John Brassil
Ceist:76. Deputy John Brassil asked the Minister for Health the position regarding the action which is being taken to find a solution for persons with alpha 1 that need Respreeza. [29073/17]
Amharc ar fhreagraMedicinal Products Availability
Ceisteanna (76)
Freagraí scríofa
The 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.
Health Services Provision
Ceisteanna (77)
Charlie McConalogue
Ceist:77. Deputy Charlie McConalogue asked the Minister for Health if the necessary funding will be provided in order that St. Joseph's, Ramelton and Lifford community hospitals in County Donegal can meet HIQA standards and at a minimum retain their existing bed capacity; and if he will make a statement on the matter. [27784/17]
Amharc ar fhreagraFreagraí scríofa
Many public units are housed in buildings that are less than ideal in the modern context, but notwithstanding this, the care delivered to residents is generally of a very high standard. It is important therefore that we upgrade our public bed stock and this is the aim of the 5 year Capital Investment Programme for Community Nursing Units which was announced last year. This provides the framework to allow for an enhanced programme to replace, upgrade and refurbish these care facilities, as appropriate.
Significant work was undertaken to determine the most optimum scheduling of projects within the phased provision of funding to achieve compliance with National Standards. By the end of 2016 I understand that 14 projects were operational and a further 12 are expected to be operational by the end of this year.
Under this Programme it is proposed to build a new 130 bed community nursing unit in Letterkenny by the end of 2021, through a Public Private Partnership or alternative funding model, to replace existing long-stay accommodation including that provided at St Joseph's, Stranorlar and Ramelton and Lifford Community Hospitals.
Operational responsibility for delivering the programme is a matter for the HSE. The Executive has advised that the Letterkenny project is currently at Design Feasibility stage with a projected completion date of 2021. As part of the preparatory work for the development of the new community nursing unit, I understand that the HSE is undertaking a review of the three Community Hospitals, referred to by the Deputy with a view to identifying any options for their future use.
Hospital Waiting Lists
Ceisteanna (78)
Mary Butler
Ceist:78. Deputy Mary Butler asked the Minister for Health if he will address the orthopaedic waiting list in University Hospital Waterford which is one of the highest in the country under the National Treatment Purchase Fund as a priority; and if he will make a statement on the matter. [27649/17]
Amharc ar fhreagraFreagraí scríofa
I acknowledge that waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.
Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018.
In order to reduce the numbers of long-waiting patients, I asked the HSE to develop Waiting List Action Plans for 2017 in the areas of Inpatient/Daycase and Outpatient Services. These plans have now been finalised and their implementation has commenced. It is expected that the Inpatient / Daycase and Outpatient Plans will considerably reduce the number of patients waiting 15 months or more for inpatient and daycase treatment or for an outpatient appointment by the end of October. Under these Plans, since early February, over 14,200 patients have come off the Inpatient/Daycase Waiting List and nearly 49,000 patients have come off the Outpatient Waiting List.
In addition, last December I granted approval to the NTPF for the first tranche of funding in the region of €5m, for an initiative focused on those waiting longest for Daycase treatment with a view to ensuring that in excess of 2,000 patients waiting more than 18 months for a daycase procedure will have received an offer of an appointment for their procedure by the end of June. The NTPF has advised that to date over 2,500 patients files have been transferred to private hospitals under this initiative, 631 patients have accepted an offer of treatment in a private hospital and that 178 patients have received their procedure. In relation to the specific query concerning waiting times for orthopaedic services at University Hospital Waterford, I have asked the HSE to reply to you directly.
Hospital Staff
Ceisteanna (79)
Alan Kelly
Ceist:79. Deputy Alan Kelly asked the Minister for Health if there are senior management staff in the National Maternity Hospital that have financial interests through tax break schemes or otherwise in St. Vincent's private hospital. [27537/17]
Amharc ar fhreagraFreagraí scríofa
The personal information requested by the Deputy is not available to me. However, he may wish to note that all voluntary hospitals, under the terms of their Service Arrangements with the HSE, are obliged to comply with all applicable laws and regulations as set out in the Department of Public Expenditure and Reform's Code of Practice for the Governance of State Bodies (2016).
The National Maternity Hospital is funded by the HSE under section 38 of the Health Act 2004. Under its Service Arrangement with the HSE, the hospital is obliged to comply with the requirements of the Ethics in Public Office Acts 1995 and 2001. Under the Act all staff remunerated at Grade VII salary or higher must declare any interest which could materially influence them in performance of their official duties. These declarations must be made in an Annual Compliance Statement to the HSE.
