Written Answers Nos. 157-176
157. Deputy Róisín Shortall asked the Minister for Health further to the recently published NTPF audit and quality assurance reports on waiting lists, the reason Beaumont Hospital did not participate in this audit as planned; if the NTPF collected information in respect of the public or private status of the patients who were adversely affected; and if so, the data on same. [49542/17]
Amharc ar fhreagraThe RTE Investigates programme in February highlighted the deeply moving personal stories of people waiting for treatment in public hospitals. Following the programme I was determined that the health service must learn from those patients’ experiences. As a result, I asked the NTPF to examine waiting list practices in the hospitals highlighted in the programme.
The NTPF has now reported to me on its findings and I recently published the finding of the Special Audit. The NTPF’s report has a number of actions to be implemented by the individual hospitals and across the public hospital system as a whole, to drive better performance in terms of how waiting lists are managed in our hospitals.
Arising from the audit, the HSE has taken immediate steps to put in place a plan at national level that will focus on driving system-wide implementation of performance and process improvement in waiting list management. As part of this plan, the HSE will assess, review and oversee implementation of performance and process improvement to address the Special Audit findings across all hospitals.
Addressing the Special Audit Report’s recommendations will be a priority for the HSE for the remainder of the year and will form a core pillar of the Waiting List Action Plans for 2018 as well as the HSE’s National Service Plan. In addition I have asked the NTPF to develop a plan to extend the Special Audit process in 2018 to other public acute hospitals.
The HSE and Beaumont Hospital are currently engaging with a view to having this audit completed. The Audit Report of Beaumont Hospital will be published upon its completion by the NTPF.
The audit did not collect the information in respect of the public or private status of the patients that were adversely affected.
158. Deputy Niamh Smyth asked the Minister for Health if he will address the delay in the provision of two scans for a person (details supplied); and if he will make a statement on the matter. [49544/17]
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 you directly.
159. Deputy Clare Daly asked the Minister for Health the annual induction rates for first time mothers in each of the State's 19 maternity hospitals and units for each of the years 2011 to 2016 and to date in 2017; and if he will make a statement on the matter. [49545/17]
Amharc ar fhreagra160. Deputy Clare Daly asked the Minister for Health his views on the concerns expressed by the UN Committee on the Elimination of Discrimination Against Women in 2017 in regard to induction rates in Irish hospitals (details supplied); and if he will make a statement on the matter. [49546/17]
Amharc ar fhreagraI propose to take Questions Nos. 159 and 160 together.
Firstly, I would like to assure the Deputy that no national policy is in place which specifies a target number of births per bed in 24 hours. On the contrary, the National Maternity Strategy recognises pregnancy and birth as a normal physiological process. It recognises that all pregnant women require a certain level of support and that some will need more specialised care. As such, it proposes a woman-centred and integrated care model that encompasses all the necessary safety nets in line with patient safety principles, which delivers care at the lowest level of complexity. Equally, the model has the capacity and ability to provide specialised and complex care, quickly, as required.
In terms of induction rates, the fact is that pregnancy care in Ireland has become more complex. More challenging cases arise due to increases in obesity levels, diabetes, average age of primigravidas, assisted reproduction, multiple pregnancies etc. However, we have established a National Programme for Women & Infants Health within the HSE, to drive improvements in maternity services. In addition, the Programme will lead on the implementation of the National Maternity Strategy.
The Deputy may find the following data sources useful:
1. The Irish Maternity Indicator System (IMIS) http://www.hse.ie/eng/services/publications/hospitals/IMISnationalreport14.pdf;
2. The Maternity Patient Safety Statement (MPSS) http://www.hse.ie/eng/services/list/3/maternity/MPSS/MPSS.html.
In particular, the 2014 & 2015 IMIS reports includes data showing the range of the rate of induction of first time mothers at hospital/unit level for those years, while the national induction rate of all mothers for the years 2008 – 2014 is available in the 2014 IMIS report. In addition, since December 2015, the Maternity Patient Safety Statements have detailed the monthly rate of induction, including of first time mothers. While I am not sure if the further information requested by the Deputy is readily available, I have asked the HSE to reply to you directly with whatever information may be available.
161. Deputy Kevin O'Keeffe asked the Minister for Health if he will consider the provision of kuvan here (details supplied). [49549/17]
Amharc ar fhreagraThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, under the Health (Pricing and Supply of Medical Goods) Act 2013.
In reaching a decision, the HSE examines all the evidence which may be relevant in its view for the decision and will take into account such expert opinions and recommendations which it may have sought, including, for example, advice from the National Centre for Pharmacoeconomics (NCPE).
Sapropterin (Kuvan) was considered under the national pricing and reimbursement processes in 2009. At that time, insufficient evidence was available to support the pricing and reimbursement application submitted.
In 2016, the HSE was advised that a new health technology assessment dossier would be submitted on sapropterin. The NCPE completed its assessment of the new dossier in September 2017 and did not recommend sapropterin for reimbursement, as it was not deemed cost effective at the price sought by the company.
