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Thursday, 14 Jun 2018

Written Answers Nos. 149-173

Services for People with Disabilities

Ceisteanna (149)

James Lawless

Ceist:

149. Deputy James Lawless asked the Minister for Health when an assessment of need will be carried out for a person (details supplied); and if he will make a statement on the matter. [25976/18]

Amharc ar fhreagra

Freagraí scríofa

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Question No. 150 answered with Question No. 148.

Hospital Services

Ceisteanna (151)

Éamon Ó Cuív

Ceist:

151. Deputy Éamon Ó Cuív asked the Minister for Health when an operation will be provided for a person (details supplied); the reason for the delay in issuing a date for the procedure; if the person can undergo the procedure on the treatment purchase fund scheme or in another way; and if he will make a statement on the matter. [25983/18]

Amharc ar fhreagra

Freagraí scríofa

Reducing waiting time for patients for hospital operations and procedures is a key priority for the Government.

The recently launched Inpatient/Day Case Action Plan outlines the combined impact of HSE and National Treatment Purchase Fund (NTPF) activity in 2018. The Action Plan places a particular focus on cataract surgery and includes a commitment that the NTPF will provide 5,000 cataract procedures to patients. In addition, the NTPF commits to offer treatment to all clinically suitable patients waiting more than 9 months for a cataract procedure.

This year, in line with the Action Plan, the HSE is planning to open a dedicated Cataract theatre in Nenagh Hospital in July.

The NTPF authorises public hospitals to offer outsourced treatment to clinically suitable long waiting patients who are on an inpatient/day case waiting list for surgery. These patients would have been referred on to such a list following clinical assessment by a consultant/specialist at an outpatient clinic. The NTPF advise that they cannot discuss details of individual patients. NTPF authorisations are made in respect of the longest waiting patients first.

The patient may be eligible for treatment under the Cross Border Directive (CBD). The HSE provides information for patients on the CBD on its website which can be accessed at http://www.hse.ie/eng/services/list/1/schemes and also by phone at 056 7784551.

In respect to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Audiology Services Provision

Ceisteanna (152, 153, 154)

Lisa Chambers

Ceist:

152. Deputy Lisa Chambers asked the Minister for Health his plans to help the children affected by the recent review of paediatric audiology services in counties Mayo and Roscommon; and if he will make a statement on the matter. [25989/18]

Amharc ar fhreagra

Lisa Chambers

Ceist:

153. Deputy Lisa Chambers asked the Minister for Health the length of time the children affected by the recent review of paediatric audiology services in counties Mayo and Roscommon will be waiting for follow up appointments; and if he will make a statement on the matter. [25990/18]

Amharc ar fhreagra

Lisa Chambers

Ceist:

154. Deputy Lisa Chambers asked the Minister for Health the location in which the children affected by the recent review of paediatric audiology services in counties Mayo and Roscommon will have their follow-up appointments; and if he will make a statement on the matter. [25991/18]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 152 to 154, inclusive, together.

The HSE's Report of the look-back Review of Audiology Services in Mayo and Roscommon has been finalised and was sent to families on 8 June 2018. The final Report and accompanying communication includes an apology from the HSE for the failures identified and for the anxiety that this has caused to families and those who may have been harmed. It also includes an invitation to the parents of children affected to meet with a HSE senior manager and a senior audiologist to discuss the finding of the Report and to be updated on their child's care.

The HSE has confirmed that all 49 children who needed follow-up as a result of the look-back process are either currently receiving or have already received the appropriate care they need. The HSE has been asked to contact the Deputy directly with regard to the location of any future follow-up appointments.

The look-back report represents a thorough analysis of the quality of service delivery in the area against the standards for such services that were set out in the National Audiology Review Group Report (2011). Since 2011, the recommendations of this Report, including clinical governance and quality assurance processes, have been the benchmark for the quality of service delivery throughout the country.

