Written Answers Nos. 108-128
108. Deputy Willie Penrose asked the Minister for Health his plans to provide for pay restoration for persons working for publicly funded organisations that took pay cuts during the economic crisis; his views on whether staff should have their salaries restored on a parallel basis to civil servants; and if he will make a statement on the matter. [21711/18]
Amharc ar fhreagra313. Deputy Peter Burke asked the Minister for Health the status of the negotiations regarding section 39 pay restoration for employees who were employed before 2008 in view of the 2017 Labour Court recommendations; the actions taken by the HSE, his Department and the Department of Public Expenditure and Reform to date regarding this set of employees; when a solution can be expected; and if he will make a statement on the matter. [23098/18]
Amharc ar fhreagra410. Deputy Barry Cowen asked the Minister for Health if the results of the audit on pay restoration for section 39 organisations have been published; if not, when he plans to publish it; the engagement he has had with section 39 agencies in relation to this issue; and if he will make a statement on the matter. [23359/18]
Amharc ar fhreagraI propose to take Questions Nos. 108, 313 and 410 together.
On 9 February 2018, an agreement was reached at the WRC between the Department of Health, the HSE and health sector Trade Unions in relation to a process aimed at resolving the pay restoration issue for staff employed by section 39 bodies. 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 has put in place a process to establish a deeper understanding of the funding position in these grant - aided organisations and the true extent of the pay reductions applied. The Minister for Health asked the HSE to engage with the Section 39 organisations to establish the facts around what cuts were applied and how and when they were implemented.
On foot of agreement at the WRC, the interim data gathering exercise is being progressed. The HSE has shared a draft of the interim report, which covers a sample of 50 agencies identified in the WRC agreement, with the staff side. Upon receipt of feedback it will be finalised and issued formally to the DoH. Initial indications are that of the 50 pilot sites, most did apply pay reductions and only some have commenced pay restoration.
110. Deputy Margaret Murphy O'Mahony asked the Minister for Health the plans being put in place to address the impact that demographic changes and an ageing society will have on persons with disabilities. [23506/18]
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.
The self- reported rate of disability has risen in Ireland over the last number of years with an additional 47,796 or 13.5% of the population now reporting at least one disability (Census 2016). This is an increase of 8% since 2011.
Of those aged 65 years and over, the number has risen by 20,319 to 9.5% since 2011. Generally, people are living longer including adults with intellectual disability who have acquired age-related illnesses and conditions. In addition, more people with a disability have more complex needs. Around 15% of over-60s with intellectual disabilities live with family members, usually with sibling or parents.
The change in demographics and family structure, increased life expectancy and changing needs for those with both a physical and sensory disability and/or an intellectual disability, has led to a significant increase in the need for disability services across all settings. This includes day supports, residential and respite services, personal assistant and home support services.
Disability services focus on enabling people with disabilities to achieve their full potential, living ordinary lives in ordinary places, as independently as possible while ensuring that the voices of service users and their families are heard, and that they are fully involved in planning and improving services to meet their needs.
The HSE recognises that in 2018 it faces a significant financial challenge in meeting essential demand, particularly in relation to residential placements for people with an intellectual disability. In this regard, they have committed to developing a strategic five year framework to support multi-annual planning for residential care services and community supports to include day, respite, personal assistant, home support services as well as therapeutic interventions taking account of national database projections and the need to develop sustainable models of service which achieve HIQA compliance within approved timeframes.
To meet the challenges arising from the increase in the number of people living with disability, the increase in age and life expectancy both of the person with the disability and their carer and the changing needs of people with a disability, collaborative working is required across the wider health and social care setting with the aim of improving access to services for all people with disability. It is important to recognise that the needs of people with a disability extend well beyond health service provision, and the health service will participate fully with other governmental departments and services in the development of cross-sectoral strategies to maximise access to services and supports for people with disabilities.
My Department also provides funding through the Health Research Board, for the intellectual Disability Supplement to The Irish Longitudinal Study on Ageing.
