Wednesday, 5 Dec 2018

Written Answers Nos. 101-125

Cancer Incidence

Ceisteanna (101)

Alan Kelly

Ceist:

101. Deputy Alan Kelly asked the Minister for Health the number of women who have been diagnosed with stage four cervical cancer in each of the years from 2015 to 2017, and to date in 2018. [50782/18]

Freagraí scríofa

Minister for Health

Based on data from the National Cancer Registry, the number of women who have been diagnosed with Stage IV cervical cancer in the Republic of Ireland in each of the years 2015 to 2017 is set out as follows:

Cancer Type	2015	2016	2017
Cervical (Stage IV)	31	29	37

These figures relate to the stage at the time of the patient’s initial diagnosis with cervical cancer, or within a window of up to 4 months after diagnosis date. While the figures are believed to be substantially complete, it is possible that a small number of late registrations of Stage IV cases may be added to the Registry files.

The National Cancer Registry advise that figures for 2018 are not yet available.

Health Services Staff Training

Ceisteanna (102)

Thomas Byrne

Ceist:

102. Deputy Thomas Byrne asked the Minister for Health the reason the request by the College of Psychiatrists of Ireland for a 10% increase in basic specialist training places for 2018 was rejected; and if he will make a statement on the matter. [50790/18]

Freagraí scríofa

Minister of State at the Department of Health

I have asked the HSE to respond directly to the Deputy on this matter.

Health Services Provision

Ceisteanna (103)

Bobby Aylward

Ceist:

103. Deputy Bobby Aylward asked the Minister for Health his plans to improve and enhance cardiac care services for those living in the south east; his views on whether there is an equal provision of cardiac services in this region when compared with the rest of the country; and if he will make a statement on the matter. [50874/18]

Freagraí scríofa

Minister for Health

An independent review in 2016 concluded that the needs of the effective catchment population of University Hospital Waterford could be accommodated from a single cath lab and recommended that the operating hours of the existing cath lab should be extended. Approval and funding has been provided for the additional staff required to facilitate this service expansion.

While the hospital group has experienced difficulties recruiting the necessary staff to facilitate the expansion in hours of operation, I am pleased to note that five staff have now been recruited on an 8am to 8pm working day basis. Documentation is also being finalised for the recruitment of a consultant cardiologist required to facilitate the provision of additional operating hours.

A mobile cath lab has been deployed at the hospital since October 2017 to conduct diagnostic cardiac procedures.

I have decided to proceed with the provision of a second cath lab in University Hospital Waterford in order to address waiting times at the hospital and to provide a better service for the people of Waterford and the South East. It is intended that the cost of progressing the project to design, planning and construction stages will be considered in the context of the HSE's Capital Plan for 2019.

The independent review in 2016 also recommended that the current 9 to 5 provision of emergency pPCI services should cease to allow the hospital focus on the much larger volume of planned work. I asked my Department to address the implications of this recommendation by undertaking a National Review of Specialist Cardiac Services. The aim of this Review is to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive by establishing the need for an optimal configuration of a national adult cardiac service.

As set out in the National Development Plan 2018-2027, investment in cardiac cath labs and other cardiac services infrastructure nationally will be informed by the outcome of the National Review, which is expected to be complete by June 2019.

Hospital Services

Ceisteanna (104)

Billy Kelleher

Ceist:

104. Deputy Billy Kelleher asked the Minister for Health the actions the HSE will take to enable the Mercy University Hospital regain accreditation for carrying out colonoscopies; and if he will make a statement on the matter. [50707/18]

Freagraí scríofa

Minister for Health

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

Question No. 105 answered with Question No. 66.

