Written Answers Nos. 34-53
34. Deputy Peter Burke asked the Minister for Health the details of the radiology unit for the Regional Hospital Mullingar, as outlined in the Capital Plan 2016-2021, which will host the MRI scanner that was funded by a group (details supplied); the timeframe for the establishment of the unit; and if he will make a statement on the matter. [16741/18]
Amharc ar fhreagraMy Department has asked the Health Service Executive to reply directly to the Deputy with regard to current position on the radiology department and the MRI at the Regional Hospital, Mullingar.
35. Deputy John Curran asked the Minister for Health the timeframe for the delivery of a primary care centre (details supplied); the staffing and range of services to be provided at the centre; and if he will make a statement on the matter. [16289/18]
Amharc ar fhreagraMy Department has asked the Health Service Executive to respond to the Deputy directly in relation to the development of a primary care centre at Rowlagh, Clondalkin, Dublin.
37. Deputy Jack Chambers asked the Minister for Health his views on whether it is appropriate for endoscopy day beds in Connolly Hospital to be used to cope with emergency department overcrowding. [17096/18]
Amharc ar fhreagraAgainst a background of growing demand for unscheduled care and high acute hospital occupancy rates, Government provided €30 million in 2017 and a further €40 million in 2018 for measures to increase acute hospital capacity and alleviate overcrowding in Emergency Departments (EDs). Almost 50% of this funding was used to deliver home support packages and transitional care beds to reduce the incidence of delayed discharges. Furthermore, over 200 beds have been opened this winter and more beds are due to come on stream later in the year.
Notwithstanding the increased level of resources provided, this winter has been particularly difficult for our health services with ED attendances up 3.7%, admissions up 3.3% and trolleys up 13.1% during the first quarter of the year, as compared to the same period in 2017.
The situation was further exacerbated by Storm Emma and the severe weather that followed. In response to this, I approved a further €5m in emergency funding to provide additional home support packages and transitional care beds to assist the safe discharge of patients who required support to return home following the adverse weather.
In the light of the conclusions of the Health Service Capacity Review that the system will need nearly 2,600 additional acute hospital beds by 2031, I have asked my Department to work with the HSE to identify the location and mix of beds across the hospital system which can be opened and staffed this year and into 2019 in order to improve preparedness for Winter 2018/2019.
In relation to the specific question asked regarding the use of endoscopy day beds in Connolly Hospital, as this is a service matter I have referred it to the HSE for a direct response.
38. Deputy Catherine Connolly asked the Minister for Health the status of the provision of ambulance services for the Connemara region; and if he will make a statement on the matter. [17112/18]
Amharc ar fhreagraAs this is a service issue, I have asked the HSE to reply to you directly.
39. Deputy Pat Casey asked the Minister for Health the reason Wicklow local health office, LHO, experienced a reduction of 33,722 home help hours in 2017; and if he will make a statement on the matter. [17040/18]
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.
40. Deputy Stephen S. Donnelly asked the Minister for Health if the recommendations of the recent Oireachtas Joint Committee on Health's report on evaluating orphan drugs will be implemented; and if he will make a statement on the matter. [17089/18]
Amharc ar fhreagraThe report of the Joint Committee on Health entitled Evaluating Orphan Drugs was recently received by my Department. The report contains a number of recommendations which are under consideration at present.
41. Deputy Ruth Coppinger asked the Minister for Health if he is satisfied an association's (details supplied) guidelines are implemented in the health service; and if he will make a statement on the matter. [17117/18]
Amharc ar fhreagraThe World Professional Association for Transgender Health (WPATH) publishes the Standards of Care and Ethical Guidelines, which articulate a professional consensus about the psychiatric, psychological, medical and surgical management of gender dysphoria. The guidelines are designed to help professionals understand the parameters within which they may offer assistance to those with gender dysphoria conditions.
The guidelines are designed to be flexible and, as described in the document, adaptations are suggested depending on the local clinical professional codes of conduct and regulatory and legislative frameworks. In Ireland, the diagnosis of gender dysphoria and clinical pathways for physical transitions are provided in the context of Irish professional codes, as well as regulatory and legislative frameworks, informed by WPATH Guidelines.
I am satisfied that the treatment of gender dysphoria in the Irish healthcare services reflects best practice in meeting the complex needs of transgender people.
42. Deputy Brendan Smith asked the Minister for Health the action being taken to ensure that rural Ireland has sufficient general practitioner cover; and if he will make a statement on the matter. [17092/18]
Amharc ar fhreagraGeneral Practitioners play an important role in the primary care system. The number of General Practitioners on the specialist register continues to increase – up from 2,270 in 2010 to 3,637 at the end of 2017 and the number of GPs contracted by the HSE under the GMS scheme has also risen from 2,098 in 2008 to 2,485 as of 1 April 2018.
