Written Answers Nos. 1530-1548
1530. Deputy Louise O'Reilly asked the Minister for Health the status of recommendation 8.1 of the national cardiovascular health policy 2010-2019; the detail of evidence based guidelines and standards that have been agreed; the detail of performance indicators and reporting structures that have been established; the way these have been met to date; and if he will make a statement on the matter. [28785/17]
Amharc ar fhreagraThe cardiovascular policy acknowledged the role of evidence based guidelines in the development of services. The policy itself recommended the adoption of the 2007 ESC Clinical Practice Guidelines which have now been updated and revised. International evidence was also used in relation to the provision of acute hospital services for cardiovascular disease.
In relation to the broader issues of guidelines and standards, clinical effectiveness is considered as a key component of patient safety and quality. Clinical effectiveness incorporates the utilisation of quality assured National Clinical Guidelines, National Clinical Audit and general clinical practice guidance. This is a quality improvement approach which promotes cost-effective healthcare that is evidence-based with subsequent improved clinical decision making and clinical outcomes.
The Irish clinical effectiveness agenda is led by the National Clinical Effectiveness Committee (NCEC) which is a Ministerial committee of key stakeholders including patients. Its role is to prioritise and quality assure to the level of international methodological standards a suite of National Clinical Guidelines and National Clinical Audit, prioritised, as significant for the Irish healthcare system. National Clinical Audit and National Clinical Guidelines, quality assured and recommended by NCEC for implementation in the Irish health system provide robust evidence-based approaches to underpin or define systems of service or models of care as appropriate. They assist in developing and monitoring the improvement and standardisation of service delivery. Since 2013, the NCEC has published 14 National Clinical Guidelines in the areas of clinical deterioration, cancer and palliative care, hospital acquired infections and chronic diseases. A further 14 are in development as new or updates of existing guidelines. The National Clinical Effectiveness Committee (NCEC) prioritised and quality assured its first national clinical audit the Major Trauma Audit, which the Minister launched in December 2016. The NCEC, in November 2015, published the Standards for Clinical Practice Guidance setting out the standards for development of clinical guidance such as policies, procedures, protocols and guidelines. This has been followed by the HSE's Framework for utilisation of these NCEC Standards.
1531. Deputy Louise O'Reilly asked the Minister for Health the status of recommendation 8.2 of the national cardiovascular health policy 2010-2019; the progress to date on developing a comprehensive cardiovascular health services information system; the detail of systematic data collection methods and analytic standards; if co-ordinated collation, analysis and evaluation of data has been ensured; and if he will make a statement on the matter. [28786/17]
Amharc ar fhreagra1532. Deputy Louise O'Reilly asked the Minister for Health the status of recommendation 8.3 of the national cardiovascular health policy 2010-2019; and if he will make a statement on the matter. [28787/17]
Amharc ar fhreagraI propose to take Questions Nos. 1531 and 1532 together.
As these matters relate to patient information issues they have been referred to the Health Service Executive for attention and direct reply to the Deputy.
1533. Deputy Louise O'Reilly asked the Minister for Health the status of recommendation 8.4 of the national cardiovascular health policy 2010-2019; the detail of the national adult and child surveys conducted to date to establish health profiles in adults and children; and if he will make a statement on the matter. [28788/17]
Amharc ar fhreagraRegarding recommendation 8.4 of the cardiovascular policy, a new annual Healthy Ireland Survey commenced in 2014 to enhance data collection and monitoring capacity to track progress in achieving targets to evaluate the success of Healthy Ireland. The Survey provides an up to date picture of the nation’s health with a robust and credible baseline set of data on a range of health behaviours, including those relevant to cardiovascular heath. The Department is now in a position to report credibly on a range of issues which have a significant impact on health outcomes, as well as being able to provide reliable and current data to fulfil a number of international reporting requirements. The first Healthy Ireland Survey was published in 2015, a second in 2016 and the work on a third wave is well advanced with publication expected in October 2017.
These data are now being used to inform current and future policy direction, programme development and implementation.
The Health Behaviour in School-aged Children (HBSC) survey is a WHO (European) collaborative study. Participating countries cooperate on survey content, methodology and time, and an international protocol is developed. The Health Behaviour in School-aged Children Trends Report explores the trends in the health and wellbeing of children in Ireland between 1998 and 2014. The study has been collecting data from school-aged children aged 10-17 years since 1998. The most recent data collection took place in 2014. Previous studies were undertaken in 1998, 2002, 2006 and 2010.