IDS-TILDA is a longitudinal study researching ageing in Ireland among people with an intellectual disability aged 40 and over. This study is the first of its kind in Europe, and the only study able to directly compare the ageing of people with intellectual disability with the general ageing population.
The underpinning values of IDS-TILDA are inclusion, choice, empowerment, person centred, the promotion of people with intellectual disability, the promotion of best practice and to make a contribution to the lives of people with intellectual disability.
The recently published Wave 3 IDS-TILDA report marked the 10-year anniversary of IDS-TILDA and captured how much has changed in Ireland, over those 10 years in the lives of people ageing with an intellectual disability. Thanks to IDS-TILDA, more is known today about the lives of people with an intellectual disability as they age.
Further details are available from IDS-TILDA at https://idstilda.tcd.ie/.
111. Deputy Anne Rabbitte asked the Minister for Health the status of the implementation of the recommendations of the external independent clinical review of maternity services at Portiuncula Hospital. [23507/18]
Amharc ar fhreagraI would like to convey my sympathies to the families involved and welcome the completion of this review process for them.
The HSE has advised me that Portiuncula University Hospital and Saolta University Health Care Group have reviewed the findings and recommendations in the report. An Implementation Team is already in place to progress the recommendations. I particularly welcome the fact that the team includes input from some of the families affected.
I am also assured that a significant number of actions are already underway which will advance the implementation of the recommendations.
I trust that this clarifies the position.
112. Deputy Niamh Smyth asked the Minister for Health if the HSE's waiting times for assessment of need for children with disabilities will be addressed; and if he will make a statement on the matter. [23446/18]
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.
113. Deputy Aindrias Moynihan asked the Minister for Health when the proposed extension for Macroom hospital will advance to construction; and if he will make a statement on the matter. [23462/18]
Amharc ar fhreagraAs the Health Service Executive is responsible for the delivery of health care infrastructure projects, the Executive has been requested to reply directly to you in relation to the proposed extension at Macroom Hospital.
114. Deputy Anne Rabbitte asked the Minister for Health if he will be announcing new measures to address the long waiting times for paediatric outpatient appointments. [23508/18]
Amharc ar fhreagraImproving waiting times for hospital procedures and outpatient appointments is a key commitment in the programme for Government. It is acknowledged that outpatient waiting lists are a challenge which need to be addressed.
The development of a sustainable and safe paediatric orthopaedic service, including scoliosis services for children and young people has been prioritised in the 2018. An additional €9 million has been provided to the HSE in 2018 specifically to develop paediatric orthopaedic services, including increasing access to scoliosis services. The HSE and Children’s Hospital Group developed a Paediatric Scoliosis Waiting List Action Plan for 2018 and this includes actions targeted at patients waiting longest for an outpatient appointment.
The NSP sets out a target that 80% of patients waiting for a first outpatient appointment will be seen within a 52 week wait timeframe. HSE figures for March 2018 show that the three hospitals of the CHG are seeing 62-64% of outpatients within 52 weeks.
In 2017, almost 150,000 (148,948) patients attended outpatients across the three hospitals of the CHG. It is worth noting that in the same year, across the three hospitals, over 21,000 (14%) of patients did not attend their hospital appointments.
The most recent NTPF figures for April 2018 show that there was a total of 43,316 patients on the outpatient waiting list across the three hospitals of the CHG. 77% of these patients are waiting 18 months or less.
The CHG advise that capacity challenges are managed daily, with each of the three children’s hospitals supporting each other in terms of bed utilisation and availability.
A key component of the management of waiting lists by hospitals is the categorisation of patients by clinical priority to ensure that all patients receive care in a timely and clinically appropriate manner.
The HSE is working with the NTPF and my Department to finalise a joint plan focused on improving overall use of resources to tackle long patient waiting times and ensure timely access to treatment and care for our patients. I hope to publish this Plan shortly. As part of this process the NTPF and the HSE are currently reviewing proposals from hospitals, including the hospitals across the CHG, for outpatient initiatives.
