Michael Healy-Rae
Ceist:834. 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. [35522/17]
Amharc ar fhreagraHospital Appointments Status
Ceisteanna (834)
Freagraí 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 (835)
Michael Healy-Rae
Ceist:835. Deputy Michael Healy-Rae asked the Minister for Health the status of a procedure for a person (details supplied); and if he will make a statement on the matter. [35524/17]
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 (836)
Barry Cowen
Ceist:836. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment in the Royal Victoria Eye and Ear Hospital, Dublin. [35525/17]
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.
Medical Aids and Appliances Provision
Ceisteanna (837, 870)
Brian Stanley
Ceist:837. Deputy Brian Stanley asked the Minister for Health if the payment to purchase post-surgery bras and prosthesis every two years which breast cancer patients receive following a mastectomy procedure has ceased; and if he will make a statement on the matter. [35549/17]
Amharc ar fhreagra
Mary Lou McDonald
Ceist:870. Deputy Mary Lou McDonald asked the Minister for Health his plans to proceed with changes to the national policy for post-mastectomy patients; and his further plans to increase the proposed value of post-surgery vouchers to reflect the true cost to persons of products such as prosthesis and bras for women recovering from a mastectomy. [35607/17]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 837 and 870 together.
I am informed by the HSE that they will engage further with the various stakeholders, including patients and suppliers, on arrangements for the provision of supports to patients who are being or have been treated for cancer and other illnesses. This process is expected to take several months to conduct and no changes to existing services are to be introduced in the meantime.
Home Care Packages Funding
Ceisteanna (838, 846)
Micheál Martin
Ceist:838. Deputy Micheál Martin asked the Minister for Health if the HSE has written to him or his officials regarding the lack of funding to meet the extra demand in health services particularly in care of the elderly and disability services; and if he will make a statement on the matter. [35562/17]
Amharc ar fhreagraMicheál Martin
Ceist:846. Deputy Micheál Martin asked the Minister for Health his views on the increased demands for home care packages; the way in which this will be addressed; and if he will make a statement on the matter. [35571/17]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 838 and 846 together.
The Deputy will be aware that many more of our older people with complex care needs are now being maintained at home, leading to increased demand for additional levels of service, and for services outside of core hours of Monday to Friday. The HSE has not formally written to me or the Department yet in relation to resource requirements. However, following my appointment as Minister of State for Mental Health and Older People I have met and been briefed by officials from both the Department and the HSE on relevant issues including in particular the demand for the home care which continues to grow in parallel with the increasing numbers of older people. In the context of these discussions the HSE provided an outline of requirements. The HSE will be engaging further on these issues with my Department over the coming months in the context of the budget process.
The overall funding for Services for Older People is €765 million in 2017 with €367m for direct funding of Home Help and Home Care Packages. A further €9m supported by HSE and Atlantic Philanthropies will provide Intensive Home Care Packages (IHCPs) for people with more complex needs. The HSE’s National Service Plan for 2017 provides for a target of 10.57 million Home Help Hours to support about 49,000 people, 16,750 Home Care Packages and 190 Intensive Home Care Packages for clients with complex needs including 60 clients with dementia supported with co-funding from Atlantic Philanthropies under the Irish National Dementia Strategy. This represents a significant increase on home care in comparison to last year’s Service Plan, which had an original target of 10.4 million hours home help and 15,450 Home Care Packages.
Despite this significant level of service provision, the demand for Home Care continues to grow. It is important to note that the allocation of funding for home care across the system, though significant, is finite and services must therefore be delivered within the funding available. The level of activity and associated costs must be managed in a way that ensures that those with the greatest needs are supported and that the overall expenditure on home care services by the HSE does not exceed the available funding.
The Programme for Government commits to increasing funding for Home Care Packages and Home Help every year. The planning and management of future health expenditure will be considered as part of the annual estimates and budgetary process which seeks to balance available funding across all of the various service areas to achieve the best possible outcomes for the greatest number of service users and prioritise areas of greatest need.