The Government is aware of the manpower issues facing general practice and has taken steps to increase the numbers of General Practice training places accordingly.
In 2009, there were 120 General Practice training places available and this year it is expected that over 190 training places will be filled, an increase of around 60% over a nine year period. The number of training places will rise to 259 in coming years. There were over 400 applications for the 2018 training programme which is a significant increase of almost 50% on the number of applications from 2017.
Other efforts undertaken in recent years to increase the number of practicing GPs include changes to the entry provisions to the GMS scheme to accommodate more flexible/shared GMS/GP contracts, and to the retirement provisions for GPs under the GMS scheme, allowing GPs to hold GMS contracts until their 72nd birthday. An enhanced supports package for rural practices has also been introduced which includes improved qualifying criteria for rural support and an increase in the financial allowance from €16,216.07 to €20,000 per annum.
The Government is also committed to engaging with General Practitioner representatives on necessary service improvements and contractual reforms to the current GMS contract. This process is expected to commence in the coming weeks.
Our goal is to develop a contractual framework that has a population health focus, providing in particular for health promotion, disease prevention and for the structured care of chronic conditions. This will enable general practitioners to better meet the needs of patients and will also promote general practice as a viable and rewarding career for both existing doctors and future medical graduates.
43. Deputy Eamon Scanlon asked the Minister for Health the reason for excluding persons over 21 years of age with type 1 diabetes from accessing the FreeStyle Libre glucose monitor available to all persons with diabetes based on clinical need; his plans to remove the age barrier recently set by the HSE; and if he will make a statement on the matter. [16240/18]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
44. Deputy Niall Collins asked the Minister for Health the reason 291 persons over 75 years of age waited more than 24 hours in the emergency department of University Hospital Limerick during the first two months of 2018; and if he will make a statement on the matter. [17048/18]
Amharc ar fhreagraAgainst a background of growing demand for unscheduled care and high acute hospital occupancy rates, Government provided €30 million in 2017 and a further €40 million in 2018 for measures to increase acute hospital capacity and alleviate overcrowding in Emergency Departments. Almost 50% of this funding was used to deliver home support packages and transitional care beds to reduce the incidence of delayed discharges. Furthermore, over 200 beds have been opened this winter and more beds are due to come on stream later in the year.
Notwithstanding the increased level of resources provided, this winter has been particularly difficult for our health services with ED attendances up 3.7% and admissions up 3.3% during the first quarter of the year, as compared to the same period in 2017. In relation to Limerick, in the first quarter of 2018, attendances rose by 11.6% and admissions rose by 10.8%, with a steep rise of 16.4% in attendances and 21% in admissions by those in the over 75 age group.
The situation was further exacerbated by Storm Emma and the severe weather that followed. In response to this, I approved a further €5m in emergency funding to provide additional home support packages and transitional care beds to assist the safe discharge of patients who required support to return home following the adverse weather.
In relation to the specific question asked regarding waiting times in UHL ED, as this is a service matter I have referred it to the HSE for a direct response.
45. Deputy Mary Butler asked the Minister for Health the timeframe for clinical staffing levels for the community psychiatry of old age mental health services to reach the level recommended in A Vision for Change; and if he will make a statement on the matter. [17098/18]
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.
46. Deputy John Brassil asked the Minister for Health the reason a full-time cardiologist, respiratory consultant and an associate professor from UCC that agreed to be assigned to University Hospital Kerry have not yet been appointed; and the status of progress in regard to same. [16236/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive (HSE) to respond to you directly as soon as possible.
47. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he is satisfied that issues affecting long waiting lists in public hospitals, overcrowding at accident and emergency services and other contributory factors affecting the fast, efficient and effective delivery of public health services are fully addressed or are in the course of so being; and if he will make a statement on the matter. [17024/18]
Amharc ar fhreagraThis Government is committed to tackling the key challenges our health system faces in relation to hospital overcrowding and long waiting times for treatment.
Against a background of growing demand for hospital services care and high acute hospital occupancy rates, Government provided €30 million in 2017 and a further €40 million in 2018 for measures to increase acute hospital capacity and alleviate overcrowding in Emergency Departments (EDs). Reflecting the focus on reducing patient waiting times, the National Treatment Purchase Fund (NTPF) allocation was increased to €55m this year, including administrative costs of €5m. That is more than double its 2017 allocation of €20m.