It is appropriate that our health service strives continually to improve the quality of the services it provides and promotes a culture of learning where shortcomings are identified. My priority in relation to the families and children who have been impacted by the findings of this look-back is that the HSE takes swift action, including the provision of appropriate care, and I am satisfied that this has been done in this case.

Hospital Services

Ceisteanna (155)

Joan Collins

Ceist:

155. Deputy Joan Collins asked the Minister for Health the location in which persons can access the 2018 waiting list action plan for scoliosis; and when it will be publicised [26005/18]

Amharc ar fhreagra

Freagraí scríofa

The CEO of the Children's Hospital Group has advised that the publication of the Paediatric Orthopaedic Action Plan 2018 is scheduled for early July 2018.

Medical Records

Ceisteanna (156)

Michael McGrath

Ceist:

156. Deputy Michael McGrath asked the Minister for Health the number of individual medical files that have been requested from the HSE or the national cervical cancer screening programme in connection with the work of the national cervical screening programme; the number of complete files that have been provided to the patient or their representative in each of the years 2015 to 2017 and to date in 2018, in tabular form; and if he will make a statement on the matter. [26016/18]

Amharc ar fhreagra

Freagraí scríofa

The Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to him.

Medical Records

Ceisteanna (157)

Michael McGrath

Ceist:

157. Deputy Michael McGrath asked the Minister for Health the number of individual medical files that have been requested from the HSE or the national bowel cancer screening programme in connection with the work of the national bowel screening programme; the number of complete files that have been provided to the patient or their representative in each of the years 2015 to 2017 and to date in 2018, in tabular form; and if he will make a statement on the matter. [26017/18]

Amharc ar fhreagra

Freagraí scríofa

The Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to him.

Medical Records

Ceisteanna (158)

Michael McGrath

Ceist:

158. Deputy Michael McGrath asked the Minister for Health the number of individual medical files that have been requested from the HSE or the BreastCheck programme in connection with the work of the BreastCheck programme; the number of complete files that have been provided to the patient or their representative in each of the years 2015 to 2017 and to date in 2018, in tabular form; and if he will make a statement on the matter. [26018/18]

Amharc ar fhreagra

Freagraí scríofa

The Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to him.

Respite Care Services Provision

Ceisteanna (159)

Brendan Smith

Ceist:

159. Deputy Brendan Smith asked the Minister for Health if services will be restored to cover a geographic area (details supplied); and if he will make a statement on the matter. [26021/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Hospital Consultant Contracts

Ceisteanna (160)

Michael McGrath

Ceist:

160. Deputy Michael McGrath asked the Minister for Health the role his Department played in the sanctioning of the use of private investigators to monitor the work of hospital consultants in the context of a current pay claim; the nature and extent of the surveillance; the duration and number of consultants involved; the other Departments or State agencies involved in the decision to undertake such surveillance; the role of the HSE in the matter; if the HSE approved the method; and if he will make a statement on the matter. [26023/18]

Amharc ar fhreagra

Freagraí scríofa

This issue relates specifically to a case currently before the courts and as such, it would not be appropriate to comment at this time.

Physiotherapy Provision

Ceisteanna (161)

Róisín Shortall

Ceist:

161. Deputy Róisín Shortall asked the Minister for Health the waiting times for a physiotherapist appointment in Dublin 9; when a person (details supplied) will be seen by a physiotherapist; and if he will make a statement on the matter. [26025/18]

Amharc ar fhreagra

Freagraí scríofa

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.

Infectious Diseases

Ceisteanna (162)

Eamon Scanlon

Ceist:

162. Deputy Eamon Scanlon asked the Minister for Health his plans to follow the example of the Canadian government and implement guidelines (details supplied); and if he will make a statement on the matter. [26032/18]

Amharc ar fhreagra

Freagraí scríofa

Lyme disease (also known as Lyme borelliosis) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi. The infection is generally mild affecting only the skin but can occasionally be more severe and highly debilitating. Lyme Disease is the commonest cause of tick-borne infection in Europe.

