Written Answers Nos. 137-148
137. Deputy Timmy Dooley asked the Minister for Health his views on safety concerns expressed regarding the conditions in University Hospital Limerick's emergency department; and if he will make a statement on the matter. [4679/17]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to you directly.
138. Deputy Brendan Howlin asked the Minister for Health if he has raised Ireland's bid to secure the European Medicines Agency with his EU counterparts in bilateral meetings. [2781/17]
Amharc ar fhreagraThe European Medicines Agency plays a vital role in the protection and promotion of public health through the evaluation and supervision of medicines for human and veterinary use. The result of the Brexit vote has caused considerable uncertainty for the Agency and its staff as it will have to be relocated to a country remaining within the European Union. This scenario creates real risks for the EMA and its stakeholders – foremost, European citizens and the industries which the Agency regulates.
The Government believes that it will be important to address the question of the Agency's future location relatively early in the Brexit process. It is important that the selection of a new host country is informed by clear and careful consideration of the requirements which will need to be met in order to ensure continuity of the EMA's activities and a sustainable future for the Agency. It will be particularly important to maximise the retention of the EMA staff whose expertise and skills have been key to the Agency's development over the last 20 years and to the standing which it enjoys as a regulator at a global level.
In October the Government decided to propose Dublin as a new home for the EMA. An interdepartmental/interagency working group led by my Department was established to prepare a proposal.
Last week I visited the EMA in London in order to better understand the workings of the Agency and the challenges it will face as a result of Brexit. I met the Executive Director, Professor Guido Rasi, and key members of his team. It was agreed that we would not speak publicly about the content of those discussions.
Work is continuing on Ireland's proposal to host the EMA and I will travel to Brussels next week for discussions with a range of stakeholders.
Ultimately the decision on the new location for the EMA will be made by the European Council at heads of state or government level. I have not discussed Ireland's bid for the EMA with fellow health ministers, many of whom are also actively campaigning to host the Agency.
139. Deputy John Brassil asked the Minister for Health the timeframe for the decisive shift to primary care promised in the programme for Government; the way in which this will be benchmarked in terms of health expenditure; and if he will make a statement on the matter. [4671/17]
Amharc ar fhreagraThe Programme for Partnership Government confirmed the Government's commitment to a decisive shift towards primary care. In this context, I am bringing a renewed focus to the development of primary care and my Department's Statement of Strategy 2016-2019 sets out a range of actions aimed at improving health outcomes and the health services over the next three years. Amongst the key areas to be addressed in this context are:
- Further development of multidisciplinary primary care teamworking;
- Planning and resourcing the primary care workforce;
- Promoting the provision of necessary infrastructural capacity;
- Development of chronic disease management in primary care; and
- Negotiation of a modernised GP contract.
My Department will work with a range of stakeholders, including healthcare professionals, service users and the HSE to advance the work in these areas.
My Department has also commenced work on an overall model of care which will inform the assessment of future capacity requirements across the different parts of the health sector. This model of care will be informed by international best practice and the work underway has included engagement with experts from the European Observatory on Health Systems and Policies.
As the Deputy will be aware, the Oireachtas Committee on the Future of Healthcare was established by order of the Dáil to agree an all-party 10 year plan for the future of the health service and will consider issues such as the direction of health policy. I look forward to the outcome of the Committee's work as a further contribution to the development of the direction of travel over the years ahead.
The HSE's annual National Service Plans detail the expenditure limits for the HSE and provide details on priorities, actions and the type and volume of service that will be provided from the annual funding allocated. In addition, they list the performance indicators against which performance is measured. The Performance and Accountability Framework provides for the HSE to closely monitor the delivery of services in accordance with the agreed targets and within the agreed financial allocation and to take appropriate steps in terms of support and/or intervention as and when the need arises.
140. Deputy Brian Stanley asked the Minister for Health if Abbeyleix Hospital will be included in the capital programme; and the plans there are to refurbish, upgrade and extend the facility. [4267/17]
Amharc ar fhreagraAs the HSE is responsible for the delivery of health care infrastructure projects, the Executive has been requested to reply directly to you in relation to Abbeyleix Hospital.
141. Deputy Mick Wallace asked the Minister for Health if his Department has an official position on whether serious mental conditions are physical malfunctions in the brain or otherwise; and if he will make a statement on the matter. [4502/17]
Amharc ar fhreagraThe position of my Department, and the HSE, in relation to the question raised by the Deputy is broadly guided by the Mental Health Act, 2001, and also by reference to mental health as outlined in "A Vision for Change". There are many different definitions and descriptions surrounding concepts of mental health, which can reflect also different cultures or degrees of importance on different aspects surrounding mental health. It would be the case, too, that the question relating to any physical aspects of mental health would be open to interpretation, particularly in light of evolving clinical judgement or knowledge both nationally or internationally.
