Written Answers Nos. 422-441
422. Deputy Catherine Martin asked the Minister for Health the long-term policy and funding strategy for the care of adults with intellectual disabilities particularly in scenarios in which close relatives are no longer able to provide care. [41767/17]
Amharc ar fhreagraThe 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.
Funding of €1.69 billion was allocated by the Health Service Executive, HSE, for disability services in 2017. This represented an increased allocation of €130 million compared to the previous year. Funding in 2017 has supported the provision of a wide range of services to people with disabilities as follows:
|
Disability Services Programme: €1.69 billion 2017 |
Quantum of Services |
|
Residential services |
9,000 people |
|
Day services |
Over 22,000 people |
|
Respite residential support |
182,500 overnights |
|
Personal Assistant services |
1.4 million hours |
|
Home Support services |
2.75 million hours |
|
Move from institutions to homes in the community |
223 people |
In addition, 2017 has seen targeted improvements in a number of priority areas. These include the reconfiguration of disability residential services, supported by €20 million in capital funding and by the Service Reform Fund and improved compliance with National Standards for Residential Centres for Children and Adults with Disabilities.
My Department is currently engaged in discussions with the HSE and the Department of Public Expenditure and Reform as part of the Estimates Process for Budget 2018. Pending the conclusion of these discussions, I am not in a position to comment on the level of funding that will be available in 2018 for disability services.
423. Deputy Catherine Martin asked the Minister for Health if he has satisfied himself with the quality of record keeping, archiving and recording of case histories at a facility (details supplied); if he has further satisfied himself with the level of continued professional development available to and availed by all staff; if he has satisfied himself with the communication with persons by electronic, telephone and other means; if he has further satisfied himself with the availability of information such as leaflets on mental health to persons within the facility; and if he will make a statement on the matter. [41772/17]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
424. Deputy Marcella Corcoran Kennedy asked the Minister for Health the reason a person (details supplied) will not be considered under the HSE treatment abroad scheme; and if he will make a statement on the matter. [41784/17]
Amharc ar fhreagraThe Health Service Executive operates the Treatment Abroad Scheme, for persons entitled to treatment in another EU/EEA Member State or Switzerland under EU Regulation 883/04, as per the procedures set out in EU Regulation 987/09, and in accordance with Department of Health Guidelines.
The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
425. Deputy Joe Carey asked the Minister for Health the progress made to date and future changes envisaged in the context of three monthly reports (details supplied); and if he will make a statement on the matter. [41785/17]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply.
426. Deputy Mary Lou McDonald asked the Minister for Health the status of a hip replacement operation for a person (details supplied); and if he will make a statement on the matter. [41787/17]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive, HSE, is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to the Deputy directly.
427. Deputy Brendan Ryan asked the Minister for Health if he will investigate the case of a person (details supplied) who is in need of urgent orthodontic treatment and who does not qualify for such treatment under the school dental service; and if he will make a statement on the matter. [41809/17]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
428. Deputy Mary Lou McDonald asked the Minister for Health further to Parliamentary Question No. 159 of 15 June 2016, the reason the person concerned was not seen by an occupational therapist in February 2017 as committed to by the HSE; his views on whether it is acceptable that a child should have to wait for two years for an appointment within the health service; and if he will make a statement on the matter. [41810/17]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive, HSE, for direct reply.
429. Deputy Hildegarde Naughton asked the Minister for Health if his attention has been drawn to the fact that County Galway had one of the largest yearly increases in the number of persons with diabetes requiring inpatient treatment for diabetic foot ulceration; the reason for the sudden increase; if funding for a further podiatrist in County Galway will be made available in budget 2018; and if he will make a statement on the matter. [41811/17]
Amharc ar fhreagraAs the issues raised refer to service matters, I have asked the Health Service Executive to reply directly to the Deputy.
