Written Answers Nos. 180-202
180. Deputy Jan O'Sullivan asked the Minister for Health when construction work will commence on the redeveloped St. Mary's Hospital and Boyne View House expansion project in Drogheda, County Louth; the overall cost of the project; the timeframe for the completion of the work; and if he will make a statement on the matter. [10793/17]
Amharc ar fhreagraThe Capital Programme announced in January 2016 provides for the replacement and refurbishment of 90 public nursing homes across the country over the next five years. Under this Programme it is proposed to deliver a combination of a new build and refurbishment at St Mary's Hospital and Boyne View House by 2020. This will replace existing facilities where the physical environment requires significant improvement.
Significant work has been undertaken by the HSE in determining the most appropriate scheduling of projects over the period 2016 to 2021, within the phased provision of funding, to achieve compliance and registration with HIQA. All healthcare infrastructure developments, including this development, must comply with DPER guidelines and EU directives and will require a lead-in time to complete the various stages. These stages include appraisal, project brief, design feasibility, detailed design, some of which may overlap, the review of costing estimates and finalisation of financing.
181. Deputy Jan O'Sullivan asked the Minister for Health when construction work will commence on the development of a new residential care facility for older persons at St. Brigid's complex, Ardee, County Louth; the overall cost of the project; the timeframe for the completion of the work; and if he will make a statement on the matter. [10800/17]
Amharc ar fhreagraI presume the Deputy is referring to St Joseph's Hospital, as the St Brigid's complex is a large former psychiatric hospital which now accommodates a variety of HSE services. The Capital Programme announced in January 2016 provides for the replacement and refurbishment of 90 public nursing homes across the country over the next five years. Under this Programme it is proposed to deliver a 50 bed replacement unit at St Joseph's Hospital, Ardee by 2021. This will replace existing facilities where the physical environment requires significant improvement.
Significant work has been undertaken by the HSE in determining the most appropriate scheduling of projects over the 5 year period from 2016 to 2021, within the phased provision of funding, to achieve compliance and registration with HIQA. All healthcare infrastructure developments, including this development, must comply with DPER guidelines and EU directives and will require a lead-in time to complete the various stages. These stages include appraisal, project brief, design feasibility, detailed design, some of which may overlap, the review of costing estimates and finalisation of financing.
182. Deputy Barry Cowen asked the Minister for Health the status of the case of a person (details supplied) and when the person can expect an appointment at St. James's Hospital, Dublin. [10801/17]
Amharc ar fhreagraUnder 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.
183. Deputy Bernard J. Durkan asked the Minister for Health if post-operative home help will be facilitated in the case of a person (details supplied); and if he will make a statement on the matter. [10819/17]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply.
184. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [10820/17]
Amharc ar fhreagraUnder 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.
185. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) has been waiting a significant length of time to receive a hospital appointment. [10844/17]
Amharc ar fhreagraUnder 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.
186. Deputy Ruth Coppinger asked the Minister for Health when he will make medical cards available to persons in receipt of domiciliary care allowance without the requirement of a means test; and if he will make a statement on the matter. [10854/17]
Amharc ar fhreagra241. Deputy Pat The Cope Gallagher asked the Minister for Health his plans to introduce medical cards for the children of parents in receipt of domiciliary care allowance; if primary legislation is required to allow this; if so, the timeframe for its introduction; and if he will make a statement on the matter. [11113/17]
Amharc ar fhreagraI propose to take Questions Nos. 186 and 241 together.
I have received permission from Government to publish the Health (Amendment) Bill 2017 which will enable the granting of full eligibility for general practitioner and other health services to all children in respect of whom a Domiciliary Care Allowance (DCA) is paid. Granting a medical card to all children in respect of whom a DCA payment is made will benefit approximately 9,800 children in this cohort who do not currently qualify for a medical card. The legislation will begin its passage through the Oireachtas next week and it is hoped to complete all Stages before the end of March.
The HSE is also finalising the administration processes that need to be in place so that the proposal can be implemented in a smooth and efficient manner.
