Thursday, 28 Sep 2017

Written Answers Nos. 202-221

Nursing Home Services

Ceisteanna (202)

Bernard Durkan

Ceist:

202. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he views the important role played by St. Brigid’s nursing home, Crooksling, in the provision of hospital care for women; if his attention has been drawn to the high quality of care available there, the dedication of the staff, the use of modern technology and equipment and the suitability of the peaceful, sylvan location of the hospital all contributing to the highest possible level of quality care; if he will ensure that this level of quality service continues at the location indefinitely having particular regard to the shortage of such facilities; and if he will make a statement on the matter. [41175/17]

Freagraí scríofa

Minister of State at the Department of Health

The long term beds provided by public nursing homes are an essential part of our infrastructure, and without them many older people would not have access to the care that they need. The standard of care delivered to residents in these units is generally very high, but we recognise that many of our public units are housed in buildings that are less than ideal in the modern context. For this reason the Capital Programme announced in January 2016 provides for the replacement and refurbishment of 90 public nursing homes across the country over the five year period from 2016 to 2021.

St. Brigid's Nursing Home, Crooksling has faced a number of challenges in recent years; the physical environment is unsuitable as a long-stay residence and works undertaken by the HSE at the home can only prolong its use on a short term basis. Under the five year programme, the Government is committed to delivering a new 100 bed Community Nursing Unit at Tymon North to provide long stay residential care.

Community Care Provision

Ceisteanna (203)

Bernard Durkan

Ceist:

203. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he has investigated the origin of rumours regarding the future of Maynooth community care unit having particular regard to the very high quality of service available there, universal satisfaction throughout the community and its strategic location; and if he will make a statement on the matter. [41176/17]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Hospital Waiting Lists Data

Ceisteanna (204)

Bernard Durkan

Ceist:

204. Deputy Bernard J. Durkan asked the Minister for Health the number of persons on waiting lists for hip replacements at various hospitals throughout the country; the longest period of time a person has been on this waiting list; and if he will make a statement on the matter. [41177/17]

Freagraí scríofa

Minister for Health

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. The Inpatient/Daycase Action Plan is being delivered through a combination of normal hospital activity, as well as insourcing and outsourcing initiatives utilising NTPF funding. Under the Inpatient/Daycase Plan, since early February, over 23,800 patients have come off the Inpatient/Daycase Waiting List.

The NTPF has advised that to date 5,901 patients have been authorised for treatment in private hospitals under its Initiatives, 2,235 patients have accepted an offer of treatment in a private hospital and that 1,112 patients have received their procedure. T he NTPF has also indicated that 2,841 patients have been authorised for treatment in public hospitals under the Plan’s insourcing initiatives, 910 offers of treatment have been accepted and 285 patients have been treated. Long-waiting orthopaedic patients are receiving treatment under the insourcing initiative.

Under the Outpatient Plan, since early February, more than 84,200 patients have come off the Outpatient Waiting List .

In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.

Hospitals Capital Programme

Ceisteanna (205)

Bernard Durkan

Ceist:

205. Deputy Bernard J. Durkan asked the Minister for Health the position regarding to the provision of the next stage of development of Naas General Hospital with particular reference to upgrading the endoscopy services; if his attention has been drawn to the need for the immediate implementation of the programme; and if he will make a statement on the matter. [41178/17]

Freagraí scríofa

Minister for Health

My Department's mid-term review submission includes this project and many others. Funding for this project will be considered in the context of the future capital envelope for the health service and the overall priorities for future service development in the Dublin Midlands Hospital Group.

Hospital Waiting Lists Data

Ceisteanna (206)

Bernard Durkan

Ceist:

206. Deputy Bernard J. Durkan asked the Minister for Health the number of persons awaiting appointment with consultants prior to getting on to a waiting list for the relevant procedure; and if he will make a statement on the matter. [41179/17]

Freagraí scríofa

Minister for Health

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. The Inpatient/Daycase Action Plan is being delivered through a combination of normal hospital activity, as well as insourcing and outsourcing initiatives utilising NTPF funding. Under the Inpatient/Daycase Plan, since early February, over 23,800 patients have come off the Inpatient/Daycase Waiting List.

The NTPF has advised that to date 5,901 patients have been authorised for treatment in private hospitals under its Initiatives, 2,235 patients have accepted an offer of treatment in a private hospital and that 1,112 patients have received their procedure. The NTPF has also indicated that 2,841 patients have been authorised for treatment in public hospitals under the Plan’s insourcing initiatives, 910 offers of treatment have been accepted and 285 patients have been treated.

Under the Outpatient Plan, since early February, more than 84,200 patients have come off the Outpatient Waiting List .

