Written Answers Nos. 401-422
403. Deputy Brendan Smith asked the Minister for Health the measures he plans to implement to deal with the imminent shortage of general practitioners, particularly in rural practices; and if he will make a statement on the matter. [27907/18]
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 3,668 as at 18 May 2018 and the number of GPs contracted by the HSE under the GMS scheme has also risen from 2,098 in 2008 to 2,497 as of 1 June 2018.
The Government is aware of the manpower issues facing general practice and has taken steps to increase the number of General Practice training places accordingly.
In 2009, there were 120 General Practice training places available and this year we expect to fill 194 training places, an increase of around 60% over a nine year period. 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.
We will continue to work to improve the recruitment and retention in general practice in the coming years. Our objective is to achieve further increases in the number of GP training places in future years, and to ensure that all the available places are filled, in order to meet the future manpower needs of general practice.
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. 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.
Officials from my Department and the HSE met with the Irish Medical Organisation on 9 May to set out the State's position in relation to the GMS contract and to progress this important issue. The Department also wrote to the Irish Medical Organisation on 14 May to set out the proposals made at that meeting in writing and is currently awaiting the Organisation's official response.
404. Deputy Brendan Smith asked the Minister for Health the measures he plans to implement to ensure there is adequate general practitioner cover in counties Cavan and Monaghan in view of forthcoming retirements by general practitioners; and if he will make a statement on the matter. [27908/18]
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 3,668 as at 18 May 2018 and the number of GPs contracted by the HSE under the GMS scheme has also risen from 2,098 in 2008 to 2,497 as of 1 June 2018.
The Government is committed to increasing GP capacity to ensure that patients across the country continue to have access to GP services and that general practice is sustainable in all areas into the future. Efforts undertaken in recent years to increase the number of practising 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, as well as the introduction of enhanced supports for rural GP practices.
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 GP training places and this year we expect to fill 194 places, an increase of around 60% over a nine year period. 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. We will continue to work to improve the recruitment and retention in general practice in the coming years. Our objective is to achieve further increases in the number of GP training places in future years, and to ensure that all the available places are filled, in order to meet the future manpower needs of general practice.
The Government is also committed to engaging with General Practitioner representatives on necessary service improvements and contractual reforms to the current GMS contract. 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.
Officials from my Department and the HSE met with the Irish Medical Organisation on 9 May to set out the State's position in relation to the GMS contract and to progress this important issue. The Department also wrote to the Irish Medical Organisation on 14 May to set out the proposals made at that meeting in writing and is currently awaiting the Organisation's official response.
In relation to forthcoming GP retirements in Cavan and Monaghan, as this is a service matter I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
405. Deputy James Browne asked the Minister for Health the number of times the Minister of State, Deputy Jim Daly, has met officially with a person (details supplied) since their appointment; the date and location of each meeting; and if he will make a statement on the matter. [27919/18]
Amharc ar fhreagraThere have been two official meetings between the Minister of State for Mental Health and the person the Deputy referred to in his capacity as chairman of the Mental Health Commission.
Minister McEntee met him on the 20 January 2017 in the Mental Health Commission offices in Waterloo Road and Minister Daly met him on the 18 September 2017 in Hawkins House.
The Minister was also due to meet with the Commission on 14 June 2018 however the meeting had to be postponed due to official business and he is now due to meet with the group in September as this time will maximise availability of the members.
406. Deputy John Curran asked the Minister for Health the steps he is taking to avoid outbreaks of measles here; the further steps he is taking to avoid vaccine complacency and to increase the uptake of the measles, mumps, and rubella, MMR, vaccine in view of the recent outbreak of measles in many European countries and the rate of uptake of the MMR vaccine here remaining at 92%; and if he will make a statement on the matter. [27922/18]
Amharc ar fhreagraMeasles is an acute and serious infection caused by the measles virus. Measles is highly infectious. It is a notifiable disease (under Infectious Disease legislation) and all cases are reported to Departments of Public Health for investigation and risk assessment.
Measles is transmitted through direct contact with an infected person or through the air when the infected person coughs or sneezes. The incubation period (the time from exposure to the virus until the first symptoms develop) is typically 10-12 days. From exposure to rash onset averages 14 days (7-18 days). Complications include a severe cough and breathing difficulties (croup), ear infections (1 in 20), viral and bacterial lung infections (pneumonia), and eye infections (conjunctivitis). Most of the complications are caused by secondary bacterial infections, which can be treated with antibiotics. More serious problems involve the nervous system and are rarer. Severe disease and complications are most likely in infants under 12 months, those with weakened immune systems, and the malnourished.
All children, teenagers and young adults should be up to date with MMR vaccination. MMR was first introduced in 1988, all people born since then should have received two doses of MMR. Any child, teenager or adult who missed getting the MMR vaccines according to national immunisation schedule (first dose at 12 months and 2nd dose at 4-5 years of age) should contact their GP and ask about the vaccine. The HSE is working hard in those areas of the country where MMR uptake is low and is also targeting marginalised groups where uptake of all vaccines has traditionally been low.