187. Deputy Brendan Griffin asked the Minister for Health the reason a person (details supplied) in County Kerry who has been formally diagnosed here and in Germany as being a sufferer of Lyme disease has not received any further contact from the HSE since November 2016 despite having informed the HSE of the positive diagnosis at that time; if he will intervene with the HSE to ensure the person receives the treatment that is required immediately; and if he will make a statement on the matter. [10868/17]
Amharc ar fhreagraAs this matter relates to an individual case, it has been referred to the Health Service Executive for a direct reply to the Deputy.
188. Deputy Brendan Griffin asked the Minister for Health the reason diagnostics here for Lyme disease appear to be at odds with those of other countries such as Germany; the measures he is taking to ensure that persons with Lyme disease are accurately diagnosed; his views on cases in which persons with Lyme disease are being told in error that they are Lyme disease negative; and if he will make a statement on the matter. [10869/17]
Amharc ar fhreagra189. Deputy Brendan Griffin asked the Minister for Health the efforts he is making to make the public aware of the risk of Lyme disease; if he will increase public awareness of the methods of contraction, the symptoms, the treatments available and the consequences of not treating the condition; the amount the HSE spends annually on public awareness surrounding Lyme disease; and if he will make a statement on the matter. [10870/17]
Amharc ar fhreagraI propose to take Questions Nos. 188 and 189 together.
Lyme disease (also known as Lyme borreliosis or LB) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi that is transmitted to humans by bites from ticks infected with the bacteria. The infection is generally mild affecting only the skin, but can occasionally be more severe. Lyme disease is the commonest cause of tick-borne infection in Europe.
Lyme borreliosis can be asymptomatic or have a range of clinical presentations. Current best advice is that diagnosis should be made only after careful examination of the patient's clinical history, physical findings, laboratory evidence and exposure risk evaluation. Exposure to ticks prior to disease manifestations is necessary for the diagnosis of Lyme borreliosis. Since an awareness or recollection of a tick-bite is not always present, however, this should not exclude the diagnosis of Lyme borreliosis. Later stages require the use of antibody detection tests (or advanced DNA detection techniques). Testing for Lyme Disease is undertaken in most of the larger hospitals in Ireland. In undertaking Lyme testing, it is essential that the results are interpreted in the light of the clinical condition of the patient. If the result of this initial screen is equivocal, the patient's samples are referred to the U.K.'s Public Health England Porton Down facility which uses a two-tier system recommended by American and European authorities. This involves a screening serological test followed by a confirmatory serological test.
Some laboratories abroad do not use antibody tests like the EIA (screening ELISA test) and Western Blot and instead will use other types of tests, for example, testing for levels of a specific white blood cell (CD-57) or lymphocyte transformation tests (tests to measure how specific cells in a person's immune system respond when exposed to antigens against Borrelia burgdorferi - the bacterium responsible for Lyme disease). These types of tests are not currently recommended by international groups such as the CDC, IDSA or BIA for a number of reasons:
1. There is not enough scientific evidence that they are suitable tests to diagnose Lyme disease.
2. There is no standard method to perform and interpret these kind of tests and
3. Positive results in these kinds of tests may be due to other illnesses or conditions and not just Borrelia infection.
Since 2013, the HPSC has held an annual ‘Lyme Awareness Week’ at the beginning of the tick biting season, the purpose of which is to draw attention - particularly in the media - to Lyme disease and the ticks that can spread this disease. Lyme cases tend to appear in Ireland with greater frequency after April, hence the choice of this time of year for Lyme Awareness Week.
The literature on the HPSC website points out that campers, walkers and certain occupational groups such as forestry workers, conservation workers, deer cullers and farmers are at particular risk of exposure to ticks (and therefore LB). That said, anyone walking or hiking in the countryside is at risk of biting ticks. The ticks responsible for LB are generally hard-bodied ticks (Ixodidae). Ixodes ticks are hosted by a wide range of mammals including deer, sheep and cows, and occasionally birds; their tiny size (less than 2mm unfed) means they can remain undetected for long periods.
Ixodes ticks are most likely to be found in:
- Shady and humid woodland clearings with grass;
- Open grassland, walking paths (especially those bordered by long grasses);
- Wooded and forested areas;
- Vegetation close to lakes and seaside beaches;
- Parkland areas; and
- Open fields and bushes.
They are present in both urban and rural environments and are active from spring to autumn.