In addition in November 2016, the HSE launched the Strategy for the Design of Integrated Outpatient Services 2016-2020. This strategy seeks to improve waiting times for outpatient services in the long term by restructuring referral pathways and utilising technology to improve service delivery.

This week, I gave approval to the HSE to put in place capacity to drive a national waiting list validation project to support systematic and regular waiting list validation and continued focus on scheduled care.

With regard to the number of patients waiting for Outpatient appointments, the NTPF publishes the waiting list figures each month on its website NTPF.ie.

Health Services Provision

Ceisteanna (207)

Bernard Durkan

Ceist:

207. Deputy Bernard J. Durkan asked the Minister for Health the extent to which a streamlined support service exists throughout the public hospital sector to ensure that consultants have the opportunity to carry out the maximum number of procedures that lack of ancillary facilities such as theatre staff, equipment and theatre space remains available and does not impede progress in this area; and if he will make a statement on the matter. [41180/17]

Freagraí scríofa

Minister for Health

To assist it in delivering on its commitments, the HSE has revised and enhanced its Performance and Accountability Framework for 2017. The Framework sets out how the HSE including the national divisions, the hospital groups and individual managers will be held to account for their performance.

It makes explicit the responsibilities of health service managers in the four equally important domains of performance which are: access to services; the quality and safety of those services; doing this within the financial resources available; and effectively harnessing the efforts of the workforce. The emphasis of the Framework is on recognising good performance, improving performance at all levels of the health service and ensuring that individual managers are held to account for their performance.

My Department oversees and monitors the HSE's implementation of its performance accountability framework and monitors implementation of the HSE corporate plan and annual national service plans.

A Capacity Review is currently being undertaken by my Department and will examine both current capacity across the health system including in acute hospitals, primary care and social care, and the drivers of future demand moving to 2030. This review is due to be concluded by the end of 2017 and the findings will feed into decisions regarding future capital expenditure.

My Department is pursuing a range of initiatives to address health service staffing, including the development of a national strategic framework for health workforce planning. The recruitment and retention of medical staff is also a priority for the HSE and the number of consultants employed in the public health service continues to increase. At the end of July 2017 there were 2,892 whole time equivalents, an increase of 105 on the corresponding month in 2016 and 700 in the past decade. There has been an increase of 722 whole time equivalent nurses and midwives in the last year.

The 2017 total Health Budget of €14.6 billion was the highest ever health budget and is enabling both progress towards addressing the challenge of increased demand from a growing and aging population, and the commencement of some significant new developments which will over time deliver real improvements for patients. The increased funding and growth in staffing within our health service are allowing for expansion in service levels and optimum utilisation of facilities.

General Practitioner Data

Ceisteanna (208)

Bernard Durkan

Ceist:

208. Deputy Bernard J. Durkan asked the Minister for Health the number of general practitioners practising here; the extent to which this number has fluctuated in the past ten years; the extent to which demographic trends are affecting requirements in this area; and if he will make a statement on the matter. [41181/17]

Freagraí scríofa

Minister for Health

While no central register exists specifically for GPs working in Ireland, all doctors in practice in Ireland must be registered with the Medical Council. A number of sources provide data on GPs working in Ireland at present. The Medical Council collects and analyses data from the general, specialist and trainee specialist registers to produce valuable data on the GP workforce. The HSE Primary Care Reimbursement Service collects data on the number of GMS contract-holders and those GPs delivering state-funded primary care services. The Irish College of General Practitioners also collects and analyses data on the GP workforce, including the number of doctors registered for professional competence and those holding membership of the ICGP.

As of 19 September 2017, there are 3,556 doctors on the Medical Council's Specialist Register in the Speciality of General Practice. Holding registration does not, however, necessarily mean that a medical practitioner is active in general practice at the time. In the last ten years, the number of GPs contracted by the HSE to provide services to medical card holders and GP visit card holders under the GMS scheme has increased. At the end of 2007 there were 2,129 GPs who held GMS contracts. As of 1 September 2017, there are 2,496 GPs who hold GMS contracts. Many GPs also hold contracts with the HSE to provide services under other state schemes, e.g. the Primary Childhood Immunisation Programme. There are a further 437 GPs at 1 September 2017 without GMS contracts who hold other such contracts with the HSE, bringing the total number of GPs contracted by the HSE at present to 2,993.

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 and that general practice is sustainable in all areas into the future. Several efforts to increase the number of practising GPs have been undertaken in recent years. These 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 enhanced supports for rural GP practices. These steps should help to address the future demand for GPs by enticing GPs who may have ceased practicing 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. Separately, the State is seeking to train more GPs to provide GP services to the population. In 2009, there were 120 GP training places and in 2017 there were 170 training places filled. The Government is committed to further increasing this number to 259 places annually in future years.