The terms 'mental disorder' and 'mental illness' are currently defined in section 3 of the Mental Health Act 2001. The Report of the Expert Group which reviewed the Mental Health Act 2001 was published in 2015 and the Group recommended that the term 'mental disorder' should be removed from the Act and replaced by a definition of the term 'mental illness'. The definition of mental illness proposed by the Group is: 'mental illness means a complex and changeable condition where the state of mind of a person affects the person's thinking, perceiving, emotion or judgment and seriously impairs the mental function of the person to the extent that he or she requires treatment'. Work is underway in the Department to prepare the General Scheme of a Bill which will reflect the recommendations of the Expert Group in revised mental health legislation.
It is generally accepted in this country that certain serious mental health conditions would be regarded as involving, or potentially involving, the type of issue raised by the Deputy. This, for example, is reflected in the HSE National Clinical and Integrated Care Programmes being developed under the annual HSE Mental Health Operational Plans, and which are published on the HSE website. These cover areas such as Self-Harm, Eating Disorders, Early Intervention for Psychosis, Attention Deficit Hyperactivity Disorder (ADHD), and Co-Morbid Dual Diagnosis for Mental Health and Substance Abuse, and may be relevant to varying degrees in the context overall mental policy and professional care delivery.
If the Deputy has further queries he wishes me to consider on this matter, I will be happy to do so if he supplies me with detailed information.
142. Deputy Eugene Murphy asked the Minister for Health if there will be any increase in the number of home help hours provided in 2017 in County Roscommon; and if he will make a statement on the matter. [4693/17]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply.
143. Deputy Margaret Murphy O'Mahony asked the Minister for Health his views on whether the HSE's one-year target for children's speech and language therapy assessments is sufficiently ambitious; and if he will make a statement on the matter. [4664/17]
Amharc ar fhreagraI am aware of initiatives in train in the HSE addressing the delivery of speech and language therapy provision and I believe they will bring with them positive impacts on the models of care and waiting lists.
In 2016, the HSE committed to undertake a review of the model and provision of primary care speech and language therapy services, particularly for children. The National Therapy Service Review Group was established to agree a revised national model of Speech and Language Therapy provision that would be standardised across all Community Healthcare Organisations. This would cover referral criteria, assessment and treatment arrangements, models of care and standardisation of a prioritisation system for Speech and Language Therapy. It is anticipated that the group will have completed its work by the end of March 2017.
In addition, in 2016, €4 million was provided under the HSE's National Service Plan to focus specifically on speech and language therapy waiting lists in Primary Care and Social Care for children up to 18 years old. This funding is enabling the HSE to fill 83 new full-time and recurring posts to address waiting lists, prioritising the longest-waiting children and recruitment is ongoing. I understand that there was a 9.3% reduction in the overall 0-18 year old waiting lists for the period 31 July 2016-31 December 2016.
The HSE National Service Plan has a target that, at end 2017, no one will wait more than one year for Speech and Language Therapy. For further details on the particular targets for speech and language therapy in 2017, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
144. Deputy James Browne asked the Minister for Health if he will reinstate a monitoring group for the implementation of A Vision for Change; and if he will make a statement on the matter. [4654/17]
Amharc ar fhreagraIn January 2006, the Government adopted the Report of the Expert Group on Mental Health Policy 'A Vision for Change' as the basis for the future development of mental health services in Ireland. In March 2006, in line with the recommendation in 'A Vision for Change', the First Independent Monitoring Group was established for a three-year period to monitor progress on the implementation of the report recommendations. The term of the first group ceased in April 2009 and in June 2009 a Second Independent Monitoring Group was appointed for a further three-year period. The Second group finished its work, delivering its final report in 2011.
'A Vision for Change' came to the end of its 10-year term in 2016. The increased investment in mental health services over the last number of years has helped to facilitate an increase in the number and staffing levels of both Adult, and Children & Adolescent Community Mental Health Teams. Of the additional 1,550 new mental health posts approved since 2012, some 1,150 have been, or are in the process of being, recruited, notwithstanding the generally challenging recruitment market in which the HSE is operating.
Increased investment has also funded the development of specialist services recommended in A Vision for Change, including Forensic, Eating Disorders, Psychiatry of Later Life, and Mental Health Intellectual Disability services. There has also been continued development of community mental health teams, improved 7-day responses and liaison services, Peri-natal Mental Health and two new clinical programmes – specifically for ADHD in Adults and Children, and for Dual Diagnosis of those with Mental Illness and Substance Misuse.
