Brian Stanley
Ceist:43. Deputy Brian Stanley asked the Minister for Health if a facilitator in respect of the consultation process on the future of Portlaoise hospital has been appointed. [50833/18]
Amharc ar fhreagraHospital Services
Ceisteanna (43)
Freagraí scríofa
I am committed to securing and further developing the role of the Midland Regional Hospital Portlaoise as a constituent hospital within the Dublin Midlands Hospital Group. Since 2014, the focus has been on supporting the hospital to develop and enhance management capability, implementing changes required to address clinical service deficiencies, and incorporating the hospital into the governance structures within the Dublin Midlands Hospital Group.
Significant work has been undertaken to strengthen and stabilise current arrangements for services at the hospital to ensure that services that are not sustainable are discontinued and those that are, are safety assured and adequately resourced. Funding has increased by 35% relative to the 2012 budget and staffing levels have risen by 32% from the 2014 base. Governance and management arrangements in Portlaoise Hospital have been strengthened, additional clinical staff have been appointed and staff training, hospital culture and communications have improved.
As I have outlined previously, no decision has been made yet on the draft Action Plan for Portlaoise Hospital. I committed to ensuring that local clinicians and the community would be consulted with before a decision is made. I have decided that a comprehensive consultation exercise should be undertaken by the HSE, with an external facilitator, with the key stakeholder groups involved in the Portlaoise Hospital. The consultation will involve key stakeholders and local community representatives and provide an opportunity to listen to and address the issues and concerns the stakeholders have highlighted. The consultation will also provide an opportunity to set out clearly the immediate priorities for service development and improvement in the hospital.
I intend to appoint an independent external facilitator for the consultation process in the coming weeks. The outcome of the consultation process will be a submission from my Department, setting out the key findings from the consultation process and recommended response to inform me in making a final decision on the draft Action Plan.
Child and Adolescent Mental Health Services
Ceisteanna (44)
Pat Buckley
Ceist:44. Deputy Pat Buckley asked the Minister for Health the waiting times for CAMHS in CHO 4 in counties Cork and Kerry. [50601/18]
Amharc ar fhreagraFreagraí scríofa
Developing all aspects of our Mental Health services, including Child and Adolescent services (CAMHS) remains a priority for Government. The recent Budget provided an additional €55 million to progress new developments in mental health, which brings overall HSE mental health funding to nearly €1 billion in 2019.
There are now 70 CAMHS teams, and 3 Paediatric Liaison Teams. Around 18,500 CAMHS referrals are expected in 2018, with around 14,500 to be seen by this specialist service. Cases assessed by professionals as being urgent are seen as a matter of priority.
There are 76 CAMHS In–patient beds in 4 Acute Units nationally, with plans for additional provision in the new children’s hospital, and in the new National Forensic Mental Health facility now being built at Portrane.
The Cork/Kerry Community Healthcare area (CHO 4) has just over 168,000 young people under the age of 18, which is in line with the national average of 25% of the overall population. CAMHS referrals nationally have increased by over 20% since 2012, reflected also in the Cork/Kerry region.
The total number of children on CAMHS Waiting List nationally was 2,453 at the end of September last. The HSE has prioritised reducing CAMHS waiting lists, particularly those over 12 months, which was 313 in September. Within this broader context, there were 656 on the CHO4 CAMHS waiting list in September, with 174 waiting longer than 12 months. The latter decreased to 162 in October, representing a 30% reduction in those waiting to be seen over one year since January 2018.
All aspects of CAMHS nationally are being improved by the HSE under its annual Service Plans, including the Cork/Kerry region. This includes better out-of-hours and 7/7 day cover, progression of Day Hospital care, developing specialist teams such as Eating Disorders, and improved Prevention and Early Intervention services.
The development of a new mental health telephone line, a signposting tool and other digital on-line supports for those accessing information about mental health is being developed by the HSE. A key objective for me is that the potential of using such new technology, to augment existing CAMHS services with new delivery approaches, will be introduced as quickly as possible. A particular focus will be geographic areas of greatest service pressure, such as Cork/Kerry.
I have had various meetings in recent times with the HSE about CAMHS Waiting Lists in CHO4, with a view to filling vacancies within CAMHS teams, improving access for young people and reducing waiting lists. I will continue to closely monitor the position in Cork/Kerry to realise further improvements over 2019.