Notwithstanding increased investment, this winter has been particularly difficult for our health services, with ED attendances up 3.7%, admissions up 3.3% and trolleys up 13.1% during the first quarter of the year, as compared with the same period in 2017. This situation was further exacerbated by the severe weather that followed Storm Emma, which led to approval of a further €5m in emergency funding for extra home support packages and transitional care beds to assist the safe discharge of patients who required support to return home following the adverse weather.
The recently launched Inpatient/Day Case Action Plan for 2018 projects a reduction in the number of patients waiting for treatment to below 70,000 by year end - from a peak of 86,100 in July 2017. To achieve this, the NTPF will arrange treatment for 20,000 patients, while the HSE will deliver 1.14 million inpatient or day case procedures. I am committed to building on this progress in 2019 and further reducing waiting time for Irish patients.
In the light of the Health Service Capacity Review conclusion that the system will need nearly 2,600 additional acute hospital beds by 2031, I have asked my Department to work with the HSE to identify the location and mix of beds across the hospital system which can be opened and staffed this year and into 2019 in order to improve preparedness for Winter 2018/2019.
Finally, a review of the Winter Initiative 2017/2018 is being undertaken, which will inform a 3 year plan for unscheduled care, as well as supporting the provision of additional capacity in Winter 2018/19.
48. Deputy Michael McGrath asked the Minister for Health the action being taken to address long waiting times for both CAMHS and primary care psychology services for children in County Cork; and if he will make a statement on the matter. [17038/18]
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.
49. Deputy John McGuinness asked the Minister for Health his plans to implement a similar practice to that in Germany for the detection and treatment of Lyme disease; his plans to improve follow-up care for persons following diagnosis; his views on whether current training for doctors is adequate; and if he will make a statement on the matter. [17059/18]
Amharc ar fhreagra106. Deputy Eamon Scanlon asked the Minister for Health his plans to implement a similar practice to that in Germany for the detection and treatment of Lyme disease; his plans to improve follow-up care for persons following diagnosis; his views on whether current training for medical professionals is adequate; and if he will make a statement on the matter. [16502/18]
Amharc ar fhreagraI propose to take Questions Nos. 49 and 106 together.
Lyme disease (also known as Lyme borreliosis) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. The infection is generally mild affecting only the skin but can occasionally be more severe and highly debilitating. Lyme disease is diagnosed by medical history and physical examination. The infection is confirmed by blood tests which look for antibodies produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease. The standard laboratory approach to Lyme diagnostics is a two-stage approach and has been agreed by experts from the Scientific Advisory Committee of the Health Protection Surveillance Centre and other Irish and international experts. This testing is available in Ireland.
Laboratories in Ireland generally follow the laboratory testing recommendations of the US Centres for Disease Control and Prevention, the Infectious Disease Society of America, the European Federation of Neurological Societies, and the British Infection Association. Irish laboratories have their own quality assurance methods to make sure the tests are working correctly as well as being accredited by the Irish National Accreditation Body to perform the test correctly. In undertaking Lyme testing, it is essential that the results are interpreted in the light of the clinical condition of the patient. If the result of this initial screen is equivocal, the patient's samples are referred to the U.K.'s Rare and Imported Pathogens Laboratory. This laboratory uses a two-tier system recommended by American and European authorities which involves a screening test followed by a confirmatory test.
Testing which is performed abroad may be performed in laboratories which have not met National or International Accreditation (Quality Standards). These tests may be more likely to give a “false positive” result.
Medical training programmes at undergraduate or postgraduate level in Ireland provides specialist training in infectious diseases, including Lyme disease.
Lyme disease can be very successfully treated using common antibiotics by General Practitioners. These antibiotics are effective at clearing the rash and helping to prevent the development of complications. Antibiotics are generally given for up to three weeks. If complications develop, intravenous antibiotics may be considered.
The HSE Health Protection Surveillance Centre website (www.hpsc.ie ) gives extensive information on Lyme disease diagnosis, treatment and how to avoid tick bites. A Lyme Disease Subcommittee of the Scientific Advisory Committee of HPSC with professional clinical, entomological, scientific and environmental health expert representation (including a representative of the Lyme Support Group, Tick-Talk Ireland) has been established to explore all possible ways of raising awareness about Lyme disease. This Subcommittee is expected to meet shortly with a view to finalising it report. This report will cover a number of areas, including initiatives undertaken to date, summary advice relating to awareness, preventive advice for the general public, preventive advice and material for those responsible for sites or locations known to have or suspected as having higher densities of ticks, and summary advice relating to GP management of the condition. Any person who is suffering ill health is eligible to seek medical attention, and to access appropriate health and social care services, irrespective of the cause of their symptoms.
