Brian Stanley
Ceist:1108. Deputy Brian Stanley asked the Minister for Health if the general practitioners contractual review process has commenced; and if he will make a statement on the matter. [26891/17]
Amharc ar fhreagraGeneral Practitioner Contracts
Ceisteanna (1108)
Freagraí scríofa
The development of primary care is central to the Government's objective to deliver a high-quality, integrated and cost effective health service. The Programme for Government commits to a decisive shift within the health service towards primary care in order to deliver better care close to home in communities across the country. The development of a new, modernised contract for the provision of general practitioner services will be a key element in facilitating this process.
Since 2015, negotiations have resulted in a number of service developments including the provision of free GP care to under 6's and over 70's, the introduction of a Diabetes Cycle of Care for adult GMS patients with Type 2 Diabetes and enhanced supports for rural GPs. The next phase of discussions on a new GP contract is under way and engagement with GP representative bodies began in January. As with any negotiation-type process, and given the range and complexity of the issues to be discussed, the engagement may take some time. While I am of course anxious to see good progress made, it is not my intention to set a deadline for completion of discussions. I look forward to positive and constructive engagements with GP representatives in the months ahead.
Hospital Appointments Administration
Ceisteanna (1109)
Robert Troy
Ceist:1109. Deputy Robert Troy asked the Minister for Health if he will schedule an appointment for a person (details supplied); and if he will make a statement on the matter. [26892/17]
Amharc ar fhreagraFreagraí scríofa
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.
Services for People with Disabilities
Ceisteanna (1110)
Niamh Smyth
Ceist:1110. Deputy Niamh Smyth asked the Minister for Health further to Parliamentary Question No. 430 of 21 February 2017, when a reply will issue from the HSE in view of the fact that no reply has issued to date (details supplied). [26894/17]
Amharc ar fhreagraFreagraí scríofa
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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
Brexit Negotiations
Ceisteanna (1111)
Stephen Donnelly
Ceist:1111. Deputy Stephen S. Donnelly asked the Minister for Health the threats identified by his Department with regard to the responsibilities of his Department as a result of no deal being reached in Brexit negotiations; and if he will make a statement on the matter. [26905/17]
Amharc ar fhreagraFreagraí scríofa
On 2nd May, the Government published a comprehensive document on Ireland and the negotiations on the UK’s withdrawal from the European Union under Article 50 of the Treaty on European Union.This document sets out the approach of the Government to the forthcoming negotiations, following the successful campaign to have key Irish issues recognised in the EU negotiation position.
Following on from this publication, work is underway to prepare a further paper on economic implications of the Brexit challenge. This will draw on the work to date across Departments, which will be developed to mitigate emerging sectoral challenges. These plans will build on ongoing cross-Government research, analysis and consultations with stakeholders, and will reflect the core economic themes of the Taoiseach's speech to the IIEA on 15 February last. Ireland’s economic interests lie firmly in a strong and well-functioning EU with continued and unfettered access to the single market. There is a lot of negotiation to be done around trading arrangements. Our contingency work is examining all scenarios and we cannot pre-empt the outcome at this stage. We are not under any illusions about the complexity of these negotiations and are engaged in detailed planning to prepare for these.
The Department of Health and its agencies have been conducting detailed analysis on the impacts of Brexit in the area of health. A number of issues are being examined and contingency planning for a range of eventualities is underway. A key issue will be to ensure that there is minimum disruption to health services and that essential services are maintained on a cross-border, all-island and Ireland-UK basis. The health sector has a highly mobile workforce and free movement issues and the mutual recognition and assurance of professional qualifications are being considered. On regulatory issues, it is clear that having a single set of rules across the European Union is enormously helpful – to protect human health, to ensure consumer protection and to provide a level playing field for industry. The UK no longer being part of a harmonised regulatory system in relation to food safety standards, pharmaceuticals, medical devices and cosmetics could necessitate increased certification requirements or disrupt trade between Ireland and the UK. Ensuring continuity in the supply of medicines and medical devices following the UK’s departure from the EU is a priority. The issue of customs is of relevance as it relates to additional food safety controls and medicines. The implications of Brexit for networks and organisations such as the EU Rapid Alert System for Food and Feed, European Reference Networks on rare diseases, or the European Centre for Disease Prevention and Control are also under consideration.
These issues are currently being examined by the Department and its agencies and this work will continue over the period ahead. The key priorities for my Department are to ensure continuity in the provision of health services and to avoid, or mitigate against, changes to the current situation that would have a negative impact on human health.