430. Deputy Seán Haughey asked the Minister for Health his views on the number of Irish doctors taking up permanent positions abroad following qualification; the reason for this; the steps he will take to deal with the problem; and if he will make a statement on the matter. [41815/17]
Amharc ar fhreagraI appreciate that there are many reasons why doctors – both from Ireland and from other countries – emigrate. There is always a mixture of "push and pull" factors at play when one decides to leave one’s country. A number of our consultants and Non-Consultant Hospital Doctors go abroad as part of their training, and some following completion of their training, to gain experience and expertise prior to taking up posts in Ireland. A further group goes abroad for a variety of other reasons, such as working conditions, life style, and pay.
With regard to employment levels, the figures at the end of July 2017 show that there are more consultants employed in the public health services than at the same time last year. At the end of July 2017, there were 2,892 whole-time equivalent consultants. This is 105 more than the end July 2016 figure and an increase of over 700 in the past decade. Alongside this, the number of Non-Consultant Hospital Doctors has increased year on year. At the end of July 2017, there were almost 6,000 whole-time equivalent NCHDs. This is an increase of 178 compared with the July 2016 number and an increase of over 1,100 in the past decade.
In July 2013 a Working Group, chaired by Professor Brian MacCraith, President, Dublin City University, was established to carry out a strategic review of medical training and career structures. The Working Group completed its work at the end of June 2014 and, in all, submitted three reports and made 25 recommendations. The reports address a range of barriers and issues relating to the recruitment and retention of doctors in the Irish public health system.
A number of the Group's recommendations have been addressed including revised pay rates for new entrant consultants, though implementation of others is ongoing. Other positive developments include:- the launch of a careers and training website, which gives information about each specialty, including details of training pathways and training durations; a doubling of the number of family-friendly training places over a three-year period; the roll-out of an online National Employment Record that has streamlined processes and eliminated the paperwork burden associated with NCHD rotations; and the appointment of 45 Lead NCHDs to improve communication with management across acute and non-acute settings. All of these initiatives are making a positive contribution to the recruitment and retention of Irish-trained doctors in the Irish health system.
431. Deputy Mattie McGrath asked the Minister for Health the amount of counterfeit medication that has been confiscated annually since 2011; the types of counterfeit medication involved; and if he will make a statement on the matter. [41850/17]
Amharc ar fhreagraThe Health Products Regulatory Authority, HPRA, is the statutory agency responsible for the regulation of human and veterinary medicines, cosmetics and clinical trials in Ireland. One of the HPRA’s roles is to investigate potential breaches of legislation and, where necessary, to take corrective action including legal proceedings. The HPRA works closely with Revenue’s Customs Service, an Garda Síochána and with international enforcement agencies to prevent the unauthorised movement of illegal medicinal products, medical devices and cosmetic products into and out of the State.
Since 2011, the HPRA, working in co-operation with An Garda Síochána and Revenue Customs, has focused on enforcement actions related to four categories of falsified medicinal products: weight-loss products, sedatives, medicinal products for erectile dysfunction, and anabolic steroid-containing medicinal products. The level of medicines detained in any one year varies depending on the particular focus of enforcement activity at that time.
The HPRA has confirmed details of annual confiscations of falsified medicines since 2011 as follows:
2011
Total Number of Dosage Units: 762,641
Top 4:
- Weight Loss: 251,883
- Sedatives: 95,747
- ED: 63,270
- Anabolic Steroids: 14,572
2012
Total Number of Dosage Units: 758,276
Top 4:
- Sedatives: 195,105
- Weight Loss: 153,042
- ED: 52,089
- Anabolic Steroids: 12,872
2013
Total Number of Dosage Units: 919,965
Top 4:
- Sedatives: 422,622
- Weight Loss: 154,251
- ED: 94,754
- Anabolic Steroids: 24,854
2014
Total Number of Dosage Units: 730,056
Top 4:
- Sedatives: 407,502
- ED: 96,703
- Weight Loss: 53,963
- Anabolic Steroids: 20,752
2015
Total Number of Dosage Units: 1,136,494
Top 4:
- Sedatives: 726,164
- ED: 98,642
- Weight Loss: 34,398
- Anabolic Steroids: 38,049
2016
Total Number of Dosage Units: 673,906
Top 4:
- Sedatives: 271,545
- Anabolic Steroids: 109,006
- ED: 95,739
- Weight Loss: 14,830
2017 (to 31 August)
Total Number of Dosage Units: 1,088,394
Top 4:
- Anabolic Steroids: 443,263
- Sedatives: 133,485
- ED: 73,831
- Weight Loss: 14,416.
