Written Answers Nos. 66-86
66. Deputy Jack Chambers asked the Minister for Health the reason for the substantial increase in overcrowding in Connolly Hospital emergency department over the first four months of 2018 relative to the same period in 2017. [23530/18]
Amharc ar fhreagraIn the context of a difficult winter for our health services, further compounded by Storm Emma, the first four months of the year saw a higher level of trolleys nationally, up 13.9%, as compared to the same period in 2017. This increase reflects a rise in demand for unscheduled care across the hospital system, characterised by increased attendances and admissions, in particular, of those in the over 75 age group.
In relation to Connolly Hospital, there was a sharp increase of 148.9% in trolley numbers between January and April 2018, compared to the same period last year. This increase was in the context of a 5.8% rise in Emergency Department (ED) attendances and an 0.5% rise in admissions at the site in the first four months of the year.
Despite marginal increases in admissions since the start of 2018, the HSE has indicated that Connolly Hospital has been operating significantly above capacity, with a high level of delayed discharges for a Model 3 site and high levels of surge capacity in use on a continuous basis. Length of stay data supports the premise that the site has been operating above capacity for an extended period, with overall medical length of stays at 8.4 days and overall surgical length of stays at 4.5 days between 1 January 2018 and 28 February 2018.
At the end of 2017, the hospital had significantly increased outturns in ED attendances and admissions and high occupancy levels. According to the HSE, these factors impacted significantly on hospital performance this year, characterised by high levels of surge in use and slow patient flow, as reflected by poor patient experience times. It is worth noting that occupancy levels in Connolly Hospital in January 2018 were particularly high at 116.9%.
Against this background, and in 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.
The Government has approved a record level of capital investment in health at €10.9 billion over the next 10 years. This will provide for a major enhancement of the capacity of our health services to meet demand.
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
68. Deputy Timmy Dooley asked the Minister for Health his views on concerns being expressed by psychologists in relation to new assessment of needs procedures for children with disabilities. [23548/18]
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.
69. Deputy James Lawless asked the Minister for Health the reason behind the substantial increase in overcrowding in Naas Hospital emergency department over the first four months of 2018 relative to the same period in 2017. [23533/18]
Amharc ar fhreagraIn the context of a difficult winter for our health services, further compounded by Storm Emma, the first 4 months of the year saw a rise of 13.9% of patients on trolleys nationally, as compared to the same period in 2017. This reflects a rise in demand for unscheduled care across the hospital system, characterised by increased attendances and admissions, especially of those in the over 75 age group.
In relation to Naas Hospital, the first four months of the year saw a significant increase in trolley numbers, up 75.4%, on the same period last year. This was against a background of:
- a 1.7% increase in overall Emergency Department (ED) attendances;
- a 4.1% increase in ED attendances by persons over the age of 75;
- a 0.9% increase in ED admissions; and
- a 0.1% decrease in ED admissions of those in the over 75 age group.
I am advised by the HSE that delayed discharges in this hospital over an extended period, and bed capacity challenges, have impacted on the hospital's ability to respond during periods of peak ED demand, especially during the winter months. In February 2018, the overall medical length of stay recorded in Naas General Hospital was 7.7 days. Such long lengths of stay are related to the age and acuity of patients and contribute to slower bed turnover, which in turn, impacts on patient flow and ED congestion.
As Minister for Health, I am committed to continuing the effort to address overcrowding in our EDs, most notably, the capacity of the system to respond during periods of peak demand. In this context, 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. Proposals received from the HSE in this regard are currently under consideration by the Department.
70. Deputy Declan Breathnach asked the Minister for Health the reason some 468 children and teenagers in County Louth had been waiting over a year for a first assessment for occupational therapy in March 2018. [23570/18]
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.
71. Deputy Sean Fleming asked the Minister for Health the status of the plan prepared by the HSE regional management on the future of the Midland Regional Hospital, Portlaoise. [23556/18]
Amharc ar fhreagraI am committed to securing and further developing the role of the Midland Regional Hospital Portlaoise as a constituent hospital within the Dublin Midlands Hopsital Group. Since 2014, the focus has been on supporting the hospital to develop and enhance management capability, implementing changes required to address clinical service deficiencies, and incorporating the hospital into the governance structures within the Dublin Midlands Hospital Group.
Significant work has been undertaken to strengthen and stabilise current arrangements for services at the hospital to ensure that services that are not sustainable are discontinued and those that are, are safety assured and adequately resourced. Funding has increased by 35% relative to the 2012 budget and staffing levels have risen by 29% from the 2014 base. Governance and management arrangements in Portlaoise Hospital have been strengthened, additional clinical staff has been appointed and staff training, hospital culture and communications have improved.
