Written Answers Nos. 355-378
355. Deputy John Brassil asked the Minister for Health if he will establish an adrenaline station in Leinster House as a matter of good practice, with a view to setting up such a provision in all workplaces, community facilities and schools; and if he will make a statement on the matter. [42752/17]
Amharc ar fhreagraThe Deputy will be aware that in October 2015, my predecessor, Minister Leo Varadkar, T.D., signed regulations which allow certain prescription-only medicines to be administered by trained members of the public in emergency situations. It is important to note that these regulations do not in any way change the existing, "good Samaritan", rule, which allows any member of the public to assist a person in distress to administer a medicine which has been prescribed to them. Equally, these regulations in no way diminish the responsibility or the importance of people continuing to carry the medicines that they need to manage their own health needs.
In order for an organisation to avail of an emergency medicine without the need for a prescription, it must first register with the Health Products Regulatory Authority, HPRA, and undergo a training course accredited by the Pre-Hospital Emergency Care Council, PHECC. This register is publically available through the Emergency Medicines Portal on the HPRA website and can be found at: www.hpra.ie/homepage/medicines/emergency-medicines/emergency-medicines-search/results.
There is currently a total of 14 organisations, and 21 accountable persons, listed on the register for Emergency Medicines. Each organisation may register more than one site and more than one accountable person.
Prescription-only medicines, POMs, such as adrenaline auto-injectors, are so designated because there are safety concerns about these medications. The administration of a POM should not be done lightly and should only occur following appropriate training. Any decision to undergo training on the use and administration of an emergency medicine rests with individual organisations.
356. Deputy Billy Kelleher asked the Minister for Health the powers he has delegated to the Ministers of State in his Department; the date on which such a delegation was made; if there were changes in powers delegated relative to the situation in place prior to 14 June 2017; if so, the details; and if he will make a statement on the matter. [42782/17]
Amharc ar fhreagraI have delegated responsibilities to the three Ministers of State assigned to my Department as follows:
Finian McGrath, T.D., Minister of State for Disabilities at my Department, has been delegated responsibility for all legislation, policy and funding relating to the provision of specialist health and personal social services to persons with a disability. The Order S.I. No. 335 of 2017 Health (Delegation of Ministerial Functions) (No. 2) Order 2017 delegating these functions was signed by the Taoiseach on 18 July 2017.
Catherine Byrne, T.D., Minister of State, has been delegated responsibility for Communities, the National Drugs Strategy and also the additional responsibility of Health Promotion. The Order S.I. No. 339 of 2017 Health (Delegation of Ministerial Functions) (No. 4) Order 2017 delegating these functions was signed by the Taoiseach on 18 July 2017. I have also assigned responsibility for Social Inclusion issues to Minister Byrne on a non-statutory basis.
Jim Daly, T.D., Minister of State for Mental Health and Older People, has been delegated responsibility for all legislation, policy and funding relating to the provision of mental health services for adults, children and adolescents, including the strategy on suicide prevention. Minister Daly will also be responsible for all services for older people, including the Nursing Homes Support Scheme. The Order S.I. No. 340 of 2017 Health (Delegation of Ministerial Functions) (No. 3) Order 2017 delegating these functions was signed by the Taoiseach on 18 July 2017.
The Orders also include any new relevant legislation pertaining to the areas of responsibility given to the Ministers of State which has been enacted in the period since the last delegation orders were made.
357. Deputy Brendan Smith asked the Minister for Health if the necessary resources will be provided to a hospital (details supplied) to launch a new service before the end of 2017; and if he will make a statement on the matter. [42796/17]
Amharc ar fhreagraIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
358. Deputy Billy Kelleher asked the Minister for Health the number of persons under 65 years of age in the fair deal scheme, under the nursing homes support scheme; and the number of persons under 65 years of age in receipt of it in each of the years 2012 to 2016. [42797/17]
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.
359. Deputy James Browne asked the Minister for Health the number of children in County Wexford awaiting primary care psychology services; the number of those children waiting longer than 12 months, 24 months and more than 36 months respectively; and if he will make a statement on the matter. [42807/17]
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.
360. Deputy James Browne asked the Minister for Health if he is satisfied with the inability of primary care psychology services in County Wexford to offer urgent appointments; and when this matter will be addressed. [42808/17]
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.
362. Deputy Fiona O'Loughlin asked the Minister for Health the number of persons waiting for a psychology appointment in primary care; and the number waiting more than a year. [42823/17]
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.