Home Help Service Provision

Ceisteanna (106, 125, 130, 250)

Niamh Smyth

Ceist:

106. Deputy Niamh Smyth asked the Minister for Health if he will address the waiting times for the provision of home help; and if he will make a statement on the matter. [50829/18]

Mick Wallace

Ceist:

125. Deputy Mick Wallace asked the Minister for Health his views on the discrepancies between the number of persons waiting for home care packages in different counties; and if he will make a statement on the matter. [50868/18]

Mick Wallace

Ceist:

130. Deputy Mick Wallace asked the Minister for Health the steps he plans to take to address the estimated deficit of 1.5 million hours in the provision of home care packages in 2018 and 2019 detailed in a report (details supplied). [50869/18]

Bernard Durkan

Ceist:

250. Deputy Bernard J. Durkan asked the Minister for Health the degree to which the number of home care packages can be increased in line with the demand; and if he will make a statement on the matter. [51217/18]

Freagraí scríofa

Minister of State at the Department of Health

I propose to take Questions Nos. 106, 125, 130 and 250 together.

As a Government, we have made improved access to home support services a key priority. Progress in this area is reflected in the additional funding made available in recent years with the home support budget growing from a base of €306 million in 2015 with expected expenditure of almost €420 million in 2018. Overall, the 2018 HSE National Service Plan provides for over 17 million home support hours to be delivered to 50,500 people at any time. In addition, a further 156,000 hours, relating to adverse weather funding, were provided from Spring 2018. Intensive Home Care Packages will be delivered to approximately 235 people at any time and will deliver approximately a further 360,000 hours in the full year. Despite this significant level of service provision, the demand for home support continues to grow. It is important to note that the allocation of funding for home supports across the system, though significant, is finite and services must therefore be delivered within the funding available.

In that context, we are keenly aware and acknowledge that in some cases access to the service may take longer than we would like. People who are on the waiting list for Home Support Services are reviewed, as funding becomes available, to ensure that individual cases continue to be dealt with on a priority basis within the available resources. Priority is determined by local front line staff who know and understand the clients’ needs, and who undertake regular reviews of those care needs to ensure that the services being provided remain appropriate. Waiting times will vary as some clients are dealt with as a priority depending on individual circumstances, risk assessment and urgency of services required, along with availability of capacity at any given time.

Following the recent Budget announcement, the HSE and officials from the Department of Health are in the process of developing and agreeing the HSE National Service Plan 2019, which will set out, in detail, the type and quantum of services to be delivered in 2019 including in relation to services for older people.While the existing home-care service is delivering crucial support to many people across the country, it needs to be improved to better meet the changing needs of our citizens. The Programme for a Partnership Government signals the Government’s intention to improve home care services and to introduce a uniform home-care service. At present the Department is engaged in a detailed process to develop plans for a new statutory scheme and system of regulation for home support services. The Sláintecare Implementation Strategy sets a target of 2021 for introduction of the new statutory scheme.

The new scheme will introduce clear rules in relation to the services for which individuals are eligible and in relation to how decisions are made on allocating services. For that reason, developing a new statutory scheme will be an important step in ensuring that the system operates in a consistent and fair manner for all those who need home support services. It will also help to improve access to the home support services that people need in an affordable and sustainable way. The system of regulation for home support will help to ensure that the public can be confident that the services provided are of a high standard.

While the new home support scheme is under development, the Department and HSE are continuing efforts to incrementally improve the existing home support services. The HSE has begun streamlining home care services by introducing a single funded home support service in 2018. This brings together the funding for home help and standard home care packages which now operates as a single home support service from 2018 onwards. This new approach is providing significant benefits including making the services easier to understand; streamlining the application and decision-making processes; and facilitating service users to move to changed levels of service as their assessed needs change, without the need for an additional application process.

Voluntary Sector Funding

Ceisteanna (107)

Catherine Connolly

Ceist:

107. Deputy Catherine Connolly asked the Minister for Health the reason he has not allocated funding to an organisation (details supplied) in view of the essential service it provides to persons with autism in Galway city and county; and if he will make a statement on the matter. [50613/18]

Freagraí scríofa

Minister of State at the Department of Health

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.

Disabilities Assessments

Ceisteanna (108)

Niamh Smyth

Ceist:

108. Deputy Niamh Smyth asked the Minister for Health the steps he is taking to address the backlogs and waiting lists for children who are waiting for assessments of needs; and if he will make a statement on the matter. [50830/18]

Freagraí scríofa

Minister of State at the Department of Health

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.