As outlined at a meeting with Laois Oireachtas members, no decision has been made yet on the draft Action Plan for Portlaoise Hospital and I am currently giving consideration to a process for wider consultation.
72. Deputy Louise O'Reilly asked the Minister for Health if the central sterilising supply department at the Mater Hospital will be retained within the public health system; if plans are in place to outsource the service; and if he will make a statement on the matter. [23449/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly, as soon as possible.
73. Deputy Niall Collins asked the Minister for Health his views on whether the level of emergency department provision in the UL hospital group area is adequate for the population catchment of the group both in overall terms and in those of the demographic make-up. [23540/18]
Amharc ar fhreagraAs the Deputy will be aware, a new Emergency Department was opened at University Hospital Limerick (UHL) on the 29th of May 2017. The €24 million development aimed to provide UHL with increased capacity for emergency medicine to meet the demands of population growth, changing service models and to improve efficiency targets.
UHL was identified as a focus site under the Winter Initiative in terms of ED congestion. As such, UHL has put in place improvement plans setting out specific mitigating actions to improve patient flow and improve processes in the ED. In addition, 17 short-stay beds were opened in UHL under the Winter Initiative, and the Hospital Group was also supported over the recent winter months with additional home support packages and transitional care beds. UHL is now fully engaged with the National Patient Flow Improvement Project, as a pilot site, to further improve processes within the hospital.
Since its opening in 2017, the new ED at UL has seen 5.6% more activity. International evidence indicates that when facilities such as UL open, there is a corresponding increase in attendances. Reflecting this trend, UHL had the second highest number of ED attendances in the first four months of 2018, a rise of 11.3%, and a 7.9% rise in admissions, as compared to the same period last year. In relation to persons over the age of 75, UHL also experienced a rise of 15.5% in attendances and a 16.7% rise in admissions between January and April 2018. The combination of these factors contributed to the 13.7% increase in trolley numbers in the first months of the year, notwithstanding performance improvement initiatives by UHL and increased investment in capacity over the winter months.
As Minister for Health, I am committed to continuing the effort to address overcrowding in our Emergency Departments, and in particular, the capacity of the system to respond during periods of peak demand, In this context, 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. A submission received from the HSE in this regard, which includes proposals in relation to UHL, is currently under consideration by my Department.
74. Deputy Willie O'Dea asked the Minister for Health the reason more than 12,000 persons had been waiting over a year for an outpatient appointment in County Limerick hospitals in April 2018. [23551/18]
Amharc ar fhreagraI acknowledge that Outpatient waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.
The HSE service plan 2018 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 University of Limerick Hospitals Group are seeing 67% outpatients within 52 weeks.
Each year 3.3 million patients attend Hospital Outpatient clinics for appointments, with demand for services growing year-on-year. 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 timely and clinically appropriate matter.
In 2017, University of Limerick Hospitals Group had over 216,000 (216,812) Outpatient department attendances. However, over 35,000 patients did not attend their appointments last year.
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 ensuring 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 for outpatient initiatives.
75. Deputy Charlie McConalogue asked the Minister for Health if approval will be forthcoming for a request for additional funding of €1.8 million from Letterkenny University Hospital to enable it to open an additional 20 bed ward and staff it appropriately in order to address an issue with persons waiting on trolleys for hospital admission; and if he will make a statement on the matter. [23257/18]
Amharc ar fhreagraIn 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.
A submission in this regard from the HSE is currently under consideration by my Department, which includes proposals from Saolta Hospital Group in relation to opening additional capacity at Letterkenny University Hospital.
76. Deputy Lisa Chambers asked the Minister for Health the reason for the planned €2 million reduction in the Saolta Hospital Group’s expenditure in 2018. [23518/18]
Amharc ar fhreagraAs this is a service issue, I have asked the HSE to reply to you directly.
77. Deputy Mary Butler asked the Minister for Health the reason more than 15,309 persons had been waiting over a year for an outpatient appointment in University Hospital Waterford in April 2018. [23509/18]
Amharc ar fhreagraI acknowledge that Outpatient waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.
The HSE service plan 2018 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 Waterford University Hospital is seeing over 58% of outpatients within 52 weeks.
Each year 3.3 million patients attend Hospital Outpatient clinics for appointments, with demand for services growing year-on-year. 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 timely and clinically appropriate matter.
In 2017, Waterford University Hospital had over 147,000 (147,274) Outpatient Department attendances. However, over 20,000 patients did not attend their appointments last year.
Waterford University Hospital has advised that it is currently providing additional insourced clinics for those specialities with the longest waiting lists, including Urology, Rheumatology, Dermatology and ENT. It is expected that 300 additional patients will be seen in each of these services as a result of this initiative.
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 for outpatient initiatives.
