Written Answers Nos 37-61
37. Deputy Martin Heydon asked the Minister for Health if he will report on recruitment initiatives in CHO7, particularly in Lakeview unit, Naas hospital, and CAMHS in Kildare town; and if he will make a statement on the matter. [6377/18]
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.
38. Deputy Jack Chambers asked the Minister for Health the status of the wider roll-out of the opioid overdose antidote Naloxone. [6446/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
40. Deputy John McGuinness asked the Minister for Health the reason for the 96% increase in overcrowding in St Luke’s hospital, Kilkenny in January 2018 relative to January 2016; and if he will make a statement on the matter. [6436/18]
Amharc ar fhreagra52. Deputy Robert Troy asked the Minister for Health the reason for the 49% increase in overcrowding in Mullingar hospital in January 2018 relative to January 2016; and if he will make a statement on the matter. [6440/18]
Amharc ar fhreagra54. Deputy Michael McGrath asked the Minister for Health the reason for the 38% increase in overcrowding in Cork University Hospital in January 2018 relative to January 2016; and if he will make a statement on the matter. [6442/18]
Amharc ar fhreagraI propose to take Questions Nos. 40, 52 and 54 together.
Tackling overcrowding in Emergency Departments (EDs) is a key commitment of the Government. Accordingly, €30 million in additional funding in 2017, and a further €40 million in 2018, has been made available to manage the expected peak in demand for our health services over the winter period and to strengthen capacity moving forward.
Since the start of this winter, 170 additional beds haven been opened nationally, in St Vincent’s University Hospital, Our Lady of Lourdes Hospital Drogheda, University Hospital Limerick, University Hospital Galway, Beaumont Hospital Dublin, St. James Hospital Dublin, the Mater Hospital Dublin and in Naas General Hospital.
Building further on the learning from the Health Systems Capacity Review, and as part of planning for Winter 2018/2019, my Department is working closely with the HSE to identify where additional bed capacity can be brought on stream as early as possible in 2018, with a view to supporting patient flow within our Acute Hospitals and alleviating the level of overcrowding the system is currently experiencing.
I am advised by the HSE that hospitals are currently working with their respective Hospital Groups to address overcrowding being experienced in EDs. In relation to the particular queries raised, as these are service matters, I have asked the HSE to respond directly to the Deputies.
41. Deputy Maureen O'Sullivan asked the Minister for Health if he will report on the most recent meeting of the standing implementation committee with regard to the national drugs strategy. [6285/18]
Amharc ar fhreagra“Reducing Harm, Supporting Recovery – a health-led response to drug and alcohol use in Ireland” was launched by An Taoiseach in July 2017. A National Oversight Committee (NOC), which I Chair, was established to give leadership and direction to support the implementation of the strategy. A Standing Sub-Committee (SSC) of the NOC has been set up to drive the implementation of the strategy and promote coordination between national, local and regional levels. The SSC will report to the NOC on progress in the implementation of its work programme. The SSC held its most recent meeting on January 9th when it discussed the committee arrangements, the annual work plan, high risk drug use and the governance and performance of drug and alcohol task forces. As the minutes of this meeting have not yet been agreed, it is not possible for me to share them with the Deputy at this time.
43. Deputy John Lahart asked the Minister for Health the reason for the surge over the past two years in the number of children waiting 18 months plus for an outpatient appointment in the three children’s hospitals in Dublin; and if he will make a statement on the matter. [6401/18]
Amharc ar fhreagraThe most recent NTPF figures published for December 2017 show that there was a total of 41,678 people on the Outpatient waiting list for hospitals in the Children's Hospital Group. 65% of these children (26,958) are waiting up to 12 months and 35% (14,720) are waiting over 12 months for a first Outpatient appointment.
The HSE has confirmed there have been challenges in addressing the OPD waiting times due to consultant resourcing issues, arising from retirements, vacancies and demand in single-handed consultant services, such as allergy and immunology. In addition, the NTPF focus over the last two years has been on addressing Inpatient and Daycase waiting times. However, the HSE and NTPF are working together to develop Waiting List Action Plans for 2018. October's Budget announced a total 2018 allocation of €55m for the NTPF for 2018. This significant increase in funding more than doubles their 2017 total allocation of €20m.
It is acknowledged that the Outpatient Waiting Lists generally remains a challenge that needs to be addressed. It is worth noting that in 2016 the children's hospitals recorded that approximately 13% of patients did not attend their Outpatient appointment. This is something that must be tackled. A number of steps, including the commencement of a national waiting list validation project by the HSE, are being taken to ensure the lists are accurate and these efforts are to intensify in the coming months.
