Tuesday, 16 Jan 2018

Written Answers Nos. 825-847

Hospital Appointments Status

Ceisteanna (825)

Barry Cowen

Ceist:

825. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect a hospital appointment. [54970/17]

Freagraí scríofa

Minister for Health

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The 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.

Medicinal Products Availability

Ceisteanna (826)

John Brassil

Ceist:

826. Deputy John Brassil asked the Minister for Health if the availability of Vimizim will be considered as a priority at the upcoming HSE drug group meeting on 18 January 2018; and if he will make a statement on the matter. [54971/17]

Freagraí scríofa

Minister for Health

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.

Health Services Provision

Ceisteanna (827)

Seán Fleming

Ceist:

827. Deputy Sean Fleming asked the Minister for Health if he will address a matter regarding the case of a person (details supplied); and if he will make a statement on the matter. [54973/17]

Freagraí scríofa

Minister for Health

As this PQ refers to a service issue regarding an individual, I have referred it to the Health Service Executive for attention and direct reply to the Deputy.

Medicinal Products Supply

Ceisteanna (828)

Charlie McConalogue

Ceist:

828. Deputy Charlie McConalogue asked the Minister for Health if the HSE has had discussions on the provision of a drug (details supplied); if the drug will be made available here for multiple sclerosis patients; and if he will make a statement on the matter. [54974/17]

Freagraí scríofa

Minister for Health

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.

Respite Care Services

Ceisteanna (829)

John Brassil

Ceist:

829. Deputy John Brassil asked the Minister for Health if the respite facility at Kilmorna, Listowel, which is due to open shortly, will be open on a full-time basis; and if he will make a statement on the matter. [54975/17]

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.

The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.

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.

Addiction Treatment Services

Ceisteanna (830)

Peadar Tóibín

Ceist:

830. Deputy Peadar Tóibín asked the Minister for Health if an organisation (details supplied) or its affiliate organisations has been granted certification, accreditation or a licence by organisations under the direction of his Department to deliver health, education or addiction programmes; and if the organisation must have certification, accreditation or a licence to deliver health, education or addiction services here. [54980/17]

Freagraí scríofa

Minister for Health

The advice of my Department would be that anyone seeking treatment for addiction should contact their local HSE addiction service.

The Department has no jurisdiction over agencies that provide private addiction services. There is currently no provision in legislation for the regulation or inspection of residential treatment or rehabilitation centres specialising in addiction.

Organisations which provide addiction services and are funded by the HSE are required to meet minimum standards in the delivery of services across a range of criteria which form the basis of any service level agreement.

There is no evidence to suggest that the drug treatment programme, provided by the organisation referred to by the Deputy, would meet any of the criteria set out by the HSE for agencies that provide addiction services in its behalf.

That organisation's drug treatment programme comprises a series of interventions with limited or no basis in a scientific understanding of human physiology and brain functioning.

Hospital Appointments Status

Ceisteanna (831)

Robert Troy

Ceist:

831. Deputy Robert Troy asked the Minister for Health if an appointment for a person (details supplied) will be scheduled; and if he will make a statement on the matter. [54982/17]

Freagraí scríofa

Minister for Health

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The 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.

Mental Health Services Provision

Ceisteanna (832)

Michael Healy-Rae

Ceist:

832. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [54998/17]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter, I have asked Health Service Executive to respond directly to the Deputy as a matter of urgency.

The Deputy may be aware that the HSE provides advice on their website: http://www.yourmentalhealth.ie/supports-services/urgent-help.htl for people who may have concerns regarding persons with suicidal tendencies. The HSE advises that where someone has such concerns, they should contact as quickly as they can their G.P., their local Emergency Department, HSE Mental Health Services or the Samaritans. The Samaritans 24 hour helpine number is 116 123 and further information regarding support services can be found at the following weblink http://www.yourmentalhealth.ie/ .

Question No. 833 withdrawn.