432. Deputy Mattie McGrath asked the Minister for Health the status of the introduction of legislation dealing with assisted human reproduction; the areas which will be covered under such legislation; and if he will make a statement on the matter. [41851/17]
Amharc ar fhreagraThe General Scheme of legislative provisions for assisted human reproduction, AHR, and associated research has been completed. This comprehensive piece of legislation encompasses the regulation a range of practices, including: gamete (sperm or egg) and embryo donation for AHR and research; surrogacy; pre-implantation genetic diagnosis, PGD, of embryos; posthumous assisted reproduction; and stem cell research. The General Scheme also provides for an independent regulatory authority for AHR.
As I consider the AHR legislation to be a priority, I submitted a Memorandum to Government seeking approval to draft the Assisted Human Reproduction Bill based on the General Scheme and to submit the Scheme to the Joint Oireachtas Committee for review.
433. Deputy Clare Daly asked the Minister for Health if his attention has been drawn to the dangerous levels of overcrowding at the emergency department of Tallaght hospital in the week of 25 September 2017; if the HSE will act on the recommendations of the 2011 HIQA inquiry into overcrowding at the hospital; and if he will make a statement on the matter. [41857/17]
Amharc ar fhreagraThere is no doubt that our public hospital system is seeing growing demand for care. Last year alone, there was a 2% increase in inpatient and day-case activity over 2015, as well as approximately 5% increase in Emergency Department, ED, attendances. Demand for services at Tallaght hospital is increasing year on year. The hospital experienced a 9% increase in ED presentations in 2016, with a 10% increase in presentations of 75-year-old patients. The trend continues in 2017 with further 10.7% increase in attendances and a 7% increase in admissions by persons aged 75 years up to August. Overall admissions to the hospital have increased by 4.7% this year.
The hospital is working to address this demand and the HSE has highlighted the following improvements in relation to Tallaght Hospital Emergency Department.
The new Emergency Department, ED, at Tallaght hospital is fully functional. There has been a 50% increase in the space available within the ED with the appropriate level staffing in place.
There has been significant focus on process improvements within the acute floor and the hospital in general. This has taken place with support of the clinical programmes, some of these include the opening of a rapid assessment and treatment area within the ED, development of clinical patient pathways (including for DVT, PE and patients presenting with seizures), the opening of a surgical assessment unit within the ED, and Nurse lead return clinics for ambulatory care patients which have improved the PET for this cohort of patients.
Tallaght hospital has an escalation framework in place to manage surge of activity in ED - this is based on the HSE/INMO escalation framework.
In relation to the care of frail older patients, there is a protocol in place in relation to the allocation and placement of over 75-year-old patients within nine hours of their presentation/registration in ED. A community geriatrician was appointed in late 2016 in conjunction with Community Health Organisation 7. This has enhanced the services to older person within the Tallaght Hospital catchment area.
In relation to the specific service issues raised in relation to the action the HSE has taken to address the recommendations of the 2011 HIQA report on Tallaght, I have asked the HSE to respond to the Deputy directly.