Lyme borelliosis is diagnosed by medical history and physical examination. The infection is confirmed by blood tests which look for antibodies to Borrelia burgdorferi 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 approach to Lyme diagnostics is a two-stage approach and involves using a sensitive enzyme immunoassay (EIA) as an initial, screening step. Screening EIAs can be insufficiently specific, giving false-positive reactions in the presence of other spirochaete infections including syphilis, and certain viral infections including glandular fever. In addition, sera from patients with autoimmune disorders and other inflammatory conditions can also lead to false-positive results. 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 (RIPL) Service of Public Health England Porton which uses a two-tier system recommended by American and European authorities. This involves a screening serological test followed by a confirmatory serological test. All clinical (and other) laboratories must undergo continuous quality assurance to ensure that the quality of the diagnostics they provide is maintained at the highest international level for human diagnostics. This two tier approach gives a great degree of certainty around the diagnosis of Lyme.

Lyme disease can be very successfully treated using common antibiotics. 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. In Ireland, treatment by most clinicians is based on that laid out in evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis published by the Infectious Diseases Society of America (IDSA) in 2006.

The Health Protection Surveillance Centre of the HSE (HPSC) is responsible for the surveillance of notifiable infectious diseases such as Lyme Disease. The Scientific Advisory Committee (SAC) of the HPSC has established a Lyme Borreliosis Sub-Committee, the aim of which is to develop strategies to undertake primary prevention in order to minimise the harm caused by Lyme Borreliosis in Ireland. In addition to staff from the HPSC, the membership of the Sub-Committee includes specialists in Public Health Medicine, Consultants in Infectious Diseases, Clinical Microbiology, Occupational Health an Entomologist from the Parks and Wildlife Service, a representative from the Local Government Management Agency, an Environmental Health Officer and a representative from Tick Talk Ireland. The Subcommittee report on 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.

Following the establishment of the Lyme Borreliosis Subcommittee, a thorough review was performed to ensure existing material was fully up to date, comprehensible and appropriately presented to assist members of the public to obtain the necessary knowledge to protect their and their family’s health. In addition, material to support clinicians (primarily GPs) in identifying Lyme disease was also developed.

The members of the Subcommittee identified the need to accurately describe and map laboratory practice relating to Borrelia diagnostics in Ireland. HPSC undertook a Borrelia Burgdorferi laboratory Survey in 2016, and following development and analysis, the survey was published in Epi-Insight in 2017. The following are the additional resources that have subsequently been identified, and developed by the Subcommittee, and are now hosted on the HPSC website:

- Laboratory testing for Lyme Disease: FAQs for general public

- Borrelia burgdorferi diagnostic methods in Ireland: microbiology laboratory survey (2016) – this laboratory survey, had a 75% response rate. All the major laboratories participated, and all laboratories participating were accredited to the important ISO 15189 standard. The full results were published in Epi-Insight (August 2017)

- Erythema Migrans Diagnostic Support Tool

- Erythema migrans image slide set

- Map of Lyme neuroborreliosis in Ireland, 2012-2016 cumulative incidence

During the preparation of the Final Report, the HPSC learned that National Institute for Health and Care Excellence (NICE) in the UK were undertaking a systematic review of Lyme disease. This process resulted in the NICE Lyme disease guideline. This guideline is based on the most exhaustive systematic review yet undertaken, of the evidence around Lyme disease and focused on producing recommendations based on best available evidence relating to awareness raising, and on the diagnosis and management of Lyme disease. We delayed the final production of the report, to enable us to undertake a review of the final NICE Lyme Guideline which was finally published in mid-April 2018.