Awareness has been raised about the on-going risk of measles in the community among health care staff, as cases, if more occur, are likely to present to health care settings. For hospitals and health care facilities, it is important that there is an immediate triage and isolation of all suspect cases presenting to the facility as this can help prevent spread in the facility.
Due to increased MMR vaccination uptake in Ireland in the past decade measles has become relatively rare in recent years. In 2015 there were 6 measles cases, the lowest annual number reported since 1948 and a significant decrease on the previous year. Since then the number of cases reported has increased due to a number outbreaks associated with imported cases in people who had not been vaccinated. The Weekly Infectious Disease Report for week 24-2018 (10/6/18-16/6/18), published by the HSE-Health Protection Surveillance Centre on 20 June 2018, indicates that 63 cases of measles have been notified so far in 2018. The bulk of these are associated with an outbreak in the Mid-West, with linked cases elsewhere.
The HSE is taking actions to control this outbreak. An Outbreak Control Team meets weekly to investigate and control the spread of this potentially serious illness. The HSE Departments of Public Health in areas where cases are identified are investigating and implementing control and communication measures with local GPs, and hospitals and in the community. The response has emphasised increasing uptake of the MMR vaccine which is the best method of preventing additional cases of measles.
407. Deputy John Curran asked the Minister for Health the reason for the increases in the number of older persons waiting for home supports; and if he will make a statement on the matter. [27927/18]
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.
408. Deputy John Curran asked the Minister for Health the number of home support carers recruited by the Health Service Executive, HSE in each of the years 2015 to 2017 and to date in 2018; and if he will make a statement on the matter. [27928/18]
Amharc ar fhreagraI have asked the HSE to respond to the Deputy directly on this question.
409. Deputy Aengus Ó Snodaigh asked the Minister for Health the status of the outcome of a review into the additional care needs of a person (details supplied); the reason since receiving a reply from his Department on 17 October 2017 no further progress has been made in assessing his or her care needs; and the reason there has been a delay of eight months in deciding if he or she is entitled to additional care supports. [27929/18]
Amharc ar fhreagraFollowing receipt of a report from the Health Service Executive (HSE) regarding the individual's additional care needs, a reply issued to the family from my office in February, 2018. I have arranged for a copy of the February reply to be forwarded to the Deputy.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the HSE for a direct reply to the Deputy.
410. Deputy Fiona O'Loughlin asked the Minister for Health if there are car park subsidies for persons in receipt of social welfare payments and attending hospitals to visit a sick relative. [27930/18]
Amharc ar fhreagra411. Deputy Fiona O'Loughlin asked the Minister for Health if there are car park subsidies for persons attending regular hospital appointments. [27931/18]
Amharc ar fhreagra412. Deputy Fiona O'Loughlin asked the Minister for Health if there are car park subsidies for persons whose loved ones are in hospital long term. [27932/18]
Amharc ar fhreagraI propose to take Questions Nos. 410 to 412, inclusive, together.
I am advised that hospitals which charge parking fees are cognisant of the financial implications parking costs can have on patients and their families, particularly those with long-term illnesses. Some hospitals have introduced a maximum daily fixed parking charge, thus capping this expense. I understand that some hospitals also provide reduced rate parking for long-term patients and visitors for whom the payment of the full rate would cause hardship.
In March, I requested the HSE to carry out a review of hospital car parking charges, with the aim of establishing clear national guidelines in this area. The review will involve a wide range of stakeholders and will take account of the views of patient advocacy groups, the income generated by charges and the impact of any reduction in car parking income on hospital services. This review is ongoing and the HSE has advised it expects it to be completed in August.
413. Deputy Fiona O'Loughlin asked the Minister for Health if he is satisfied with the level of mental health supports that are in place for persons with eating disorders; and if he will make a statement on the matter. [27933/18]
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.
414. Deputy Fiona O'Loughlin asked the Minister for Health if he is satisfied with the level of mental health supports that are in place for persons with anxiety disorders; and if he will make a statement on the matter. [27934/18]
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.
415. Deputy Fiona O'Loughlin asked the Minister for Health if he is satisfied with the level of mental health supports that are in place for persons with suicidal ideations; and if he will make a statement on the matter. [27935/18]
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.
416. Deputy Fiona O'Loughlin asked the Minister for Health his plans to address the lack of a dedicated community neurorehabilitation team in counties Laois and Offaly. [27936/18]
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 a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
417. Deputy Fiona O'Loughlin asked the Minister for Health when he expects the practice of admitting children and young persons to adult mental health units to cease. [27937/18]
Amharc ar fhreagraThe reduction in the numbers of children admitted to adult psychiatric units has been a priority for the HSE Mental Health Services over recent years.