434. Deputy Maria Bailey asked the Minister for Health if he has the authority to prohibit the sale of so-called combi boxes which contain rolling tobacco, papers and filters under the Public Health Tobacco Acts, in view of HSE research which reports huge growth in the use of rolling tobacco by under 25s; and if he will make a statement on the matter. [41867/17]
Amharc ar fhreagraThe HSE report referred to by the Deputy entitled "Roll Your Own Cigarettes in Ireland - Key Patterns and Trends" indicates a significant increase in the consumption of roll-your-own tobacco, particularly among those under 25 years of age. This is in the context of an overall decrease in the numbers who smoke tobacco products in Ireland in recent years.
The Public Health (Tobacco) Acts 2002 to 2015 do not prohibit the sale of the roll-your-own tobacco "combi boxes" referred to by the Deputy. However, a number of measures have been introduced aimed at having a positive public health impact on the numbers of people smoking roll-your-own tobacco. The EU Tobacco Products Directive came into force in 2014 and was transposed into Irish legislation in 2016. Under that legislation the sale of roll-your-own tobacco packs weighing less than 30g is prohibited. Prior to this roll-your-own tobacco could be purchased in 12.5g and 25g packets. This increase in the size of the packet has the effect of making roll-your-own tobacco less affordable than before, particularly to younger adults. Evidence indicates that pricing is a key means of reducing tobacco consumption. Government Policy, Tobacco Free Ireland, contains recommendations in relation to raising taxes on tobacco products including reducing the price differential between roll-your-own tobacco and cigarettes. In the context of Budget 2018, my colleague, Minister Harris has recently written to Minister Paschal Donohoe TD requesting that consideration be given to increasing the excise duty on tobacco products generally and, in particular, to increasing the excise duty on roll-your-own tobacco so as to reduce the price differential between roll-your-own tobacco and cigarettes.
Irish legislation which came into force on 30 September 2017 provides that all retail packaging of tobacco products manufactured from that date must be in standardised packaging. The aim of standardised packaging is to make all tobacco packs look less attractive, make health warnings more prominent and prevent packaging from misleading consumers about the harmful effects of tobacco. In relation to the health warnings the EU Tobacco Products Directive had the effect of significantly increasing the size of the picture health warnings on tobacco packaging.
It is anticipated that these and other tobacco control, cessation and health promotion measures will continue to reduce the numbers smoking tobacco. My Government colleagues and I are committed to the on-going implementation of Tobacco Free Ireland.
435. Deputy Brendan Smith asked the Minister for Health if persons currently using respreeza will not be denied access to this medication; and if he will make a statement on the matter. [41869/17]
Amharc ar fhreagraI am aware that a number of patients were on an access scheme operated by the manufacturer CSL Behring. The HSE has advised my Department that the manufacturer has confirmed it will no longer fund the drug with effect from 30 September 2017 and that the access scheme is discontinued.
I consider this action by the company as unethical and as I have stated previously, there should be no link between compassionate use schemes and reimbursement decisions. It is the responsibility of both the company and the investigator (clinician) to ensure that they have considered and made arrangements for the patients, including in circumstances where the product is not reimbursed by the HSE.
On my request, the HSE has sought assurances from Beaumont hospital that appropriate care arrangements are in place for patients who were on the access programme, and that appropriate ethical guidelines have been and continue to be followed in relation to all aspects of the clinical trial and access programme. The HSE has advised that this process is ongoing.
The HSE has also advised that it has decided to continue with the provision of this treatment to this patient cohort only, for an initial period of two weeks.
436. Deputy Brendan Smith asked the Minister for Health the measures he plans to implement to ensure the retention of newly qualified doctors in the health system in view of shortages at general practitioner level; and if he will make a statement on the matter. [41870/17]
Amharc ar fhreagraThe 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. I want to ensure that existing GP services are retained and that general practice remains an attractive career option for newly-qualified GPs.
Efforts undertaken in recent years to increase the number of practicing 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 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, an increase of over 40%. The Government is committed to further increasing this number to 259 places annually in future years.