The Trends Report describes the self-reported health status of children over time in relation to key indicators: health behaviours, health outcomes and the contexts of their lives.
1534. Deputy Louise O'Reilly asked the Minister for Health the status of recommendation 8.5 of the national cardiovascular health policy 2010-2019; the number of audits which have taken place of cardiovascular networks to assess volume and quality of service delivery; the way these have aided in service planning; and if he will make a statement on the matter. [28789/17]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1535. Deputy Louise O'Reilly asked the Minister for Health the status of recommendation 8.6 of the national cardiovascular health policy 2010-2019; and if he will make a statement on the matter. [28790/17]
Amharc ar fhreagraSince the publication of the Cardiovascular Policy in 2010, an e-Health strategy was approved by Government in 2013 and a Knowledge and Information Strategy was published by Health Service Executive in 2015. A number of strategic e-health programmes are being progressed including the Individual Health Identifier and the development of business case for a national Electronic Healthcare Record.
The Health Identifiers Bill was published in 2013 and enacted in 2014. Since enactment, necessary follow-up legislative measures under the Act have been taken, as required, to facilitate the practical and phased implementation of the Health Identifier Project. The latest of these measures was the introduction of further commencement provisions and the making of Regulations, at the end of May, allowing for accessing the register of individual health identifiers and the initial deployment of health identifiers in the regulated manner envisaged in the Act.
A revised and expanded General Scheme of a Health Information and Patient Safety Bill was approved by Government in November 2015 and published on the Department's website. That legislation was the subject of further Pre-Legislative Scrutiny, in December 2016, by the Oireachtas Committee on Health. The Committee has now forwarded its report to the Minister and the Department is currently considering the points raised by the Committee so as to respond fully.
1536. Deputy Louise O'Reilly asked the Minister for Health the status of recommendation 8.7 of the national cardiovascular health policy 2010-2019 on the establishment of a national group representative of stakeholders to determine priorities for research and health technology in cardiovascular care; the frequency with which this group has met since the publication of the policy; the outcomes and recommendations from this group, in addition to current projects; and if he will make a statement on the matter. [28791/17]
Amharc ar fhreagraThe Health Research Board, in line with the recommendation, coordinates the priorities for research in conjunction with key stakeholders such as academics, service providers and policy makers.
In relation to the research being carried out in conjunction with the Health Research Board, the Board has supported a number of awards conducting research into cardiovascular health. Cardiovascular health research is supported through a wide variety of funding instruments ranging from Summer Student projects, Investigator Led Projects through to a Stroke Clinical Trials Network awarded in 2014 to support the conduct of multi-centre clinical trials.
Examples of cardiovascular research include:
- In 2012 we supported Professor Rose Ann Kenny with an ICE Award entitled “Effecting change in cardiovascular health of older Irish adults: rapid translation of cardiovascular health research findings into policy and practice in a recession”;
- In 2011 we supported Dr Andrew Smyth with a NSAFP award entitled “Sodium and Potassium Intake and Risk of Cardiovascular and Chronic Kidney Disease”.
This is complemented by other types of assessment such as health technology assessment (HTA). In 2014 the Government granted approval for the Health Information and Quality Authority (HIQA) to undertake a HTA of a public access defibrillation programme (PAD) for Ireland because there were a number of questions that needed consideration before designing a public access defibrillation programme. Following a Public Consultation in October 2014, the HIQA Board approved a Report and set of recommendations for the Minister. The Health Technology Assessment (HTA) examined the implication of establishing a national public access defibrillation (PAD) programme in Ireland to increase survival from out-of-hospital cardiac arrest (OHCA). It estimated the clinical and cost effectiveness of a range of PAD configurations.
1537. Deputy Martin Ferris asked the Minister for Health when a person (details supplied) can expect to receive an MRI scan; and if he will make a statement on the matter. [28795/17]
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.
1538. Deputy Sean Sherlock asked the Minister for Health the availability of a drug (details supplied). [28800/17]
Amharc ar fhreagraThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.