Disabilities Assessments
Ceisteanna (45)
Bríd Smith
Ceist:45. Deputy Bríd Smith asked the Minister for Health if his attention has been drawn to the fact that parents of children who are in one community healthcare organisation or CHO area with regard to gaining access to assessments of needs lose their place in the queue if they move home and are placed in a different CHO area; and if, in view of the housing crisis, the way in which access to these services is impacted by such a move, which is often forced on parents, will be examined. [50773/18]
Amharc ar fhreagraFreagraí scríofa
A standard pathway is in place for all children applying for Assessment of Need. The pathway involves three stages:
1. The Initial Planning Stage is often referred to as the desktop assessment: It is carried out by the assessment officer, who will clarify with clinical assessors the specific aim and purpose of assessing the child, and the team/assessors will identify what is required to give a picture of each particular child's service needs;
2. The Assessment of Need itself: Where assessors interact with the child using formal and/or informal assessments either jointly or individually to form an opinion of the child's strengths and needs; and
3. Compilation of the report: Where all assessors involved in the assessment of need process share outcomes and agree joint recommendations and goals.
If during the Assessment of Need process, a child moves to a new geographical area then their Assessment of Need application will transfer to a different assessment officer and if the assessment has commenced Stage 2 i.e. after the referral for clinical services has been initiated, then the move will most likely require referral to services in his/her new catchment area under a different team of clinical assessors. It is important to note that while a child’s position on the Assessment of Need database will not change, the processing of assessments may take longer in some parts of the country than others and so a delay may be experienced.
The Government is committed to improving waiting times for Assessment of Need and therapy services. Funding for an additional 100 therapy posts was secured as part of Budget 2019. These additional posts, along with the wider reconfiguration of services and other innovative approaches will have a significant positive impact on waiting times over the course of the next year.
Ambulance Service
Ceisteanna (46)
Pat Casey
Ceist:46. Deputy Pat Casey asked the Minister for Health the status of the review of ambulance services in Arklow and west County Wicklow; and if he will make a statement on the matter. [50730/18]
Amharc ar fhreagraFreagraí scríofa
There is no specific review of ambulance services in Arklow and West County Wicklow planned at present. The National Ambulance Service continues to monitor its services provided to the public in order to ensure a safe, efficient and timely response to requests for assistance.
Current rostering arrangements of ambulance services in County Wicklow were adjusted in 2012 following a Labour Court Recommendation in which the National Ambulance Service and the Trade Unions representing ambulance staff were instructed to remove overtime generating inefficiencies. This culminated in a number of adjustments to rostering arrangements at a number of ambulance stations around the country. I am pleased to inform you that the resulting changes have increased overall resource availability across the North Leinster Area, in particular Dublin, Kildare and Wicklow which provides for dynamic cover to be applied to areas or to respond to incidents as they arise.
The National Ambulance Service is increasingly moving to a policy of dynamic deployment. This ensures that vehicles are strategically located where they are most likely to be required, rather than located at a particular station. In line with this policy, and using the Advanced Medical Priority Dispatch System to triage calls, County Wicklow is also supported by other National Ambulance Service bases in Loughlinstown, Gorey, Naas and Athy. An additional Advanced Paramedic rapid response vehicle was introduced in Newcastle. Co Wicklow around 2015 to further support resources in the area.
Dynamic deployment of resources is just one aspect of a significant process of modernisation of the National Ambulance Service in recent years and is being accompanied by a multi-annual reform programme of investment in new developments, increased manpower and fleet and improved technology. Over recent years, year on year, additional investment has been directed towards the National Ambulance Service. This year, an additional sum of €10.7m has been made available which includes €2.75m to fund new developments.
Emergency Departments Services
Ceisteanna (47)
John McGuinness
Ceist:47. Deputy John McGuinness asked the Minister for Health if St. Luke’s Hospital, Kilkenny, will be provided with 24-7 emergency medicine consultant cover; and if he will make a statement on the matter. [50793/18]
Amharc ar fhreagraFreagraí scríofa
I have been informed by the HSE that St Luke's Hospital, Kilkenny has two Consultants in Emergency Medicine and that the hospital provides a 24/7 consultant service in all emergency specialty areas.