My Department, the HSE and the Irish College of General Practitioners are committed to working together in a positive drive to improve the recruitment and retention in general practice in the coming years. The objective is to achieve further increases in the number of GP training places in future years, and to ensure that all the available places are filled, in order to meet the future manpower needs of general practice. The ICGP are currently carrying out a social media campaign in advance of the 2018 GP training recruitment process, in order to promote the profession of general practice, and thus to encourage applicants for GP training. A dedicated website has been created, www.beagp.com, which provides tailored information for medical undergraduates in Ireland and internationally who are interested in becoming a GP.
437. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) will receive the next lidocaine infusion; and if he will make a statement on the matter. [41873/17]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive, HSE, is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for inpatient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
438. Deputy Pearse Doherty asked the Minister for Health if the service available to patients at University Hospital Galway for the administration of lidocaine infusion has been reduced resulting in access for existing patients having been restricted; if so, the reason for reducing the number of appointments being allocated to existing patients; and if he will make a statement on the matter. [41874/17]
Amharc ar fhreagraIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
439. Deputy Michael Harty asked the Minister for Health when a person (details supplied) will be called for a knee operation in Limerick following numerous cancellations of same; and if he will make a statement on the matter. [41883/17]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive, HSE, is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The scheduling of appointments is a matter for the hospital to which the patient has been referred. Should a patient’s general practitioner consider the patient’s condition warrants and 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 the Deputy directly.
440. Deputy Louise O'Reilly asked the Minister for Health his Department's business priorities for each of the past five years; the way in which scoliosis surgeries have been a part of these plans for each of the past five years; the location and funding for same; the way in which paediatric access and surgery have been a part of these plans for each of the past five years; the location and funding for same; and if he will make a statement on the matter. [41884/17]
Amharc ar fhreagra441. Deputy Louise O'Reilly asked the Minister for Health if his Department received submissions as part of the Estimates process in the past five years to address the specific issue of scoliosis surgery; the way in which this was included in his Department's statement of priority over the past five years; the way in which this was included in his department’s budget over the past five years; and if he will make a statement on the matter. [41885/17]
Amharc ar fhreagraI propose to take Questions Nos. 440 and 441 together.
On foot of submissions received in 2014 and discussions with the HSE on scoliosis service requirements, the Department provided additional funding of €1.042 million under the 2015 National Service Plan to increase capacity at Our Lady's Children's Hospital Crumlin. A further €0.987 million was allocated under the 2016 Service Plan for Orthopaedics and Trauma to continue the development of paediatric scoliosis services in Crumlin hospital. The HSE Winter Initiative 2016-17 also included €2 million specifically for scoliosis. In addition, capital funding was provided for a new orthopaedic theatre in Crumlin which is now operational. The Children's Hospital Group Operations Plan for both 2016 and 2017 prioritised the improvement of capacity of paediatric scoliosis services to address ongoing deficits and waiting lists. It is acknowledged that paediatric orthopaedic services, including scoliosis, will require additional investment in the next few years to further improve access for children requiring elective or trauma orthopaedic services, and to build up the orthopaedic work force for the new children's hospital.
The Department's Business Priorities for this year include the overseeing of plans to tackle waiting lists overall. The Department's Statement of Strategy 2016-2019 commits to sustaining the progress made to date on waiting lists, and it has been made clear that one of this Government's key priorities is to reduce waiting times for the longest waiting patients. Consequently, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018. In this regard, I would like to highlight that up to the end of August 2017, 202 scoliosis procedures have been carried out in the two children's hospitals (Crumlin and Temple Street), as compared with 142 in those hospitals in the same period in 2016, representing a 42% increase in activity by end of August between 2016 and 2017. Up to 22 September 2017, the two children's hospitals have already exceeded the number of surgeries undertaken in the whole of last year - 226 to 22 September in 2017 compared with 220 in the full year in 2016.
I have asked the HSE to provide further details on how the additional funding provided over the last few years has been used to improve scoliosis services.