50. Deputy Fiona O'Loughlin asked the Minister for Health if new hospitals built in Dublin under the National Development Plan 2018-2027 will be located in areas of easy access for persons from the wider Leinster area; and if he will make a statement on the matter. [17103/18]
Amharc ar fhreagraThe National Development Plan is a ten year plan which will provide the capital funding to develop dedicated ambulatory elective-only hospital facilities in Dublin, Cork and Galway. The aim is to both increase capacity in the hospital system and provide a better separation of scheduled and unscheduled care, in line with the recommendations of Health Service Capacity Review and the Sláintecare Report. They will provide increased, protected capacity for elective treatment and free up capacity in major hospitals to address higher complexity and emergency care.
It is envisaged that these facilities will be sited adjacent to general hospitals.
As is to be expected with a ten year plan, many proposals, including dedicated ambulatory elective-only hospital facilities in Dublin, are at a very early stage and will require to progress through appraisal, planning, design and tender before a firm location, timeline or funding required can be established.
51. Deputy Éamon Ó Cuív asked the Minister for Health when work will commence on the building of the proposed new elective hospital in County Galway; and if he will make a statement on the matter. [17050/18]
Amharc ar fhreagraThe National Development Plan provides €10.9 billion to invest in infrastructure, equipment and additional service capacity for the public health sector.
The National Development Plan is a ten year plan which will provide the capital funding to develop dedicated ambulatory elective-only hospital facilities. We must ensure that we carefully plan the use of this capital funding so as to meet the populations health needs and achieve value for money.
As is to be expected with a ten year plan, many proposals, including an elective-only hospital in Galway, are at a very early stage and will require to progress through appraisal, planning, design and tender before a firm location, timeline or funding required can be established.
52. Deputy Stephen S. Donnelly asked the Minister for Health when a Sláintecare implementation plan will be brought forward; and if he will make a statement on the matter. [17090/18]
Amharc ar fhreagraAs the Deputy is aware, I supported the work of the All-Party Committee on the Future of Healthcare and I welcomed the publication of the Sláintecare Report. The Report represents a significant milestone in the history of health services development in Ireland, and I intend to harness the consensus generated by the Report to move forward with a programme of health reform. The Government is committed to making tangible improvements in our health service and the Sláintecare Report provides the direction of travel for this.
To that end, work is at an advanced stage in my Department in developing a Sláintecare Implementation Plan. This Plan will translate the Sláintecare Report into a detailed programme of reform over the next 10 years, with a focus on the immediate years ahead. I expect to bring these proposals to Government very shortly. Furthermore, Government gave approval last year to the establishment of a dedicated Sláintecare programme office in my Department and the recruitment of an Executive Director to lead this office. This recruitment process will conclude in the coming weeks.
53. Deputy James Browne asked the Minister for Health his plans to address the deficiencies in child and adolescent mental health services at primary, community and acute levels; and if he will make a statement on the matter. [17026/18]
Amharc ar fhreagraThe development of all aspects of mental health services for young people, as reflected in the agreed HSE Service Plan 2018, remains a priority for Government. Services have benefitted from the significant additional investment for mental health over recent years which has resulted in an overall provision of some €910 million for this care programme in the current year.
There are currently 69 Child and Adolescent Mental Health Service (CAMHS) teams, 4 CAMHS units and three Paediatric Liaison Teams. Approximately 18,800 children will be referred to the CAMHS service this year, with around 14,400 to be seen by CAMHS professionals.
There are acknowledged difficulties in recruiting and retaining specialist CAMHS staff, particularly Consultant Psychiatrists. Intensive recruitment efforts are ongoing but there is currently a serious shortage of suitably qualified CAMHS Consultants both at national and European level. Steady progressing is being made by the Executive in filling approved posts for mental health. Despite increasing demands on CAMHS overall, the HSE Service Plan 2018 has a target of 72% for referrals offered or first appointment and to be seen within twelve weeks.
Individual cases professionally assessed as requiring urgent access to services receive priority.
Reducing CAMHS Waiting Lists is a priority for the HSE. The HSE Service Plan 2018 will further develop CAMHS, including delivering a major improvement initiative to increase the numbers of CAMHS referrals to be seen in 2018 by 27%, compared to 2017 (i.e. over 3,000 additional service users year on year). Improvements are also planned for Out-of- Hours liaison, seven-day response services, and progressing the CAMHS Day Hospital service.
A key initiative to improve counselling services at Primary Care level has been the recent approval by Government for the appointment of 114 Assistant Psychologists and 20 Psychologists to assist young people. These are currently being put in place by the HSE.
In addition, I have requested the HSE to examine as a matter of priority the feasibility of providing counselling support services remotely via a Tele-Psych type service at primary care centres.
