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Wednesday, 5 Dec 2018

Written Answers Nos. 126-143

Hospital Overcrowding

Ceisteanna (126)

Maurice Quinlivan

Ceist:

126. Deputy Maurice Quinlivan asked the Minister for Health his plans to address the overcrowding in University Hospital Limerick; and if he will make a statement on the matter. [50831/18]

Amharc ar fhreagra

Freagraí scríofa

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 University Hospital Limerick.

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.

Question No. 127 answered with Question No. 113.

Cancer Screening Programmes

Ceisteanna (128)

Bríd Smith

Ceist:

128. Deputy Bríd Smith asked the Minister for Health the number of the 221 cases of false negatives given to women under the CervicalCheck screening programme by laboratory. [50771/18]

Amharc ar fhreagra

Freagraí scríofa

As has previously been advised to the Deputy, the HSE has advised that analysis is required in order to make the requested data available. Noting that the Deputy has requested, in effect, that the unanalysed data be provided, the interpretation of such data would not be clear. The requirement for analysis reflects the complexities involved. For example, some women may have had multiple smears, not necessarily read in the same lab; slides may have changed by one grade or multiple grades which is a complexity that would not be shown by a simple breakdown across labs; labs dealt with different regional populations; in the early years of the programme, it was dealing with an unscreened population which is a further complexity. Following significant efforts on the part of the HSE, appropriate expertise has been identified to ensure that the necessary analysis can be done and the HSE has advised that it expects the information sought by the Deputy to be available by the end of the year.

Voluntary Sector Funding

Ceisteanna (129)

Éamon Ó Cuív

Ceist:

129. Deputy Éamon Ó Cuív asked the Minister for Health the funding he plans to make available to voluntary organisations operating in the western region to provide back-up to families who have a member who is autistic; and if he will make a statement on the matter. [50867/18]

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. 130 answered with Question No. 106.

Substance Misuse

Ceisteanna (131)

Gino Kenny

Ceist:

131. Deputy Gino Kenny asked the Minister for Health if his attention has been drawn to the crisis level of opioid addiction and death by overdose in the United States of America according to data from the Centres for Disease Control and Prevention (details supplied); if his attention has been further drawn to its increasing misuse here; if a specific public health campaign on management of the use and misuse of fentanyl has been put in place; and if he will make a statement on the matter. [50599/18]

Amharc ar fhreagra

Freagraí scríofa

The OECD Health Committee has been developing a comparative analysis of international strategies to address and prevent problematic opioid use, and their effectiveness in reducing or preventing opioid-related harm. Officials from the Department of Health have been engaging with international agencies in order to improve responses to this worrying trend that has resulted in the loss of many lives.

Since 2012, the EU Early Warning System, which includes Ireland, has received an increasing number of reports in relation to fentanyl analogues and the harms caused by them. However, I am pleased to inform the deputy that the situation here in Ireland is very different from what is being experienced in the United States of America and other parts of the world.

Drug trends in Ireland are monitored by the HSE, the HRB and An Garda Síochána. Fentanyl has not been documented as an issue since 2015/16. In 2016 the HSE issued an alert in relation to 5 fentanyl-related deaths and a small number of hospitalisations. The latest drug-related deaths data from the HRB reports that fentanyls were implicated in 7 deaths in 2015. Forensic Science Ireland toxicology service identified 3 fentanyls and analogues in 2016.

I have been informed that neither the HSE nor An Garda Síochána are aware of an increase in the misuse of fentanyls here and the Garda Drugs and Organised Crime Bureau have not recorded any seizures of fentanyls recently. For these reasons, and in the absence of clear evidence of an increase in fentanyl use, it is not proposed to undertake a public health campaign that focuses on fentanyls specifically.