Finally I would like to assure the Deputy that the Government is committed to promoting care in the community for older people so that they can continue to live in their own homes for as long as possible. On 6 July Minister Harris and I announced the opening of a public consultation on home care services. The purpose of this consultation is to allow all those who have views on this topic to have their say, including older people themselves, their families, and health care workers. The Department wants to find out what people think about current home care services and would also like to hear the public’s views on what the future scheme should look like. I strongly urge all those with an interest in home care services to make a submission to the consultation. The consultation is an important step to inform the development of a Statutory Scheme for homecare, which is being prioritised by my Department. The development of such a Scheme will improve the operation of the homecare system and access to services that people need in an affordable and sustainable way.
Health Services Funding
Ceisteanna (839)
Micheál Martin
Ceist:839. Deputy Micheál Martin asked the Minister for Health if the HSE has written to him or his officials regarding the lack of funding to meet the extra demand in health services particularly in acute hospital services; and if he will make a statement on the matter. [35563/17]
Amharc ar fhreagraFreagraí scríofa
My Department is in regular communication and continues to work closely with the HSE regarding delivery of the National Service Plan 2017, and planning for 2018. The level of funding available for my Department in 2018 will be considered as part of the national Estimates campaign, and pending completion of this process it is not appropriate for me to comment further at this stage.
Departmental Reviews
Ceisteanna (840)
Micheál Martin
Ceist:840. Deputy Micheál Martin asked the Minister for Health if he has received reports on the bed capacity review; and if he will make a statement on the matter. [35564/17]
Amharc ar fhreagraFreagraí scríofa
The Programme for a Partnership Government committed the government to undertaking a capacity review of the health service. This is intended to provide a systematic analysis of the existing capacity across primary, acute and social care, and to assess the required capacity over the next 15 years. The Health Service Capacity Review is not due to report until later in the year.
Work on the Capacity Review is ongoing and is being led by the Department. As part of the Capacity Review, the Department has commissioned external technical and analytical expertise to assist in the review process. A Steering Group is overseeing the project and has already met on a number of occasions. In addition to this, an independent peer review group, comprising of international health experts, has been established to examine and validate the methodology and findings. My Department also plans to engage in a consultation process regarding the capacity review, in order to ensure that all stakeholder voices are heard as part of the process.
National Treatment Purchase Fund Data
Ceisteanna (841)
Micheál Martin
Ceist:841. Deputy Micheál Martin asked the Minister for Health the number of inpatients and outpatients that have been treated on the NTPF; and if he will make a statement on the matter. [35565/17]
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, Scoliosis and Outpatient Services. These plans have been published and their implementation is ongoing. The Inpatient / Daycase and Outpatient Plans focus on reducing the number of patients waiting 15 months or more for inpatient and daycase treatment or for an 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 16,700 patients have come off the Inpatient/Daycase Waiting List and nearly 62,000 patients have come off the Outpatient Waiting List.
In addition, the NTPF is currently rolling out its Daycase Waiting List 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 3,200 patients files have been transferred to private hospitals under this Initiative, over 1,100 patients have accepted an offer of treatment in a private hospital and around 470 patients have received their procedure.
National Treatment Purchase Fund Data
Ceisteanna (842)
Micheál Martin
Ceist:842. Deputy Micheál Martin asked the Minister for Health the amount of the NTPF allocation for 2017 that has been spent; the way in which it has been spent; and if he will make a statement on the matter. [35566/17]
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. Of this 2017 allocation, €15 million has been set aside for the treatment of those patients waiting longest for inpatient and daycase procedures.
In December 2016, I granted approval to the NTPF to dedicate the first tranche of €5m to a Daycase Waiting List Initiative 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 3,200 patients files have been transferred to private hospitals under this Initiative, over 1,100 patients have accepted an offer of treatment in a private hospital and around 470 patients have received their procedure.
The second tranche of €5m is to be used in an Insourcing Initiative whereby approximately 3,000 patients will receive inpatient and daycase treatment in a public hospital by the end of October 2017. This initiative is currently in process.
Finally, a further €5m will be used in another outsourcing initiative in which a further 2,000 patients will receive inpatient and daycase treatment in the private hospital system. Development of this initiative by the NTPF is ongoing and will be rolled out in 2017. These Plans will utilise both the capacity within the private hospital system through outsourcing, whilst maximising existing capacity in our public hospital system through insourcing within hospital groups.