The HSE assessment process is ongoing and the HSE will take into account any relevant expert advice when making its decision, in line with the Health (Pricing and Supply of Medical Goods) Act 2013.
162. Deputy Barry Cowen asked the Minister for Health the status of a hospital appointment for a person (details supplied). [49551/17]
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.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
163. Deputy Bernard J. Durkan asked the Minister for Health the position regarding funding or reimbursement in respect of the drugs vimizin, kuvan and brineura; if his attention has been drawn to the fact that the manufacturers are amenable to making appropriate financial arrangements on a confidential basis; if these issues will be investigated with a view to making the products available at manageable cost through the HSE to the small number of persons involved; and if he will make a statement on the matter. [49560/17]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the pricing and reimbursement of medicines; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
164. Deputy Robert Troy asked the Minister for Health the arrangements which exist with home help providers; the onus placed on these providers to put in place a replacement assistant on occasions when the regular assistant is unable to report for work duties; and if he will make a statement on the matter. [49565/17]
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.
165. Deputy Noel Grealish asked the Minister for Health the number of persons awaiting cataract surgery at University Hospital Galway; the length of time they have been waiting; the average waiting time; and if he will make a statement on the matter. [49568/17]
Amharc ar fhreagraIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
166. Deputy Noel Grealish asked the Minister for Health the number of persons awaiting cataract surgery at Sligo University Hospital; the length of time they have been waiting; the average waiting time; and if he will make a statement on the matter. [49569/17]
Amharc ar fhreagraIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
167. Deputy Noel Grealish asked the Minister for Health the status of the community optometry project in County Sligo; if the project is operational; if it will be rolled out to other areas; and if he will make a statement on the matter. [49570/17]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
168. Deputy Mattie McGrath asked the Minister for Health the number of perinatal psychologists employed by the HSE; the number of consultant obstetrician-gynaecologist positions that are vacant; the locations of such vacancies; and if he will make a statement on the matter. [49584/17]
Amharc ar fhreagraI have asked the HSE to respond to the Deputy directly on this matter.
169. Deputy Mattie McGrath asked the Minister for Health the funding provided by his Department to an organisation (details supplied) for the past six years; and if he will make a statement on the matter. [49585/17]
Amharc ar fhreagraMy Department administered a National Lottery Discretionary Fund up to and including 2016 from which once-off grants were paid to community and voluntary organisations providing a range of health related services. No National Lottery funding was provided to the organisation named by the Deputy during the past six years.
170. Deputy Billy Kelleher asked the Minister for Health the enforcement measures in place with regard to the 80/20 public private split in hospitals; if it is departmental policy to allow individual hospitals to disregard this rule as long as the overall hospital group comes in around the target; and if he will make a statement on the matter. [49599/17]
Amharc ar fhreagraA key objective of Consultant Contract 2008 is to improve access for public patients to public hospital care. Latest data from September 2017 shows that the public/private mix at a system level stands at 82% public for elective in-patient work and at almost 86% for day-case work. This is consistent with the typical 80/20 split provided for in the consultant contract.
The Contract allows consultants engage in differing levels of private practice, depending on the contract type held. Consultants holding a Type A contract are not permitted to engage in privately remunerated professional practice. Consultants holding a Type B contract may undertake private practice on-site, up to a limit of 20% of activity on a casemix-adjusted basis, and limited off-site private practice in cases where the individual consultant previously held a Category I or Category II contract under Consultant Contract 1997. Serving consultants whose public to private ratio in 2006 was greater than 20% are permitted to retain this higher ratio, subject to an overriding maximum ratio of 70:30%. Consultants holding a B* Contract or a Type C Contract may engage in off-site private practice. Their in-patient and out-patient private practice activity is also subject to maximum limits.
Arrangements concerning implementation and monitoring of Consultant Contract 2008, including the provisions in relation to private practice, are matters for the HSE in the first instance. Section 20 of the Contract provides a framework for the regulation of private practice, monitoring of the applicable ratio and steps to be taken where it is exceeded. It is incumbent on publicly-funded hospitals to ensure compliance with the terms of the contract, including the provisions in relation to private practice.
My Department has written to the HSE in recent months requesting that the HSE satisfy itself that no consultant is engaged, or will be permitted to engage, in private practice beyond the level, if any, provided for in their contract. I have asked the HSE to ensure that more robust measures are in place in 2018 to make sure consultants comply with their contractual obligations.
171. Deputy Billy Kelleher asked the Minister for Health when the next HSE performance report will be published. [49600/17]
Amharc ar fhreagraThe HSE publish their Performance Profiles on a quarterly basis. The next Performance Profile, covering July-September, is expected to be published on the HSE website on 23 November, 2017. Management Data Reports in respect of the three months will also be published on the HSE website at the same time.