1539. Deputy Pat Deering asked the Minister for Health his plans to establish a forum for all stakeholders to address and plan for an ageing population; and if he will make a statement on the matter. [28804/17]
Amharc ar fhreagraThe National Positive Ageing Strategy (NPAS), published on 24 April 2013, provides a framework for cooperation to address age-related policy and service delivery across Government and society in the years ahead. The Strategy is intended to promote older people’s health and well being so that older people can continue to contribute to social, economic, cultural and family life in their own communities for as long as possible, thereby representing a vision for an age-friendly society. The Strategy highlights that ageing is not just a health issue, but rather requires a whole of Government approach to address a range of social, economic and environmental factors that affect the health and wellbeing of our ageing citizens.
At the launch of the Strategy, a commitment was made to publish an Implementation Plan to facilitate the translation of the Goals and Objectives of the Strategy into action on the ground. The approach to implementation originally included in the Strategy would have worked where a finite number of discrete and concrete steps could be taken after which the implementation could be deemed complete. However, many of the objectives included in this Strategy are quite broad, and can be viewed as a set of principles to which Government has committed, and which will inform policies that affect older people on an indefinite basis into the future, rather than concrete objectives that can be delivered in the short term.
The Department has therefore formulated new arrangements to implement and monitor the implementation of the National Positive Ageing Strategy. The revised arrangements were approved by the Cabinet Committee on Social Policy and Public Service Reform on 27 October, 2016.
The new arrangements establish mechanisms that will give stakeholder groups effective and on-going access to Government Departments and State Agencies relevant to older people. This includes an annual Forum for stakeholders to identify what they consider to be their key priorities for Government for the coming year and the next three years; and establishing clear channels of communications between stakeholders and relevant Government Departments. In this regard, stakeholder representatives will engage with a named senior official on issues relevant to their remit, in order that the priorities identified by the stakeholders at the Forum can be pursued.
The inaugural stakeholder Forum took place on 30th March 2017, and was attended by civic society organisations who are representative of the needs and views of older people in Ireland. Following on from this successful Forum, the Department of Health has opened a dialogue with each of the Government Departments identified as having responsibility for the priorities agreed by stakeholders, in order that they are aware of the issues for discussion prior to being contacted by a stakeholder representative group. The Department of Health recently met with this stakeholder representative group, and will meet with them again in late 2017 to establish progress made and assist with any issues arising.
As part of the NPAS implementation process, a Healthy and Positive Ageing Initiative has been established in collaboration with the HSE’s Health and Wellbeing Programme and the Atlantic Philanthropies to measure the impact of the Strategy and establish an ongoing system for measuring and reporting on Positive Ageing. The Initiative will monitor changes in older people’s health and wellbeing linked to the Goals and Objectives of the National Positive Ageing Strategy. This will be done primarily through the development of Positive Ageing indicators to be published every two years. The Initiative is intended to provide evidence of the factors contributing to positive ageing, including at local level and ultimately inform policy responses to population ageing in Ireland. The first national Positive Ageing Indicators report was published in 2016 and highlights many of the positive and negative aspects of growing old in Ireland.
The National Positive Ageing Strategy and the activities of the HaPAI are strongly embedded within the vision and actions set out for Healthy Ireland, the Government-led initiative which aims to create an Irish society where people of all ages can enjoy good physical and mental health, and where wellbeing is supported at every level of society. The Healthy Ireland Framework was launched in 2013 and seeks to provide people and communities with accurate information on how to improve their health and wellbeing and to make the healthy choices easier choices. Healthy Ireland takes a whole-of-Government and whole-of-society approach to improving health and wellbeing and the quality of people’s lives and a number of new structures have been put in place to ensure that all sectors of society are given opportunities to participate.
1540. Deputy Thomas P. Broughan asked the Minister for Health the immediate steps being taken to fill the 95 vacant nursing posts for Beaumont hospital; and if he will make a statement on the matter. [28807/17]
Amharc ar fhreagraIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
1541. Deputy John Brassil asked the Minister for Health the likely timeframe for a decision to be reached regarding the addition of the FreeStyle Libre flash glucose monitoring system for persons with diabetes to the long-term illness reimbursement list; and if he will make a statement on the matter. [28849/17]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
1542. Deputy Dara Calleary asked the Minister for Health further to Parliamentary Question No. 481 of 30 May 2017, if he will provide a breakdown of the 524 figure by number of months on the waiting lists showing 12, 24 and 36 months respectively by age and showing those under five years of age, 12 years of age and over 12 years of age; and if he will make a statement on the matter. [28850/17]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
1543. Deputy Michael McGrath asked the Minister for Health if he will address an urgent matter raised in correspondence relating to a person (details supplied) in County Cork. [28866/17]
Amharc ar fhreagraAs this is a service issue, this question has been referred to the HSE for direct reply.