Hospital Appointments Status

Ceisteanna (834)

Eugene Murphy

Ceist:

834. Deputy Eugene Murphy asked the Minister for Health if an appointment for a person (details supplied) will be expedited; when an appointment will be forthcoming; and if he will make a statement on the matter. [55007/17]

Freagraí scríofa

Minister for Health

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The 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.

Hospital Appointments Status

Ceisteanna (835)

Niamh Smyth

Ceist:

835. Deputy Niamh Smyth asked the Minister for Health the position of a person (details supplied) on the waiting list for two facilities; if an appointment will be expedited; and if he will make a statement on the matter. [55009/17]

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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Community Care Provision

Ceisteanna (836)

Thomas Byrne

Ceist:

836. Deputy Thomas Byrne asked the Minister for Health if his attention has been drawn to a recent cut to funding of the counties Louth and Meath branch of an organisation (details supplied) through the national lottery grant scheme 2017; and his views on whether this cut will reduce the ability of the branch to carry out work in the community. [55011/17]

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 a service matter, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Nursing Homes Support Scheme

Ceisteanna (837, 838, 839, 840)

Billy Kelleher

Ceist:

837. Deputy Billy Kelleher asked the Minister for Health the action that has been taken to implement the 2015 review of the nursing homes support scheme recommendations on the administration of the scheme, in tabular form (details supplied). [55016/17]

Billy Kelleher

Ceist:

838. Deputy Billy Kelleher asked the Minister for Health the action that has been taken to implement the 2015 review of the nursing homes support scheme recommendations on the price of long-term residential care, in tabular form (details supplied). [55017/17]

Billy Kelleher

Ceist:

839. Deputy Billy Kelleher asked the Minister for Health the action that has been taken to implement the 2015 review of the nursing homes support scheme recommendations for future service provision, in tabular form (details supplied). [55018/17]

Billy Kelleher

Ceist:

840. Deputy Billy Kelleher asked the Minister for Health the action that has been taken to implement the 2015 review of the nursing homes support scheme recommendations on residential care capacity, in tabular form (details supplied). [55019/17]

Freagraí scríofa

Minister of State at the Department of Health

I propose to take Questions Nos. 837 to 840, inclusive, together.

When the Nursing Homes Support Scheme (NHSS) commenced in 2009, a commitment was made that it would be reviewed after three years. The Report of the Review was published in July 2015. Arising out of the Review, a number of key issues have been identified for more detailed consideration across Departments and Agencies.

An Interdepartmental/Agency Working Group has been established to progress the recommendations contained in the Review. This Group is chaired by the Department of Health and includes representatives from the Department of the Taoiseach, the Department of Public Expenditure and Reform, the HSE, the Revenue Commissioners, and when required, the National Treatment Purchase Fund (NTPF). These recommendations include:

- Examining the treatment of business and farm assets for the purposes of the financial assessment element of the Scheme;

- The implementation of administrative reforms to the Scheme (Chapter Four of NHSS Review);

- A review by the NTPF of present pricing arrangements in private residential facilities.

Work is on-going across the range of recommendations and many of these have been completed and operationalised. A number of the recommendations in the Review relate to the identification of specific areas of the Scheme that require further and considerable detailed analysis and review. One of these recommendations included a detailed review of pricing mechanisms by the NTPF, with a view to:

- Ensuring value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers;

- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and

- Ensuring that there is adequate residential capacity for those residents with more complex needs.

A Steering Committee has been established to oversee the review of the pricing system for private long-term residential care facilities. This Steering Committee is chaired by the NTPF and includes representatives from the Department of Health, the Department of Public Expenditure and Reform, and the NTPF, and work in this area is ongoing and well advanced.

The Review also recommended that a Value For Money (VFM) and Policy Review of the differences in the comparative cost of public and private long-term residential care be undertaken. Work on the scoping of this review began in late 2017. Detailed work on the VFM review wil commence in 2018 and is expected to be completed in 2019.