Hospital Waiting Lists

Ceisteanna (109)

Aindrias Moynihan

Ceist:

109. Deputy Aindrias Moynihan asked the Minister for Health the steps he is taking to address the waiting times experienced by women for gynaecological services in County Cork; and if he will make a statement on the matter. [50837/18]

Freagraí scríofa

Minister for Health

Reducing waiting times for health services is a priority and progress is being made. In Budget 2019 the Government has further increased funding to the National Treatment Purchase Fund (NTPF) from €55m in 2018 to €75m in 2019.

Data from the NTPF indicates that, at the end of October 2018 there were a total of 613 patients waiting for an inpatient or day case Gynaecology procedure in Cork University Maternity Hospital (CUMH) and South Infirmary Victoria University Hospital. The data shows that 82.5% (506) of these patients, were waiting less than 9 months. The waiting list has seen an increase of 8% compared to the same period last year.

The South-Southwest Hospital Group advise that CUMH have engaged in a number of initiatives to reduce waiting times, including working with the NTPF to provide extra theatre sessions to treat patients and reduce timelines. The Hospital Group plan to have no patient waiting more than 18 months for a gynaecology procedure by the end of the year at either CUMH or South Infirmary.

The Waiting List data for the end of October 2018 shows an outpatient gynaecology waiting list of 3,297 in County Cork, of whom 72.5% (2,392) are waiting 9 months or less. The waiting list has seen a reduction of over 19% compared to the same period last year. South-Southwest Hospital Group advise that CUMH are running additional OPD clinics to reduce waiting times for patients.

I recently met with the CEO’s of all hospital groups and requested that they develop innovative proposals to address the number of long waiters on outpatient lists in 2019.

In 2019, the NTPF and the HSE will continue to work closely with Hospital Groups, inviting proposals to improve access for patients waiting for either Inpatient/Daycase or Outpatient procedures.

Disabilities Assessments

Ceisteanna (110)

Thomas P. Broughan

Ceist:

110. Deputy Thomas P. Broughan asked the Minister for Health the number of assessments of needs under the Disability Act 2005 which are undertaken within the mandatory timeframe of within three months of application; the number of applications that are not commenced within the mandatory timeframe; the sanctions placed on the HSE for breaching its statutory requirements in this regard; and if he will make a statement on the matter. [50597/18]

Freagraí scríofa

Minister of State at the Department of Health

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.

National Treatment Purchase Fund

Ceisteanna (111)

Bernard Durkan

Ceist:

111. Deputy Bernard J. Durkan asked the Minister for Health the degree to which the treatment purchase scheme can be activated to alleviate overcrowding at hospital accident and emergency departments and waiting lists; and if he will make a statement on the matter. [50826/18]

Freagraí scríofa

Minister for Health

The potential role of the National Treatment Purchase Fund (NTPF) in relation to the provision of support for diagnostics for patients who present at Emergency Departments is one of a number of issues which is being considered by the HSE as part of the winter planning process.

The full details of the Winter Plan will be outlined when it is published by the HSE on 6 December.

Hospital Overcrowding

Ceisteanna (112)

Michael McGrath

Ceist:

112. Deputy Michael McGrath asked the Minister for Health the initiatives being taken to alleviate overcrowding in Cork University Hospital; and if he will make a statement on the matter. [50720/18]

Freagraí scríofa

Minister for Health

I acknowledge the distress overcrowded EDs cause to patients, their families, and frontline staff working in very challenging working conditions in hospitals throughout the country. This year has been characterised by high demand for unscheduled care, particularly among the over-75 age group, which was further exacerbated by Storm Emma and the extended influenza season earlier this year.

My Department has been working with the HSE throughout the year to ensure the most effective response to the pressures on our hospital system associated with the winter period. As part of this process, integrated Winter Preparedness Plans have been developed by Hospital Groups and Community Healthcare Organisations to meet the anticipated surge in demand for healthcare services during the winter months. The Plans are designed to optimise existing resources and encompass:

- planning and escalation;

- operational management of patient flow; and

- maintaining public health.

The Winter Plan, which was endorsed by the Emergency Department Task Force at its meeting on 26 November, is now in place and is due to be launched on the 6th of December. The Plan runs from 1 December 2018 until 31 March 2019 and includes a period of focused action from 17 December to 13 January targeting 9 sites of concern.