The Department of Health has now commenced the process of updating A Vision for Change. An evidence-based expert review which will focus on the progress made to date in the implementation of A Vision for Change, including a review of current delivery of services in Ireland, was commissioned in November 2016. The review will also take account of international best practice and will inform the next steps in the development of our mental health policy, having regard to both human rights and health and wellbeing objectives. This will provide a solid evidence base to determine the policy direction for a revision of A Vision for Change and is expected to be completed in February 2017.
An oversight committee will be established within three months of the review being finalised to oversee the development of a new policy for mental health based on the outcome of the expert review.
145. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he has sought or received confirmation from the HSE in regard to the optimum in terms of resources and facilities required to prevent overcrowding at accident and emergency departments at various general hospitals and waiting lists for various procedures; if comparisons continue to be made with best practice in other jurisdictions, with a view to identifying the most appropriate structures for Ireland; if he has had discussions with the various hospital and community care authorities, including private hospitals, to achieve the necessary results; the role he envisages for primary care centres in the delivery of acute services in this context; and if he will make a statement on the matter. [4637/17]
Amharc ar fhreagraIn order to respond to increasing demand for hospital services, Budget 2017 provides an additional €118 million for hospital services in 2017.
Of this funding, €109 million will be used to maintain our existing level of service to take into account the costs associated with: our aging demographics; meeting increased demand for medicines, medical technology and procedures in hospitals. This funding will also provide for the costs associated with the restoration of payments to staff under the Lansdowne Road Agreement. In addition, €9 million has been allocated to expand existing, or develop new acute hospital services in 2017.
The 2017 National Service Plan emphasises the HSE's need during 2017 to continue to pursue increased efficiency, value for money and budgetary control in delivering safe and effective healthcare services within its budget allocation.
My Department continues to engage with a wide range of stakeholders including the HSE, the National Treatment Purchase Fund (NTPF), Hospital Groups, Community Health Organisations, both public and private hospitals, and healthcare professionals on a range of issues regarding the provision of safe and clinically appropriate unscheduled and scheduled care services to patients in acute hospitals.
As part of measures to alleviate winter pressures on Emergency Departments, this Government approved the allocation of €40 million of additional funding for a Winter Initiative in 2016 - 2017. So far, the Initiative has delivered 75 newly-opened additional beds in the Mercy University Hospital Cork, University Hospital Galway, the Mater, Beaumont and Midlands Regional Hospital, Mullingar. Also, as of 24 January, delayed discharges have reduced nationally to 469, freeing up hospitals beds to alleviate ED pressures. In addition under the Initiative, since October: over 3,900 patients have availed of aids and appliances; over 780 additional homecare packages and 410 additional transitional care beds have been provided, enabling patients to be discharged from hospital sooner.
With regard to reducing waiting times for elective care, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018. In December 2016, I granted approval to the NTPF to dedicate €5 million to a daycase waiting list initiative with the aim of ensuring that no patient will be waiting more than 18 months for a daycase procedure by 30 June 2017. Around 3,000 daycases will be managed through this process and outsourcing of treatment will commence shortly.
The HSE is currently developing a 2017 Waiting List Action Plan for inpatient/daycase procedures to ensure that no patient is waiting more than 15 months by the end of October. This Plan is being developed in conjunction with the NTPF's proposal for utilisation of its remaining €10 million funding for patient treatment in 2017.
Along with my Department, I meet every week with senior officials from the HSE, including the Director General, to monitor progress on the Winter Initiative and ED performance, as well as waiting list performance.
146. Deputy Alan Kelly asked the Minister for Health the way in which he proposes to fully fund the national maternity strategy; and the funding spent to date in 2017. [4408/17]
Amharc ar fhreagraThe National Women & Infants Health Programme will lead the management, organisation and delivery of maternity, gynaecology and neonatal services, strengthening such services by bringing together work that is currently undertaken across primary, community and acute care.
In leading the implementation of Ireland's first National Maternity Strategy - Creating A Better Future Together 2016-2026 - the Programme will draw up a detailed action plan that will inform the full implementation of the Strategy on a phased basis; this work will include the identification of both capital and revenue funding requirements which will in turn inform the annual Estimates process over the lifetime of the Strategy.
€3 million in development funding provided for maternity services in 2016 was allocated in line with the Strategy, and included funding for additional staff, including 100 midwives, the development of specialist bereavement teams and for the implementation of the Maternal and Newborn Clinical Management System. Increased funding of €6.8m being provided for maternity services in 2017 will allow for the continued implementation of the Strategy. In relation to the query about expenditure to date in 2017, as this is an operational matter, I have asked the HSE to respond to you directly.
147. Deputy Brendan Smith asked the Minister for Health if there will be any increase in the number of home help hours provided in 2017 in counties Cavan and Monaghan; and if he will make a statement on the matter. [4683/17]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply.