116. Deputy John Brassil asked the Minister for Health the strategies the HSE south west group has in place to deal with the chronic staffing shortages across key disciplines, that is, consultants, doctors, nurses and healthcare professionals at University Hospital Kerry; and if he will make a statement on the matter. [23448/18]
Amharc ar fhreagraThe Government is firmly committed to supporting the recruitment and retention of the right mix of workers across the health service. Notwithstanding recruitment and retention challenges, the number of consultants has increased by 110 in the 12 months to end March 2018 and by 462 in the past five years. Similarly, funding was provided in 2017 for the Nursing Recruitment and Retention Agreement workforce plan which committed the HSE to recruiting 1,224 additional nurses and midwives. There has been a significant growth in the appointment of nurses and midwives with 942 WTE of the 1,224 posts filled (including student nurses) or 69% (847 WTE) excluding student nurses. The HSE remain committed to the Agreement and efforts will continue to fill the remaining posts.
The National Strategic Framework for Health and Social Care Workforce Planning aims to support the recruitment and retention of the right mix of workers across the health and social care system to meet planned and projected service need. Early actions to implement the Framework are currently taking place.
In relation to the specific query raised regarding staffing levels at UHK, the HSE has advised that the South/South West Hospital Group (S/SWHG) is working with University Hospital Kerry (UHK)to address staffing shortages at the hospital via local, national and international campaigns.
For example, the S/SWHG and UHK are working with the Consultant Appointments Advisory Committee (CAAC) and the Public Appointments Service (PAS) for the approval, advertisement and recruitment of all new and replacement consultant posts. The S/SWHG has approval to fill Training Lead positions across the S/SWHG at consultant level and this will support efforts to recruit in specialities which to date have failed to attract candidates.
An International Recruitment Agency appointed under the HSE National Framework has been used for nursing and midwifery recruitment in UHK. Furthermore, UHK is an approved site for training of nursing students and the HSE has confirmed that the hospital will be offering all its graduates permanent contracts following successful completion of the nursing degree programme.
For all other staff groups, the S/SWHG continues to run campaigns through the recruitment body of the HSE’s Health Business Services group. It regularly updates information supporting these campaigns to reflect additional opportunities unique to working in UHK, including opportunities for training and further career development.
The S/SWHG acknowledges the recruitment challenges in UHK but wishes to assure the Deputy that it will continue to actively recruit suitably qualified staff to ensure that staffing levels are safe and to ensure patient centred care.
118. Deputy Richard Boyd Barrett asked the Minister for Health if he will report on planned changes to introduce a screening process in the assessment of needs for children; and if he will make a statement on the matter. [23525/18]
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.
119. Deputy Denise Mitchell asked the Minister for Health the steps he is taking to address the targeted advertising of junk food to children and young persons online. [18727/18]
Amharc ar fhreagraIn February, I launched new voluntary Codes of Practice for the advertising and marketing of food and non-alcoholic drinks in the non-broadcast media - including digital media - in accordance with a recommendation in the national Obesity Policy and Action Plan (OPAP). The OPAP was launched in September 2016 under the auspices of the Healthy Ireland agenda.
The purpose of the Codes, which have been agreed with the food industry, is to ensure that foods high in fat, salt and sugar are marketed in a responsible way. In particular the Codes seek to ensure that children are not exposed to inappropriate marketing, advertising or sponsorship associated with these kinds of food and drink products, and that healthier food choices are actively promoted.
In effect, the purpose of the Codes is to reduce the exposure of children to unhealthy foods.
120. Deputy Stephen S. Donnelly asked the Minister for Health the way in which he plans to address the ongoing and continuing difficulty in growing the nursing and midwifery workforce; and if he will make a statement on the matter. [23501/18]
Amharc ar fhreagraThe Government and the HSE remain committed to recruiting and retaining nurses and midwives in the public health service. As part of the Nursing Recruitment and Retention Agreement with the INMO and SIPTU, the HSE agreed to appoint 1,224 additional nurses and midwives in 2017.
