Tuesday, 18 Oct 2016

Written Answers Nos. 485-509

Mental Health Services Funding

Ceisteanna (486)

Bernard Durkan

Ceist:

486. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he remains satisfied that adequate resources remain available for child psychology and psychiatry services, with particular reference to early intervention and identification of the relevant and appropriate supports, thereby making available an adequate suite of services to meet the growing requirements evenly throughout the country; if any analysis has been carried out to identify possible weaknesses in the services over the past number of years; and if he will make a statement on the matter. [22939/16]

Freagraí scríofa

Minister of State at the Department of Health

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

I am satisfied that, in light of the additional funding announced in Budget 2017 for mental health and disability services, together with the significant funding provided in recent years, that the service issues highlighted by the Deputy will continue to be enhanced by the HSE.

I have referred the Deputy's question to the Executive, in respect of the detailed information sought.

Mental Health Policy

Ceisteanna (487)

Catherine Connolly

Ceist:

487. Deputy Catherine Connolly asked the Minister for Health the steps he is taking to end the practice of placing children and adolescents in adult psychiatric wards; and if he will make a statement on the matter. [23032/16]

Freagraí scríofa

Minister of State at the Department of Health

It is the policy of the HSE, as reflected in its annual service plans, to provide an age appropriate mental health service. A significant majority of young people are now being treated by a Child and Adolescent Mental Health Team.

Progress on this issue has been significant overall in recent years, demonstrated by the fact that the number of such admissions in 2008 was 247, reducing to 95 last year. This is despite a background of increasing demands on the Child and Adolescent Mental Health services generally. There are a number of reasons why such admissions are made. These include distance from a Child and Adolescent Mental Health Services facility, timing of admissions, potential medical issues, and the agreement of the young person, and their family. The HSE monitors the situation closely with a view to limiting inappropriate admissions as much as possible, and putting in place safeguards to protect young people in such situations. A total of 47 Child and Adolescent Mental Health service users have been admitted to adult mental health units up to the end of August this year, out of a total amount of 247 Child and Adolescent Mental Health admissions. In August 2016, 99.6% of the bed days used by children admitted to mental health acute inpatient units were in age appropriate Child and Adolescent Acute Inpatient Units.

CAMHS has been prioritised in the new funding made available by Government since 2012, designed to support timely access to appropriate services to address the mental health needs of all children, with the emphasis on the early intervention and integrated service. Additional resources and facilities means that we now have 67 CAMHS teams, and 3 Paediatric Liaison Teams, supported by 66 operational CAMHS beds across the country.

There have been some difficulties in recruiting and retaining Specialist Child and Adolescent Mental Health Services staff, particularly consultant psychiatrists. Due to these operational staff recruitment and retention challenges at local level, a number of referrals in the 16-18 year age group are dealt with by local Adult Teams under appropriate CAMHS procedures. The Executive is addressing this issue on an on-going basis.

Bearing in mind all the circumstances, I am satisfied that the HSE is making good progress in relation to the issues raised by the Deputy, including taking account of the wishes of each young person and their parents or guardians, and the complexities of each case. In many cases, a multi-disciplinary or inter-agency approach is required. I will continue to closely monitor this issue, in conjunction with the HSE, to ensure that the new funding I secured for mental health overall for 2017 will contribute to improving Child and Adolescent Mental Health Services, and aiming to maximise age appropriate admissions across all regions.

Commissions of Inquiry

Ceisteanna (488)

Clare Daly

Ceist:

488. Deputy Clare Daly asked the Minister for Health the progress of the establishment of a commission of investigation into the Grace foster home scandal; and if he will provide assurance that a previous undertaking that Dáil Éireann would be given an opportunity to debate the terms of reference of the commission will be honoured. [22240/16]

Freagraí scríofa

Minister of State at the Department of Health

I wish to assure the House that I am fully committed to the establishment of a Commission of Investigation into this matter. I remain very concerned about the issues which have been raised in this case and cannot stress highly enough that the safety and protection of all vulnerable people in the care of the State is paramount. The previous Government's approval to the establishment of a Commission of Investigation, was given in principle, subject to a further decision to be made by the Government on detailed terms of reference, timelines and costs which will be informed by the Report on the South East Foster Care Review undertaken by Mr. Conor Dignam Senior Counsel, which I received in late August.

When submitting his Report to me, Mr Dignam drew attention to some legal procedural and administrative matters which he advised should be addressed before the Report is published. The Department immediately initiated the procedural steps necessary to address the matters set out by Mr. Dignam. As soon as these legal procedural and administrative matters have been addressed I will bring the Report to Government with a view to its early publication.

