Written Answers Nos. 220 - 229
220. Deputy Bernard J. Durkan asked the Minister for Health the extent to which out-of-hour services, particularly at weekends, remain available or need to be augmented; and if he will make a statement on the matter. [43436/15]
Amharc ar fhreagraGeneral Practitioners contracted under the General Medical Services Scheme must make suitable arrangements to enable contact to be made with them (or a locum/deputy) for emergencies outside normal practice hours. While there is no obligation on GPs to participate in (GP) out-of-hours co-operatives as a means of meeting the contractual requirement, such services have been developed and expanded over time such that they are now an essential part of our primary care services and help to ensure that, to the greatest extent possible, urgent care needs are met in the primary care setting.
Out-of-hours co-operatives provide urgent GP services to patients of participating practices outside normal surgery hours, i.e. between 6 p.m. and 8 a.m. Monday to Friday and for the 24-hour period on Saturdays, Sundays and Bank Holidays. GP out-of-hours services are delivered through 14 GP co-operatives nationally and five extended hours co-operatives in Dublin. 2,068 GPs (85% of GMS contract holders nationally) participate in out-of-hours co-operatives, along with 204 non-GMS GPs.
The following range of services is provided, entirely or partially, by the GP co-operatives: Call centre; Telephone Triage; GP consultation at treatment centre or home visit.
Currently, services are provided nationally in the following settings: 7 call centres and 1 satellite call centre; 82 treatment centres, including extended hours services; 13 peripheral centres.
Since 2008, GP out-of-hours services have been extended in the following areas: Roscommon; Limerick City; Tullamore; Moate; Edenderry; Tallaght; Lucan; and Clondalkin
Plans are at an advanced stage to extend services in Sligo, North Leitrim and West Cavan in the coming weeks.
The HSE has commenced a review of existing GP out-of-hours services with a view to maximising efficiencies and to identify areas which would benefit from extension, within existing resources, of GP out-of-hours services.
221. Deputy Bernard J. Durkan asked the Minister for Health the number of available medical and surgical public hospital beds; the extent to which this number has fluctuated over the past ten years; and if he will make a statement on the matter. [43437/15]
Amharc ar fhreagraWith regard to the detailed queries raised by the Deputy, as these are service matters, 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.
222. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he will be able to alleviate the congestion at accident and emergency departments in the public hospital system; and if he will make a statement on the matter. [43438/15]
Amharc ar fhreagraED overcrowding is a priority issue for the Government. Last December I convened the ED Taskforce to assist in dealing with the challenges presented by ED overcrowding and significant progress has been made to date.
Additional funding of €117 million has been provided in 2015 to relieve pressures on acute hospitals. In April, €74 million was provided to reduce delayed discharges, lower the waiting time for Fair Deal funding and provide additional transitional care beds and home care packages. In July, €18 million provided to support the acute hospital system over the winter period by providing additional bed capacity and other initiatives to support access to care.
In preparation for the 2015/16 winter period, hospital groups have provided comprehensive winter resilience plans to the HSE. This approach is intended both to avoid unnecessary admissions to acute hospitals and to expedite discharges from hospital efficiently.
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. Last week I co-signed the ED Congestion Escalation Directive to ensure that progress made to date on overcrowding is improved upon. The Directive requires hospitals to implement their Escalation Plan whenever the Emergency Department experiences overcrowding and it is expected that this will add to the progress made on overcrowding to date.
223. Deputy Bernard J. Durkan asked the Minister for Health if patients with private health insurance have access to public and-or private health services; if any crossover affects either service in a positive or negative fashion; and if he will make a statement on the matter. [43439/15]
Amharc ar fhreagraThe Health Act 1970 (as amended) provides that all persons ordinarily resident in the country are entitled, subject to certain charges, to public in-patient hospital services and to public out-patient hospital services. Section 55 provides that the HSE may provide private in-patient services to persons who are not entitled to, or who do not have or have waived eligibility to public in-patient services. An essential element of the eligibility arrangements is that the public or private status of a patient must be specified on admission to hospital.
Where a patient elects to be treated privately by a consultant the hospital must treat that patient as a private patient. Persons who opt to be private on admission to hospital are liable for the fees of all consultants involved in his or her care and for hospital charges under Section 55 for that episode of care. Taking out health insurance is optional. People who do not take out, or who choose not to utilise, their health insurance continue to have the same entitlement to services in the public hospital system. 46% of the Irish population has private health insurance and many people opt to be treated privately. The main benefits cited by people for having private health insurance are the choice of consultant and hospital.
224. Deputy Bernard J. Durkan asked the Minister for Health his plans to make a career in the public health sector more attractive in order to encourage newly qualified health professionals to take up a career in this jurisdiction; and if he will make a statement on the matter. [43440/15]
Amharc ar fhreagraAction 46 of Future Health commits the Department of Health to work with the HSE to implement an approach to workforce planning and development that achieves the objectives of: recruiting and retaining the right mix of staff; training and upskilling the workforce; providing for professional and career development; and creating supportive and healthy workplaces. This approach will include the development by my Department of a national integrated strategic framework for health workforce planning during 2016.
The Department of Health and HSE have sought to stabilise the workforce through initiatives such as the Strategic Review of Medical Training and Career Structure (also known as the Mac Craith Report) and the Taskforce on Staffing and Skill Mix for Nursing.