Nursing Staff

Ceisteanna (132)

Louise O'Reilly

Ceist:

132. Deputy Louise O'Reilly asked the Minister for Health the reason the health service has not published a funded workforce plan for nursing and midwifery for 2018; if a plan will be forthcoming in 2018; if there has been progress on a 2019 plan; and if he will make a statement on the matter. [50780/18]

Amharc ar fhreagra

Freagraí scríofa

The Nursing Recruitment and Retention Agreement was agreed between the parties in 2017. This agreement provided for a funded workforce plan for 2017 and for funded workforce plans to be developed for subsequent years. Progress was made by the HSE in relation to recruitment in 2017, with the number of nurses and midwives increasing by 942 WTEs (including student nurses). This meant that 77% of the target of the 1,224 WTEs set out in the funded workforce plan for 2017 was met. I understand that a draft workforce plan was shared with the nursing union in June 2018 but it has not been agreed as yet. It should be noted that recruitment of nurses has continued throughout 2018, notwithstanding the absence of an agreed plan. Recruitment of all staff within the HSE, including nurses and midwives, must be on an affordable basis. Planning for all recruitment, including nurses and midwives, is being developed in the context of the HSE’s National Service Plan 2019 which is at an advanced stage of drafting.

Health Services Staff Remuneration

Ceisteanna (133)

Louise O'Reilly

Ceist:

133. Deputy Louise O'Reilly asked the Minister for Health if he will engage with organisations (details supplied) to try to avert industrial action caused by the continuing recruitment and retention crisis, understaffing and safety in the health service; and if he will make a statement on the matter. [50779/18]

Amharc ar fhreagra

Freagraí scríofa

The Public Service Stability Agreement is delivering wage increases of 6.4% to 7.2% over 2018-2020 and is weighted toward the lowest paid. On top of the pay increases provided under the PSSA, in September agreement was reached with staff interests on proposals relating to the so-called “new entrant pay” issue. This would deliver an average of an additional €3,000 over the coming years starting in March next year to over 60,000 post-2011 new entrants, including 10,000 nurses. In addition, the Public Service Pay Commission recommended a 20% increase in the Location and Qualification Allowances for nurses and midwives and accelerated promotion for nurses to the senior staff nurse level. Subject to acceptance, these measures will be implemented from March 2019 at a cost of €20m per annum.

Both the INMO and the PNA have rejected these pay proposals. However, the pursuit of cost increasing pay claims and engagement in industrial action are both specifically excluded under the terms of the Public Service Pay and Stability Agreement (PSSA 2018 – 2020) – a collective agreement which the INMO and the PNA currently subscribe to. Concession of a pay claim for nursing and midwifery grades, which has been costed at up to €300m p.a., would compromise public pay and budgetary policy and would also generate follow on claims from the rest of the public service workforce.

Notwithstanding their rejection of these proposals, officials from my Department and the HSE have continued to engage with both of these unions and have tried to clarify their issues. I understand that the parties have also been invited to attend the National Oversight Body and I am hopeful this will help to progress matters.

Hospital Admissions

Ceisteanna (134)

John Lahart

Ceist:

134. Deputy John Lahart asked the Minister for Health his views on the finding in the patient experience survey that just 23% of respondents in Tallaght Hospital said they were admitted to a ward within six hours of arriving at the emergency department; and if he will make a statement on the matter. [50696/18]

Amharc ar fhreagra

Freagraí scríofa

According to the National Patient Experience Survey which was published recently, 84% of respondents said they had a very good or good experience in our hospitals. The results regarding the confidence and trust, as well as the dignity and respect patients experience while in hospital, were also encouraging.

It is a matter of concern, however, that in the case of Tallaght University Hospital, just 23% of respondents said they were admitted to a ward within six hours of arriving at the emergency department (ED). Moreover, as of the end of September 2018, 42.5% of people attending at Tallaght University Hospital ED were discharged or admitted within six hours of registration. This compares to 64.6% nationally and falls short of the target of 75% in the HSE's National Service Plan.

While hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged over the winter months, it is regrettable that any patient, and especially older patients, should have to wait for admission to a hospital ward.

