Written Answers Nos. 1-48
38. Deputy Dessie Ellis asked the Minister for Health the number of beds that have not or cannot be reopened or are experiencing a delay in being opened as a result of the absence of safe staffing levels; and if he will make a statement on the matter. [4562/17]
Amharc ar fhreagraAs of September 2016, acute hospital bed capacity was 12,728 beds, comprising 10,569 inpatient and 2,159 daycase beds. As of 22nd January 2017, the HSE advises that there are 128 acute beds closed, with 20 closed owing to infection prevention and control, 3 for refurbishment, and 105 due to staffing constraints.
In order to enable the reopening of acute beds, recruitment of additional nurses, non-consultant hospital doctors and consultants is ongoing. By the end of November 2016, an additional 118 consultants, 267 hospital doctors and 466 nurses were employed in our health services, in comparison with November 2015. Also, a recruitment fair for nurses was held over the Christmas holiday period. The HSE reports that, since early January, an additional 57 nurses have taken up employment in the acute hospital sector.
Further, to increase acute bed capacity under the Winter Initiative, 98 beds additional beds are being opened. Of these, 57 acute beds and 18 step-down beds have already opened, with the remaining 23 to open across three hospitals shortly.
The Programme for a Partnership Government commits to a national bed capacity review, which will be undertaken this year. In addition to acute bed capacity, this review will examine capacity in the primary and community care sectors, as the availability of non-acute beds and services can mitigate the need for acute hospital admission, or facilitate earlier discharge. The review will also consider how reforms to the model of care will impact on future capacity requirements.
39. Deputy Eoin Ó Broin asked the Minister for Health if he or his Department has had consultation with the European Medicines Agency, EMA, on the application for market authorisation in the EU for the drug nusinersen; the timeframe, following a decision from the EMA, in which the National Centre for Pharmacoeconomics, NCPE, can commence its own process for assessment; the timeframe for this drug to be available; and if he will make a statement on the matter. [4554/17]
Amharc ar fhreagraFor a medicine to be considered for reimbursement by the HSE it must first have a marketing authorisation from the European Medicines Agency or the Health Products Regulatory Authority, before being assessed under the Health (Pricing and Supply of Medical Goods) Act 2013.
I understand that in Autumn 2016 Biogen applied to the European Medicines Agency for marketing authorisation in the EU for the drug Nusinersen. Along with other member states, Ireland's Health Products Regulatory Authority will actively participate in the assessment of this application. The European Medicines Agency assessment process generally takes around one year.
Should Nusinersen receive European marketing authorisation, the manufacturer would then be open to make an application to the HSE to have the product reimbursed under the community drug schemes.
The HSE assessment process is undertaken within the 180 day timeline as set out in the Health (Pricing and Supply of Medical Goods) Act 2013. This Act allows for a temporary suspension of the timeline where companies are required to provide additional data. The assessment process requires the National Centre for Pharmacoeconomics to conduct a health technology assessment of the applicant’s economic dossier on the cost effectiveness of the treatment. Once this assessment is completed, a summary report will be published on the National Centre for Pharmacoeconomics website.
The HSE then examines all the evidence which may be relevant in its view for the decision to reimburse the drug, including the assessment by the National Centre for Pharmacoeconomics.
While the authorisation process is on-going early access to this medicine has been granted to two Irish families. I understand that following an application from a consultant paediatric neurologist at Temple Street hospital, the company has extended their early access programme to two of his patients with SMA Type 1. The patients' families have been informed.
42. Deputy Billy Kelleher asked the Minister for Health when he expects the 18-month target for outpatient consultations to be fully achieved; and if he will make a statement on the matter. [4649/17]
Amharc ar fhreagra43. Deputy Seán Haughey asked the Minister for Health his plans to speed up the provision of outpatient appointments to the 2,610 persons waiting more than 18 months for a consultation in Beaumont Hospital; and if he will make a statement on the matter. [4675/17]
Amharc ar fhreagraI propose to take Questions Nos. 42 and 43 together.
