intellectual disabilities; and if he will make a statement on the matter. [40295/15]
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.
393. Deputy Thomas P. Broughan asked the Minister for Health if discrepancies in supply versus demand for adult places in autism services have now been rectified; if they will recur in 2016 and in coming years; the plans that are in place to ensure that there are sufficient services to meet the numbers of school leavers with disorders on the autism spectrum; and if he will make a statement on the matter. [40304/15]
Amharc ar fhreagra394. Deputy Thomas P. Broughan asked the Minister for Health if there is a waiting list to access Gheel's adult school leaver services; the available services for such a client base in the Dublin local health office areas; the number of places available in each; and if he will make a statement on the matter. [40305/15]
Amharc ar fhreagraI propose to take Questions Nos. 393 and 394 together.
Government policy is to enable young people with disabilities to develop the skills they will need to live independent lives to the greatest extent possible, and to receive the supports they need in order to achieve this. Additional funding of €12 million, was allocated by the Health Service Executive (HSE) to meet the needs of almost 1,400 young people who required continuing health-funded supports on leaving school or rehabilitative training (RT) this year, of which €6 million was made available to provide services from September.
Finding the resources and the physical capacity to meet the needs of a growing number of new service users every year is a challenging task. When this year’s support requirements were identified, the cost of meeting those needs in full exceeded the amount available and an additional €1.5 million was added by the HSE to the overall allocation, making a total of €13.5 million full-year costs available to meet those needs. A further €1.5 million once-off capital funding was also allocated by the HSE for the provision of suitable buildings, premises and accommodation.
I understand from the HSE that by early July, 97% of all school-leavers in Community Healthcare Area 9 had been offered a placement from September which met their needs in full. In relation to the individuals that had applied for a service from Gheel Autism Services, the HSE indicated that there would be an allocation of €708,000 made available to Gheel to provide the model of day service that they had developed and once off capital funding of €80,000. However, following extensive negotiations with Gheel, it was established that services for these individuals could not be delivered by Gheel within this allocation.
Following these negotiations, the HSE initiated discussions with two alternative service providers, Praxis Care and Autism Initiatives, who already provide quality day services to young people with autism. These providers have agreed to develop appropriate service responses for 21 young people. Of these 21, two individuals have recently commenced with Praxis. Home support services are being made available to the remaining 19 individuals as an interim arrangement and I understand from the HSE, that their new service will be in place by the end of March 2016 at the latest.
A meeting of the HSE's National Project Group to plan for next years school-leavers and RT graduates will take place during November. At this meeting, the process for 2016 will be drafted for discussion with the HSE’s Head of Operations and Service Improvement.
In relation to the other operational aspects of the Deputy's questions, I have arranged for the questions to be referred to the 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.
395. Deputy John Paul Phelan asked the Minister for Health his plans to establish a medical injuries assessment board, along the same lines as the Personal Injuries Assessment Board; his position with regard to the high legal costs and awards relating to medical injuries; and if he will make a statement on the matter. [40309/15]
Amharc ar fhreagraI have no plans to establish a Medical Injuries Assessment Board. The Injuries Board is the responsibility of the Minister for Jobs, Enterprise and Innovation. Its role is to assess claims for compensation for anyone who has been in an accident and suffered an injury.
Clinical indemnity cover in respect of clinical negligence claims occurring in public hospitals and HSE funded facilities is provided by the State’s Clinical Indemnity Scheme (CIS). The State Claims Agency has a statutory responsibility to manage claims to ensure that the State’s liability and associated legal and other expenses are contained at the lowest achievable level. In this regard it has referred some minor cases to the Injuries Board for assessment and resolution.
A suite of reform measures is currently being advanced by the Government which will result in a positive impact on the tort system and the management of clinical negligence claims. The Government agreed also in October that there will be a review of the State Claims Agency and how claims are handled. The review will be undertaken by the Department of Finance as it has overall responsibility for the State Claims Agency. It is expected that the terms of reference for this review will be drawn up shortly.
396. Deputy Michael McGrath asked the Minister for Health when a psychological assessment of a child (details supplied) in County Cork will be carried out, given that it has been applied for. [40312/15]
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.