The HSE has submitted the final report setting out progress on implementation of the Agreement as at end December 2017. The report shows that there has been significant growth in the appointment of nurses and midwives in the final months of the year with 942 WTE of the 1,224 posts filled (including student nurses) or 69% (847 WTE) excluding the student nurses. The HSE remain committed to the Agreement and efforts will continue to fill the remaining posts.
The measures put in place by the HSE to recruit nurses and midwives included two international recruitment campaigns in 2017, the "Bring Them Home" campaign and the "New Year New Career" campaign. Nurses who relocate to work in the Irish public health service can receive up to €3,000 in relocation expenses. The HSE is also in the process of offering all 2018 graduate nurses and midwives permanent posts within a Hospital Group or CHO subject to them attaining registration and satisfactory performance.
Retention measures undertaken by the HSE include a pre-retirement initiative, career breaks and education and training opportunities. In 2017, an additional 130 nursing undergraduate places were made available in the nursing degree programme to increase the supply of nurses. Also 120 Advanced Nurse Practitioner education places were made available.
The Public Service Pay Commission has already recognised that nurses and midwives are one of the grades which have recruitment and retention difficulties. Their second phase of work is underway, with nurses and midwifery grades being one of the first groups to be looked at. I expect their report in June and look forward to hearing what recommendations they will make.
121. Deputy Louise O'Reilly asked the Minister for Health the number of respite care hours provided for the first quarter of 2018 in each CHO area; the way in which this compares with applications for respite care; the respite care provided in each of the years 2011 to 2017 and to date 2018, by CHO area; and if he will make a statement on the matter. [23450/18]
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.
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.
122. Deputy Mick Wallace asked the Minister for Health the status of the general practitioner contractual review process particularly in relation to the provision of routine phlebotomy services; and if he will make a statement on the matter. [23490/18]
Amharc ar fhreagraI acknowledge the important role that general practitioners play in our health service and I recognise the commitment of GPs to ensuring a responsive, accessible and high-quality service to patients. The Government is committed to engaging with the representatives of GPs on the development of a package of measures and reforms to modernise the current GMS contract and which will enable additional resources to be put into general practice if agreement can be reached.
Earlier this month officials from my Department and the HSE met with the Irish Medical Organisation in order to progress this agenda. In line with the long-established approach to such processes, and by agreement of the parties concerned, I am not in position to give further details while discussions between the parties are under way.
Under the terms of the current GMS contract, GPs are required to provide eligible patients with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess." There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition. The HSE has advised GPs that where a blood test forms part of the investigation or necessary treatment of a patient’s symptoms or conditions, this should be free of charge for patients who hold a medical card or GP visit card. Notwithstanding this, I am aware that some GPs are charging GMS patients for phlebotomy services in some circumstances.
This is a matter of concern for me as it has long been the position, under successive Governments, that no user charges should apply to GP services provided to GMS and GP visit card patients. If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient may take the matter up with their HSE Local Health Office, who will investigate the complaint.
If the local office determines that the charge was inappropriate, it will inform the HSE Primary Care Reimbursement Service who will arrange to refund the cost of the blood test to patient and recoup this amount from the GP. The local office will inform the GP of the decision to deduct the payment.
124. Deputy Pat The Cope Gallagher asked the Minister for Health the timeframe for bringing the child and adolescent mental health services in CHO1 to the level envisaged in A Vision for Change. [23560/18]
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.
125. Deputy Catherine Connolly asked the Minister for Health the HSE's policy in relation to the provision of out of hours emergency scan services for pregnant women; and if he will make a statement on the matter. [23455/18]
Amharc ar fhreagraAs this is a service issue, I have asked the HSE to reply to you directly.