The following table provides the current status in relation to the consideration of the recommendations contained in the review.

Review of Nursing Homes Support Scheme

Progress in Actions

No.	Recommendation – Administration of Scheme	Position – January 2018
1	Centralise certain elements of the scheme where appropriate, with built in appropriate management and training processes to ensure customer service is maintained	This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group
2	Consolidate local NHSOs (from 17 to 4)	Work in Progress
3	Develop a web based form to enable nursing homes to submit invoices electronically	Work in Progress
4	Centralise the processing of invoices	This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group
5	Centralise the calculation of loan repayments	This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group
6	Clarify for how long the application form/documentation and the CSAR form remain valid without any new processes or medical checks	Implemented
7	Provide additional information regarding nursing homes to assist with the process of identifying one that is suitable	This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group
8	Review documents and application forms with advice from the National Adult Literacy Agency to ensure they are sufficiently user-friendly and informative and that they include clear guidance on where relevant information/documentation can be obtained	Implemented
9	Consider whether any additional questions should be included in the application form	Implemented
10	Make sample completed application forms available	Implemented
11	Include in the application form a mechanism for an applicant to authorise a representative to submit the application on their behalf	Implemented
12	Consider the need to establish an NHSS Best Practice Group (consisting of NHSO/national office staff) to share experiences and agree on best practice	Implemented
13	Consider splitting application form into two parts to avoid delaying the care needs assessment while financial information and documentation is being assembled	This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group
14	Standardise informal advice provided to applicants regarding the nursing home loan, including clarity re legal aspects	Implemented
15	Provide advice regarding the possibility of claiming tax relief for medical expenses/nursing home fees	Implemented
16	Review current letter templates and, where possible, replace with alternative, quicker forms of communication	Work in Progress
17	Review content of correspondence to ensure it is as clear as possible	Work in Progress
18	Examine the possibility of scanning/electronic transmission of forms and documentation from NHSOs to the national office	This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group
19	Clarify that the involvement of a solicitor is not required in order to apply for the loan	Implemented
20	Consider making it a condition of availing of the loan that the required details, including the PPSN of the responsible person are provided	Implemented
21	Complete analysis of home ownership levels	Implemented
22	Establish what databases exist that may contain useful data for the financial assessment and establish the access by NHSOs to these, including standard operating procedures, requiring review, of such information sources	Work in Progress
23	Develop a consistently applied standard operating procedure for the initial financial assessment based on available resources of information	Implemented
24	Introduce a policy of undertaking random spot checks of financial data	Work in Progress
25	Follow up with the Revenue Commissioners on the scope for improved validation of declarations of income/assets	Work in Progress
26	Consider the options to encourage realistic valuations of declared property assets	Work in Progress
27	Standardise procedures in relation to reviews across NHSOs and ensure that all available information is utilised and accessed	Implemented
28	Consider amending legislation to provide for fluctuating values of assets and incomes	Requires legislative change. This may be considered as part of amendment for 2018
29	Continue to operate the national placement list in chronological order	Implemented
30	Increase time for recovery of loan to 18 months	Requires legislative change. This may be considered as part of amendment for 2018
31	Amend definition of ordinarily resident to ‘those who have been living in Ireland for at least a year’	Work in Progress
32	Consideration should be given to whether a cap should be applied to the charge for nursing home care based on non-residential productive assets which are passed on to a direct family member after, or in the five years prior to, the death of an NHSS participant, and where the new owner carries on the farm or other business as their principal livelihood	Amendment to legislation planned for 2018