The 2018/19 Winter Plan, which runs from 1 December 2018 to 31 March 2019, is now in place and is due to be launched by the HSE on the 6th of December. The Plan includes a period of focused action from 17 December 2018 to 13 January 2019 targeting nine key hospital sites of concern, including Tallaght University Hospital, identified on the basis of pressures experienced in previous winters. A priority of the Plan is ensuring that the values of Patient Dignity and Respect are upheld at all times, especially at times of overcrowding.

Voluntary Sector Remuneration

Ceisteanna (135)

Martin Heydon

Ceist:

135. Deputy Martin Heydon asked the Minister for Health the timeline for a review of the 2015 CEO banding exercise that follows the review of salary levels for CEOs of section 38 funded agencies completed in 2015 as it relates to an organisation (details supplied) in County Kildare; and if he will make a statement on the matter. [43893/18]

Amharc ar fhreagra

Freagraí scríofa

I am aware that the organisation referred to by the Deputy has had difficulties in attracting a replacement Chief Executive Officer. Discussions are taking place between officials from my Department and the Department of Public Expenditure and Reform with a view to deciding whether the salary bands for certain Section 38 funded agencies require adjustment in the context of such difficulties.

I will keep the Deputy informed of developments.

Question No. 136 answered with Question No. 61.

Hospital Services

Ceisteanna (137)

Bernard Durkan

Ceist:

137. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he remains satisfied with the adequacy of the public hospital bed complement and that relevant staff are available throughout the public health sector to meet the challenges of the coming winter; and if he will make a statement on the matter. [50825/18]

Amharc ar fhreagra

Freagraí scríofa

As Minister for Health, I recognise that hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged over the winter months. It is against this background that the Health Service Capacity Review recommended an increase in acute hospitals beds of over 2,600 by 2031 to support the projected increase in demand for services in the years ahead.

Furthermore, as many hospitals are running at over 95% bed occupancy rates, the Review indicated that an additional 1,260 beds in the system would be required to bring occupancy rates down to 85% in line with international norms. Increasing capacity is therefore a Government priority. Over the past 12 months, an additional 240 beds have been opened and a further 78 additional beds are planned for early 2019.

The Winter Plan, which was endorsed by the Emergency Department Task Force at its meeting on 26 November, is due to be published on 6 December. The Winter Plan will also seek to increase capacity and my Department is 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.

In terms of winter preparedness, Hospital Groups and Community Healthcare Organisations were asked by the HSE in June 2018 to develop robust and integrated winter plans at site, group and community levels. These integrated Plans, which have been reviewed by the HSE, underpin the 2018/19 Winter Plan and address preparedness under the headings of Planning and Escalation, Operational Management of Patient Flow and Maintaining Public Health. Planning and escalation encompasses integrated cross-divisional activity plans for winter months and includes staffing capacity plans and rosters.

Hospital Services

Ceisteanna (138)

Joe Carey

Ceist:

138. Deputy Joe Carey asked the Minister for Health the status of the provision of a new ear, nose and throat service for persons in the mid-west region at Ennis General Hospital; and if he will make a statement on the matter. [50609/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service issue, I have asked the HSE to reply to you directly.

Emergency Departments Data

Ceisteanna (139)

Peter Fitzpatrick

Ceist:

139. Deputy Peter Fitzpatrick asked the Minister for Health the number of attendances at Our Lady of Lourdes Hospital accident and emergency department to date in 2018; and if he will make a statement on the matter. [50592/18]

Amharc ar fhreagra

Freagraí scríofa

The most up to date validated data in relation to attendances is to the end of October 2018.

Up to the end of October 2018, total ED attendances at Our Lady of Lourdes Hospital were 51,571, up 3.1% compared with the same period in 2017.

ED admissions were 15,791, up 3.5% compared with the same period in 2017.

For those over 75, ED attendances were 5,245, up 8.6% compared with the same period in 2017 and ED admissions were 3,321, up 11.4% compared with the same period in 2017.