Reducing waiting times for the longest waiting patients is one of this Government's key priorities.
We are seeing a considerable increase in demand for health services as our population grows and ages. For example, the HSE has advised that to the end of September, there was a sustained increase in referrals for outpatient appointments, each month in the order of 10%, in comparison with the same period in 2015.
In November, the HSE launched the Strategy for the design of Integrated Outpatient Services 2016-2020. It seeks to improve waiting times for outpatient services by enhancing patient referral pathways and utilising technology to enable better planning. In the context of rolling out this Strategy, the HSE is currently developing an Outpatient Waiting List Action Plan for 2017. The plan will focus on ensuring that no patient is waiting more than 15 months on this list by the end of October 2017.
In relation specifically to Beaumont Hospital which has a high number of patients waiting 18 months or more for an outpatient appointment, the RCSI Hospital Group is currently finalising its Operational Plan for 2017. This Plan will set out the specific actions to be implemented this year to address waiting lists, including outpatient waiting lists. These specific actions will form part of the HSE’s Outpatient Waiting List Action Plan.
I expect to make known the details of this plan in the coming weeks.
44. Deputy Mick Barry asked the Minister for Health his views on the possibility of industrial action by nurses; and if he will make a statement on the matter. [4545/17]
Amharc ar fhreagraI wish to reassure the Deputy that all efforts are being taken to reach an agreement with the INMO and SIPTU nursing to prevent any industrial action. Discussions between the INMO, SIPTU, my Department, the Department of Public Expenditure and Reform and the HSE have been ongoing over the past week and are continuing.
Issues relating to staffing, recruitment and retention of nursing and midwifery staff are being considered. The HSE, Department of Health and Department of Public Expenditure and Reform supplied a joint proposal document setting out a number of specific measures to attract and retain nursing staff, in addition to a funded workforce plan.
As part of the engagement, management are committed to maximising the number of additional nursing posts that can be provided in 2017 within the funding made available in the 2017 Estimates. Management is also committed to addressing recruitment and retention issues, while recognising that remuneration, including the global competitiveness of nursing salaries and allowances, is subject to a process under the auspices of the Public Service Pay Commission.
45. Deputy Clare Daly asked the Minister for Health his views on the fact that the number of claims for which damages were paid in maternity services cases jumped from 15 in 2007 to 101 in 2015, an almost seven-fold increase in eight years; if this increase is linked to staff and resource cutbacks over that period; and if he will make a statement on the matter. [4262/17]
Amharc ar fhreagraThe State Claims Agency which manages clinical negligence claims against consultants, including maternity claims occurring on or after 1st February 2004, on behalf of the State has advised me that the growth in maternity-related claims against consultants from 2006 onwards is in line with the actuarial predictions made by the Agency. It has also advised that there are three complicating factors that have impacted on the payments of damages figures.
Firstly, maternity-related cases involving infants, including cerebal palsy cases, often involve timelines of several years from the date of incident to the date of claim and ultimate settlement. This, therefore, greatly complicates the payments of damages picture as several claims arising from payment of damages in any particular year invariably relate to prior years.
Secondly, thirteen cerebal palsy cases in which Periodic Payment Orders (PPOs) were agreed between 2010 and 2013 were returned to Court on subsequent returnable Court dates. This means that there is double counting of payments of damages in these years.
Finally, the Symphysiotomy litigation has also had an effect on the payments of damages picture even though events giving rise to these cases occurred decades earlier.
There does not appear to be any direct evidence linking staff and resource levels to the payment of damages in the period referred to by the Deputy. The number of cases arising for payment of damages in the period 2007 to 2015 is very much in line with the State Claims Agency's actuarial model which indicated that the payment of damages over these years would continue to increase over these years, plateauing in or about 2020.