The Review of Medical Training and Career Structure involved a Working Group examining and making high-level recommendations relating to training and career pathways for doctors with a view to improving graduate retention in the public health system; planning for future service needs; realising maximum benefit from investment in medical education and training. The Group made a series of recommendations in its three reports aimed at improving the retention of medical graduates in the public health system and importantly, planning for future service needs. The implementation of the Group's recommendations is being actively pursued and monitored.
The main aim of the Nursing Taskforce is to contribute to the stabilisation of the nursing workforce through the development of a framework to determine the safe nurse staffing and skill mix requirements in a range of major specialities.
The first phase of work by the Taskforce is focused on the development of a framework for safe nurse staffing and skill mix in general and specialist medical and surgical adult care settings in acute hospitals. The framework will take account of a range of factors that influence the determination of safe nurse staffing and skill mix. Chaired by the Chief Nurse, the Taskforce has employed a partnership approach to the development of its work and in its membership, with representatives of the Department of Health, the HSE, The Irish Association of Directors of Nursing and Midwifery, the Staff Associations, the Clinical Care Programmes and national and international Academic experts.
225. Deputy Bernard J. Durkan asked the Minister for Health the number and location of primary care centres currently in operation in County Kildare; the number proposed or pending; the current staffing levels and the levels required; and if he will make a statement on the matter. [43441/15]
Amharc ar fhreagraThe HSE has responsibility for the provision, maintenance and operation of Primary Care Centres. Therefore, this matter has been referred to the HSE for attention and 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.
226. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the extra accommodation available at Naas General Hospital in County Kildare has been recommissioned, with a view to alleviating overcrowding and trolley occupation in lieu of beds; and if he will make a statement on the matter. [43442/15]
Amharc ar fhreagraLast December I convened the ED Taskforce to assist in dealing with the challenges presented by ED overcrowding. Significant progress has been made to date on the ED Taskforce Plan implementation.
Additional funding of €117m has been provided in 2015 to relieve pressures on acute hospitals including reducing delayed discharges, lowering the waiting time for Fair Deal funding and providing additional transitional care beds and home care packages. Funding has been made available to support the acute hospital system over the winter period by providing additional bed capacity and other initiatives to support access to care.
All hospitals, including Naas, 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 co-signed the ED Congestion Escalation Directive recently to ensure that progress made to date on overcrowding is sustained and deepened. The Directive requires hospitals to implement their Escalation Plan whenever the Emergency Department experiences overcrowding and it is expected that this will add to the progress made on overcrowding so far. The Plan makes it compulsory for each acute hospital to take specific steps to address overcrowding such as extra ward rounds if trolley figures reach ‘red’ status as set out on the daily reports from the SDU. It also requires each hospital to take steps if any patient is left on a trolley for more than nine hours, the recommended maximum waiting time.
Capital investment in Naas Hospital in recent years has provided a new Central Sterile Stores Department, Minor Injuries Unit, Acute Medical Assessment Unit and an MRI service. The HSE is currently developing a substantial infrastructure project at Naas General Hospital which includes a new endoscopy unit. This project also incorporates the development of the Physical Medicine (Physiotherapy & Occupational Therapy) Departments and Oncology Departments. Other recent developments include the refurbishment of a ward to protect Day Services which will result in 11 additional beds being available to accommodate overcrowding in the Emergency Department.
In relation to the specific query about measures that Naas general Hospital has taken to alleviate ED overcrowding, as 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.
227. Deputy Bernard J. Durkan asked the Minister for Health the extent to which waiting lists for elective surgery will be shortened by way of administrative practices, treatment purchase schemes and otherwise; and if he will make a statement on the matter. [43443/15]
Amharc ar fhreagraImproving waiting times for scheduled care for patients is a key priority for the Government. In January, I put in place maximum permissible waiting times for inpatient and day case treatment and outpatient appointments of 18 months by 30 June and 15 months by year end.
The HSE was provided with additional funding of €51m to ensure that these maximum waiting times would be achieved. In June, the HSE reported a performance against the 18 month maxima of 99.6% for in-patient/day cases (IP/DC) and 92% for out-patients (OPD).
There are personnel and structural challenges which impact on individual specialties and hospital sites. The impact of ED escalation policies, which require the cancellation of non-essential surgery in order to safely manage demand and capacity, may pose a further challenge which cannot be accurately predicted in advance.
The latest NTPF figures, published on Friday 6 November, continue to show improvements. There are reductions in the total Inpatient/Daycase waiting list, and in the numbers of patients waiting between 15 – 18 months and waiting over 18 months.
This is very positive, as it is the first time that we have seen reductions in all 3 key categories. Improvements are also evident in Outpatient lists with the end of October seeing a reduction of almost 5000 and of over 3000 in the number of people waiting between 15 – 18 months for appointments.
228. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the extra nurses required at Naas General Hospital in County Kildare have taken up appointments or are pending; and if he will make a statement on the matter. [43444/15]
Amharc ar fhreagraI 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.
229. Deputy Bernard J. Durkan asked the Minister for Health the extent to which all operating theatres at Naas General Hospital in County Kildare are fully utilised and functional; and if he will make a statement on the matter. [43445/15]
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.