Between January and October 2018, the number of patients recorded as waiting on trolleys at 8 a.m. in Our Lady of Lourdes Hospital ED was 1,996, a decease of 32.2% compared with the same period in 2017 (2,943).

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.

HSE Properties

Ceisteanna (140)

Joan Burton

Ceist:

140. Deputy Joan Burton asked the Minister for Health the impact on the national development plan of recent disclosures of serious problems in respect of publicly contracted building projects including health facilities; the amount of extra funding required to repair buildings; the impact of same on the overall spend on the national development plan; if he plans an additional Supplementary Estimate to meet the extra cost; if not, if the costs will come from savings; and if so, the source from which they will come. [49203/18]

Amharc ar fhreagra

Freagraí scríofa

Western Building Systems has undertaken work for the Health Service Executive over the last ten years at eleven HSE owned buildings. Further to an assessment of all eleven buildings it was found that there were no fire safety or structural issues arising and therefore the Health Service Executive determined that no further action is required.

Health Strategies

Ceisteanna (141)

Barry Cowen

Ceist:

141. Deputy Barry Cowen asked the Minister for Health the status of the implementation of the trauma strategy; and if he will make a statement on the matter. [50787/18]

Amharc ar fhreagra

Freagraí scríofa

The report of the Trauma Steering Group was approved by Government in February 2018. It recommends the establishment of an inclusive trauma system and sets out key recommendations for the organisation of trauma care and the provision of patient-centred trauma services. Implementation of the National Trauma Strategy is part of the wider Sláintecare Implementation Strategy.

An interim implementation group has been established by the HSE, as recommended in the report, and is progressing four immediate actions (orthopaedic bypass protocols, selection of the Major Trauma Centre in Dublin, recruitment of a National Clinical Lead for Trauma Services and detailed implementation planning).

Funding has been provided for the recruitment of a National Clinical Lead for Trauma Services and the establishment of a National Trauma Office in the HSE. Bypass protocols have been developed by the National Ambulance Service and roll out of the bypass protocols has commenced. The process for the selection of the Major Trauma Centre in Dublin is expected to commence in early 2019.

Emergency Departments Services

Ceisteanna (142)

Stephen Donnelly

Ceist:

142. Deputy Stephen S. Donnelly asked the Minister for Health the additional resources in terms of additional staff and beds required for emergency departments to meet the six hour target for admission; and if he will make a statement on the matter. [50797/18]

Amharc ar fhreagra

Freagraí scríofa

As Minister for Health, I fully recognise that hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged over the winter months.

The Health Service Capacity Review baseline forecast is for a sharp rise in the capacity needed across all sectors by 2031 to meet the projected demand for services in the years ahead. This includes an additional 7,150 extra hospital beds in public hospitals by 2031. Of course, investment without reform will not deliver the health service we aspire to. Health and well being initiatives, recalibration towards community care, especially for older people and productivity improvements are the three key aspects of a reformed health system. Full implementation of all three reforms would alter the capacity needed across all sectors by 2031 and would reduce the additional acute capacity required to 2,600 extra hospital beds.

Furthermore, the Health Service Capacity Review outlined that many hospitals are running at over 95% bed occupancy rates and an additional 1,260 beds in the system would be required to reduce occupancy rates to 85%. The review, drawing on international evidence indicates that high bed occupancy is associated with a number of adverse factors including reduced efficiency in patient flow. Improved efficiency in patient flow is one of the key reforms identified in the Capacity Review that will lead to improved patient experience times in our hospital Emergency Departments.

The National Development Plan provides for a major increase of 2,600 in bed capacity in the next 10 years and increasing bed capacity will remain a priority in 2019. Over the past 12 months, an additional 240 beds have been opened and the 2019 National Service Plan will include the details on the sites for investment and the associated number of beds, as part of an agreed capacity programme for 2019. This process is subject to financial, operational, human resource and policy considerations and priorities.

Question No. 143 answered with Question No. 81.
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