These sites have been identified on the basis of pressures experienced in previous winters and include Cork University Hospital.

A key component of the Plan, which is already underway, is the provision of an additional 550 home care packages over the winter period to help patients return home from hospital with the supports they need.

The Winter Plan will also seek to increase capacity and the Department of Health is currently in discussions with the HSE, in the context of the National Service Plan 2019, to identify the sites for investment and the associated number of beds, as part of an agreed capacity programme for 2019.

Hospital Car Parks

Ceisteanna (113, 127)

John Curran

Ceist:

113. Deputy John Curran asked the Minister for Health the timeline and the next steps to implement the findings of the review of hospital parking charges; and if he will make a statement on the matter. [50617/18]

Fiona O'Loughlin

Ceist:

127. Deputy Fiona O'Loughlin asked the Minister for Health the timeframe for changes to be made to parking charges in public hospitals. [50564/18]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 113 and 127 together.

Early this year I requested the HSE to undertake a review of car parking charges in public hospitals. The HSE established a review group with the aim of providing clear national guidance and principles for hospitals with regard to car parking.

I met with HSE officials in October to discuss the progress of this review. I understand that the HSE is considering the draft recommendations in the context of the development of its National Service Plan for 2019 and will submit the final report shortly.

Home Help Service Oversight

Ceisteanna (114)

Shane Cassells

Ceist:

114. Deputy Shane Cassells asked the Minister for Health the reason CHO 8 missed its target for home support hours during the first nine months of 2018; and if he will make a statement on the matter. [50788/18]

Freagraí scríofa

Minister of State at the Department of Health

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

Hospital Records

Ceisteanna (115)

Catherine Connolly

Ceist:

115. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 127 of 6 November 2018, if he is satisfied that Galway University Hospital has no system to record the number and cost of all external reviews or investigations of patient care at the hospital for each of the past ten years; the steps he will take to establish this information; and if he will make a statement on the matter. [50612/18]

Freagraí scríofa

Minister for Health

The Quality Assurance and Verification Division of the HSE was established in 2015 to monitor and report on the quality and safety of health and social care services. I have asked the HSE to refer the original question to the QAVD and to provide information to the Deputy directly.

Hospital Services

Ceisteanna (116)

Marc MacSharry

Ceist:

116. Deputy Marc MacSharry asked the Minister for Health when a permanent catheterisation laboratory will be in place at Sligo University Hospital; and if he will make a statement on the matter. [50794/18]

Freagraí scríofa

Minister for Health

The National Review of Specialist Cardiac Services is ongoing and it is expected that the work will be completed by the end of June 2019.

The aim of the Review is to achieve the optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive by establishing the need for an optimal configuration of a national adult cardiac service.

As set out in the National Development Plan 2018-2027, investment in cardiac catheterisation laboratories and other cardiac services infrastructure nationally will be informed by the outcome of the National Review.

Hospital Services

Ceisteanna (117)

Stephen Donnelly

Ceist:

117. Deputy Stephen S. Donnelly asked the Minister for Health when an outpatient action plan will be published; and if he will make a statement on the matter. [50796/18]

Freagraí scríofa

Minister for Health

Improving access to hospital treatment is a key priority for government. This year €55 million was allocated to the National Treatment Purchase Fund (NTPF) to provide treatment for patients.

This has been increased to a total of €75 million for 2019 and as a result of this additional funding, my Department is working closely with the NTPF and the HSE to finalise a Scheduled Care Access Plan for inpatients/day case and outpatients for 2019 before the end of this year.

Under the plan it is expected that the NTPF planned activity for Outpatient initiatives will quadruple from 10,000 first appointments in 2018 to 40,000 in 2019.

I recently met with the CEO's of all hospital groups and requested that they develop innovative proposals to address their outpatient lists in 2019.

In 2019, the NTPF and the HSE will continue to work closely with Hospital Groups, inviting proposals to improve access for patients waiting for either Inpatient/Daycase or Outpatient procedures.