Since then the guideline and the associated evidence and papers has been reviewed, to determine if there were any aspects of this review that would be of relevance or possibly require mention/inclusion in the Subcommittee’s Final Report. This was important as a significant element of the Guideline relates to the evidence around raising awareness of Lyme disease. This review indicated that the approach that we had been undertaking, both in HPSC before the establishment of the Subcommittee, and subsequent to the Subcommittee coming into being, was very much in line with that recommended by NICE. Where appropriate, reference will be made in the Final Report to the NICE Guideline.

The report is in the final stages of preparation it is planned to circulate to the members of the Lyme Subcommittee with a view to having a final sign-off meeting of the Subcommittee in late June or early July. Following this the report will be sent for consideration to the SAC (the Lyme Group is a Subcommittee of HPSC’s SAC), with a view to then being sent out for consultation. It would be inappropriate to consider changes to the testing or treatment and management of the condition until the report has been finalised and published.

Hospice Services Provision

Ceisteanna (163)

Michael Healy-Rae

Ceist:

163. Deputy Michael Healy-Rae asked the Minister for Health the status of an application for a hospital bed by a person (details supplied); and if he will make a statement on the matter. [26038/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter it has been referred to the HSE for direct reply to the Deputy.

Nursing Homes Support Scheme Review

Ceisteanna (164)

John McGuinness

Ceist:

164. Deputy John McGuinness asked the Minister for Health the status of the review of the fair deal scheme as it is applied to farms; and if he will make a statement on the matter. [26046/18]

Amharc ar fhreagra

Freagraí scríofa

A review of the Nursing Homes Support Scheme (NHSS) was published in July 2015. Arising out of the review, a recommendation was made to examine the treatment of business and farm assets for the purposes of the financial assessment element of the scheme. The Programme for a Partnership Government also committed to reviewing the NHSS to remove any discrimination against small businesses and family farms.

At present, the capital value of an individual's principal private residence is only included in the financial assessment for the first three years of their time in care. This is known as the three year cap. This cap does not apply to productive assets such as farms and businesses except in cases of sudden illness or disability where specific conditions are met.

It is proposed to amend the scheme to treat farm and business assets in the same manner as the principal private residence where a family successor commits to working the farm or business, i.e. to cap contributions at three years.

The Department of Health has been examining the potential for changes to the treatment of business and farm assets under the Nursing Homes Support Scheme. Any changes to the scheme, if approved by Government, will require amendment of the Nursing Homes Support Scheme Act 2009.

A Memorandum for Government setting out the details of the proposed policy change and seeking Government approval to draft the General Scheme of a bill to amend the Nursing Homes Support Scheme Act 2009 has been circulated to other Government Departments for observations.

Departmental Agencies Staff Remuneration

Ceisteanna (165)

Jan O'Sullivan

Ceist:

165. Deputy Jan O'Sullivan asked the Minister for Health if there has been progress on the payment of increments to section 39 funded organisations; the status of same; and if he will make a statement on the matter. [26060/18]

Amharc ar fhreagra

Freagraí scríofa

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, a data gathering exercise was conducted. Following discussions with the Trade Unions on a draft of the report, the HSE has submitted their completed interim report to my Department on 11 June 2018. This reports covers a sample of 50 agencies identified in the WRC agreement. The Department of Health will consider the findings of the report and commence discussions with the Department of Public Expenditure and Reform as required.

Health Services Reform

Ceisteanna (166)

Róisín Shortall

Ceist:

166. Deputy Róisín Shortall asked the Minister for Health his plans regarding the full implementation of Sláintecare; the reason for the delay in its implementation; when a response (details supplied) will issue to the Cabinet; the status of the recruitment of a lead executive to head up the implementation office; and when both of these actions will be expedited. [26128/18]

Amharc ar fhreagra

Freagraí scríofa

The successful delivery of the ambitious reform plans envisaged in the Sláintecare report will be a significant undertaking and needs to be translated into a detailed and phased programme of work to be delivered over a ten year timeframe. In this regard, my Department is currently finalising an implementation plan in response to the Sláintecare report, with a focus on the initial three year period. It is my intention to bring proposals to Government in the next few weeks and to publish the implementation plan shortly thereafter. While I accept that this is later than originally envisaged, it is important that we get it right.