In September 2015, the HSE published a medical workforce planning report entitled Medical Workforce Planning - Future Demand for General Practitioners 2015 - 2025. The report identified a current unmet service demand of around 500 GPs, and estimated that there will be a shortage of around 493 GPs in Ireland by 2025 if the impact of population ageing on GP consultation rates alone is considered. This estimate was based on the assumption that there would be no inward migration of GPs and that the GP training intake would remain at the 2015 level of 157 training places annually. As I have indicated, the Government is committed to increasing GP trainee places on a phased basis.

Mental Health Services Funding

Ceisteanna (209)

Bernard Durkan

Ceist:

209. Deputy Bernard J. Durkan asked the Minister for Health the extent to which adequate and financial provision remains available to his Department to meet the requirements of the mental health services with particular reference to the need to ensure the maintenance of the necessary supportive structures; and if he will make a statement on the matter. [41182/17]

Freagraí scríofa

Minister of State at the Department of Health

As reflected in the agreed Programme for Government, the Government remains strongly committed to developing all aspects of mental health policy and services. This includes, for example, on-going reviews of both the Mental Health Act 2001, and A Vision for Change. We will increase also the HSE Mental Health budget annually, as resources allow over future years. In the region of €140m additional funding has been provided for mental health since 2012, involving the approval of around 1,500 new posts to delivery the change necessary to achieve a modern, high quality service. The overall HSE funding provision for mental health in 2017 is significant at around €853m.

Key priorities being addressed in this context include youth mental health, further improvement to child & adolescent (CAMHS) and adult services, older people's services and enhanced Out-of-Hours response for those in need of urgent services. Other new initiatives, such as those arising from the National Task Force on Youth Mental Health are also being progressed. While this sector is experiencing difficulties in staff recruitment and retention, similar to other areas of the health sector, this is being addressed by the HSE, and funding is not an issue in that specific regard. However, as I have indicated, further investment will be required in the future to develop mental health services on all fronts, including progressing improved supports and continuing structural change.

I am satisfied that, bearing in mind all the circumstances, adequate financial provision exists at present to underpin this year development of mental health services, and that the Government is fully committed to improving this in the future.

Question No. 210 answered with Question No. 195.

Nursing Staff Provision

Ceisteanna (211)

Bernard Durkan

Ceist:

211. Deputy Bernard J. Durkan asked the Minister for Health the degree to which adequate numbers of nurses are likely to become available throughout the public health sector over the next three years; and if he will make a statement on the matter. [41184/17]

Freagraí scríofa

Minister for Health

Nursing and midwifery recruitment and retention is a priority for the Government and my Department is in regular contact with the HSE on matters concerning the recruitment of nurses and midwives. The HSE is currently focused on offering graduating nurses and midwives permanent posts and replacing agency staff with permanent staff. Recruitment of additional nurses is also the subject of considerable ongoing activity by the HSE and voluntary hospitals with campaigns in train in Ireland and abroad. As part of the 2017 Nursing and Midwifery Recruitment and Retention Agreement, reached with the INMO and SIPTU earlier this year, it committed to put in place an additional 1,224 nursing and midwifery posts across the public health service by the end of December 2017. Very extensive and detailed work has been sustained throughout 2017 to implement the Agreement.

As part of the Agreement there was a commitment to increase the number of nursing and midwifery undergraduate places. Since 2010, the four year undergraduate nursing programme had an annual intake of 1,570 nurses which includes 140 midwifery students. In 2016, an additional 60 places were made available for Psychiatric nursing. In 2016, 1,428 Irish trained nurses and midwives undertook the internship programme. This programme is a requirement for first time registration with the Nursing and Midwifery Board of Ireland (NMBI). In 2017, there are 1,421 nurses currently undertaking the internship programme. As already mentioned, the nursing agreement also allows for permanent contracts to be offered to all student nurse graduates. A nursing and midwifery workforce plan for 2018 and 2019 to meet service need with relevant engagement to be undertaken with stakeholder is also provided for in this agreement. These measures should help provide a good supply of nurses to the public health sector in the years to come.

HSE Waiting Lists

Ceisteanna (212)

Billy Kelleher

Ceist:

212. Deputy Billy Kelleher asked the Minister for Health the number of persons in each community healthcare organisation, CHO, waiting for a podiatry appointment in primary care; and the numbers waiting zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks and more than 52 weeks, respectively. [41185/17]

Freagraí scríofa

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.