No.	Recommendations on Price of Long Term Residential Care	Position January 2018
1	Nursing homes to consider offering access to a ‘house’ doctor in each facility.	This is for individual Nursing Homes to consider
2	A person in a long-term residential care setting should receive the same level of other health services as they would if they remained in their own home and it is important that this policy is implemented consistently by the relevant HSE personnel.	Residents in Long Term residential Care are entitled to the same level of service as those who remain in their own homes
3	The existing system of agreeing prices facility by facility should continue for the immediate future.	The NTPF continue to negotiate the cost of care in private Nursing Homes registered under NHSS
4	Within 18 months, the NTPF should review the present system and submit future pricing proposals to the Minister for Health with a view to:-  i) Ensuring that there is adequate residential capacity for those residents who require higher level or more complex care; ii) Ensuring value and economy, with the lowest possible administrative cost for the State and administrative burden for providers; iii) Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible	The NTPF was asked to conduct the pricing review by the Secretary General in January 2016. This review is well advanced and a report is expected to be submitted to the Minister for consideration in the first half of 2018
5	The cost of public long-term residential care should be based on a pricing model that is objectively and consistently formulated, and which takes account of and accurately quantifies unavoidable price distortions.	The NTPF has statutory independence in the performance of its function, and negotiates with each nursing home on an individual basis.
6	It is important that the position of section 39 voluntary agencies be addressed. A clear plan must be developed by such facilities, supported by the HSE to agree their purpose and function and where necessary to get the cost structures into line within a reasonable and specified timeframe.	Work in progress
7	Nursing homes should have a published fee schedule showing all the costs associated with being a resident.	Minister Daly has requested that NHI request its members to make proposed contracts of care (containing fee schedules) available to potential nursing home clients at enquiry stage
8	Consideration should be given to introducing a new provision under the scheme to prohibit the levying of additional charges for any service or facility from which residents can not readily opt out without penalty while remaining as residents of that facility, or in which they cannot participate because of the level of their dependency.	The inter departmental working group has been asked to examine the issue of additional charges. This is currently being examined by a Department of Health/HSE Group.
9	Consideration should be given to including in the price contracts with facilities, details of what additional charges are proposed, of the opt-out arrangements that exist for residents and confirmation that residents will not be charges for extra services that they cannot participate in because of their dependency or lack of capacity.	As above
10	It may continue to be necessary for the HSE to make additional payments in circumstances where very specialist care is required. Engagement with acute, disability and other services is required to give a more comprehensive service for this co-hort.	This HSE approach is continuing to operate.
11	The HSE should publish the cost of care on an annual basis.	The weekly cost of care for private and voluntary nursing homes is published following agreement being reached with the NTPF
12	The HSE should continue to review the costs in its facilities to examine if facilities can be made more cost efficient. The review should start with the most expensive nursing homes and then cascade down.	HSE continue to review the cost of care in their Nursing Home Facilities
13	A value for money and policy review will be undertaken of HSE public long-term residential care facilities to examine the extent to which cost differentials with care in private facilities can be attributed to patient dependency characteristics or other objective factors for which a higher level of cost is justified.	A VFM review will be undertaken by the Department of Health. Scoping commenced on this in 2017 and detailed work will commence in 2018