Both the Health Protection Surveillance Centre and Tick Talk Ireland provide guidance on protection against contracting Lyme borelliosis. The best protection is to prevent tick bites, when walking in grassy, bushy or woodland areas, particularly between May and October:
- Arms and leg should be covered; wearing long trousers tucked into socks or boots, and long-sleeved shirts with cuffs fastened is advised. Shoes or boots should be worn rather than open-toed sandals.
- The use of insect repellent on clothes is recommended, or on limbs if it is not practicable to cover up. DEET or permethrin (insect repellents) can be used – advice can be obtained from pharmacies.
- Skin and clothing should be inspected for ticks every three to four hours and children's skin and clothes checked frequently.
- Ticks should be removed as soon as they are seen attached to the skin. Further advice on tick removal can be obtained from the HPSC website.
- It is not recommended that antibiotics are given to prevent the transmission of Lyme disease following a tick bite. Only if the area becomes inflamed may treatment be required; and advice should be sought from a doctor.
- People should see their doctor if they develop a rash or become unwell with other symptoms, letting the doctor know of exposure to ticks.
Further advice can be obtained from the HPSC website (www.hpsc.ie) and the HPSC produced a leaflet on “Protecting Yourself Against Tick Bites and Lyme Disease” which is available for the public to download.
A Lyme Borreliosis Sub-Committee of the Scientific Advisory Committee of the HPSC has been established to look at methods of raising awareness especially in those areas (including recreation areas) where Lyme carrying ticks can be most expected to be found. The aim of this Sub-Committee is to develop strategies to undertake primary prevention in order to minimise the harm caused by Lyme Borreliosis in Ireland. In addition to staff from the HPSC, the membership of the Sub-Committee includes specialists in Public Health Medicine, Consultants in Infectious Diseases, Clinical Microbiology, Occupational Health an Entomologist from the Parks and Wildlife Service, a representative from the Local Government Management Agency, an Environmental Health Officer, and member of Tick Talk has been invited to be the patient representative on the Sub-Committee. The initial involves a survey of laboratory methods for the diagnosis of Lyme borreliosis in Ireland, the development of Lyme borreliosis guidance for general practitioners, the publication of medical media articles to highlight diagnostics and laboratory methods relating to Lyme borreliosis available in Ireland for general practitioners, and ongoing work in drawing together the Final Report of the Sub-Committee.
190. Deputy David Cullinane asked the Minister for Health the number of visits from the Mental Health Commission to University Hospital Waterford in each year from 2010 to date in 2017, inclusive, in tabular form; and if he will make a statement on the matter. [10876/17]
Amharc ar fhreagra192. Deputy David Cullinane asked the Minister for Health if the Mental Health Commission has outlined to the HSE a shortage in therapies and therapy positions in the psychiatric unit at University Hospital Waterford. [10878/17]
Amharc ar fhreagra193. Deputy David Cullinane asked the Minister for Health if the Mental Health Commission highlighted a lack of physical space in the psychiatrist position at University Hospital Waterford; the nature of the issues highlighted; and if he will make a statement on the matter. [10879/17]
Amharc ar fhreagraI propose to take Questions Nos. 190, 192 and 193 together.
The Mental Health Act 2001 provides that the Inspector of Mental Health Services visits, inspects and reports on every approved centre at least once every year.
Between 2010 and 2017, the Department of Psychiatry, Waterford was inspected on the following dates:
|
Year |
Inspection date |
|
2010 |
22 April 2010 |
|
2011 |
16 June 2011 |
|
2012 |
25 June 2012 and 8 November 2012 |
|
2013 |
5 June 2013 |
|
2014 |
31 July 2014, 1 August 2014, 15 August 2014 |
|
2015 |
24-26 August 2015 |
|
2016 |
11-13 June 2016 and 13-14 July 2016 |
|
2017 |
24-25 January 2017 |
The Inspector of Mental Health Services has informed the Mental Health Commission that in both the annual inspection on 11 May 2016 and the focused Inspection on 13 July 2016 the Inspectorate highlighted the lack of therapeutic services and programmes resulting in non-compliance with Regulation 16. Both inspection reports have been published.
The Inspector also advised that there was not a shortage of therapy posts in Waterford, as there were 0.6 occupational therapist and 2.6 WTE activity nurses, but that there was a lack of therapeutic services and programmes and recreational activities provided rather than staffing difficulties.