172. Deputy Seán Barrett asked the Minister for Health his plans to increase annual funding to an organisation (details supplied); and if he will make a statement on the matter. [49616/17]
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.
The particular issue raised by the Deputy is a service matter for the HSE. Accordingly I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
173. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal will receive an appointment from the HSE speech and language service and the psychology service; and if he will make a statement on the matter. [49617/17]
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.
174. Deputy Róisín Shortall asked the Minister for Health the position regarding the audit of consultant contract compliance as reported to have commenced in May 2017 (details supplied); and if he will make a statement on the matter. [49641/17]
Amharc ar fhreagraI have asked the Health Service Executive to respond to the Deputy directly on the position regarding the audit of consultant contract compliance.
A key objective of Consultant Contract 2008 is to improve access for public patients to public hospital care. The contract sets out clear rules on the level of private practice that may be undertaken by consultants, depending on the individual contract held, and the arrangements for measurement and management of the public/private mix. Consultants holding a Type A contract are not permitted to engage in privately remunerated professional practice. Consultants holding a Type B contract may undertake private practice on-site, up to a limit of 20% of activity on a casemix-adjusted basis, and limited off-site private practice in cases where the individual consultant held a Category I or Category II contract under the Consultants Contract 1997. Serving consultants whose public to private ratio in 2006 was greater than 20% are permitted to retain this higher ratio, subject to an overriding maximum ratio of 70:30%. Consultants holding a B* Contract or a Type C Contract may engage in off-site private practice. Their in-patient and out-patient private practice activity is also subject to maximum limits.
It is incumbent on publicly-funded hospitals to ensure compliance with the terms of the contract, including the provisions in relation to private practice. My Department has been working with the HSE on this matter in recent months and emphasised that the HSE satisfy itself that no consultant is engaged, or will be permitted to engage, in private practice beyond the level, if any, provided for in their contract.
175. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 147 of 16 November 2017, when a reply will issue from the HSE to Parliamentary Question No. 650 of 26 July 2017 in view of the fact that a reply to Parliamentary Question No. 803 of 26 July 2017 was received on 8 August 2017. [49650/17]
Amharc ar fhreagraI can advise the Deputy that I responded to her question, 850, regarding maternal deaths on 26 July 2017. At the same time I referred question 650 to the HSE for response, which was issued directly to the Deputy on 8 August 2017, a copy of which has been provided to the Deputy.
As you will be aware, since December 2015, each of the 19 Maternity Units in the country are obliged to publish a Maternity Patient Safety Statements with 17 indicators on each report. These monthly reports are published on the HSE website: www.hse.ie/eng/services/list/3/maternity/MPSS/.
With regard to annual maternity statistics, these are published in the Irish Maternity Indicator System (IMIS) National Report and can be found on the HSE website.
176. Deputy Jackie Cahill asked the Minister for Agriculture, Food and the Marine when the new hen harrier scheme will commence; the way in which landowners will be reimbursed; the way in which he will support the restoration of the value of the lands; and if he will make a statement on the matter. [49505/17]
Amharc ar fhreagraAt the outset, I should stress that this is a locally-led programme, which is not directly administered by my Department. The design and management of the programme are primarily matters for the local project team, who will work closely with my Department, as this is rolled-out.
The design work for the new Hen Harrier programme has already commenced following the appointment of a locally-led Project Team earlier this year. The Project Team has now completed a series of consultation meetings with farmers in the six designated Hen Harrier Special Protected Areas (SPAs), which more than 500 farmers attended. A seminar for advisors took place in September, and comprehensive training courses are planned for January 2018 and May 2018. The scientific officers in the team have carried out Hen Harrier monitoring in all SPAs and preliminary results from this campaign will be available within weeks. Work is also progressing on detailed Terms & Conditions for the new programme.
I understand that the first expressions of interest from farmers in taking part in the new programme will be invited before the end of 2017. Unlike other schemes, the new hen-harrier programme will not be tied to calendar years and this provides for greater flexibility in both recruitment and payment. The programme will be action based, with a result based approach. Most importantly it will be farmer led and tailored to each individual SPA.
I would like to clarify that my Department has no role in the designation of lands. That function is exercised through the National Parks and Wildlife Service of the Department of Culture, Heritage and the Gaeltacht. The question of compensation does not arise, therefore, in the context of any schemes or measures introduced by my Department.
I have allocated a budget of €25 million for the hen harrier programme. It is worth noting that a significant framework of support for farmers with hen-harrier designated land is already in place through my Department's agri-environment scheme GLAS. Under GLAS, farmers with hen harrier habitat qualify for a payment of €370 per hectare and can earn up to €7,000 per annum through a combination of GLAS and GLAS Plus payments. The GLAS Hen Harrier action has proved hugely successful, with some 2,678 farmers now signed up. This accounts for almost 70% of all farmers with hen harrier habitat and represents a major step forward in the conservation of the bird and in securing important additional income for the farmers concerned.