Embedded in all NTPF Initiatives are procedures to report on the type, nature and cost of treatments commissioned, including controls to ensure quality patient treatment, value for money and efficient processes. My Department has implemented a robust monitoring framework in this regard.
The NTPF submit regular reports to the Department of Health on the number of patients treated, referring hospitals, treating hospitals, and treatment specialty. It may not be possible to make specific information on costs in relation to individual private hospitals available due to its commercial sensitivity however, the NTPF provide to the Department financial reports regarding the waiting list initiatives.
Maternity Services
Ceisteanna (843)
Micheál Martin
Ceist:843. Deputy Micheál Martin asked the Minister for Health the reason the funding to promote breast feeding in maternity hospitals was cut; if it will be reinstated; the way in which breast feeding will be promoted to increase levels; and if he will make a statement on the matter. [35567/17]
Amharc ar fhreagraFreagraí scríofa
Increasing the rates of breastfeeding in Ireland is an important national health policy objective and is emphasised in the Healthy Ireland Framework, the National Maternity Strategy 2016-2026, the National Obesity Policy and Action Plan 2016-2025, and the recently published National Cancer Strategy 2017-2026. The HSE Breastfeeding Action Plan, Breast Feeding in a Healthy Ireland, 2016 – 2021 sets out the priority areas to be addressed over the next 5 years to improve breastfeeding supports, to enable more mothers in Ireland to breastfeed and to improve health outcomes for mothers and children in Ireland. Funding to promote breast feeding in maternity hospitals remains ongoing.
The Deputy may be referring to funding in relation to the Baby Friendly Hospital Initiative. The Baby Friendly Hospital Initiative was launched by the World Health Organisation and the United Nations Children's Fund (UNICEF) in 1991 and is a global effort to implement practices that protect, promote and support breastfeeding.
The Initiative is funded by the HSE, who in 2016 commissioned a research team at Trinity College Dublin to undertake a review of the existing Initiative in place since 1991. The review, which highlighted a number of issues, recommended the need for a revised model to be developed in line with the Maternity Strategy and the HSE National Breastfeeding Action Plan 2016-2020.
A key finding of the Trinity Review was that there was no difference in breast feeding rates in hospitals that had achieved ‘Baby Friendly’ designation, and those that hadn’t achieved this designation.
Following completion of the Trinity Review, the HSE has paused funding of the existing model and is currently working on a revised model with input from maternity services and other key stakeholders to ensure a model suitable for the promotion and support of breastfeeding in Ireland is achieved.
The HSE Breastfeeding Action Plan outlines the actions needed to enhance breastfeeding rates and provide skilled support to mothers, through maternity services, hospitals, primary care services and in partnership with voluntary breastfeeding organisations and other stakeholders. A new support source for mothers is provided at www.breastfeeding.ie which was launched in 2015.
Emergency Departments
Ceisteanna (844)
Micheál Martin
Ceist:844. Deputy Micheál Martin asked the Minister for Health if he is satisfied on the way in which overcrowding in emergency departments is being tackled; and if he will make a statement on the matter. [35569/17]
Amharc ar fhreagraFreagraí scríofa
I would like to acknowledge the distress to patients, their families and those fronting staff experiencing overcrowding in Emergency Departments throughout the country, and I would like to reiterate my commitment as Minister to working towards improving access and waiting times for Emergency Care for patients.
In relation to ED overcrowding, data from the HSE indicates that the national picture improved from January to early May 2017. However, since May, there has been an increase in trolley numbers due to a series of factors including increased ED attendances, ED admission rates, elective activity and delayed discharges at certain hospitals. For example this year to the end of June attendances at EDs have increased by 1.7% nationally.
In September 2016 the HSE launched its ‘Winter Initiative Plan 2016-2017’ which provided €40 million of additional funding for winter preparedness. This Initiative was developed to manage the expected winter surge in demand for hospital care in an integrated way across Primary, Acute and Social Care. It ran over the winter period, from early October and concluded at the end of March. Following on from the Winter Initiative, a Roadmap was developed by the HSE and Department, setting out an approach to driving incremental reduction through process improvement in both trolley numbers and wait times.