44. Deputy Jackie Cahill asked the Minister for Health his views on the lack of a dedicated physiotherapy service for adults with neurological conditions in south County Tipperary resulting in long waiting lists and limited access to therapies, especially physiotherapy. [6412/18]
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.
45. Deputy Clare Daly asked the Minister for Health the reason his Department has not complied in full with the order for discovery made by the High Court in November 2016; and if he will make a statement on the matter. [6205/18]
Amharc ar fhreagraThis matter is the subject of litigation in which plaintiffs allege personal injury in which they claim the development of narcolepsy (cataplexy) resulted from the administration of the H1N1 pandemic vaccine. As Deputies would be aware, it would be inappropriate for me to comment on individual cases or matters that are the subject of litigation. However, I can provide background information on this litigation and clarify matters that are already in the public domain.
In October 2013, the Government approved (S180/46/01/0005B) the delegation to the State Claims Agency (SCA) of the management of claims in relation to individuals alleging the development of narcolepsy resulting from the administration of the pandemic vaccine. The management of the cases transferred to the SCA when the National Treasury Management Agency (Delegation of Claims Management Functions) (Amendment) Order 2013 (S.I. no. 405 of 2013) was signed by the Taoiseach on 15 October 2013. This reflects the greater experience and expertise that the State Claims Agency has in the area of medical litigation.
An Order requiring the defendants to make Discovery was made in the High Court on 28 November 2016 in the most advanced case. Discovery is a legal process which must be carried out in accordance with Orders made by the Courts. There have been a number of High Court Motion hearings concerning this matter since then and the Department of Health and the HSE continue to comply with all Orders made by the Courts.
The Department of Health is working assiduously to complete its Discovery and has kept the Court fully appraised as to its progress in that regard. However, the sheer size and complexity of the Discovery which requires to be made means that this is not a trivial or quick process. The Department undertook a full access review of the entire email, database and shared network drive which serves the whole Department of Health with a dedicated team undertaking the appropriate searches against vast sources of data supported by both internal and external IT experts. The Department has identified over 680,000 records, all which must be examined and scheduled by the State’s legal team. To that end, the Department put in place a dedicated team of 8 discovery personnel to carry out this work with support from solicitors, to ensure that the terms of any Orders are fully complied with.
47. Deputy Alan Farrell asked the Minister for Health if his Department has identified priority areas for primary health care centres in the Fingal area of north County Dublin; and if he will make a statement on the matter. [6101/18]
Amharc ar fhreagraAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
48. Deputy Eugene Murphy asked the Minister for Health when the medical assessment unit in County Roscommon will be open at evenings and weekends; and if he will make a statement on the matter. [6403/18]
Amharc ar fhreagraTackling overcrowding in Emergency Departments (EDs) is a key commitment of the Government. As such, €30 million in additional funding in 2017, and €40 million in 2018, was made available as part of the Budget 2018 to manage the expected peak in demand for our health services over this winter period and strengthen capacity moving forward.
As part of the package of measures agreed, funding will be provided for the expansion of services at Roscommon Medical Assessment Unit. It is my understanding, from advice of the HSE, that this funding is due to come on line in the final quarter of 2018.
49. Deputy Mick Barry asked the Minister for Health if funds will be made available to help resolve the dispute involving section 39 workers in the health care sector (details supplied); and if he will make a statement on the matter. [2164/18]
Amharc ar fhreagra60. Deputy Jonathan O'Brien asked the Minister for Health his plans to ensure that section 39 workers are treated fairly in the restoration of pay cuts; and if he will make a statement on the matter. [2336/18]
Amharc ar fhreagra61. Deputy Dara Calleary asked the Minister for Health if he will be involved in discussions with a union (details supplied) and section 39 organisations within the health system; if not, if this will be exclusively for the HSE; the mechanisms within his Department if it requires further funds to address this issue; and if he will make a statement on the matter. [53589/17]
Amharc ar fhreagra74. Deputy Mick Barry asked the Minister for Health his views on the scheduled day of strike action due to be taken by a union (details supplied) in section 39 organisations on 14 February 2018; the measures he plans to take in order to settle the dispute; and if he will make a statement on the matter. [6089/18]
Amharc ar fhreagra243. Deputy Dara Calleary asked the Minister for Health the status of the process of engagement between section 39 organisations and the HSE; and if he will make a statement on the matter. [6655/18]
Amharc ar fhreagraI propose to take Questions Nos. 49, 60, 61, 74 and 243 together.