Home Help Service Provision
Ceisteanna (80)
Éamon Ó Cuív
Ceist:80. Deputy Éamon Ó Cuív asked the Minister for Health the reason behind the 13% reduction in home help hours in County Galway for January to April 2017 relative to the same period in 2016. [29082/17]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter it has been referred to the Health Service Executive for direct reply.
Nursing Home Services
Ceisteanna (81)
Catherine Connolly
Ceist:81. Deputy Catherine Connolly asked the Minister for Health the position in relation to the provision of nursing home services in view of the fact that the private public ratio has reached critical level of approximately 80 to 20; and if he will make a statement on the matter. [27904/17]
Amharc ar fhreagraFreagraí scríofa
Residential care in Ireland is provided through a mix of public, voluntary and private provision. It is worth highlighting that the net budget for long-term residential care in 2017 is €940m and the Nursing Homes Support Scheme will support 23,603 clients by the end of the year. Public Nursing Units are an essential part of our national nursing home infrastructure. They provide 5,000 long stay residential care beds. Public nursing home provision will continue to be an important part of the mix into the future, including for geographic reasons. There are also about 2,000 short stay community public beds nationally providing a combination of ‘step up/step down’ care, intermediate care, rehabilitation and respite care. To allow flexibility, these are interchangeable in their use depending on demand.
Many public units are housed in buildings that are less than ideal in the modern context, but notwithstanding this, the care delivered to residents is generally of a very high standard. It is important therefore that we maintain and upgrade our existing stock and this is the aim of the 5 year Capital programme for Community Nursing Units which was announced last year. This provides the framework to allow for an enhanced programme to replace, upgrade and refurbish these care facilities, consolidating our existing public stock and providing approximately 250 additional beds.
Hospital Waiting Lists
Ceisteanna (82)
Eugene Murphy
Ceist:82. Deputy Eugene Murphy asked the Minister for Health the number of persons on the waiting list to see a paediatric diabetes consultant or paediatric diabetes endocrinologist at University College Hospital Galway in each of the years 2014 to 2016 and to date in 2017, in tabular form; and if he will make a statement on the matter. [27732/17]
Amharc ar fhreagraFreagraí scríofa
In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
Long-Term Illness Scheme
Ceisteanna (83)
Bobby Aylward
Ceist:83. Deputy Bobby Aylward asked the Minister for Health if motor neurone disease is not included in the long-term illness scheme; the reason this is the case; his plans to add it to the scheme; if this can be prioritised; and if he will make a statement on the matter. [27907/17]
Amharc ar fhreagraFreagraí scríofa
The LTI Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
There are no plans to extend the list of conditions covered by the Scheme.
Health Services
Ceisteanna (84)
Bernard Durkan
Ceist:84. Deputy Bernard J. Durkan asked the Minister for Health if consideration will be given to the setting up of regional bodies consisting of public representatives, the professional stakeholders and patient representatives with a view to restoring a demographic structure throughout the entire country at which the specific issues relative to these particular regions can be discussed in detail, senior representatives of which might then be considered for a national body accountable to him in the context of reorganisation of the health services; and if he will make a statement on the matter. [27854/17]
Amharc ar fhreagraFreagraí scríofa
As the Deputy is aware, the Committee on the Future of Healthcare published its final report on the 30th May 2017. As part of its report, the Committee has made a series of recommendations in relation to the organisation, leadership and governance structures in our health system, including the potential role for regional bodies to support integrated care.
I have been clear since the cross-party Committee on the Future of Healthcare commenced the development of a long term vision for Ireland's healthcare system that I would not advance major structural reforms until it had reported out of respect for the process. The Committee has now completed its work and I would like to commend it on the significant achievement of developing a future vision, based upon political consensus, for our health services.
The report is the culmination of a year-long process of unprecedented cross-party collaboration, dialogue and engagement and is testament of the desire across the political spectrum and across the broader stakeholder community to work collaboratively to address the challenges in the health service. It is vital that we now allow time to reflect and deliberate on the findings of the Committee. I look forward to the forthcoming Dáil debate on the report and I will give full consideration to the report’s recommendations when I have had the opportunity to hear views from across the Dáil.
The Taoiseach was very clear in his speech to the Dáil last week that delivering real improvements in our health services is a key priority for this Government. He has tasked me with preparing a detailed response to the report including proposed measures and timelines. It is my intention to do so following the Dáil debate and I hope to bring detailed analysis and proposals to Government quickly. I have no doubt that the report will be an essential reference point for all Governments and parties in the fundamental reform of our health services over the next decade.