46. Deputy Thomas Byrne asked the Minister for Health the position regarding the emergency department of Our Lady's Hospital, Navan. [4362/17]
Amharc ar fhreagraOur Lady’s Hospital Navan is part of the Ireland East Hospital Group. Every hospital in that Group, large and small, has a vital role to play within the Group, with smaller hospitals managing routine, urgent or planned care locally and more complex care managed in the larger hospitals.
Currently, the Hospital Group is engaged in a programme of re-design work to further integrate and enhance the role of Navan hospital within the Group and to ensure that it will provide more services safely and appropriately. A key development has been efforts to promote better integration between the Mater and Navan hospitals, in relation to day surgical activity in Navan, with surgeons from the Mater carrying out surgery in Navan. Recent capital investments include upgrade of general theatres and the Sterile Services Unit and refurbishment of the Emergency Department.
The Hospital Redesign Working Group includes representation from local GPs, the National Ambulance Service, the Mater and Navan Hospitals and from the Ireland East Hospital Group. It is intended that the Hospital Group will continue to engage closely with all interested parties to ensure that the needs of patients, staff, the local and wider community are addressed.
I can assure the Deputy that there are no immediate plans to change Emergency Department services at Navan. Any proposed changes to Emergency Department services will only take place after stakeholder consultation in the context of overall service reorganisation in the Hospital Group and will be undertaken in a planned and orderly manner.
47. Deputy Billy Kelleher asked the Minister for Health his views on the claim by the director general of the HSE that the health services will require in the order of €9 billion in capital spend over the next ten years in order to overcome both historic and existing deficiencies. [4647/17]
Amharc ar fhreagraThe Director General said that €9 billion was a high level estimated requirement taking account of a number of factors including an aging population and increases in chronic disease.
During 2017 my Department will work with the HSE and the Department of Public Expenditure and Reform to conduct a mid-term review of the capital programme. My Department will also conduct a Bed Capacity Review which will assess projected health care needs over the next decade and the associated infrastructural requirements to meet these needs.
48. Deputy Richard Boyd Barrett asked the Minister for Health the action he will take to cease the downgrading of emergency services at University Hospital Waterford consequent on the lack of 24-7 emergency cath lab facilities and the contingent transfer of patients to Cork and Dublin; if he will cease the ad hoc regional service planning between his Department, the HSE and hospital groups and ensure that local communities served have the final say in the provision of services in their areas; and if he will make a statement on the matter. [4621/17]
Amharc ar fhreagraThere has been no downgrading of emergency services at University Hospital Waterford (UHW).
In relation to the issue of 24/7 primary PCI services at UHW, as the Deputy will be aware, an independent report undertaken by Dr Niall Herity recommended that the provision of such services at UHW should cease, in order to allow the hospital to focus on the much larger volume of planned cath lab work. However, as I have made clear, before any changes are made to how a service is delivered, I want to establish how services are improved for the patients using that service. Therefore, the implications of ceasing primary PCI services at UHW will be addressed by undertaking a national review of all primary PCI services with the aim to ensure that as many patients as possible have access on a 24/7 basis to safe and sustainable emergency interventions following a heart attack. The review is expected to be completed by the end of July 2017.
I should also mention that while Dr Herity found that the needs of the effective catchment population of UHW can be accommodated in a single cath lab, he recommended increased investment in cardiology services at the hospital. I am therefore pleased to confirm that an additional €5m funding has been provided to UHW in 2017 which will enable the hospital to provide 2 additional cath lab sessions (8 hours) per week. The UHW cath lab will now be funded to provide 12 sessions i.e. 48 hours activity per week.
Finally, the Deputy may wish to note that I have recently written to the HSE Director General requesting that consideration be given to a targeted Cardiology Waiting List initiative. Such an initiative would, I envisage, incorporate a range of measures including the sharing of facilities and resources within and between Hospital Groups, the use of any appropriate facilities in the private hospital sector, as well as the deployment of a mobile cath lab. I look forward to receiving the Director General's proposals in this regard.