There has been significant investment in recent years in St. Luke's Hospital in developing the Acute Floor which encompasses the Emergency Department, the Acute Medical Assessment Unit and the Acute Surgical Assessment Unit. This state of the art facility, in the new wing of the hospital is more spacious, affords patients much more privacy and dignity and is a safer environment for staff to care for the increasing number of patients. St. Luke's Hospital, Kilkenny is a pilot site for the roll-out of the Acute Floor Programme. As part of the Ireland East Hospital Group, a number of initiatives to improve emergency services for patients have been introduced in the hospital including the Geriatric Emergency Medicine Service which ensures that a comprehensive geriatric assessment is carried out on all frail older persons over 75 years of age as soon as possible after they present to the Acute Floor.
This year has been characterised by high demand for unscheduled care, particularly among the over-75 age group. Total ED attendances at St. Luke's Hospital, Kilkenny have increased by 3.1% (+1,042), to end October 2018 as compared with the same period in 2017. However, the emergency patient flow has improved at the hospital with a significant reduction of 36.8% (- 1,426) in patients waiting on trolleys at 8 a.m. between January 2018 and October 2018, as compared with the same period in 2017.
Question No. 48 answered orally.
Home Care Packages Administration
Ceisteanna (49)
Brendan Smith
Ceist:49. Deputy Brendan Smith asked the Minister for Health the reason CHO 1 missed its target for home support hours during the first nine months of 2018; and if he will make a statement on the matter. [50698/18]
Amharc ar fhreagraFreagraí scríofa
The Home Support Service is a core service for older people and is highly valued by service users, their families and by the HSE. It provides supports which assist older people to live independently in their own homes for longer and enables large numbers of people to return home following acute hospital admission who otherwise would remain in hospital or would be admitted to long stay residential care.
In 2018 the HSE began streamlining home care services by introducing a single funded home support service. 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.
Performance activity across the country is on target, however there is some variation across the Community Healthcare Organisations. It should be noted as clients become more dependent, the need for non-core hours increases as more hours are required on Sunday or bank holidays. These hours cost more than core hours and can impact on activity levels.
At the end of September CHO 1 was about 8.5% below its planned target, providing approximately 1.23 million home support hours against a target of 1.35 million hours. While performance activity is currently below target for CHO 1 the HSE has advised that it expects that activity levels will be closer to the target by year end subject to remaining within the funding allocated.
Suicide Incidence
Ceisteanna (50)
Fiona O'Loughlin
Ceist:50. Deputy Fiona O'Loughlin asked the Minister for Health the action he will take in view of the recent finding that Ireland has the highest suicide rate for female children in the EU; and if he will make a statement on the matter. [50714/18]
Amharc ar fhreagraFreagraí scríofa
The claim that Ireland has the highest suicide rate of child suicide for girls in the European Union was made in a report by the National Women’s Council of Ireland, which was launched on 6 November last.
On the day the report was launched, officials in my Department contacted the National Office for Suicide Prevention in light of the associated media coverage. The NOSP confirmed the data is incorrect and that it relates to outdated information from WHO European comparison data on suicide rates. The data used is based on 3-year averages for the years 2009 to 2011.
The most recent comparisons between Ireland and the EU, obtained from Eurostat – the European Commission databank, are from 2015. That year Ireland was ranked as 10th lowest out of 33 countries for both men and women. Regrettably, this statistic was not reflected in the 15-19 age bracket, as Ireland ranked 7th highest among our European counterparts.
Tackling suicide is a priority for the Government. For this reason, a Cross Sectoral Steering Group was established to implement Connecting for Life - Ireland’s National Strategy to Reduce Suicide, which runs from 2015 to 2020. The National Office for Suicide Prevention is part of the HSE office, within the Mental Health Division, and was specifically established to coordinate suicide prevention efforts around the country and to implement Connecting for Life. To support NOSP, funding increased from €3.7 million in 2010 to the current level of €12 million. An additional €2.75m was provided in 2015 for additional Resource Officers for Suicide Prevention and for priority actions under Connecting for Life.
The work of NOSP has helped to reduce the number of suicides in Ireland from 495 in 2010 to 392 in 2017. It must be noted that the 2017 figures are provisional and by their nature are subject to change, so should be interpreted with caution at this time.
NOSP efforts in suicide prevention include training programmes such as safeTALK and ASSIST. In addition, the Little Things campaign focuses on measures we can all do to protect our own mental health, and to support the people we care about.
The Deputy can rest assured that I, in conjunction with the Department of Health and the HSE, will continue to enhance policies and services to minimise the incidence of suicide in Ireland.