126. Deputy Catherine Connolly asked the Minister for Health when the new 50 bed mental health unit will open at Galway University Hospitals; and if he will make a statement on the matter. [23459/18]
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.
127. Deputy Mary Butler asked the Minister for Health the status of the implementation of the National Dementia Strategy. [23510/18]
Amharc ar fhreagraThe National Dementia Strategy was launched in December 2014, and seeks to increase awareness and understanding of dementia, ensure earlier diagnosis and intervention and develop enhanced community based supports and services. It was created to meet the challenges faced by the 55,000 people living with dementia in Ireland and to provide a network of services that will meet growing demand in future years. The number of people with dementia is expected to almost treble by 2046.
The Strategy identified 35 priority and additional actions to be implemented over its lifetime. Of these 35 actions, one has been fully implemented. Substantial work has been completed on 16 others, while preliminary work has been conducted on a further 17. One action has suffered from significant delays because there is a number of pending legislative streams which are impacting on the progression of this action.
Work is underway on the vast majority of actions. Due to the lack of reliable national data on dementia care services in Ireland, much of this work has focused on collecting baseline information on current dementia service structures, to generate an evidence base for the development of services. This work is necessary in order to ensure that the development of national dementia services meets the identified needs of people with dementia, their families and carers, while also integrating with existing structures and services.
Priority actions, which received funding from the HSE and grants from the Atlantic Philanthropies, have included the establishment of a National Dementia Office within the HSE, which is responsible for overseeing the implementation of the Strategy.
The PREPARED programme offers GPs and Primary Care Teams upskilling and training to diagnose and manage dementia. It will also map local services and supports.
The Dementia: Understand Together has been working with individuals, businesses, organisations and communities to take steps in creating inclusive and supportive environments for people with dementia. Radio and television advertisements have featured prominently, and continue to play a role in combatting the stigma and social isolation that a diagnosis of dementia often causes.
Recognising that many people with dementia wish to continue living in their own homes and communities, and that flexible, person-centred services are an integral component of supporting people to remain at home, dementia specific intensive home care packages have been introduced to assist people with dementia who have complex needs. Funding which had been granted by Atlantic for the first three years has been replaced by resources from the HSE. At the end of April, 316 people had benefitted from a package, with 147 active at that point. The HSE has committed to continue funding the delivery of intensive home care packages to people with dementia.
A number of additional actions within the National Dementia Strategy are being addressed. Funding for these actions has been secured through the Dormant Accounts Fund, with the Department securing €2.28 million through the 2016 and 2017 Action Plans. These projects include a dementia diagnostic programme, a post-diagnostic support pathway, the development of a network of memory technology resource rooms, the mapping of dementia specific community based services, and the creation of a dementia registry.
On Wednesday 23rd May, a mid-term review of the implementation of the National Dementia Strategy was launched, fulfilling a commitment made by the Department. This Review provides an overview of work completed to date and work ongoing for each action identified in the Strategy. Also contained is an action plan for the work of the National Dementia Office over the next 18 months.
A large scale external evaluation of the Strategy is currently being conducted, with the aim of detailing the level of success in improving the dementia care system and the extent to which programmes and activities have impacted on people with dementia and their families and carers. The results of this external evaluation will be available during Q1 2019.
The Department is committed to the full implementation of the National Dementia Strategy, and will continue to co-operate with the National Dementia Office and stakeholders in progressing actions contained in the Strategy.
This is an area that I am very conscious of and recognise that it needs more focus to deliver on the full strategy. I am also conscious that dementia is becoming a condition that affects more and more families across the country. I have already had high level meetings with my officials and the HSE to discuss further deliverables in the context of the estimates for budget 2019 and I hope to be able progress new measures at this time.
128. Deputy Louise O'Reilly asked the Minister for Health his plans for a new neuro interventional angiography suite at Beaumont Hospital; if there is a contingency plan should the suite cease to operate suddenly; and if he will make a statement on the matter. [23453/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