Currently the HSE is engaged in a process of working with Hospital Groups and individual hospitals to progress winter planning for this year. In addition the Department, in conjunction with the HSE, continue to examine possible measures to be put in place as part of a programme of work to be implemented over the next 18 months aimed at providing improved access to scheduled and unscheduled care.
Nursing Homes Support Scheme
Ceisteanna (845)
Micheál Martin
Ceist:845. Deputy Micheál Martin asked the Minister for Health if he will report on continued funding for the fair deal scheme; his views on whether it will be sufficient to meet the increased demand; and if he will make a statement on the matter. [35570/17]
Amharc ar fhreagraFreagraí scríofa
The Nursing Homes Support Scheme (NHSS) is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their income and assets while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.
The Scheme has a budget of €940 million in 2017, providing support to just over 23,600 people by the end of the year. In order to manage the available funds within the budget throughout the year, a national placement list is operated by the HSE. Funding approvals issue to applicants in chronological order. In 2017 the time applicants to the Scheme spend on the placement list for funding should not exceed 4 weeks.
A number of factors may impact on future cost and demand for long-term residential care services, including possible new models of care for older people, demand at any particular point in time, changes in population health status, changes in the cost of care, and of course demographic projections. All relevant factors are considered as part of the budgetary process.
Question No. 846 answered with Question No. 838.
Departmental Budgets
Ceisteanna (847, 932, 1115, 1159)
Micheál Martin
Ceist:847. Deputy Micheál Martin asked the Minister for Health if his attention has been drawn by the HSE to the fact that expenditure is above profile; if he has satisfied himself that there will be no overruns on the health budget in 2017; and if he will make a statement on the matter. [35572/17]
Amharc ar fhreagra
Pat Buckley
Ceist:932. Deputy Pat Buckley asked the Minister for Health if the HSE has reported to him that it will be over budget for 2017; if so, the amount; and if he will make a statement on the matter. [35771/17]
Amharc ar fhreagra
Dara Calleary
Ceist:1115. Deputy Dara Calleary asked the Minister for Health the latest profiles in value and outruns forecasted in his Department for the end of December 2017 and any variances that may arise based on his Department’s performance against profile in gross voted expenditure at the end of June 2017 [36569/17]
Amharc ar fhreagra
Michael McGrath
Ceist:1159. Deputy Michael McGrath asked the Minister for Health if there will be an underspend in his Department's current or capital budget for 2017; if so, the subheads that are now below profile and those that may come in below profile at the end of the calendar year; if underspends in his Department will be available to the central Exchequer at year end; and if he will make a statement on the matter. [36748/17]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 847, 932, 1115 and 1159 together.
Government Departments are required to manage expenditure within the allocations set out in the Estimates for each year, agreed by the Dáil. Any underspend that arises against agreed allocations is surrendered to the Exchequer at the end of the year.
At end June 2017, the Health Vote is €55m under profile in Vote terms. However, this largely reflects profiling issues and the timing of cash disbursements to the HSE in particular. Expenditure on capital construction and equipping is currently under profile due to timing issues on the progress of a number of projects which have not progressed as initially projected. Expenditure is expected to progress steadily as construction begins. My Department does not anticipate any surplus on the Health Vote in 2017.
Whilst the Vote is below profile, a deficit exists in income and expenditure terms in the HSE, with pressures evident in acute hospital and disability services in particular. My Department is engaging with the HSE in relation to the issue, cognisant of the need to minimise any potential deficit.
It is too early, at this stage, to accurately assess any projected overall deficit in 2017. The Department will continue to work with the HSE to ensure that every effort is made to maximise cost containment and cost avoidance measures while delivering on the commitments set out in the NSP 2017 and, as provided in the Health (Amendment) Act, that all expenditure must be managed within the level of the net non-capital determination notified to the HSE.
Hospital Beds Data
Ceisteanna (848)
Micheál Martin
Ceist:848. Deputy Micheál Martin asked the Minister for Health if he or his officials have been informed of proposed bed closures in the acute hospitals between July and 31 December 2017; and if he will make a statement on the matter. [35573/17]
Amharc ar fhreagraFreagraí scríofa
HSE data indicated that at the end of June there were approximately 100 beds closed nationally due to a range of factors including for infection control reasons, refurbishment or due to staff shortages.