397. Deputy Tom Fleming asked the Minister for Health if he will provide the necessary funding to upgrade the operating theatre in Kerry General Hospital, given that no funding has been provided to carry out necessary structural improvement to the theatre since the hospital opened in 1985; and if he will make a statement on the matter. [40322/15]
Amharc ar fhreagraBetween 2007 and 2014, over €14m capital has been invested in Kerry General Hospital. This includes projects which delivered a new emergency department, new endoscopy department and operating theatre air handling and chiller replacement. An agreed rolling plan is being put in place to address infrastructure including theatre department requirements and associated costs.
Following the announcement last month of the health capital envelope of €3,061 million for the multi-annual period 2016-2021, the HSE is working on the Capital Plan. This Plan requires my approval together with the consent of the Minister for Public Expenditure and Reform. Details of the approved Capital Plan 2016-2021 will be published in due course. This recently announced capital envelope has increased funding available in the later years of the period and therefore potential scope for additional investment concentrated towards the end of the period.
398. Deputy Derek Nolan asked the Minister for Health if he will publish an interim report on the review of the progress of the fair deal scheme; when the final report is due; and if he will make a statement on the matter. [40323/15]
Amharc ar fhreagraThe Nursing Homes Support Scheme, which commenced in 2009, provides financial support towards the cost of care of long-term residential care services in nursing homes. A commitment was made in 2009 that the Scheme would be reviewed after three years. The Report of the Review was published on 20th July 2015. The Review included a general examination of the operation of the Scheme, as well as the balance between residential care and care in the community, and a number of key issues have been identified for more detailed consideration across Departments and Agencies.
An Interdepartmental/Agency Working Group is currently being established to progress the recommendations contained in the Report. This Group will be chaired by the Department of Health and will comprise relevant officials from the Department of the Taoiseach, the Department of Public Expenditure and Reform, the HSE, the Revenue Commissioners and, where relevant, the National Treatment Purchase Fund. This Group is due to report to the Cabinet Committee on Health in June 2016.
399. Deputy Aengus Ó Snodaigh asked the Minister for Health the average length of time spent on the personal assistant service waiting list; and the estimated cost of clearing the waiting list. [40329/15]
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.
400. Deputy Aengus Ó Snodaigh asked the Minister for Health the estimated additional cost of extending the assessment entitlements in the Disability Act 2005 beyond children born after 2002; and a breakdown indicating the figures if the 2002 threshold were to be moved back in five year intervals. [40331/15]
Amharc ar fhreagraPart 2 of the Disability Act 2005 was commenced on 1 June 2007 in respect of children aged under 5 years. In 2008, the then Government decided, in the light of financial circumstances, to defer further implementation of the Disability Act 2005 and the Education for Persons with Special Educational Needs Act 2004. However, in light of legal advice following a ruling of the High Court, children born after 1 June 2002 are being treated by the Health Service executive as eligible to apply for an assessment under the Act. Part 2 of the 2005 Act provides for an assessment of the needs of eligible applicants, occasioned by their disability, to be commenced within three months of receipt of an application and completed within a further three months.
The HSE recognises that it faces significant challenges in respect of meeting the statutory time-frames which apply to the assessment of need process, given the number and complexity of cases, and has taken a number of measures to address the issue. While any delay in assessment or intervention for any child is not desirable, it should be noted that the assessment process under the Disability Act can take place in parallel with any intervention which is identified as necessary.
Following the publication of a National Disability Authority report commissioned by the Department of Health and the HSE, a major emphasis is being placed on reconfiguring children’s disability services into integrated multi-disciplinary geographically-based early-intervention and school-aged teams under the HSE’s Progressing Disability Services for Children and Young People Programme. The key objective of this Programme is to bring about equity of access to disability services and consistency of service delivery, with a clear pathway for children with disabilities, including autism, and their families to services, regardless of where they live, what school they go to, or the nature of the individual child’s difficulties. In 2014 an additional €4 million was specifically allocated to drive implementation of the Programme, equating to approximately 80 additional therapy posts. A further additional €4m (equating to €6m in a full year) has been allocated to the Programme this year to support its ongoing implementation.