I have already acted on several of the specific recommendations proposed in the Sláintecare report. A Sláintecare Programme Office is being established in the Department of Health. This office will be tasked with implementing a programme of reform, as agreed by Government, arising from the Sláintecare Report. The process for the appointment of an Executive Director to lead the Sláintecare Programme Office has been managed independently by the Public Appointments Service. It is anticipated that an appointment will be made shortly.

An independent board for the HSE is being established as recommended in the Sláintecare report. The General Scheme of a Bill has been published and it is hoped that legislation will be enacted this year.

The Sláintecare Report recommended the removal of private practice from public hospitals. I have established an Independent Review Group to examine how private practice can be removed from public hospitals. It will report later this year.

A public consultation on the geographical alignment of Hospital Groups and Community Healthcare Organisations has recently been completed and will inform work on broader health service structural reform as recommended in the Sláintecare report.

Finally, the Government has demonstrated significant commitment to invest in our health and social care services since the publication of the Sláintecare report. Funding for new initiatives in Budget 2018 were closely aligned with proposals in Sláintecare. These new initiatives included investing €25 million a new Primary Care fund, additional funding of €25 million allocated for home care and transition beds, €17 million to reduce medicine and prescription charges, €75 million targeted to reduce waiting list and €1 million for the Sláintecare Programme Office.

As I have stated previously, The Sláintecare report represents a significant milestone in our political and health policy history. It is the first time in the history of the State that cross-party consensus of this scale has been achieved on health policy and I welcome this. I intend to harness the consensus generated by the Report to move forward with a significant 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.

Hospital Beds Data

Ceisteanna (167)

Róisín Shortall

Ceist:

167. Deputy Róisín Shortall asked the Minister for Health the number of drug and alcohol detox beds by location; if they are public or private beds; the number that are for alcohol, drug or drug and alcohol detox; the waiting list for each category by each location in tabular form; and if he will make a statement on the matter. [26133/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Home Care Packages Provision

Ceisteanna (168)

Róisín Shortall

Ceist:

168. Deputy Róisín Shortall asked the Minister for Health the average cost of providing a home care package for each CHO area; the number of home care packages provided within each CHO; the number of persons waiting for home care package allocation within each CHO area in tabular form; and if he will make a statement on the matter. [26136/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Physiotherapy Provision

Ceisteanna (169)

Bernard Durkan

Ceist:

169. Deputy Bernard J. Durkan asked the Minister for Health the extent to which a physiotherapy programme and rehabilitation can be offered in the case of a person (details supplied); and if he will make a statement on the matter. [26141/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to you directly, as soon as possible.

Medical Card Delays

Ceisteanna (170)

Bernard Durkan

Ceist:

170. Deputy Bernard J. Durkan asked the Minister for Health the reason a full medical card has not issued in the case of a person (details supplied); and if he will make a statement on the matter. [26146/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the HSE to respond to the Deputy directly.

Home Care Packages Provision

Ceisteanna (171)

Bernard Durkan

Ceist:

171. Deputy Bernard J. Durkan asked the Minister for Health when a homecare package will be provided in the case of a person (details supplied); and if he will make a statement on the matter. [26147/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Medical Card Delays

Ceisteanna (172)

Bernard Durkan

Ceist:

172. Deputy Bernard J. Durkan asked the Minister for Health when a medical card will issue in the case of a person (details supplied); and if he will make a statement on the matter. [26148/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the HSE to respond to the Deputy directly.

Medical Card Delays

Ceisteanna (173)

Bernard Durkan

Ceist:

173. Deputy Bernard J. Durkan asked the Minister for Health when a medical card will issue in the case of persons (details supplied); and if he will make a statement on the matter. [26153/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the HSE to respond to the Deputy directly.

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