The Department has not been informed in advance of proposed bed closures in acute hospitals in the period July to 31 December 2017. As such I have asked the HSE to respond to you directly in this regard.
Hospital Waiting Lists
Ceisteanna (849)
Micheál Martin
Ceist:849. Deputy Micheál Martin asked the Minister for Health if he will report on waiting times for endoscopies; the breakdown of same for each hospital; and if he will make a statement on the matter. [35574/17]
Amharc ar fhreagraFreagraí scríofa
The NTPF publishes waiting list data for endoscopies by hospital and hospital group each month. This data can be viewed on its website at NTPF.ie.
General Practitioner Services Provision
Ceisteanna (850)
Micheál Martin
Ceist:850. Deputy Micheál Martin asked the Minister for Health the actions he has taken to address the shortage of general practitioners across the State; and if he will make a statement on the matter. [35575/17]
Amharc ar fhreagraFreagraí scríofa
The Government is committed to the continued development of GP capacity to ensure that patients across the country continue to have access to GP services, especially in remote rural areas and also in disadvantaged urban areas, and that general practice is sustainable in all areas into the future. I want to ensure that existing GP services are retained and that general practice remains an attractive career option for newly qualified GPs.
The annual number of training places available has been increased from 120 in 2009 to an intake of 170 in 2017. The Government is committed to further increasing this number in future years.
Further efforts undertaken in recent years to increase the number of practising GPs include changes to the entry provisions to the GMS scheme to accommodate more flexible/shared GMS/GP contracts, and to the retirement provisions for GPs under the GMS scheme, allowing GPs to hold GMS contracts until their 72nd birthday, as well as the introduction of an enhanced supports package for rural GP practices. These steps should help to address the future demand for GPs by enticing GPs who may have ceased practising for family or other reasons back into the workforce, facilitating GPs to work past the standard retirement age and encouraging more GPs to work in rural areas.
In addition, I have repeatedly emphasised the need for a new GP services contract which will help modernise our health service and develop a strengthened primary care sector, and health service management have already progressed a number of significant measures through engagement with GP representatives in recent years. The next phase of engagement on a new GP contract is under way. I am keen to ensure that future contractual terms for GPs would enjoy the support of the broad community of GPs and in this regard officials from my Department and the HSE are engaging with the relevant GP representative bodies in relation to the wide range of matters which will need to be encompassed by the contract development process. The GP contracts review process will, among other things, seek to introduce further measures aimed at making general practice a fulfilling and rewarding career option into the future.
Hospital Beds Data
Ceisteanna (851)
Micheál Martin
Ceist:851. Deputy Micheál Martin asked the Minister for Health the number of acute beds that were closed in the first six months of 2017; the reason for same; and if he will make a statement on the matter. [35576/17]
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.
Question No. 852 answered with Question No. 663.
General Practitioner Contracts
Ceisteanna (853)
Micheál Martin
Ceist:853. Deputy Micheál Martin asked the Minister for Health if he will report on the general practitioner contract negotiations; the date on which the last meeting was held; if progress was made; and if he will make a statement on the matter. [35578/17]
Amharc ar fhreagraFreagraí 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.
The aim is to develop a contract which has a population health focus, providing in particular for health promotion and disease prevention and for the structured ongoing care of chronic conditions. A new contract should be flexible and be able to respond to the changing nature of the GP workforce. It should also include provisions in relation to service quality and standards, performance, accountability and transparency. I think this will be key in making general practice a more attractive career.
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 officials from my Department and the HSE meet with the two GP representative bodies the IMO and the NAGP on a regular basis. The most recent meetings were held on 12 July and 30 June respectively and further meetings are confirmed for early August.
I understand that the discussions taking place are wide ranging and definitely ambitious in their scope. I think it is important to acknowledge that this will not be a straight forward process. As with any negotiation-type process, and given the range and complexity of the issues to be discussed, the engagement may take some time. It would not be appropriate at this stage to comment on progress to date. While there will be challenges for all parties involved, I would hope that everyone will remain focused on our common goal of putting suitable new arrangements in place that will work for patients, GPs, and other health care providers in primary care. I look forward to continued ongoing positive engagement with GP representatives in the months ahead.