No.	Recommendations for Future Service Provision	Position January 2018
1	Development of a community based model of care that includes: a) access to short-stay community beds, b) sufficient home help and home care packages, c) Intensive home care packages, d) Integration and communication links between the acute hospital and community services, e) Access to the expertise of the consultant geriatrician team when required with additional supports from the voluntary sector.	Additional resources have been provided in recent years to strengthen supports, in particular for homecare and transitional care, to facilitate speedier discharge from acute hospitals. The Integrated Care Programme for Older Persons will, in 2018, consolidate progress to date within the existing 12 pioneer sites in accordance with the 10-step integrated care framework.  Home support services from 2018 onwards will be delivered through a single funded model.
2	Addressing the uneven availability of home care.	The Department is currently engaged in a detailed process to develop plans for a new statutory scheme and system of regulation for home care services.
3	Developing clear and effective linkages and co-ordination between acute hospitals and home care services, including the development of an IT System.	This will be part of the statutory homecare scheme currently being developed
4	Reviewing, simplifying and standardising procedures for assessing, approving and procuring home supports across the system.	This will be part of the statutory homecare scheme currently being developed.
5	Providing additional short-stay beds, particularly in areas that are most relevant to major acute hospitals.	Additional resources have been provided in recent years to strengthen supports, in particular for homecare and transitional care beds, to facilitate speedier discharge from acute hospitals. In 2018 a further approx €6m has been provided for additional transitional care and bed capacity
6	Including day care beds as appropriate in planning future services.	Currently accounted for in Service Planning
7	Explore the potential of assistive technology in possible collaboration with researchers and industry.	The HSE have explored and encouraged the take up of assistive technology.
8	Exploring the potential of a collaborative approach across the Departments of Health, Environment, Community and Local Government to provide appropriately supported sheltered housing.	The Department of Health and the Department of Housing, Planning and Local Government are collaborating on a policy framework for supported housing and support for a demonstration project on supported living.
9	Considering the extension of the boarding out model where appropriate.	The HSE has examined this model and the Department will consider same in due course
10	Maintaining and fostering links with the voluntary sector which can make an important contribution in supporting older people to remain in their own communities.	This relationship is being maintained and a National Positive Ageing Strategy Stakeholder Forum was established in 2017
11	Evaluating the Older People Remaining at Home (OPRAH) project with a view to applying learning from the project to other areas.	Learning from OPRAH will be considered on an on-going basis including in the context of inter alia  the development of a Statutory Home Care Scheme
12	Considering ways to bring greater clarity and consolidation to budgets for older person’s community services.	The home care and home help services have been streamlined into one single funded home support service.  This will improve the efficiency of the system and also improve oversight by making performance data clearer and easier to understand.

No.	Recommendations on Residential Care Capacity	Position January 2018
1	The Department of Health continues to progress the project to identify and assess the various options available to encourage the provision, including the upgrading and refurbishment, of long-term residential care facilities for older people.	5 year Capital investment programme for Community Nursing Units 2016-2021 is on-going
2	The implications for HSE residential facilities of the relevant standards should be clarified with a view to agreeing an approach that achieves the best achievable outcome for residents.	5 year Capital investment programme for Community Nursing Units 2016-2021 is on-going
3	Detailed consideration should be given to whether there is potential for new models of collaboration between the public and private sectors.	5 year Capital Investment programme for Community Nursing Units includes a number of CNU’s for Public Private Partnership
4	The potential of sheltered housing and assisted housing models should be considered in consultation with the Department of Environment, Community and Local Government.	Collaboration  with the Department of Housing Planning and Local Government is on -going and includes  the development of a demonstration project for supported living

Hospital Waiting Lists

Ceisteanna (841, 842, 845)

Billy Kelleher

Ceist:

841. Deputy Billy Kelleher asked the Minister for Health his views on the dropping of the four scoliosis surgery wait targets for 2018 contrary to the Ombudsman for Children's recommendations contained in the report, Waiting for Scoliosis Treatment - A Children's Rights Issue; and if he will make a statement on the matter. [55028/17]

Billy Kelleher

Ceist:

842. Deputy Billy Kelleher asked the Minister for Health his views on the fact that there are no agreed surgical criteria for scoliosis surgery or agreed plan for 2018 (details supplied); and if he will make a statement on the matter. [55029/17]

Billy Kelleher

Ceist:

845. Deputy Billy Kelleher asked the Minister for Health the plan for 2018 in regard to children who are waiting on scoliosis surgery and procedures; and if he will make a statement on the matter. [55032/17]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 841, 842 and 845 together.