Data Protection
Ceisteanna (85)
James Browne
Ceist:85. Deputy James Browne asked the Minister for Health if he has had discussions with the Department of Justice and Equality regarding lacunas in data protection legislation that may be preventing mental health professionals from informing family members or others that are at risk of violence from a patient; and if he will make a statement on the matter. [29077/17]
Amharc ar fhreagraFreagraí scríofa
It is important to recognise that the Medical Council’s Ethical Guide already specifically allows a doctor to ethically breach confidentiality if, for example, he/she believes that the patient is at risk of harming himself/herself or others. Doctors therefore have existing powers in exceptional circumstances.
The Expert Group Review of the Mental Health Act 2001 which was published in 2015 recommended that there should be greater ‘proactive encouragement for the patient at all stages to involve his/her family/carer and/or chosen advocate in the admission process and in the development of the care and treatment plan with the patient’s consent’. The Group did not recommend that family involvement in the care and treatment of patients be made compulsory. There are some serious downsides to consider in terms of taking an absolute approach where those with mental illness may decide not to confide in their Doctor/medical team if they are strongly against involving family members for whatever reason.
Following on from the Expert Group Review, the Mental Health Commission wrote to all of the Executive Clinical Directors of mental health services reminding them of the enormous importance of involving family members as appropriate in accordance with the Commission’s Code of Practice on Admission, Transfer and Discharge to and from an Approved Centre.
In addition, the Commission asked its Health, Social Care and Regulatory Forum to inform each of the professional regulatory bodies represented on the Forum, of the importance of ‘the need to involve families/carers in the development of care and treatment plans with the patient’s consent especially in cases of serious and enduring mental health problems’.
Work is underway at official level on amending the Mental Health Act and I am satisfied that the Expert Group recommendations provide a clear and well thought out direction to amend and update our mental health legislation. While the General Scheme to be prepared will reflect the Group’s view on the need to encourage families to be involved, it will not go so far as to recommend that this be compulsory.
I am not aware of the particular lacuna in data protection legislation that the Deputy refers to in his question.
Hospital Waiting Lists
Ceisteanna (86)
John Lahart
Ceist:86. Deputy John Lahart asked the Minister for Health the way in which Tallaght hospital will be supported in reducing the number of outpatients enduring long waiting times in the hospital. [29092/17]
Amharc ar fhreagraFreagraí scríofa
I acknowledge that waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.
There is no doubt that our public hospital system is challenged in meeting the growing demand for care. Last year alone, there was a 2% increase in inpatient and day-case activity over 2015. Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018.
In order to reduce the numbers of long-waiting patients, I asked the HSE to develop Waiting List Action Plans for 2017 in the areas of Inpatient/Daycase, Scoliosis and Outpatient Services. The Inpatient / Daycase and Outpatient Plans which have now been published and are currently being implemented, focus on reducing as much as possible within existing resources the number of patients waiting 15 months or more for inpatient and daycase treatment or outpatient appointment by the end of October. The Scoliosis Action Plan aims to ensure that no patient who requires scoliosis surgery will be waiting more than four months for surgery by the end of 2017.
Under these Plans, since early February, over 14,200 patients have come off the Inpatient/Daycase Waiting List, nearly 49,000 patients have come off the Outpatient Waiting List and approximately 130 scoliosis surgeries have taken place.
In addition, the NTPF has advised that under the ongoing Daycase Waiting List Initiative over 2,000 patients files have been transferred to private hospitals under this Initiative, 483 patients have accepted an offer of treatment in a private hospital and that over 120 patients have received their procedure.
Home Help Service Provision
Ceisteanna (87)
Seán Fleming
Ceist:87. Deputy Sean Fleming asked the Minister for Health the reason behind the 12% reduction in home help hours in counties Laois and Offaly for January to April 2017 relative to the same period in 2016. [29089/17]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter it has been referred to the Health Service Executive for direct reply.
Mental Health Services Provision
Ceisteanna (88)
Bríd Smith
Ceist:88. Deputy Bríd Smith asked the Minister for Health if he has satisfied himself that the closure of 11 beds at Linn Dara CAMHS will mean that children and adolescents in need of these services will receive the care needed; if this closure is in line with the Government commitment to implement A Vision for Change; and if he will make a statement on the matter. [27901/17]
Amharc ar fhreagraFreagraí scríofa
The Department of Health, and myself, have maintained close contact with the HSE in a attempt to maxamise CAMHS service provision in the Linn Dara unit. Minister McEntee has met the HSE specifically about this, and visited Linn Dara . The HSE has confirmed that no young person will be discharged from Linn Dara, unless this is deemed clinically appropriate by their mental health team. It should be clearly understood also, that nobody is discharged simply to close a bed.