363. Deputy Fiona O'Loughlin asked the Minister for Health if he will report on the progress regarding the commitments he made in respect of reducing surgery waiting times for children with scoliosis; and if he will make a statement on the matter. [42825/17]
Amharc ar fhreagraThe HSE is actively implementing the action plan they developed to ensure that no child will be waiting over four months by year-end and are focused on maximising all available capacity both internally and externally to achieve this target.
Additional nurses are now in post in both Crumlin and Temple Street. An additional consultant orthopaedic surgeon commenced last month in Crumlin. So far in 2017, 272 scoliosis procedures have been carried out across all hospitals, in comparison to 220 procedures for the entire year in 2016. This represents a 24% increase, with 11 weeks of the year remaining.
The HSE has also completed an international tender for paediatric spinal fusion procedures and three hospitals have been successful. These hospitals have commenced patient reviews with a view to commencing treatment this month for patients whose families want to take up the offer of having procedures carried out in overseas hospitals.
The HSE has also developed a forecasting model to predict on a weekly and monthly basis the numbers of patients expected to receive surgery by year end. This is assisting the HSE further in monitoring the progress made in achieving the target.
The overall number of patients waiting for scoliosis procedures has been reducing this year and progress continues in delivering on the four-month target announced by the HSE by the end of 2017 in a planned, safe and sustainable manner.
364. Deputy Fiona O'Loughlin asked the Minister for Health the number of persons on waiting lists who were due to receive scheduled treatment during October, November and December 2017 who have been notified that their procedure has been postponed; and if he will make a statement on the matter. [42826/17]
Amharc ar fhreagraI fully acknowledge the distress and inconvenience for patients and their families when elective procedures are cancelled.
Maintaining scheduled care access is a key priority for hospitals, and balancing this with emergency demand is challenging. However, all efforts are made to limit cancellations, particularly for clinically-urgent procedures.
Cancellation of elective procedures can occur for a variety of reasons, including because a bed or the clinical team is not available, cancellations by the patient, or because the patient may not be fit for surgery at the time.
Based on data provided by the NTPF, on average around 3,400 elective procedures are cancelled per month. However, this must be seen in the context of an average of 53,000 admissions to acute hospitals on a daycase and an inpatient basis per month.
The NTPF National Inpatient/Daycase Planned Procedure Waiting List Management Protocol published in early 2017 sets out the national protocols for the management of waiting lists, including the scheduling of patient treatment. Under this Protocol, and in line with best practice, patients should not be scheduled for treatment more than six weeks in advance. On this basis, the HSE has advised that patients will not have been scheduled, as yet, for treatment in November and December. Also, data on cancellations are reported to the NTPF after cancellation and therefore are not available in advance.
The HSE continues to work with hospitals to improve the management of emergency care demand and planning of elective procedures to minimise the impact on patients, as well as the number of sessions lost through cancellations or “Do-Not Attends”.
As the Deputy is aware, the Department of Health has commenced a Health Service Capacity Review, the findings of which are due to be published before the end of the year and will inform future capacity developments.
365. Deputy Fiona O'Loughlin asked the Minister for Health the vacancy rates for consultants, doctors, nurses and midwives in the HSE; and his plans to fill those vacancies while also retaining existing staff in the HSE. [42827/17]
Amharc ar fhreagraI have asked the HSE to respond to the Deputy directly concerning the vacancy rates requested. However, it should be noted that typically the HSE does not operate a "vacancy rate", but rather records a staff turnover rate. The HSE estimates that for 2016, the adjusted turnover rate was 5.7%. This means that, each year at any one time, people will be moving in and out of about one in 20 posts across the HSE. This can be for a range of reasons such as simply moving to a new location but still within the HSE, retirements, resignations or other types of leave such as maternity leave. When a position is vacated, work may be covered through a variety of measures such as redeployment, restructuring or reallocation of the work. Also, it may be necessary for the duties to be covered by agency or overtime.
The need to increase the numbers of consultants, doctors, nurses and midwives in the public health service is a priority for me, my Department and the HSE against a backdrop of global shortages.
At the end of August 2017, there were 2,913 whole-time equivalent consultants in the public health services. This is 103 more than the end of August 2016 figure and an increase of over 700 in the past decade. At the end of August, there were 6,209 whole-time equivalent NCHDs, an increase of 278 on the August 2016 figure and an increase of over 1,300 in the past decade. The HSE has been focused on addressing issues associated with the creation and approval of consultant posts and successful recruitment. It is now giving effect to the report, "Towards Successful Consultant Recruitment, Appointment and Retention", completed in December 2016. It is also focused on implementing the recommendations of the, "MacCraith Group", to support the recruitment and retention of NCHDs.