Under section 39 of the Health Act 2004, the HSE provides financial assistance to organisations by means of a grant. Section 39 legally underpins the provision of services similar or supplementary to a service that the HSE may provide. In 2017, the HSE provided funding of approximately €800 million to over 2,200 of these agencies. The funding provided can range from high value, in their millions, to relatively modest amounts of just a few hundred euro.
Staff in these organisations were not subject to the provisions of FEMPI legislation. They were not a party to the Public Service Agreements and are not covered by the pay restoration provided for in these Agreements. While it is understood that pay savings were made by the organisations, the precise mix of pay cuts or other savings measures will have varied. Also, where there were pay cuts, it is not at all clear that they were applied in a universally consistent manner, as is the case in the public sector.
Therefore, the Government believes that we need a much deeper understanding of the funding position in these grant - aided organisations and the true extent of the pay reductions applied. In establishing the position, I am obliged to have regard to the legitimate taxpayer and value for money issues that arise. That is why I have requested that the HSE engages with the Section 39 organisations to establish the facts around what cuts were applied and how and when they were implemented. A plan then needs to be developed in relation to possible solutions and their implementation. I have asked that the Executive complete this exercise as soon as practicable, having regard to the large number of organisations concerned. Officials from my Department and the Executive are continuing to engage with the relevant trade unions to ensure that this work is carried out on a consensus basis.
I am very mindful of the threatened industrial action in a number of these organisations, which is scheduled to commence with a one day work stoppage on 14 February 2018. I believe that the process which I have outlined should address the concerns raised by the trade unions in a fair and transparent way. I can assure the Deputies that the Government and I are committed to doing all that we can to ensure that there is no disruption to the delivery of health services.
50. Deputy Richard Boyd Barrett asked the Minister for Health if his attention has been drawn to the difficulties of those in need of home care packages; if his attention has further been drawn to the difficulties many have in sourcing these packages and that many of the packages granted are for less hours than would be appropriate to the need; if his attention has been further drawn to the fact this shortfall in hours is being decided on the basis of resources available rather than on the need; and if he will make a statement on the matter. [6091/18]
Amharc ar fhreagra96. Deputy Richard Boyd Barrett asked the Minister for Health if he has satisfied himself that those in need of home care are able to access this care in a timely manner and that this care is adequate to meet their needs in view of the reliance on private companies to deliver home care packages; if an audit of these services has been carried out; and if he will make a statement on the matter. [6090/18]
Amharc ar fhreagraI propose to take Questions Nos. 50 and 96 together.
Home care is a key part of the supports we offer to older people, and, with our ageing population, will become increasingly important into the future, as we are committed to facilitating people to remain at home and in their communities for as long as possible.
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. While this is under development, both the Department and HSE keep these services under ongoing review and are continuing efforts to incrementally improve the existing home care services. As detailed in its National Service Plan, the HSE has begun work on streamlining home care services by moving towards a single funded home support service. This brings together the funding for home help and standard home care packages which will operate as a single home support service from 2018 onwards. This new approach will provide significant benefits for the service users, the public and the health system including:
- making the services easier to understand;
- streamlining the application processes resulting in only one application and decision being required for home support services for older people; and
- facilitating service users to move to changed levels of services as their assessed needs change, without the need for an additional application process.
Home support services are a particular area of focus in Budget 2018, with an additional €18.25m allocated. The additional resources made available in 2018 bring the total budget for the direct provision of home support services to €408m. The HSE’s National Service Plan provides for a target of some 17.094m home support hours to be provided to 50,500 people. This compares with the projected 16.34m hours delivered to 50,000 people last year, home help and home hours combined. This is an increase of 754,000 hours to 500 more people. In addition 235 intensive home care packages will provide 360,000 home support hours for people with complex needs.
Despite this significant level of service provision, the demand for Home Care continues to grow. It is important to note that the allocation of funding for home care across the system, though significant, is finite and services must therefore be delivered within the funding available. In that context, I acknowledge that in some cases access to the service may take longer than we would like. However, I am satisfied that the HSE monitors the delivery of home care on an ongoing basis, to ensure that activity is maximised relative to individual clients’ assessed care needs within the overall available resources for home care and having regard to demand throughout the year.