While the legal matters are being addressed, I and my officials have studied Mr. Dignam’s Report carefully and my officials are now engaged in drafting Terms of Reference for the Commission, pending publication of the Report. Submission of the Report to Government is a priority for me in the Autumn term.

In accordance with the provisions of the Commissions of Investigation Act 2004 the establishment of the Commission will then require the approval of the Oireachtas, at which point the Oireachtas will be given the opportunity to debate the Commission's Terms of Reference.

Question No. 489 answered with Question No. 90.

Hospital Waiting Lists

Ceisteanna (490)

Bernard Durkan

Ceist:

490. Deputy Bernard J. Durkan asked the Minister for Health when required surgery can be facilitated in Beaumont Hospital in the case of a person (details supplied); and if he will make a statement on the matter. [30699/16]

Freagraí scríofa

Minister for Health

Under 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.

Hospital Waiting Lists

Ceisteanna (491)

Éamon Ó Cuív

Ceist:

491. Deputy Éamon Ó Cuív asked the Minister for Health when an operation will be provided for a person (details supplied) in County Galway in view of the urgency of the medical circumstances in this case; the reason for the delay; and if he will make a statement on the matter. [30700/16]

Freagraí scríofa

Minister for Health

Under 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.

Hospital Staff Recruitment

Ceisteanna (492)

Dara Calleary

Ceist:

492. Deputy Dara Calleary asked the Minister for Health if his Department is any closer to appointing a full time rheumatologist to Mayo University Hospital; if he will divert some of his Department's increased annual budget towards the provision of a full time service at Mayo University Hospital; and if he will make a statement on the matter. [30711/16]

Freagraí scríofa

Minister for Health

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.

Departmental Schemes

Ceisteanna (493)

Kevin O'Keeffe

Ceist:

493. Deputy Kevin O'Keeffe asked the Minister for Health when payment under a specific scheme will issue to a person (details supplied). [30713/16]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter it has been referred to the Health Service Executive for direct reply.

Nursing Staff Data

Ceisteanna (494)

Louise O'Reilly

Ceist:

494. Deputy Louise O'Reilly asked the Minister for Health further to the announcement of the recruitment of nurses as part of budget 2017, the number of these posts which are intended to convert existing agency staff; the number of the 1,000 posts which are additional posts to the numbers in the health service, inclusive of agency staff; the incentives and measures to be put in place to ensure that 1,000 additional posts are filled; and if he will make a statement on the matter. [30715/16]

Freagraí scríofa

Minister for Health

The HSE intends to recruit an additional 1,000 nurses and midwives to support service delivery. The number of Nurses and Midwives employed in the public health system has increased by over 1,160 in the past two years, having fallen by almost 4,600 in the period between September 2007 and August 2014. Given the increasing and aging population it is essential that nursing and midwifery numbers continue to grow as the increasing budget allows.

The increased funding being made available in the Estimate will enable the HSE to continue to focus on recruiting graduating nurses and retaining the nurses currently in the system. This latter aim will be supported by the decision to restore incremental credit to all nursing and midwifery graduates.

The HSE is already offering permanent posts to 2016 degree programme graduates, offering full time permanent contracts to those in temporary posts and is also focused on converting agency staffing to permanent posts. The HSE will allocate the 1,000 additional nursing places on completion of the HSE National Service Plan 2017. The precise breakdown between agency conversion, recruitment to fill posts falling vacant and those that are currently vacant will be reflected in the Plan.

Hospital Appointments Status

Ceisteanna (495)

Fiona O'Loughlin

Ceist:

495. Deputy Fiona O'Loughlin asked the Minister for Health the status of a hospital appointment in respect of a person (details supplied); and if he will make a statement on the matter. [30732/16]

Freagraí scríofa

Minister for Health

Under 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.

Medicinal Products

Ceisteanna (496)

Gerry Adams

Ceist:

496. Deputy Gerry Adams asked the Minister for Health the status of the cystic fibrosis drug Orkambi; the outcome of the health technology assessment undertaken on this product; if there are current negotiations ongoing with the makers of Orkambi; if so, when these negotiations might conclude; and if he will make a statement on the matter. [30734/16]

Freagraí scríofa

Minister for Health

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Prior to deciding whether to reimburse a medicine, the HSE considers a range of statutory criteria, including clinical need, cost-effectiveness and the resources available.

The decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE, on the advice of the National Centre for Pharmacoeconomics (NCPE). The NCPE conducts health technology assessments (HTAs) of pharmaceutical products for the HSE, and can make recommendations on reimbursement to assist the HSE in its decision-making process. The NCPE used a decision framework to systematically assess whether the drug is cost-effective as a health intervention.

I am informed that, following a request from the HSE, the NCPE carried out an assessment of the manufacturer's economic dossier submitted in March 2016 on the cost effectiveness of lumacaftor/ivacaftor (Orkambi). This dossier included details on all relevant costs and relevant cost offsets including hospitalisation, disease management costs, intravenous antibiotics, adverse events and any additional costs arising in patients not taking Orkambi.

The NCPE has completed its HTA and submitted it to the HSE. The NCPE determined, following an evaluation of the economic dossier, that the manufacturer failed to demonstrate cost-effectiveness or value for money from using the drug. The NCPE have confirmed that all relevant costs were included in the analysis.

A summary of the HTA has been published on the NCPE website and is available at: http://www.ncpe.ie/wp-content/uploads/2015/12/Website-summary-orkambi.pdf.

The HSE has since had further engagements with the manufacturer in an effort to secure significant price reductions for Orkambi. The HSE will consider the outcome of these engagements and any other, together with the NCPE recommendation, in making a final decision on reimbursement.

Hospital Appointments Status

Ceisteanna (497)

Fiona O'Loughlin

Ceist:

497. Deputy Fiona O'Loughlin asked the Minister for Health the status of a hospital appointment in respect of a person (details supplied); and if he will make a statement on the matter. [30735/16]

Freagraí scríofa

Minister for Health

Under 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.

HSE Investigations

Ceisteanna (498)

Billy Kelleher

Ceist:

498. Deputy Billy Kelleher asked the Minister for Health if the inquiry into the case of a person (details supplied) has been carried out; and if so, when the family will be contacted with the outcome. [30737/16]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service issue this question has been referred to the HSE for direct reply.

Departmental Funding

Ceisteanna (499)

Niall Collins

Ceist:

499. Deputy Niall Collins asked the Minister for Health if he will provide additional funding to reinstate full-time hours for the safety of estate management workers in areas (details supplied); if he will provide assurances; and if he will make a statement on the matter. [30739/16]

Freagraí scríofa

Minister of State at the Department of Health

In line with the National Drugs Strategy, the Government is committed to continuing support for initiatives to tackle the drug problem. Drug and Alcohol Task Forces play a key role in assessing the extent and nature of the drug problem in their areas and coordinating action at local level, so that there is a targeted response to the problem of substance misuse in local communities.

The Department of Health will shortly be writing to Task Forces to invite them to submit their recommendations for funding of drugs initiatives in 2017. It is a matter for Task Forces to ensure that their budget is effectively deployed to address current priorities and locally identified needs, including in relation to the issue of community safety.

Speech and Language Therapy Provision

Ceisteanna (500)

Barry Cowen

Ceist:

500. Deputy Barry Cowen asked the Minister for Health the status of the case of a person (details supplied); and when the person will receive an appointment for speech and language therapy in Tullamore, County Offaly. [30746/16]

Freagraí scríofa

Minister for Health

As this 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.

HSE Reports

Ceisteanna (501)

John Brassil

Ceist:

501. Deputy John Brassil asked the Minister for Health the way engagement will take place with families and persons concerned in relation to Time to Move on from Congregated Settings - A Strategy for Community Inclusion (details supplied); his plans to accommodate the persons who will not want to move from their current setting; and if he will make a statement on the matter. [30747/16]

Freagraí scríofa

Minister of State at the Department of Health

The HSE’s report “Time to Move on from Congregated Settings – A Strategy for Community Inclusion”, (2011) proposes a new model of support in the community by moving people from institutional settings to the community. The plan is being rolled out at a regional and local level and involves full consultation with stakeholders.

The Programme for Government contains a commitment to continue to move people with disabilities out of congregated settings, to enable them to live independently and to be included in the community. Currently, 2725 people live in congregated settings and our objective is to reduce this figure by one-third by 2021 and ultimately, to eliminate all congregated settings.

The HSE has established a subgroup, under 'Transforming Lives', the Programme to implement the recommendations of the Value for Money and Policy Review of Disability Services, which is developing an implementation plan for moving people from institutions. I welcome the fact that the needs of people moving from congregated settings will be fully taken into account during this process as the model of care for individuals will be based on a person centred plan.