Due to staff shortages, for a variety of reasons , some beds cannot be refilled. This, unfortunately, has left Linn Dara with just half of its 22 bed complement operational. The HSE has indicated that, for those discharged for clinical reasons, dedicated follow-on supports from the community-based CAMHS service will be provided, if deemed necessary. The Executive will also make available the CAMHS Day Service, as appropriate in individual cases, to enhance supports for young people and their families. The core issue facing Linn Dara relates specifically to staff recruitment and retention difficulties for mental health professionals. This, unfortunately, reflects wider health system issues. The problem in this case does not relate to funding availability. Staffing cover has been augmented in recent times through methods such as staff working additional hours, overtime and engaging agency staff.
The HSE are exploring every option to maximise the operation of this service in the future. The Executive is intensifying its efforts on recruitment, and while a number of staff have been identified to join the Linn Dara service in the near future, this will take time. The Deputy may rest assured that all efforts will continue to be made to address on-going service difficulties at Linn Dara.
'A Vision for Change' came to the end of its 10-year term in 2016. The increased investment in mental health services over the last number of years has helped to facilitate an increase in the number and staffing levels of both Adult, and Children & Adolescent Community Mental Health Teams. Of the additional 1,550 new mental health posts approved since 2012, some 1,150 have been, or are in the process of being, recruited.
Increased investment has also funded the development of specialist services recommended in A Vision for Change , including Forensic, Eating Disorders, Psychiatry of Later Life, and Mental Health Intellectual Disability services. There has also been continued development of community mental health teams, improved 7-day responses and liaison services, Peri-natal Mental Health and two new clinical programmes – specifically for ADHD in Adults and Children, and for Dual Diagnosis of those with Mental Illness and Substance Misuse.
Respite Care Services Provision
Ceisteanna (89)
Louise O'Reilly
Ceist:89. Deputy Louise O'Reilly asked the Minister for Health the number of hours of respite care offered to families of children with disabilities in the first five months of 2017 as compared to the first five months of 2016. [27663/17]
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.
The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.
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.
Hospital Groups
Ceisteanna (90)
John Brady
Ceist:90. Deputy John Brady asked the Minister for Health his plans to put on a statutory footing hospital group boards not currently on a statutory footing; and the reason for the delay in this regard. [27655/17]
Amharc ar fhreagraFreagraí scríofa
The establishment of Hospital Groups represents a very significant reform of our hospital services. Hospital Groups continue to be implemented on an administrative basis and, until legislation is advanced, will continue to operate within the existing policy and accountability frameworks of the Department of Health and the HSE.
I have been clear since the Committee on the Future of Healthcare commenced its work that I would not advance major structural reforms until it had reported out of respect for the process. It is vital that we now allow time to reflect and deliberate on the findings of the Committee. I look forward to the Dáil debate on the report later this week and I will give full consideration to the report’s recommendations when I have had the opportunity to hear views from across the Dáil.
Ambulance Service Provision
Ceisteanna (91)
Catherine Connolly
Ceist:91. Deputy Catherine Connolly asked the Minister for Health the status of the provision of ambulance services in north and south Connemara, County Galway, in view of the repeated highlighting of serious issues in relation to same; and if he will make a statement on the matter. [27903/17]
Amharc ar fhreagraFreagraí scríofa
The Deputy will be aware that I met with a representative group from Connemara on 20th February last to hear their views and assure them of this Government's commitment to the development of our ambulance services. At this meeting the group highlighted a number of issues which I followed up with the National Ambulance Service (NAS) and the Pre-Hospital Emergency Care Council.
It is worth noting that the Capacity Review, published last year, identifies particular difficulties serving rural areas as population density in Ireland is significantly different to that of many other countries. The Review indicated that the only practical way to improve first response times in rural areas is through voluntary Community First Responder (CFR) schemes. The further developments of a comprehensive national programme of CFR schemes has therefore been prioritised in the HSE National Service Plan 2017. The NAS continues to work with local CFR Groups across the country, and in Connemara, in an effort to enhance services and greatly values their commitment and support.
I would like to assure the Deputy that the Government and the NAS are fully committed to the provision of a safe, patient focused pre-hospital emergency care service. The Programme for a Partnership Government commits to additional annual investment in terms of ambulance personnel and vehicles. In this regard, €7.2m additional funding was provided to the NAS in 2016 and in 2017, an additional €3.6m has been provided, including €1m to fund new developments.