Departmental Data
Ceisteanna (1112)
Catherine Connolly
Ceist:1112. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 240 of 3 May 2017, if the files in question have been retrieved; if not, the reason for the delay in their retrieval; when he expects the examination of the file to be completed; and if he will make a statement on the matter. [26919/17]
Amharc ar fhreagraFreagraí scríofa
I can confirm that files have been retrieved from off-site storage and are being examined. I will revert to the Deputy in the coming weeks.
Hospital Appointments Status
Ceisteanna (1113)
Niamh Smyth
Ceist:1113. Deputy Niamh Smyth asked the Minister for Health the status of an appointment for a person (details supplied); if the appointment can be expedited; and if he will make a statement on the matter. [26920/17]
Amharc ar fhreagraFreagraí scríofa
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.
Health Services Provision
Ceisteanna (1114)
Micheál Martin
Ceist:1114. Deputy Micheál Martin asked the Minister for Health the status of supports for a person (details supplied); and if he will make a statement on the matter. [26925/17]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
Hospital Waiting Lists
Ceisteanna (1115)
Micheál Martin
Ceist:1115. Deputy Micheál Martin asked the Minister for Health the steps he will take to reduce the waiting lists for paediatric spinal surgery in Crumlin children's hospital; the number of children awaiting spinal surgery; the length of time they are waiting; and if he will make a statement on the matter. [26926/17]
Amharc ar fhreagraFreagraí scríofa
In relation to the query raised by the Deputy, as this is a service issue, I have asked the HSE to respond to you directly.
Hospital Appointments Status
Ceisteanna (1116)
Micheál Martin
Ceist:1116. Deputy Micheál Martin asked the Minister for Health the status of a surgery appointment for a person (details supplied); and if he will make a statement on the matter. [26927/17]
Amharc ar fhreagraFreagraí scríofa
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 Appointments Status
Ceisteanna (1117)
Thomas Byrne
Ceist:1117. Deputy Thomas Byrne asked the Minister for Health the status of an appointment for surgery for a person (details supplied) at the Mater hospital, Dublin. [26937/17]
Amharc ar fhreagraFreagraí scríofa
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.
Question No. 1118 answered with Question No. 1002.
Hospital Waiting Lists
Ceisteanna (1119)
Mary Lou McDonald
Ceist:1119. Deputy Mary Lou McDonald asked the Minister for Health when a person (details supplied) will be provided a date for surgery in Cappagh hospital. [26951/17]
Amharc ar fhreagraFreagraí scríofa
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.
Health Services Funding
Ceisteanna (1120, 1121)
Micheál Martin
Ceist:1120. Deputy Micheál Martin asked the Minister for Health his views on whether funding being provided to a hospice (details supplied) in County Cork is not meeting service demands and does not allow for the expansion of services in the future despite previous commitments to do so; and the detail of its allocation of funding compared to other hospices with similar services. [26952/17]
Amharc ar fhreagraMicheál Martin
Ceist:1121. Deputy Micheál Martin asked the Minister for Health the funding allocation to a hospice (details supplied) in County Cork in each of the years from 2008 to 2016 and to date in 2017; the number of staff employed in each of these years; the number of persons that have received treatment in this hospice; and if he will make a statement on the matter. [26953/17]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 1120 and 1121 together.
As these are service matters they have been referred to the Health Service Executive for direct reply.
Hospice Services Provision
Ceisteanna (1122)
Micheál Martin
Ceist:1122. Deputy Micheál Martin asked the Minister for Health if it is his policy to have an occupational therapist in every hospice; the number of hospices that employ a full-time occupational therapist and-or a part-time occupational therapist; the number of hospices that do not employ an occupational therapist; his plans to provide for an occupational therapist in every hospice; and if he will make a statement on the matter. [26954/17]
Amharc ar fhreagraFreagraí scríofa
The Department of Health policy on the development and provision of specialist palliative care services is contained in the 2001 Report of the National Advisory Committee on Palliative Care (DoH). This document sets out the staffing ratios required for specialist inpatient units (hospices) and specialist palliative care services in the community (homecare). In hospices the ratios are determined by the number of beds and in the community by population.