I continue to support the HSE in its efforts to bring down the waiting times for and improve access to scoliosis services. Waiting list numbers on the scoliosis active waiting list dropped from 312 patients in February 2017 to 156 by 31 December 2017. This is as a result of the concerted efforts of staff and clinicians across the treating hospitals, HSE and Children's Hospital Group to increase activity within our children's hospitals, the Mater and Cappagh hospitals as well as of outsourcing initiatives developed by the HSE. 371 surgeries took place in 2017 across all treating hospitals both home and abroad, including two hospitals which were successful in an international tender run by the HSE for paediatric spinal fusion procedures.

A Paediatric Scoliosis Services Co-Design group is in place, which includes clinicians, hospital staff and representatives from the scoliosis advocacy groups, to design a comprehensive contemporary and patient-centred approach to the delivery of scoliosis services.

€9 million investment funding has been allocated for 2018 to the HSE for the development of paediatric orthopaedic services including scoliosis. The 2018 Service Plan includes a commitment from the HSE to continue to improve access to paediatric orthopaedics, including surgery for scoliosis, in conjunction with the Children’s Hospital Group to achieve clinically appropriate waiting times. This will be underpinned by the development of a standardised pathway of care for children and adolescents with scoliosis which will be evidence-based and patient-centred. Further development of Scoliosis services will be guided by the recommendations emerging from the work of the Co-Design Group. The Co-Design Group is also working towards publishing agreed criteria for surgery which are based on clinical grounds and national and international best practice.

The HSE has confirmed that the 4-month target for accessing surgery for scoliosis will be maintained into 2018 and beyond.

Hospital Waiting Lists

Ceisteanna (843, 844, 848, 849)

Billy Kelleher

Ceist:

843. Deputy Billy Kelleher asked the Minister for Health the HSE surgery target wait time for children who are clinically tested for scoliosis surgery as of 1 January 2018; and if he will make a statement on the matter. [55030/17]

Billy Kelleher

Ceist:

844. Deputy Billy Kelleher asked the Minister for Health the reason the 20 scoliosis surgeries due to be completed in France did not go ahead (details supplied); the number of completed surgeries outsourced under the scoliosis plan; the number of parents who were formally asked if they would consent to their child's surgery being outsourced; and if he will make a statement on the matter. [55031/17]

Billy Kelleher

Ceist:

848. Deputy Billy Kelleher asked the Minister for Health when the amalgamation of waiting lists for paediatric scoliosis intervention across the children's hospital group to one central waiting list will take place (details supplied); and if he will make a statement on the matter. [55035/17]

Billy Kelleher

Ceist:

849. Deputy Billy Kelleher asked the Minister for Health the progress that has been made to date especially on Our Lady's Children's Hospital, Crumlin, waiting times for first appointment with a paediatric orthopaedic consultant (details supplied); the measures that have been taken to ensure that no child is at risk while waiting for his or her first consultation with an orthopaedic consultant; and if he will make a statement on the matter. [55036/17]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 843, 844, 848 and 849 together.

As these are service matters, I have asked the Health Service Executive to respond to you directly.

Question No. 845 answered with Question No. 841.

Paediatric Services

Ceisteanna (846, 847)

Billy Kelleher

Ceist:

846. Deputy Billy Kelleher asked the Minister for Health when the two additional orthopaedic consultants for Our Lady's Children's Hospital, Crumlin, will be appointed; and if he will make a statement on the matter. [55033/17]

Billy Kelleher

Ceist:

847. Deputy Billy Kelleher asked the Minister for Health the timeframe for the orthopaedic theatre in Our Lady's Children's Hospital, Crumlin, to open for additional days and to be at full capacity; and if he will make a statement on the matter. [55034/17]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 846 and 847 together.

€9million investment funding has been allocated to the HSE for the development of paediatric orthopaedic services including scoliosis for 2018. The 2018 Service Plan includes a commitment from the HSE to continue to improve access to paediatric orthopaedics including surgery for scoliosis in conjunction with the Children’s Hospital Group to achieve clinically appropriate waiting times.

In relation to the queries on staffing and theatre capacity, as these are service issues, I have asked the HSE to respond to you directly.