51. Deputy Pat The Cope Gallagher asked the Minister for Health the level of joint approach his Department and the HSE have adopted in dealing with the lack of bed capacity and appropriate staffing levels at Letterkenny University Hospital and the network of community hospitals throughout County Donegal; the strategy he is adopting regarding crises within Letterkenny University Hospital which is experiencing extreme capacity issues for more than a year and no additional intervention is being provided by either the HSE or his Department; if his attention has been drawn to the degree of crises which exists within the health services in County Donegal; and if he will make a statement on the matter. [6100/18]
Amharc ar fhreagra85. Deputy Charlie McConalogue asked the Minister for Health his plans to ensure approval is forthcoming for a request for additional funding of €1.8 million for Letterkenny University Hospital in order that the hospital can open an additional 20-bed ward and staff it appropriately to address an issue with persons having to wait on trolleys for hospital admission. [6111/18]
Amharc ar fhreagraI propose to take Questions Nos. 51 and 85 together.
Tackling overcrowding in Emergency Departments (EDs) is a key commitment of the Government. Accordingly, €30 million in additional funding was provided in 2017, and a further €40 million is being made available in 2018, to manage the expected peak in demand for our health services over the winter period and to strengthen capacity moving forward.
Since the start of this winter, 170 additional beds haven been opened nationally, in St Vincent’s University Hospital, Our Lady of Lourdes Hospital Drogheda, University Hospital Limerick, University Hospital Galway, Beaumont Hospital Dublin, St. James Hospital Dublin, the Mater Hospital Dublin and in Naas General Hospital.
Building further on the learning from the Health Systems Capacity Review, and as part of planning for Winter 2018/2019, my Department is working closely with the HSE to identify where additional bed capacity can be brought on stream as early as possible in 2018, with a view to supporting patient flow within our Acute Hospitals and alleviating the level of overcrowding the system is currently experiencing.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
53. Deputy Bríd Smith asked the Minister for Health the steps he will to take to ensure the Citizens' Assembly recommendation regarding the availability of contraceptives is implemented; and if he will make a statement on the matter. [6282/18]
Amharc ar fhreagraMy Department is examining the ancillary recommendations in the Joint Committee's report. This includes consideration of the nature and scope of a free contraception service and of what the introduction of such a service would involve.
Officials in my Department, under the chairmanship of the Chief Medical Officer, have established a group to address the recommendations and formulate an effective and comprehensive response to the issues raised by the Committee in its ancillary recommendations. The Group will cover the following areas, both within the Department itself and the HSE: sexual health, primary care, acute hospitals, disability services, and mental health, as well as any other areas subsequently deemed relevant.
55. Deputy Sean Sherlock asked the Minister for Health his plans to increase the bed capacity at Mallow General Hospital; and if he will make a statement on the matter. [6086/18]
Amharc ar fhreagraTackling overcrowding in Emergency Departments (EDs) is a key commitment of the Government. Accordingly, €30 million in additional funding was provided in 2017, and a further €40 million is being made available in 2018, to manage the expected peak in demand for our health services over the winter period and to strengthen capacity moving forward.
Since the start of this winter, 170 additional beds haven been opened nationally, in St Vincent’s University Hospital, Our Lady of Lourdes Hospital Drogheda, University Hospital Limerick, University Hospital Galway, Beaumont Hospital Dublin, St. James Hospital Dublin, the Mater Hospital Dublin and in Naas General Hospital.
Building further on the learning from the Health Systems Capacity Review, and as part of planning for Winter 2018/2019, my Department is working closely with the HSE to identify where additional bed capacity can be brought on stream as early as possible in 2018, with a view to supporting patient flow within our Acute Hospitals and alleviating the level of overcrowding the system is currently experiencing.
56. Deputy Mary Butler asked the Minister for Health the number of persons from County Waterford that have applied for the treatment abroad scheme in 2017; and if he will make a statement on the matter. [6407/18]
Amharc ar fhreagraThe HSE operates the Treatment Abroad Scheme (TAS) for persons entitled to treatment in another EU/EEA Member State or Switzerland under EU Regulation (EC) No. 883/2004, as per the procedures set out in EU Regulations (EC) No. 987/2009, and in accordance with Department of Health Guidelines.
As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
57. Deputy Pat Casey asked the Minister for Health his plans in 2018 to address the lack of dedicated community neuro-rehabilitation teams in CHO6. [6414/18]
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.
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.