The Nursing Recruitment and Retention Agreement concluded with the INMO and SIPTU Nursing earlier this year committed to increasing the number of nurses and midwives by 1,224 additional permanent posts in 2017. The recent quarterly progress report (30 Sept 2017) from the HSE states that the HSE has filled 20% of the target posts. However, the report shows that there is an increase of 739 whole-time equivalents between August 2016 and August 2017. In addition, the HSE is currently concluding the process of offering all graduating nurses and midwives permanent contracts and is focused on the conversion of agency employees into HSE direct employees. This is expected to deliver a significant increase in staff nurse numbers between now and year end.
The Public Service Pay Commission will also be examining the reasons behind the recruitment and retention issues faced by some public service grades in the next phase of its work. This will include certain health sector grades, including doctors, nurses and radiographers. I look forward to reading their findings in 2018.
366. Deputy Fiona O'Loughlin asked the Minister for Health his views on the Mental Health Commission’s call for it to be given powers to regulate community-based care services. [42828/17]
Amharc ar fhreagraThe Mental Health Commission is a statutory body whose functions are set out in the Mental Health Act 2001. Among the key responsibilities of the Commission is the establishment and maintenance of a Register of Approved Centres. The Act also provides that the Inspector of Mental Health Services visit, inspect and report on every approved centre at least once every year. Details of these inspection reports, including compliance issues, are available on the Commission website. While the Commission has the authority to visit and inspect any other premises where mental health services are being provided, the enforcement powers of the Commission only apply in the case of approved centres.
As regards the regulation of community based services by the Commission, the Deputy may be aware that the Expert Group Review of the Mental Health Act 2001 examined this issue in detail in its 2015 Report. The Expert Group recommended that a proportionate and risk-based system of inspection should be developed by the Commission. This would include a phased introduction of registration and inspection of all community mental health teams. In addition, all High, Medium and Low Support Hostels, Crisis/Respite Houses, other Residential Services, Day Hospitals and Day Centres would also be subject to inspection and enforcement by the Commission.
The Expert Group also suggested that in order to enhance the standard of care that is being provided in approved centres, the revised legislation should provide for the Mental Health Commission to make standards in respect of all mental health services and to inspect against those standards. The standards would be made by way of regulations and the regulations would be underpinned by way of primary legislation.
Amendments to the Mental Health Act 2001 based on the recommendations of the Expert Group Review of the Act are currently being progressed. Government approved plans to proceed with the general scheme of a bill and officials are working on the heads of the amending bill which will legislate for the recommendations of the Review, including those relating to the proposed registration and inspection of community mental health services.
My Department and I accept the importance of advancing this work as quickly as possible and we acknowledge that it is taking longer than stakeholders in this area would like. That said, it is a comprehensive legislative undertaking which must also now take account of the provisions of the Assisted Decision-Making (Capacity) Act 2015 which was enacted after completion of the Expert Group Report. I expect the text of the General Scheme of a Bill to be progressed by the end of the year.
367. Deputy Fiona O'Loughlin asked the Minister for Health the way in which it is proposed to reduce the long waiting times being experienced by children in County Kildare who are in need of an assessment for occupational therapy. [42829/17]
Amharc ar fhreagra372. Deputy Fiona O'Loughlin asked the Minister for Health the way in which it is proposed to reduce the long waiting times being experienced by children in counties Laois and Offaly who are in need of an assessment for occupational therapy. [42834/17]
Amharc ar fhreagraI propose to take Questions Nos. 367 and 372 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.
368. Deputy Fiona O'Loughlin asked the Minister for Health if the appointment of dementia care co-ordinators and dementia advisers in each local health office area will be considered. [42830/17]
Amharc ar fhreagraThe Alzheimer Society of Ireland’s pre-budget submission recommends the appointment of dementia care coordinators and dementia advisers in each local health office area, in addition to an investment of €35 million in home care services and the appointment of dementia friendly community coordinators. I had a constructive meeting with representatives of the Alzheimer Society on 29 August, when these matters were discussed.
In response to the rising number of people with dementia, currently estimated at 55,000, the Irish National Dementia Strategy was launched in December 2014 with the objective of increasing awareness, ensuring early diagnosis and intervention and developing enhanced community-based services. The Strategy emphasises that most people with dementia live in their own communities and can continue to live well and to participate in those communities for far longer than many people appreciate.
In parallel with the Strategy, the Department of Health and the HSE agreed a joint initiative with the Atlantic Philanthropies to implement significant elements of the Strategy over the period 2014-17. This Implementation Programme represents a combined investment of €27.5 million, with the Atlantic Philanthropies contributing €12 million and the HSE €15.5 million. The programme includes the provision of intensive home care packages for people with dementia, the upskilling of GPs and primary care teams in dementia diagnosis and management, and a public awareness and inclusion campaign. A National Dementia Office has been established to drive implementation of the Strategy in the HSE.