1544. Deputy Michael Harty asked the Minister for Health his plans to fill the posts for which funding is available and for further posts in 2017 to fully implement the paediatric diabetes model of care published in December 2015. [28880/17]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1545. Deputy Tony McLoughlin asked the Minister for Health if a paediatric endocrinologist post has been approved for the centre of excellence for Sligo University Hospital; and if he will make a statement on the matter. [28888/17]
Amharc ar fhreagraSligo University Hospital provides essential high-quality hospital care to patients in the Northwest. I can assure the Deputy of the continued commitment to develop services in Sligo, including those for patients with diabetes.
With regard to paediatric diabetes services, an insulin pump therapy service commenced at Sligo University Hospital in early 2015, with outreach clinics delivered at Letterkenny. However, in mid-April the consultant paediatrician with a special interest in paediatric diabetes post in Sligo became vacant and the Saolta Healthcare Group has advised that it is actively engaged in recruiting a replacement.
Pending completion of the recruitment process, consultant paediatricians at Sligo and Letterkenny Hospitals have undertaken additional training and development to maintain provision of the paediatric insulin pump therapy services at both Hospitals. Further, additional support to these services has now been arranged with another Consultant, currently at another site within the Saolta Group.
Filling the permanent diabetes consultant post in Sligo will enable the Group to further advance its plan for this Diabetes Care Centre; provision of which is included in the 2017 Capital Plan. HSE Estates advise that planning permission for this Centre has been granted; construction is scheduled to commence by year end 2017 and to be completed by Q3 2018.
I will meet with both the HSE and the Saolta Healthcare Group during June, to discuss the current challenges and future development of diabetes services in the Northwest.
1546. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter regarding the hospital patient records of a person (details supplied); and if he will make a statement on the matter. [28889/17]
Amharc ar fhreagraAs this is a service issue, this question has been referred to the HSE for direct reply.
1547. Deputy Michael McGrath asked the Minister for Health the position regarding the approval of the drug ippy/nivo by the HSE; and if he will make a statement on the matter. [28890/17]
Amharc ar fhreagraThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.
1548. Deputy Tony McLoughlin asked the Minister for Health when interim arrangements will be put in place with an endocrinology backed service to ensure the continued safety and best medical care for children and young persons in the north west; the position regarding the recruitment of an appropriate replacement; and if he will make a statement on the matter. [28893/17]
Amharc ar fhreagraLetterkenny and Sligo University Hospitals provide essential high-quality hospital care to patients in the Northwest. I can assure the Deputy of the continued commitment to develop services in both Hospitals, including those for patients with diabetes.
Adult diabetes services at Letterkenny are currently provided by a consultant endocrinologist, supported by a locum consultant general physician with a diabetic interest. In order to address waiting lists, additional clinics are provided on a monthly basis. Further, the Saolta Healthcare Group has advised that it is making applications for approval of a second consultant endocrinologist and an advanced nurse practitioner post in insulin pump therapy, to serve both adult and paediatric patients.
With regard to paediatric diabetes services, an insulin pump therapy service commenced at Sligo University Hospital in early 2015, with outreach clinics delivered at Letterkenny. However, in mid-April the consultant paediatrician with a special interest in paediatric diabetes post in Sligo became vacant and the Saolta Healthcare Group has advised that it is actively engaged in recruiting a replacement.
Pending completion of the recruitment process, consultant paediatricians at Sligo and Letterkenny Hospitals have undertaken additional training and development to maintain provision of the paediatric insulin pump therapy services at both Hospitals. Further, additional support to these services has now been arranged with another Consultant, at another site within the Saolta Hospital Group.
Provision of a Diabetes Centre at Sligo Hospital is included in the 2017 Capital Plan. HSE Estates advises that planning permission for this Centre has been granted; construction is scheduled to commence by year end 2017 and to be completed by Q3 2018. Filling the permanent diabetes consultant post at Sligo will enable the Group to further advance its plan for this Diabetes Care Centre.
I will meet with the Donegal Branch of Diabetes Ireland, the HSE and the Saolta Healthcare Group during June, to discuss the current challenges and future development of diabetes services in the Northwest.