78. Deputy Joan Collins asked the Minister for Health further to Parliamentary Question No. 221 of 1 May 2018, the reason for the inpatient day case action plan failure to provide the NTPF scheme to patients who are transferred from waiting lists in one hospital to another hospital; and if he will make a statement on the matter. [23234/18]
Amharc ar fhreagraOfficials of my Department have discussed the matters raised in this Question with the Deputy. A response will issue directly to the Deputy.
79. Deputy Thomas Byrne asked the Minister for Health the number of speech and language therapists and occupational therapists who have been recruited by the HSE in 2018; the sectors of the health service to which they have been deployed; and the net increase in the whole time equivalent numbers of each that has resulted from this recruitment. [23563/18]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy on this matter.
80. Deputy Marc MacSharry asked the Minister for Health the reason for the substantial increase in overcrowding in Sligo University Hospital emergency department over the first four months of 2018 relative to the same period in 2017. [23536/18]
Amharc ar fhreagraIn the context of a difficult winter for our health services, further compounded by Storm Emma, the first 4 months of the year saw a rise of 13.9% of patients on trolleys nationally, as compared to the same period in 2017. This reflects a rise in demand for unscheduled care across the hospital system, characterised by increased attendances and admissions, in particular, of those in the over 75 age group.
In relation to Sligo University Hospital, the first four months of the year saw a significant increase in trolley numbers, up 77.7%, on the same period last year. This was against a background of:
- a 3.5% rise in overall ED attendances;
- a 4.5% rise in ED attendances by those in the over 75 age group;
- a 2.6% rise in overall ED admissions; and
- a 5.7% increase in ED attendances by people in the over 75 age group
The combination of these factors, including increased admissions by those over the age of 75 who tend to have more complex needs and longer lengths of stay, contributed to the significant increase in trolley numbers experienced by Sligo University Hospital between January and April this year.
As Minister for Health, I am committed to continuing the effort to address overcrowding in our Emergency Departments and, in particular, the capacity of the system to respond during periods of peak demand. In this context, 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 2018/19. Proposals received from the HSE in this regard are currently under consideration by my Department.
81. Deputy Barry Cowen asked the Minister for Health the reason some 926 children and teenagers in counties Laois and Offaly had been waiting over a year for a first assessment for occupational therapy in March 2018. [23569/18]
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.
82. Deputy Joan Collins asked the Minister for Health the date on which the monitoring of the cost efficiencies in test strip usage begin; and if he will request the HTAG to bring forward the review of FreeStyle Libre to a maximum of six months from the date the monitoring began. [23228/18]
Amharc ar fhreagraAs the provision of these devices is a service matter, the HSE has been asked to respond directly to the Deputy on its monitoring of cost efficiencies.
One of the recommendations made by the Health Technology Assessment Expert Group was that data on costs incurred by patients using the device should be reviewed after a period of one year. I do not propose to request a change to this recommendation.
83. Deputy John Lahart asked the Minister for Health the reason more than 12,000 adults and children had been waiting over a year for an outpatient appointment in Tallaght in April 2018. [23520/18]
Amharc ar fhreagraI acknowledge that Outpatient waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.
The HSE service plan 2018 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 Tallaght University Hospital is seeing 64 % outpatients within 52 weeks.
Each year 3.3 million patients attend Hospital Outpatient clinics for appointments, with demand for services growing year-on-year. 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 timely and clinically appropriate matter.
In 2017, Tallaght University Hospital had over 121,000 (121,521) Outpatient Department attendances. However, over 20,000 patients did not attend their appointments last year.
Tallaght University Hospital has advised that it has undertaken a number of actions to address the issue of long outpatient appointment waiting times. This includes the a 'see and treat' initiative for same-day minor procedures and the recruitment of additional consultants in ENT, orthopaedics and neurology. The hospital further advises it is working closely with the Acute Hospital Division of the HSE and with the NTPF to identify additional resources required to assist a reduction in waiting lists, including a joint initiative with local GPs on new patient pathways.
In addition, 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 ensuring timely access to treatment and care for our patients. I hope to publish this Plan shortly.
84. Deputy Brendan Smith asked the Minister for Health the reason some 440 children and teenagers in counties Cavan and Monaghan had been waiting over a year for a first assessment for occupational therapy in March 2018. [23567/18]
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.
85. Deputy Aindrias Moynihan asked the Minister for Health if waiting lists for ophthalmology treatment in County Cork will be reduced; and if he will make a statement on the matter. [23463/18]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
86. Deputy John Brassil asked the Minister for Health if the extended waiting times for minors for orthodontic treatment in the CHO4 area will be addressed; if he will consider extending the private procurement measures in place to reduce wait times; and if he will make a statement on the matter. [23447/18]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