The HSE's 2016 National Service Plan has set a target of 165 people to move from institutions in 2016 into suitable accommodation. Earlier this year, I announced that we are providing €100 million in capital funding from now until 2021 in respect of acquiring and renovating properties in priority institutions identified by the HSE. This will ensure that people are able to move out of congregated settings, and into their own homes in the community. I want to emphasise that the appropriate supports and resources are being put in place to ensure that people are supported as they move out of residential centres.

In addition, I am pleased to note that the Department of the Environment is providing €10 million under the Capital Assistance Scheme to provide suitable accommodation for people transitioning from institutions in 2016. The HSE estimate that a further 100 people could benefit from this initiative. €1 million in ring-fenced leasing funding is also being made available by the Department of the Environment in 2016 to support people moving from institutions into suitable social housing in the community. This demonstrates the joined up commitment of both Departments to support the de-congregation programme.

The HSE has developed a three strand approach to accelerate transitions from institutions in the period 2016-2021, with a target of 900 people to move to more suitable accommodation in this period.

- Strand 1- is focused on large institutional settings at high risk of not meeting HIQA Standards;

- Strand 2- is focused on moving people into suitable social housing in the community through the Department of Environment schemes; and

- Strand 3- is focused on remaining service users in congregated settings who could move to suitable accommodation.

I can assure any concerned residents or family members that the process of moving a person with disabilities out of a congregated setting is not something that happens overnight. This process of moving people to more suitable accommodation in the community will take place over a number of years, and will be done in full consultation with all residents and their families.

As the HSE is responsible for leading out on the recommendations on "Time to Move on from Congregated Settings - A Strategy for Community Inclusion", I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

General Practitioner Services

Ceisteanna (502)

Frank O'Rourke

Ceist:

502. Deputy Frank O'Rourke asked the Minister for Health if the recruitment process for filling the vacant general practitioner position at Johnstownbridge health clinic, County Kildare, has been completed to schedule, that is, by mid-September; if a new GP has been appointed; when the new GP contract will commence; if the previous level of 100 hour weekly GP cover will be maintained under the new contract; and if he will make a statement on the matter. [30748/16]

Freagraí scríofa

Minister for Health

As this 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.

Medical Aids and Appliances Provision

Ceisteanna (503)

Michael Healy-Rae

Ceist:

503. Deputy Michael Healy-Rae asked the Minister for Health the status of the provision of a blood monitor in respect of a person (details supplied); and if he will make a statement on the matter. [30749/16]

Freagraí scríofa

Minister for Health

As this is a service matter, it has been referred to the HSE for reply to the Deputy.

Long-Term Illness Scheme Eligibility

Ceisteanna (504)

Mary Butler

Ceist:

504. Deputy Mary Butler asked the Minister for Health his plans to adjust the eligibility to the long-term illness scheme to include conditions and illnesses such as osteoporosis, in view of the high costs associated with this; and if he will make a statement on the matter. [30756/16]

Freagraí scríofa

Minister for Health

The Long Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the scheme are: 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. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.

There are no plans to extend the list of conditions covered by the LTI Scheme.

Nursing Homes Support Scheme Applications

Ceisteanna (505)

Peter Burke

Ceist:

505. Deputy Peter Burke asked the Minister for Health if he will expedite an application for the fair deal scheme in respect of a person (details supplied); and if he will make a statement on the matter. [30760/16]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter it has been referred to the Health Service Executive for direct reply.

Departmental Inquiries

Ceisteanna (506)

Billy Kelleher

Ceist:

506. Deputy Billy Kelleher asked the Minister for Health if he will establish an independent external inquiry into events surrounding the treatment and care of a person (details supplied) and the events that followed; and if he will make a statement on the matter. [30774/16]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service issue this question has been referred to the HSE for direct reply.

Psychological Services

Ceisteanna (507)

Michael Healy-Rae

Ceist:

507. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a psychologist for a person (details supplied); and if he will make a statement on the matter. [30782/16]

Freagraí scríofa

Minister of State at the Department of Health

As 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.

Respite Care Services Provision

Ceisteanna (508)

Pat Deering

Ceist:

508. Deputy Pat Deering asked the Minister for Health the status of the provision of respite care for children with physical and intellectual disabilities in County Carlow; and if he will make a statement on the matter. [30784/16]

Freagraí scríofa

Minister of State at the Department of Health

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.

As 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.

Hospital Waiting Lists

Ceisteanna (509)

Éamon Ó Cuív

Ceist:

509. Deputy Éamon Ó Cuív asked the Minister for Health when an operation will be provided for a person (details supplied) in County Galway; the reason for the delay; and if he will make a statement on the matter. [30788/16]

Freagraí scríofa

Minister for Health

Under 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.