Improving access to therapy services for children in primary care and in disability services is a particular priority for the Government. Within this context, funding is being provided in 2016 to expand the provision of speech and language therapy in primary care and to support the reorganisation and expansion of speech and language and other therapies under the Progressing Disability Services Programme. Full implementation of the Programme is expected before the end of 2016.
There are no plans at present to extend the entitlement to an assessment of need under Part 2 of the Disability Act 2005 along the lines proposed by the Deputy.
401. Deputy Paul Murphy asked the Minister for Health the funding he provided and the Health Service Executive provided to the Order of St. John of God for the running of St. Raphael's in Celbridge in County Kildare, for each of the years since 2008, in tabular form. [40333/15]
Amharc ar fhreagra402. Deputy Paul Murphy asked the Minister for Health how funding from his Department and from the Health Service Executive is allocated to St. Raphael's in Celbridge in County Kildare by the number of on-site day service clients, off-site day service clients, residential clients, support or residential services to clients in off-site residential care, transport services, and other services provided on-site or off-site from St. Raphael's. [40334/15]
Amharc ar fhreagra403. Deputy Paul Murphy asked the Minister for Health the plans or proposals his Department and-or the Health Service Executive have with the Order of St. John of God or with other service providers or interested parties for the development of St. Raphael's in Celbridge in County Kildare, including proposals for the development of the site, the provision of on-site day services, the provision of on-site residential care for existing residential clients and future clients in need of residential care and on-site workshop, training, occupational therapy and educational services. [40335/15]
Amharc ar fhreagra404. Deputy Paul Murphy asked the Minister for Health the proposals or plans his Department and-or the Health Service Executive have with the Order of St. John of God or with the service providers or interested parties for the relocation of existing services and residential care provided to clients at St. Raphael's in Celbridge, in County Kildare to other off-site locations; and the details of those proposals. [40336/15]
Amharc ar fhreagraI propose to take Questions Nos. 401 to 404, inclusive, together.
The 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.
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.
As the Deputy's questions relate to service matters, I have arranged for the 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, he can contact my Private Office and they will follow the matter up with the HSE.
405. Deputy Shane Ross asked the Minister for Health his plans to reverse the cuts to the hourly rate of pay for nursing and midwife interns, and to implement a minimum wage hourly rate; his views that further steps need to be made to encourage and support nursing and midwifery graduates to stay here upon completion of their training; that treatment as interns is linked to the current shortage of nurses; and if he will make a statement on the matter. [40337/15]
Amharc ar fhreagraStudent nurses participate in the 4th year rostered clinical placement as part of their degree programme and are paid in accordance with the trainee rates specified in the National Minimum Wage Acts for the duration of the placement. At present they are paid €6.49 per hour for the first 12 weeks of the placement, €6.92 for the second 12 weeks and €7.79 for the third 12 weeks, excluding premium payments. This equates to approximately 53% of the 1st point of the staff nurse scale. Mental health student nurses are paid 2.3% more, reflecting existing relativities between general and psychiatric staff nurse pay scales. When undertaking the 4th year placement, the students are not qualified nurses. Consequently they do not fulfil the full range of nursing duties and require supervision. This is reflected in the 2:1 replacement ratio for student nurses replacing staff nurses.
The current rates of pay will be increased from the 1st January 2016, in line with the increase in the minimum wage to €9.15 per hour announced in Budget 2016 and provided for in the National Minimum Wage Order 2015 (S.I. No. 442 of 2015).
There is an international shortage of nurses and recruitment is a significant challenge at present, particularly in specialist areas. Irish nurses choose to go abroad having completed the degree programme for a number of reasons. There are many initiatives currently underway to improve nursing staff levels throughout the country. These include the retention of 2015 degree programme graduates, offering full time permanent contracts, and an international recruitment campaign.
Pursuant to the Lansdowne Road Agreement, the Department of Health and the HSE are to consider the extent to which the issue of pay for student nurses during the fourth year 36 week placement and the position in relation to incremental credit have a bearing on nurse/midwifery recruitment and retention. These matters are to be the subject of direct engagement between the nursing unions and my Department and the HSE. This process has commenced.