The following outlines the actions taken in respect of therapeutic services and programmes since that time:
- Local Quality and Safety Committee has been established to provide oversight and governance of the therapeutic programme in the DOP;
- A Senior Occupational Therapist has been appointed in the DOP and will act as co-ordinator of the therapeutic programme in the DOP;
- A therapeutic programme is now in place in the DOP which reflects the recovery ethos and includes input from all of the multi-disciplinary team with copies of programmes available for all service users;
- Senior Occupational Therapist provides for ongoing review of the therapeutic programme and timetable to ensure programme is meeting service user needs;
- All service users now have a timetable of daily therapeutic activities to choose from across a range of multi-disciplinary activities incl. mindfulness, stress management, art, recovery workshops, preparation for discharge, health and fitness related activities etc; and
- The weekly multidisciplinary meetings are now inclusive of a forum for service users to provide feedback and thereby creating opportunities to continually improve and develop the therapeutic services available.
With regard to the physical space of the Psychiatry Department, the Inspector noted, in the 2016 reports, that no provision had been made for dedicated dining, visiting, recreational or communal social facilities for residents.
The Mental Health Commission considered that the HSE's original proposed programme of works would not have addressed these issues. The HSE has now made representations to the Commission detailing how they intend to address the points above, including a revised programme of works with associated timelines.
Discussions are ongoing between the Mental Health Commission and the HSE. As Minister I am continuing to closely monitor the situation in Waterford and the issues raised by the Mental Health Commission, in conjunction with my Department and the HSE, to ensure that all necessary corrective actions are taken.
191. Deputy David Cullinane asked the Minister for Health the number of vacant posts at the department of psychiatry at University Hospital Waterford, by post and grade; the length of time the posts are vacant; when they will be filled; and if he will make a statement on the matter. [10877/17]
Amharc ar fhreagraAs this is a service issue, this question has been referred to the HSE for direct reply.
194. Deputy David Cullinane asked the Minister for Health if University Hospital Waterford has furnished the South-South West Hospital Group with proposals to deploy a mobile catheterisation laboratory for the hospital; if it has been given attention by the hospital group; and if he will make a statement on the matter. [10880/17]
Amharc ar fhreagra195. Deputy David Cullinane asked the Minister for Health the cost of deployment of a mobile catheterisation laboratory to University Hospital Waterford; the body that will cover the costs; and if he will make a statement on the matter. [10881/17]
Amharc ar fhreagra196. Deputy David Cullinane asked the Minister for Health the times and days it is planned a mobile catheterisation laboratory will be deployed in County Waterford; and if he will make a statement on the matter. [10882/17]
Amharc ar fhreagraI propose to take Questions Nos. 194 to 196, inclusive, together.
I have asked the HSE to respond to you directly in relation to your specific queries on the operation of mobile cath labs.
197. Deputy David Cullinane asked the Minister for Health the number of home help hours provided by the HSE for each of the years from 2011 to 2016, inclusive, by county, in tabular form; and if he will make a statement on the matter. [10883/17]
Amharc ar fhreagra199. Deputy David Cullinane asked the Minister for Health the number of home help hours provided by the HSE in Waterford city and county for each of the years from 2011 to 2016, inclusive, in tabular form; and if he will make a statement on the matter. [10885/17]
Amharc ar fhreagraI propose to take Questions Nos. 197 and 199 together.
As these are service matters they have been referred to the Health Service Executive for direct reply.
198. Deputy David Cullinane asked the Minister for Health the number of filled speech and language and occupational therapist positions in place to assist children with complex needs for each of the years from 2011 to 2016, inclusive, by county, in tabular form; and if he will make a statement on the matter. [10884/17]
Amharc ar fhreagra200. Deputy David Cullinane asked the Minister for Health the number of filled speech and language and occupational therapist positions in place to assist children with complex needs in County Waterford for each of the years from 2011 to 2016, inclusive, in tabular form; and if he will make a statement on the matter. [10886/17]
Amharc ar fhreagraI propose to take Questions Nos. 198 and 200 together.
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.
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.