The HSE has to allow for some operational flexibility surrounding emergency placements in Adult Units, particularly where very short-term placements take place. Full account is taken of all relevant factors such as the preferences of all those involved, and geographical factors relating to access or visiting. In this context, the HSE continues to closely monitor on a weekly basis all child admissions to adult units, with a view to minimising such admissions as much as possible.
I, and my Department officials, regularly meet with the HSE to review various mental health issues including the enhancement of age-appropriate care for young people nationally, as additional mental health resources comes on-stream. Relevant data is regularly published on the HSE website, and this is subject to monitoring by the Department of Health.
Bearing in mind all the circumstances, I am satisfied that, where children have to be placed short-term in adult mental health units, the HSE makes any special arrangements necessary, such as one-to-one care, to protect and monitor these young people. The Mental Health Commission is also notified of such admissions.
The Deputy may be aware that I am currently considering proposed legislative amendments in relation to this issue and I will continue to work closely with all concerned on these proposals.
418. Deputy James Browne asked the Minister for Health if he is satisfied with the differing public health standards here, in contrast to Northern Ireland, in which a procurement model will purchase quadrivalent winter influenza vaccinations for persons under 65 years of age including persons at risk, pregnant women and healthcare workers for the 2018 to 2019 flu season; and if he will make a statement on the matter. [27938/18]
Amharc ar fhreagra419. Deputy James Browne asked the Minister for Health the reason his Department is unwilling to adopt a new procurement approach to ensure that persons here are optimally protected from the most potent influenza viruses; and if he will make a statement on the matter. [27939/18]
Amharc ar fhreagra420. Deputy James Browne asked the Minister for Health the reason his Department will not procure a quadrivalent vaccination for the forthcoming winter influenza season in view of evidence that over 50% of hospitalisations from influenza arose from the B strain Yamagata, which will not be included in the trivalent vaccine procured for the 2018 to 2019 influenza season; and if he will make a statement on the matter. [27940/18]
Amharc ar fhreagra421. Deputy James Browne asked the Minister for Health his views on the World Health Organisation, WHO, published recommended composition of influenza virus vaccines for use in the 2018 to 2019 northern hemisphere influenza season, which recommends the strains to be contained within both quadrivalent and trivalent influenza vaccines; if he will request the Health Service Executive, HSE to follow this guidance; and if he will make a statement on the matter. [27941/18]
Amharc ar fhreagra422. Deputy James Browne asked the Minister for Health his views on the rise in hospitalisations and deaths from influenza this season; his plans to make a provision to prevent the same occurrence during the 2018 to 2019 flu season; and if he will make a statement on the matter. [27942/18]
Amharc ar fhreagraI propose to take Questions Nos. 418 to 422, inclusive, together.
The Flu vaccine purchased by HSE is based on WHO advice on the composition of influenza virus vaccines for use in the northern hemisphere Flu season. The WHO issued advice on 22 February 2018, recommended that quadrivalent vaccines for use in the 2018-2019 northern hemisphere influenza season contain the following:
- an A/Michigan/45/2015 (H1N1)pdm09-like virus;
- an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus;
- a B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage); and
- a B/Phuket/3073/2013-like virus (B/Yamagata/16/88 lineage).
It is recommended that the influenza B virus component of trivalent vaccines for use in the 2018-2019 northern hemisphere influenza season be a B/Colorado/06/2017-like virus of the B/Victoria/2/87-lineage.
The HSE National Immunisation Office and HSE Procurement are responsible for the purchase of influenza vaccine. To ensure vaccine supply, this tender process must be completed 9 months in advance of the first delivery into Ireland at the end of August. The HSE has already completed and awarded the tender for the supply of trivalent inactivated seasonal influenza vaccine for 2018/19 at a cost of €3.2- 4 million (depending on whether contingency doses are procured). The trivalent vaccine used in Ireland is the most widely used influenza vaccine in Europe.
Every winter the HSE develops a Flu Plan aimed at reducing the incidence of influenza in the general population and on preparing the health services to deal with increased activity resulting from increased influenza rate. Last winter the primary focus was on increasing vaccination rates among healthcare workers and at risk groups. The additional measures put in place last winter included:
- A national flu planning steering group which meets weekly is in place.
- A flu lead was put in place in each Public Health Department, who liaised with CHO and Hospital Group flu planning groups.
- There was digital advertising and promotions target at risk groups, the over 65s, pregnant women and healthcare workers.
- Each HG and associated CHO produced a Winter Plan which includes a specific section on Flu.
- The Flu Medication Protocol was revised.
The HSE also put in place additional measures to ensure it was in a position to identify and react to any significant increase in health service demands. These included:
- The National Flu Planning Group continues to meet every Friday.
- The SDU continues to liaise daily with HGs.
- Additional measures were activated when the ILI rate exceeded the baseline figures which fed into the Winter Initiative Planning and include cascading of information to HGs, CHOs and GPs concerning the use of anti-virals, respiratory hygiene, rescheduling of elective surgery and the activation of discharge plans.
These measures mitigated the impact of the sustained higher influenza rates on the health services last winter.