58. Deputy Joan Burton asked the Minister for Health his plans in respect of constitutional referenda in 2018. [51729/17]
Amharc ar fhreagraAs the Deputy will be aware, the Government has put in place a process to examine possible changes to Article 40.3.3 of the constitution.
The Government established a Citizen’s Assembly, in line with its Programme for Partnership Government commitment, to consider a number of matters including constitutional reform. The Assembly first considered the Eighth Amendment of the Constitution (Article 40.3.3), and submitted its final report, setting out its recommendations, to the Oireachtas on 29 June 2017.
The Joint Committee on the Eighth Amendment of the Constitution, chaired by Senator Catherine Noone, was established to consider the Citizens’ Assembly report and recommendations. The Committee reported its conclusions and recommendations to both Houses of the Oireachtas on Wednesday, 20 December 2017. A majority of Committee members recommended that change is needed to extend the grounds for lawful termination of pregnancy in the State, and that in order to effect change Article 40.3.3 should be removed from the Constitution. However, diverging from the Citizens’ Assembly’s view which believed Article 40.3.3 should be replaced in the Constitution with a provision giving exclusive authority to the Oireachtas to legislate on the issue of abortion, the Joint Committee recommended that Article 40.3.3 be repealed simpliciter.
At a special Cabinet meeting on 29 January, the Government approved the holding of a referendum on Article 40.3.3 in early summer 2018 subject to the timely passage of a Constitutional Amendment Bill on the matter by the Houses of the Oireachtas.
I will now prepare a Referendum Bill to amend the Constitution. The Bill will propose that 40.3.3 of the Constitution is deleted in its entirety and include an additional clause into the Constitution confirming that the Oireachtas may regulate for the termination of pregnancy. The jurisdiction of the courts will not be ousted by this text, and it will not restrict rights of access to the courts. Legislation enacted post-amendment would remain subject to review by the courts like any other legislation.
The Government also noted my intention to prepare a General Scheme of a Bill to provide for termination of pregnancy based on the recommendations of the Report of the Joint Committee on the Eighth Amendment of the Constitution (subject to such amendments as may be required for legal or operational reasons). I have also undertaken to return to Government with a policy paper on relevant matters in early March.
59. Deputy Bríd Smith asked the Minister for Health his plans to retain and recruit front-line staff in the health services, including nurses; the number of nursing staff needed in public national hospitals; and if he will make a statement on the matter. [6283/18]
Amharc ar fhreagraNotwithstanding significant recruitment and retention challenges, including global shortages, considerable progress has been made in the past four years in growing the numbers of front line staff working in the public health services, including doctors and nurses, as additional resources have become available.
The number of consultants has increased by 109 in the 12 months ending December 2017 to 2,971 whole time equivalents, and by 415 in the 4 years since December 2013. The number of NCHDS has increased by 270 in the 12 months ending December, 2017 to 6,331 whole time equivalents, and by 1,323 in the 4 years since December 2013.
It is recognised that retention of doctors is critical to the future growth of the medical workforce. In July 2013 a Working Group, chaired by Prof. Brian MacCraith, President, Dublin City University, was established to carry out a strategic review of medical training and career structure. The Group made 25 recommendations relating to training and career pathways for doctors with a focus on improving graduate retention in the public health system and planning for future service needs. Initiatives taken on foot of the Group's recommendations include the launch of a careers and training website, which gives information about each specialty, including details of training pathways and training duration, increasing the number of family friendly training places and the appointment of lead NCHDs across sites. The MacCraith Implementation Monitoring Group continues its work and has identified the need to progress other key recommendations including protected training time, task transfer and better coverage of training costs incurred by NCHDs.
With regard to nurses, the number of nurses and midwives has increased by 942 in the 12 months ending December 2017 to 36,777 whole time equivalents and by 2,599 in the 4 years since December 2013. In terms of the number of nurses required in public hospitals, the Nursing Recruitment and Retention Agreement, was concluded with the INMO and SIPTU Nursing last year. This committed the HSE to increasing the number of nurses and midwives by 1,224 additional permanent posts across the health service in 2017. Indications are that there has been significant growth in the appointment of nurses and midwives in recent months with 942 WTE of the 1,224 posts filled (including student nurses). The HSE remain committed to the Agreement and efforts will continue to fill the remaining posts. Funded workforce plans for 2018 are in the process of being developed.
I can assure the Deputy that the HSE recognises the need to continue to focus on the recruitment and retention of front-line staff, such as doctors and nurses, and that it is committed to making the public health service a more attractive place to work.