I am happy to be able to confirm that my Department has recently secured funding of €1.23 million under the 2017 Dormant Accounts Action Plan to support a number of dementia projects. These include post-diagnostic supports, dementia friendly communities, assistive technology libraries and further exploratory work on the development of a national dementia registry. These measures will help ensure that people with dementia can live well in their communities for as long as possible.
An evaluation of the Dementia Advisers employed by the Alzheimer Society of Ireland has been commenced by the HSE. It would be appropriate to await the outcome of this evaluation before considering the appointment of additional advisers.
The National Dementia Office has undertaken a project to examine the role of Key Worker for people with dementia, a commitment outlined in the National Dementia Strategy. There are a number of potential models and approaches and the NDO is currently identifying these with a view to determining a suitable approach to this action under the Strategy.
The Department and the HSE are working on a mid-term review of the implementation of the National Dementia Strategy which will identify the achievements so far and set out the further work that is required to implement the Strategy over the next 12 months and beyond. The resources required for the ongoing implementation of the Strategy, including in relation to the role of key worker, can only be considered in the context of the Estimates and Budget process. The mid-term review will assist in identifying further actions required and will be helpful in the context of budgetary considerations.
369. Deputy Fiona O'Loughlin asked the Minister for Health when he expects the day care centre in Drogheda Street, Monasterevin, County Kildare, to be open; and the services that will be provided there. [42831/17]
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.
370. Deputy Fiona O'Loughlin asked the Minister for Health if he will report on the HSE's engagement with the introduction of a new in-school speech and language service. [42832/17]
Amharc ar fhreagraThe Programme for a Partnership Government commits that a new in-school speech and language service will be established to support young children as part of a more integrated support system.
The Health Service Executive undertook an extensive review of existing Speech and Language therapy provision earlier this year and the findings and recommendations of that review, which is based on best international practice will inform the development of a new model for delivery.
It has been shown across the OECD as the most effective way of managing and intervening with the educational and social issues consequential to speech and language difficulties in children.
Teachers and SLTs have different but complementary skills in developing children’s language and learning. SLTs are trained to take a linguistically analytical approach to language, while teachers’ knowledge and skills relate to literacy, curriculum and teaching practice. These different but complementary skills and knowledge would support the language, literacy, communication and learning needs of students, especially students with or at risk of Speech and Language Complex Needs.
A joint working group, made up of The Department of Health, The Department of Education and Skills, The Health Service Executive and The National Council for Special Education, has been established to develop the proposed model. When finalised, the proposed model will represent a significant change in the way in which services are delivered. Work is currently under way to develop an initial demonstration project with a view to its implementation in 2018.
373. Deputy Fiona O'Loughlin asked the Minister for Health if the waiting times for children waiting for orthodontic treatment will be addressed; and if he will make a statement on the matter. [42835/17]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
374. Deputy Michael Harty asked the Minister for Health when a person (details supplied) in County Clare will receive an appointment at University Hospital Limerick; and if he will make a statement on the matter. [42840/17]
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.
375. Deputy Eugene Murphy asked the Minister for Health if a person (details supplied) can be advised of the date of a hip replacement operation in Merlin Park Hospital, Galway; and if he will make a statement on the matter. [42844/17]
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 in-patient, 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.
376. Deputy Róisín Shortall asked the Minister for Health the target response times for Parliamentary Questions that are submitted to the HSE for response; the percentage of responses that are returned to Deputies within this timeframe; if he is satisfied with the quality and detail of the responses that are being provided by the HSE; and if he will make a statement on the matter. [42855/17]
Amharc ar fhreagraMy Department consistently answers more Parliamentary Questions than any other. A significant number of theses, as they relate to service matters or individual queries are referred to the HSE for answer. Questions referred to the HSE should be answered within ten working days.
To October 5, this year 9,024 PQs were received by the Department, 6,342 of which were referred to the HSE. Some 74% of referred PQs have been answered within the ten working-day timeframe. I can assure the Deputy that the HSE is aware of its responsibility to provide comprehensive, accurate and timely responses to Parliamentary Questions.
377. Deputy Alan Kelly asked the Minister for Health when the list of medical conditions that are covered by the long-term illness scheme will be amended (details supplied). [42872/17]
Amharc ar fhreagraThe 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.
378. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 210 of 10 May 2017, the status of legislative change to address the issue of anomalous prescription charge pricing; and if he will make a statement on the matter. [42879/17]
Amharc ar fhreagraMy Department is aware of the issues raised by the Deputy and is in contact with the HSE to seek a resolution of the issue.