General Practitioner Training
Ceisteanna (92)
Fiona O'Loughlin
Ceist:92. Deputy Fiona O'Loughlin asked the Minister for Health if he will consider allocating a general practitioner training programme to County Kildare; and if he will make a statement on the matter. [27831/17]
Amharc ar fhreagraFreagraí scríofa
The Government is committed to the continued development of General Practitioner capacity and to ensuring that patients across the country continue to have access to GP services. The annual number of training places available has been increased from 120 in 2009 to an expected intake of 171 in 2017. The Government is committed to further increasing this number in future years.
The HSE works alongside the Irish College of General Practitioners in actively recruiting and training GP trainees. At present, GP training is delivered by 14 separate GP training programmes throughout the country. While Co. Kildare does not have its own dedicated GP training programme, there are several GP trainees based with 18 GP trainers in Co. Kildare. These trainees are principally aligned to the Midlands and Trinity training programmes. There are no plans to introduce a new training programme for County Kildare.
Maternity Services Provision
Ceisteanna (93)
Louise O'Reilly
Ceist:93. Deputy Louise O'Reilly asked the Minister for Health when 20 week anomaly scans will be available to all women in all maternity units across the State. [27664/17]
Amharc ar fhreagraFreagraí scríofa
I am advised that foetal anomaly scans are available in all Hospital Groups. Those hospitals/maternity units currently providing anomaly scans accept referrals from other maternity units, if requested. This occurs where the medical team in the referring maternity unit consider that an anomaly scan is clinically indicated.
The National Maternity Strategy is very clear that all women must have equal access to standardised ultrasound services. The Strategy will be implemented on a phased basis and this work will be led by the HSE National Women & Infants Health Programme. Indeed, the issue of anomaly scanning is a priority issue for the Programme and, accordingly, it will develop clinical guidance regarding routine detailed scans at 20 weeks. In the meantime, the Programme will continue to work with the six Hospital Groups to assist in increasing access to anomaly scans for those units with limited availability.
One of the current challenges to increase access to anomaly scans is the recruitment of ultrasonographers. In this context, it is expected that the establishment of Maternity Networks across Hospital Groups will assist in developing a sustainable model that ensures that all women within each Hospital Group can access anomaly scans.
Hospital Services
Ceisteanna (94)
Alan Kelly
Ceist:94. Deputy Alan Kelly asked the Minister for Health the reason there has not been a full roll-out of intermediate care vehicles with staff across the acute hospital network. [27540/17]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the HSE to respond to you directly.
Nursing Staff Recruitment
Ceisteanna (95)
Shane Cassells
Ceist:95. Deputy Shane Cassells asked the Minister for Health the criteria for American and Australian qualified nurses to enter the health system here; and if he will make a statement on the matter. [27829/17]
Amharc ar fhreagraFreagraí scríofa
I have received a report from the Nursing and Midwifery Board of Ireland (NMBI) on the issue raised by the Deputy. The NMBI have advised that:
Applicants who trained outside the EU/EEA are considered as Group 3 applicants for the purpose of applying for registration with NMBI. Each application is individually assessed to include a full review of the applicant's education and training programmes. This reviews includes all pre-registration and post registration nursing education programmes. The programmes are compared to Irish standards of education and training for nurses. American and Australian nurses must provide the following documents in advance of their application being individually assessed:
- Completed application form;
- Identity documents;
- Transcript(s) of training from their University/School of Nursing;
- Professional Employment Reference;
- Verification of registration and Good Standing from all Competent Authorities where they hold/held registration.
Some American and Australian applicants unfortunately do not meet NMBI standards and requirements in terms of the nursing programmes they undertook when compared to Irish standards and requirements. Many programmes fall significantly short of the hours required for registration with NMBI or to be offered a period of adaptation/aptitude test and unfortunately these applicants are refused registration. An applicant has the right to appeal this decision within 56 days of date on decision letter. American trained applicants who only hold an Associate Degree are advised in NMBI guidance documentation that they are not eligible to apply for registration with this qualification alone as it is only a two year programme and will not meet the criteria for registration. If an American applicant who holds an Associate Degree and has taken additional relevant studies wishes to apply, the NMBI will consider their application.
It may be of interest to the Deputy to learn that as of 12th June 2017, a total number of 283 individuals who undertook their training in the United States are registered on the Active Register with NMBI. The vast majority of these Registrants would have had to undertake either an adaption placement or aptitude test as a pre-requisite to registration.