201. Deputy David Cullinane asked the Minister for Health the original costs approved by his Department in respect of the national children's hospital; the projected costs as they stand today; the reason for any variation; and if he will make a statement on the matter. [10887/17]
Amharc ar fhreagraThe project to develop the new children’s hospital is an extraordinary opportunity to enhance paediatric services for children. The Government decision in 2012 to locate the hospital on St James’s Hospital campus was made in the best interests of children from a clinical perspective. St. James's has the broadest range of national specialties of all our acute hospitals, in addition to a strong and well-established research and education infrastructure, making it the hospital that best meets the criteria to enable the children’s hospital achieve our vision of excellence in modern paediatric practice.
A major milestone was achieved in this long awaited, much needed project when An Bord Pleanála granted planning permission in April 2016 to build a state of the art hospital on a campus shared with St. James’s Hospital, together with two Paediatric Outpatients and Urgent Care centres at Tallaght Hospital and Connolly Hospital. The first phase of construction (site clearing works) on the site of the new children’s hospital began in August 2016 and will be substantially completed within a matter of weeks.
The previous Government committed to making €200m available from the sale of the National Lottery for the new children's hospital, adding to the existing €450m Exchequer funding and underlining the Government's commitment to the project. The cost estimate for the core construction elements of the new children’s hospital and the Paediatric Outpatients and Urgent Care centres at Tallaght and Connolly Hospitals was prepared in early 2014. This estimate of €650m was prepared at a time when annual construction inflation predicted at 3% per annum.
The National Paediatric Hospital Development Board was appointed in 2013 to design, build and equip the new children’s hospital. An internationally recognised design team supported by an experienced Board and Project Team are in place, have followed best international design, planning and procurement process at each stage of the project. The Project Team, during the design, planning and tendering phases, has constantly monitored the external environment – tracking construction inflation and market costs.
The recently concluded tendering process for the main construction works determined the actual market cost of the construction elements of the project. Due to annual construction inflation rising from 3% in 2013 to more than 9% in 2017 and the lengthened project timeline in the planning, design and procurement process, the cost of the core construction of the hospital and Paediatric Outpatients & Urgent Care Centres has increased from the original estimate. The increase reflects the increasing volume of activity in the Irish construction industry which is having a significant impact on construction inflation.
The updated capital costs have now been incorporated into the Final Project Brief, and were submitted to the HSE for review. The HSE has now submitted the Final Project Brief to the Department of Health. While I am not in a position to comment on updated costs at this stage, I intend to bring a Memorandum to Government in the coming weeks on the new children’s hospital. Full details of the costs will be set out in the Memorandum for Government.
202. Deputy David Cullinane asked the Minister for Health his plans to open prefabs at acute hospitals to ease emergency room pressures; and if he will make a statement on the matter. [10888/17]
Amharc ar fhreagraAs the Deputy may be aware, the Winter Initiative Plan which the HSE launched in September last year, provided €40 million of additional funding for winter preparedness and to manage the expected surge in demand for hospital care in an integrated way across Primary, Acute and Social Care.
As part of this the HSE put in place a National Framework for the provision of temporary alternative accommodation, as just one part of a broad range of measures undertaken to alleviate pressure on our Emergency Departments. Under the Framework, the HSE has advised that consideration will be given to managed temporary patient accommodation solutions which are staffed. The next stage will be for a mini-tender to be conducted to request proposals in relation to temporary patient accommodation solutions.
This year’s gross budget for the Health Sector is in excess of €14 billion and represents an increase of almost half a billion compared to the 2016 allocation. The additional funding secured will continue to ease the pressure on the Health Service to provide the optimum level of safe services for patients within the budgetary limits. In addition to increasing capacity by providing additional financial resources to the public health system over the last two years, this Government has also demonstrated its commitment to increasing bed capacity in the public hospital system. Under the Winter Initiative, funding has been provided to open around 100 extra acute beds this year; of these 90 are already open.
So far, the Winter Initiative has also delivered a reduction in delayed discharges nationally from a high of 659 earlier in 2016 to 517 as of this week, freeing up hospitals beds to alleviate ED pressures, aids and appliances to over 4,250 patients, as well as almost 1,050 additional home care packages and 615 additional transitional care beds approvals, all enabling patients to be discharged from hospital sooner.
There is a commitment in the Programme for a Partnership Government regarding the conduct of a bed capacity review in the public health system. This review is already under way. It will be comprehensive with a wider scope than previous reviews, which focused on bed capacity in acute hospitals only.