HSE Waiting Lists

Ceisteanna (213)

Billy Kelleher

Ceist:

213. Deputy Billy Kelleher asked the Minister for Health the number of persons in each community healthcare organisation, CHO, waiting for an ophthalmology appointment in primary care; and the numbers waiting zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks and more than 52 weeks, respectively. [41186/17]

Freagraí scríofa

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.

HSE Waiting Lists

Ceisteanna (214)

Billy Kelleher

Ceist:

214. Deputy Billy Kelleher asked the Minister for Health the number of persons in each community healthcare organisation, CHO, waiting for an audiology appointment in primary care; and the numbers waiting zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks and more than 52 weeks, respectively. [41187/17]

Freagraí scríofa

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.

HSE Waiting Lists

Ceisteanna (215)

Billy Kelleher

Ceist:

215. Deputy Billy Kelleher asked the Minister for Health the number of persons in each community healthcare organisation, CHO, waiting for a psychology appointment in primary care; and the numbers waiting zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks and more than 52 weeks, respectively. [41188/17]

Freagraí scríofa

Minister of State at the Department of Health

The number of patients awaiting a psychology appointment across all Community Healthcare Organisations at the end of July, including those waiting more than a year are as follows:

	Total number	Of which are waiting more than a year
0-4 years	981	151
5-17 years	5830	2035
18-64 years	1491	380
65+ years	113	18

The HSE has a Service Improvement Initiative underway for Psychology Services; which includes the recruitment of an additional 22 psychologist posts and 114 Assistant psychology posts. These posts were advertised recently. A cross divisional Working Group, including the Mental Health Division, is working to ensure standardised delivery of service, setting out and communicating the arrangements for care pathways and reporting of metrics. Each CHO has been requested to submit a short-term action plan to address waiting lists in priority areas as part of the Service Improvement Initiative.

Other developments in this area include the Counselling in Primary Care Service (CIPC) for adults over 18 years who are medical card holders; a greater awareness of fostering mental health promotion in society through campaigns like the 'Let's Talk' campaign and 'The Little Things'; implementing the Suicide Prevention Strategy 'Connecting for Life'; the ongoing reduction of Child and Adolescent Mental Health Services (CAMHS) waiting lists for those waiting over 12 Months; the development of counselling services across both primary and secondary care, including early intervention at primary care level; and the opening of new Jigsaw youth mental health services, bringing the total number of services to 13.

HSE Waiting Lists

Ceisteanna (216)

Billy Kelleher

Ceist:

216. Deputy Billy Kelleher asked the Minister for Health the number of persons in each community healthcare organisation, CHO, waiting for a dietetics appointment in primary care; and the numbers waiting zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks and more than 52 weeks, respectively. [41189/17]

Freagraí scríofa

Minister for Health

As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.

HSE Waiting Lists

Ceisteanna (217)

Billy Kelleher

Ceist:

217. Deputy Billy Kelleher asked the Minister for Health the number of persons in each community healthcare organisation, CHO, waiting for an oral health appointment in primary care; and the numbers waiting zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks and more than 52 weeks, respectively. [41190/17]

Freagraí scríofa

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.

Home Help Service Data

Ceisteanna (218)

Billy Kelleher

Ceist:

218. Deputy Billy Kelleher asked the Minister for Health the number of home help hours provided in each local health office area in June, July and August 2017; and the way in which this compares against the target in tabular form. [41205/17]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Disabilities Data

Ceisteanna (219)

Margaret Murphy O'Mahony

Ceist:

219. Deputy Margaret Murphy O'Mahony asked the Minister for Health the number of children awaiting a first assessment from the HSE under the Disability Act 2005 at the end of June 2017 or latest day available in each local health office, LHO, in tabular form. [41221/17]

Freagraí scríofa

Minister of State at the Department of Health

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Speech and Language Therapy Data

Ceisteanna (220, 221)

Margaret Murphy O'Mahony

Ceist:

220. Deputy Margaret Murphy O'Mahony asked the Minister for Health the number of persons on the speech and language therapy assessment waiting list in each local health authority, LHA, in tabular form; and the number waiting less than four months, four to 12 months and more than 12 months. [41222/17]

Margaret Murphy O'Mahony

Ceist:

221. Deputy Margaret Murphy O'Mahony asked the Minister for Health the number of persons on the speech and language therapy treatment waiting list in each local health authority, LHA, in tabular form; and the number waiting less than four months, four to 12 months and more than 12 months. [41223/17]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 220 and 221 together.

As these questions relate to service matters, I have arranged for them to be referred to the Health Service Executive (HSE) for direct reply.