Occupational Therapy is one of the disciplines that work as part of specialist palliative care multi-disciplinary teams (MDTs). With regard to specialist inpatient units, the Report recommends a ratio of one occupational therapist (OT) for every 10 beds. The HSE considers this to be a high level of staffing of one discipline in consideration of the overall needs of an MDT. However, the OT skill mix is being fully maintained for the planned new hospices currently in development.
There are eight hospices providing specialist inpatient beds in Ireland. The HSE’s Palliative Care Services Three Year Development Framework (2017-2019), due to be published this summer, indicates that of the six voluntary hospices, four have either full- or part-time OTs and two do not. Of the two HSE run services one has an Occupational Therapist and the second does not.
The Palliative Care Development Framework undertook an examination of staffing levels in all existing services and whereas it found gaps in some health care disciplines it also found higher levels of staffing in some areas. One of the recommendations in the Framework is to review these and to work with services to reconfigure where possible and/or to identify the need through the budget process for additional staff to strengthen multi-disciplinary skill mix configuration. This will include the provision of occupational therapy.
The Department of Health has welcomed the Framework as a good basis for the development of palliative care services, though the implementation of the framework will be subject to the overall budgetary process and the configuration and availability of resources.
Health Services Staff
Ceisteanna (1123)
Micheál Martin
Ceist:1123. Deputy Micheál Martin asked the Minister for Health if his attention has been drawn to the fact that a hospice (details supplied) in County Cork does not employ an occupational therapist on a full-time or part-time basis; his views regarding same; and if he will make a statement on the matter. [26955/17]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter it has been referred to the Health Service Executive for direct reply.
Service Level Agreements
Ceisteanna (1124)
Micheál Martin
Ceist:1124. Deputy Micheál Martin asked the Minister for Health if his attention has been drawn to the fact that section 39 hospitals are not in a position to pay moneys owed to their staff under the public service pay agreement; if his attention has been further drawn to the fact that this is causing great anguish to the staff; if he has met with the HSE or written to the Department of Public Expenditure and Reform to address this issue; and if he will make a statement on the matter. [26956/17]
Amharc ar fhreagraFreagraí scríofa
Under section 39 of the Health Act 2004, the HSE has in place Service Level Agreements with voluntary providers which set out the level of service to be provided for the grant to the individual organisation. Any individuals employed by these section 39 organisations are not HSE employees and therefore, the HSE has no role in determining the salaries or other terms and conditions applying to these staff. It should also be made clear that as the staff of these Section 39 organisations are not public servants, they were not subject to the FEMPI legislation which imposed pay reductions or the provisions of the subsequent Public Service Agreements which provided for pay restoration.
It is a matter for Section 39 organisations to negotiate salaries with their staff as part of their employment relationship and within the overall funding available for the delivery of agreed services.
Palliative Care Services
Ceisteanna (1125)
Micheál Martin
Ceist:1125. Deputy Micheál Martin asked the Minister for Health the status of the commitment in the programme for Government on improving information and awareness of end of life services particularly those which provide persons with palliative care in the location of their choice; and if he will make a statement on the matter. [26957/17]
Amharc ar fhreagraFreagraí scríofa
The Minister, the Department of Health and the HSE are committed to ensuring that information and awareness of palliative care/end of life services is made widely available.
The HSE works in partnership with a wide range of voluntary organisations to provide this information on two levels. These organisations include the Irish Hospice Foundation, The All Ireland Institute for Hospice and Palliative Care, the Irish Cancer Society, LauraLynn and individual hospice services.
Firstly it is necessary to provide education and training to health care providers and professionals so that they can provide information, make timely and appropriate referrals to palliative care services and support individuals and families in their decision-making. Every person who avails of palliative care services will have previously come into contact with or been cared for by some other part of the health service. Therefore it is imperative that health care professionals are well-informed and able to provide expert advice to colleagues, patients and carers. Education, academic qualifications, study days etc. are currently being provided by a number of organisations / services across the country.
Two such initiatives being supported by the HSE are facilitated by the All Ireland Institute for Hospice and Palliative Care (AIIHPC). One is the provision of an on-line Palliative Care Hub which has separate information / learning platforms for healthcare professionals and for patients and their carers (http://aiihpc.org/palliative-hub/ ). The second initiative is Project ECHO which is a demonstration project supporting 22 nursing homes in Dublin. The key aim is to empower nursing home staff to improve the experiences of residents and avoid unnecessary emergency department attendances or hospital admissions, ensuring that individuals who wish to die in their normal place of residence can do so. The HSE also provides funding for the Irish Hospice Foundation’s Hospice Friendly Hospitals (HFH) programme which supports the establishment of Palliative / End of Life Care committees in acute hospitals. Initiatives associated with the HFH include improving communication skills, part of which is initiating difficult discussions about end of life care, improving hospital environments, education and training and improving bereavement care. The Irish Hospice Foundation also initiated the Think Ahead project which encourages people to discuss their wishes with their families and clinicians while they are still well enough to do so.