Health Services Provision

Ceisteanna (118)

Robert Troy

Ceist:

118. Deputy Robert Troy asked the Minister for Health his plans to introduce a STI clinic in Athlone; and if he will make a statement on the matter. [50736/18]

Freagraí scríofa

Minister of State at the Department of Health

As the question relates to service matters, it has been referred to the Health Service Executive for direct reply to the Deputy.

Pharmacy Services

Ceisteanna (119)

John Brassil

Ceist:

119. Deputy John Brassil asked the Minister for Health his plans to help community pharmacists expand their services; and if he will make a statement on the matter. [50802/18]

Freagraí scríofa

Minister for Health

The Programme for Partnership Government is committed to expanding the role of community pharmacy, where this can provide better outcomes for public patients. However, any expansion of services should address unmet public health needs, improve access to existing public health services delivered elsewhere or provide better value for money or patient outcomes if delivered through pharmacy.

Work has been done in recent years on wider healthcare roles for pharmacies, including the Pharmaceutical Society of Ireland’s Future Pharmacy report, concerning expansion of professional pharmacy practice. It is clear from this and other work that there is also potential to increase the range of publicly funded health services delivered through community pharmacy.

Influenza vaccination and emergency contraception services have already been introduced. Other services, including in the areas of medicines management and treatment of minor ailments, will be considered in the context of available resources, the potential for health gain and Government priorities for the health service.

New public services in community pharmacy, if introduced, should improve health outcomes and provide value for money and benefits for patients. Any new or transferred services should be based on sound evidence with matching improvements in governance and administration.

HSE Agency Staff Data

Ceisteanna (120)

Jonathan O'Brien

Ceist:

120. Deputy Jonathan O'Brien asked the Minister for Health the number of agency staff employed in nursing posts in the southern hospitals group in 2018; the cost and number of hours worked; and if he will make a statement on the matter. [50872/18]

Freagraí scríofa

Minister for Health

I have asked the HSE to respond to you directly on this matter.

Primary Care Centres Provision

Ceisteanna (121)

Brian Stanley

Ceist:

121. Deputy Brian Stanley asked the Minister for Health the plans in place for primary care centres in County Laois to accommodate the growing population in the county. [50832/18]

Freagraí scríofa

Minister for Health

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Hospitals Building Programme

Ceisteanna (122)

Eamon Scanlon

Ceist:

122. Deputy Eamon Scanlon asked the Minister for Health when work will commence on the construction of a 27 bed psychiatric unit in County Sligo; and if he will make a statement on the matter. [50734/18]

Freagraí scríofa

Minister of State at the Department of Health

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

Medicinal Products Expenditure

Ceisteanna (123)

John Brassil

Ceist:

123. Deputy John Brassil asked the Minister for Health the action he is taking to make savings on the drugs budget by increasing the use of biosimilar; and if he will make a statement on the matter. [50801/18]

Freagraí scríofa

Minister for Health

My Department and the HSE are engaging in a number of initiatives which will endeavour to lead to better access to medicines for patients, value for the taxpayer and the cost-effective provision of medicines in Ireland.

A public consultation on a National Biosimilar Medicines Policy was undertaken by the Department of Health in Q4 2017. The responses to the consultation and other possible policy levers are being considered by the Department with a view to developing a National Biosimilar Medicines Policy, which will require the involvement of stakeholders across the health service.

At an operational level, the HSE's Acute Hospitals Drugs Management Programme has a biosimilar strategy in place since 2017 which is making considerable progress using a collaborative approach led by hospital pharmacists with clinical teams to bring about changes in prescribing practice.

Disability Support Services

Ceisteanna (124)

Maureen O'Sullivan

Ceist:

124. Deputy Maureen O'Sullivan asked the Minister for Health if his attention has been drawn to a report (details supplied); and if he will consider the concerns raised by the not-for-profit sector that carries out vital work for persons with disabilities. [50828/18]

Freagraí scríofa

Minister of State at the Department of Health

I am aware of the recent publication of the Report, referred to by the Deputy. I facilitated a request to meet with Rehab and I am considering the contents of the Report.

Question No. 125 answered with Question No. 106.