406. Deputy Charlie McConalogue asked the Minister for Health the impact of the human papilloma vaccine on young persons; if the vaccine has had serious side effects on a number of persons; the number of persons affected; his plans to update the warning information provided to young persons who are making decisions on whether or not to have the vaccine; and if he will make a statement on the matter. [40338/15]
Amharc ar fhreagraIn Ireland, the Health Products Regulatory Authority (HPRA) is the regulatory authority for medicines in Ireland. There are 2 licensed HPV vaccines available in Ireland (Gardasil® and Cervarix®). Gardasil® is the vaccine used by the HSE in the School Immunisation Programme. The vaccine protects against two high risk types of HPV (16 & 18) that cause 73% of all cervical cancers. Vaccinated women and girls will still be at risk from other high risk types of HPV that can cause cervical cancer and will therefore need to continue to have regular cervical smear tests.
Gardasil® is a fully tested vaccine which was licensed by the European Medicines Agency in 2006. No medicine, including vaccines, is entirely without risk, there is therefore on-going pharmacovigilance and monitoring of medicinal products once they are authorised for use. The safety profile of Gardasil® has been continuously monitored since it was first authorised. The introduction of new vaccines is based on the expert advice of the National Immunisation Advisory Committee (NIAC). Decisions on the supply of vaccines into the market are undertaken by specific expert agencies rather than being the responsibility of the Minister of the day.
The European Medicines Agency (EMA) has recently completed a review of the HPV vaccine. The review which the HPRA participated in, specifically focused on rare reports of two conditions, complex regional pain syndrome and postural orthostatic tachycardia syndrome associated with heart rate increase. The outcome of the review which was carried out by the EMA Pharmacovigilance and Risk Assessment Committee (PRAC) found no evidence of a causal link between the vaccine and the two conditions examined.
As part of its monitoring of the safety of medicines, the HPRA operates an adverse reaction reporting system, where healthcare professionals and patients are encouraged to report adverse reactions they consider may be associated with their treatment, through the range of options in place for reporting. All reports received are evaluated and considered in the context of the safety profile of the product concerned, with reports followed up as necessary for further information, that may assist in the assessment of the case.
As of the 10 November, the HPRA has received 932 reports of suspected adverse reactions or events notified in association with the use of HPV vaccines. Of the 932 reports received, 929 were associated with use of Gardasil® and three were associated with Cervarix®. The vast majority have been consistent with the expected pattern of adverse effects for the vaccines, as described in the product information, such as gastrointestinal symptoms, malaise, headache, dizziness and injection site reactions. Parents of any child with a suspected adverse reaction following administration of a vaccine are advised to contact the HSE vaccination teams or their general practitioner for advice and are referred for further management if required.
All vaccination information provided to parents is prepared from the available licensed documentation for each vaccine, the Summary of Products Characteristics and Patient Information Leaflet. The information is presented in clear simple language and approved by the National Adult Literacy Agency so that it can be understood by all adults as the average reading age in Ireland is 12 years of age.
Prior to all school immunisation parents receive an information pack in a sealed package which contains an information leaflet, consent form and cover letter. Information packs for all immunisation are standardised nationally. The information booklets include information on the most common adverse events that can occur after each vaccination. Parents are also given contact details for their local immunisation office and advised to speak to a member of the school immunisation team if they have any further questions.
Should parents require additional information about vaccines the immunisation leaflet refers to the HSE’s national immunisation website (www.immunisation.ie) where further information is available. The national immunisation website has been accredited by the World Health Organisation for credibility, content and good information practices. The website allows members of the public to contact the National Immunisation Office to ask a question if they require further information. These questions, when possible, are answered by the staff of the National Immunisation Office within one working day.
The EMA has advised healthcare professionals that available data does not warrant any change to the use of HPV vaccines as there are no new safety concerns regarding HPV vaccines. Healthcare professionals should therefore continue using the vaccines in accordance with the current product information.
407. Deputy Denis Naughten asked the Minister for Health the status of the development of a sound-proof audiology room in Roscommon town; and if he will make a statement on the matter. [40364/15]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy. 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.