The second element of information and awareness raising is for the general public, including patients and families. The HSE is supporting the public information / media campaign organised on an annual basis by the AIIHPC. The purpose of the campaign is to raise awareness of palliative care among the general public. It also provides links to further information as well as to organisations involved in palliative / end of life care.
Health Services Funding
Ceisteanna (1126)
Micheál Martin
Ceist:1126. Deputy Micheál Martin asked the Minister for Health if he has met with officials from the HSE to discuss the way in which hospices are funded; if not, his plans to do so in the future; and if he will make a statement on the matter. [26958/17]
Amharc ar fhreagraFreagraí scríofa
The Minister and officials regularly meet with the HSE's National Lead for Palliative Care. The Department of Health has also engaged with the HSE in the development of the HSE's Palliative Care Services Three Year Development Framework (2017-2019) which will be published during the summer. The Framework details the development of seven new hospices over the period 2017 - 2021. The first one of these will open in Kerry at the end of this year. Kerry Hospice Foundation has agreed to provide 12.5% of the revenue requirement for the first five years, and after this period core services (pay and non-pay) will be 100% funded through the HSE.
The revenue for each new hospice will be agreed in the year prior to opening so as to include the requirement in the Estimates process. It is planned to cover core costs for each service. The ongoing contribution of local hospice fundraising groups is very much acknowledged and in many instances the groups have agreed to provide funding for ancillary services such as complementary therapies, art, volunteer co-ordinators, social activities and events, etc. They may also provide funding for specialised furniture or pieces of equipment.
The Framework recognises that existing specialist palliative care services are reliant to varying degrees on voluntary fundraising to subsidise core services. One of the Framework recommendations is the establishment of a short-life working group which will have the single aim of defining what constitutes core costs for all specialist palliative care services. This is with a view to ensuring that existing services will have these costs met on a phased basis through the Estimates / service planning processes. The working group is due to be established by the autumn.
The Department of Health has welcomed the Framework as a good basis for the development of palliative care services, though the implementation of the framework will be subject to the overall budgetary process and the configuration and availability of resources.
Palliative Care Services Provision
Ceisteanna (1127)
Micheál Martin
Ceist:1127. Deputy Micheál Martin asked the Minister for Health his views on whether his Department's staff-patient ratio policy in relation to end-of-life care in a hospice setting is adequate; and if he will make a statement on the matter. [26959/17]
Amharc ar fhreagraFreagraí scríofa
Government policy on the development and provision of specialist palliative care services is set out in the 2001 Report of the National Advisory Committee on Palliative Care. This document describes the staffing ratios required for specialist inpatient units (hospices) and specialist palliative care services in the community (homecare). In hospices the ratios are determined by the number of beds and in the community by population.
All hospices planned for development include provision for the multi-disciplinary teams described by the Report. The Report recommends one nurse and 0.5 health care attendees per bed and these will be put in place along with additional nursing managers. With regard to Allied Health Professionals, the recommendation is for one of each of the following disciplines for every 10 beds: Physiotherapist, Occupational Therapist, Social Worker, Chaplain. The Report also recommends one session per week for Dietetics and Speech and Language Therapy. In the context of current staffing requirements this ratio is considered to be high for some disciplines while low for others. However, the skill mix is being fully maintained and for example the 15-bedded Kerry Hospice which is due to open in the autumn will have one Senior Occupational Therapist, one Senior Physiotherapist, 1.2 Senior Social Workers, 0.75 Chaplain, 0.6 Senior Pharmacist, 0.5 Dietician and 0.5 Speech and Language Therapist.
In the coming months I understand the HSE will publish a Palliative Care Services Three Year Development Framework (2017 - 2019) which undertook an examination of staffing levels in all existing services. Whereas it found gaps in some health disciplines it also found higher levels of staffing in some areas. One of the recommendations in the Framework is to review these and to work with services to reconfigure where possible and/or to identify the need through the budget process for additional staff to strengthen multi-disciplinary skill mix.