408. Deputy Micheál Martin asked the Minister for Health if he will direct the Health Service Executive in the context of its 2016 service plan, and in the context of long waiting lists for essential therapy services for children with special needs, and the need to reduce waiting times, to provide a fund for the outsourcing of such services in order that they can be accessed. [40365/15]
Amharc ar fhreagraThe Government is committed to the provision and development of services for children with special needs, including early intervention services, and to improving access by these children to therapy services insofar as possible within available resources. Health related therapy supports and interventions for children, such as speech and language therapy, can be accessed through both the HSE’s primary care services and its disability services, depending on the level of need. Significant additional resources have been invested in recent years in the State’s primary care and disability services with a view to enhancing therapy service provision.
Additional funding of €20m was allocated in 2013 to strengthen primary care services and to support the recruitment of prioritised front-line posts, including over 260 additional posts for Primary Care Teams. In addition, the HSE has introduced a number of initiatives specifically in relation to speech and language therapy services that are aimed at improving access to these services, such as therapists increasing clinic based work and providing family centred interventions in a group, as opposed to a one-to-one setting, whenever possible.
The HSE is also currently engaged in a major reconfiguration of its existing therapy resources for children with disabilities into multi-disciplinary geographically based teams, as part of its National Programme on Progressing Disability Services for Children and Young People (0-18 years). The key objective of this Programme is to bring about equity of access to disability services and consistency of service delivery, with a clear pathway for children with disabilities and their families to services, regardless of where they live, what school they go to or the nature of the individual child’s difficulties. An additional €4m was allocated in 2014 to assist in implementing the Progressing Disability Services Programme, equating to approximately 80 additional therapy posts. Further investment of €4 million (equating to €6 million in a full year) has been provided this year to support its ongoing implementation.
Improving access to therapy services for children in primary care and in disability services is a particular priority for the Government. Within this context, funding is being provided in 2016 to expand the provision of speech and language therapy through primary care services and to support the reorganisation and expansion of speech and language and other therapies under the Progressing Disability Services Programme. Full implementation of the Progressing Disability Services Programme is expected before the end of 2016.
409. Deputy Róisín Shortall asked the Minister for Health if there is a priority list for the provision of primary care centres; if he will make this publicly available; the basis on which funding allocations are prioritised between direct build and operational lease approvals; and if he will make a statement on the matter. [40376/15]
Amharc ar fhreagraThe priority list of primary care centre locations compiled by the HSE in 2012 is in the public domain and available on request. The HSE has been requested to forward a copy to you. While the Government's objective is to deliver a high quality, integrated and cost effective health care service the mechanism and timescale for delivery of primary care infrastructure is dependent on a number of factors. Some of these factors are outside the control of the HSE. It is intended that infrastructure in deprived urban and small rural towns / isolated areas will continue to be funded from the Exchequer capital allocation. 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.
If you have not received a reply from the HSE within 15 working days please contact my Private Office who will follow up.
410. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 173 of 5 November 2015, the identity of the patient advocacy groups referred to in his reply. [40394/15]
Amharc ar fhreagraThe HSE have advised that the following patient advocacy groups were contacted during the consultation process on the HSE's National Guidelines on Open Disclosure:
1. Patients for Patient Safety
2. Caring for Carers
3. Irish Heart.ie
4. COPD support.
5. Patient Focus
6. Irish Patient.ie
7. Hospice Foundation.ie
8. IPOSSI (Irish Platform for Patients Organisations, Science and Industry
9. Fedvol.ie ( The National Federation of Voluntary Bodies)
It should be noted that the "Forward" to the National Guidelines was written by a representative of the WHO Patients for Patient Safety Programme, External Lead, Ms. Margaret Murphy.
411. Deputy Finian McGrath asked the Minister for Health the status of full-time residential care for a person (details supplied) in Dublin 13; and if he will make a statement on the matter. [40397/15]
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.
412. Deputy Seán Kenny asked the Minister for Health his plans to improve the D-Doc Service; the number of urgent cases where persons had to wait over four hours for a doctor to visit a house upon request; and if he will make a statement on the matter. [40410/15]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy. 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.
413. Deputy Mary Lou McDonald asked the Minister for Health when an assessment of needs report will be released to the parents of a person (details supplied) as it is delaying that person's access to services; and if he will make a statement on the matter. [40414/15]
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. 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.
