Written Answers Nos. 164-185
164. Deputy Micheál Martin asked the Minister for Health if his attention has been drawn to difficulties in providing inpatient services for women with breast cancer in CUMH due to constant overcrowding; if there are undue delays for women; the way in which this is being assessed and dealt with; and if he will make a statement on the matter. [52265/18]
Amharc ar fhreagra165. Deputy Micheál Martin asked the Minister for Health his views on the recent letter that concerned staff in the breast care unit wrote to management to outline access problems and capital funding deficiencies for diagnostic equipment together with other issues; and if he will make a statement on the matter. [52266/18]
Amharc ar fhreagraI propose to take Questions Nos. 164 and 165 together.
I am advised that the Breast Multi-Disciplinary Team in Cork University Hospital (CUH) raised issues with management in the hospital in regard to services for breast cancer patients there.
I understand that one of the main points brought up by the clinicians refers to inappropriate referrals to the Symptomatic Breast Disease Clinics. This issue is being addressed nationally and the National Cancer Control Programme (NCCP) has established a Clinical Guidelines Group. The NCCP is also working directly with GPs to better streamline breast cancer referrals to acute hospitals to avoid unnecessary referrals.
Dedicated CT slots have been allocated recently to breast cancer patients in CUH to streamline patient pathways. An amount of €0.75m has also been invested in replacement mammography equipment in the hospital and this is of major benefit in addressing cancer diagnosis.
A review of Rapid Access Clinics (including Symptomatic Breast Disease Clinics) was carried out by the National Cancer Control Programme (NCCP) in 2016. The review recommendations are being implemented at designated cancer centres to ensure the provision of quality, timely services to breast cancer patients. The performance of Rapid Access Clinics are also monitored on an on-going basis and steps will continue to be taken to address any issues that arise.
Requests for further increases in resources for personnel and equipment in CUH will be considered in the context of available resources in 2019.
166. Deputy Mattie McGrath asked the Minister for Health the status of palliative care services three year development framework 2017 to 2019; and if he will make a statement on the matter. [52267/18]
Amharc ar fhreagraNational policy on palliative care is contained within the 2001 Report of the National Advisory Committee on Palliative Care. While the quality and vision of the Report means it is still relevant today, it is recognised that the landscape of palliative care has changed in the intervening years, and it became apparent there was a need to identify measures to address the current needs of people accessing palliative care services.
As a response to current needs, the Palliative Care Services Three Year Development Framework was launched in November 2017. The objective of the Framework is to inform and direct the development of adult palliative care services, both generalist and specialist, in Ireland for a three year period. This is against the backdrop of an ageing population in Ireland, coupled with increasing numbers of deaths from cancer, dementia, and neurodegenerative disease, with an associated palliative care need.
The Framework’s focus is to identify the gaps that exist in the current level of adult palliative care service provision and to present a set of recommendations and actions which, over the duration of the Framework's lifetime, would seek to address these service issues and deficits, subject to available resources.
The Framework was commissioned by the HSE, with support from the Department of Health. As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy with an update on the status of implementation of the Framework as soon as possible.
167. Deputy Mattie McGrath asked the Minister for Health the reason St. Brigid’s Hospital, Carrick-on-Suir, County Tipperary is not included in the five year plan for refurbishment and upgrading; and if he will make a statement on the matter. [52268/18]
Amharc ar fhreagraAs the Health Service Executive is responsible for the delivery of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
168. Deputy James Lawless asked the Minister for Health his plans for the dental service operating in the health centre in Maynooth, County Kildare; if there are plans to relocate this service in the near future; and if he will make a statement on the matter. [52272/18]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
169. Deputy Bernard J. Durkan asked the Minister for Health if home supports are in place for a person (details supplied); and if he will make a statement on the matter. [52274/18]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
170. Deputy Thomas P. Broughan asked the Minister for Health when he plans to publish the health and social care professionals (amendment) Bill; and if he will make a statement on the matter. [52278/18]
Amharc ar fhreagraThe Health and Social Care Professionals (Amendment) Bill as published was initiated in the Seanad on 27 September 2018. The Bill completed its passage through the Seanad on 7 November 2018 and is scheduled for debate in the Dáil commencing Tuesday 11 December 2018.
171. Deputy Eugene Murphy asked the Minister for Health if home care hours will be provided to a person (details supplied). [52283/18]
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.
172. Deputy Sean Sherlock asked the Minister for Health the reason a person (details supplied) has been refused a medical card. [52289/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy
173. Deputy John McGuinness asked the Minister for Health the amount held or managed by the patients' private property account central unit; the way in which this fund is invested and safeguarded; the amounts held on behalf of each organisation within its remit by county; if the fund comes under the remit of the Comptroller and Auditor General; the number of individual cases in which the Circuit Court's direction was sought in circumstances in which the HSE used in excess of €5,000 of client funds in a single calendar year; the number of families refused access to the funds of a family member in circumstances in which the funds were being used to benefit the owner of the fund; the number of persons who have had welfare benefits or cut-off due to the funds held on their behalf; the way in which the fund is used for end of life care; and if he will make a statement on the matter. [52292/18]
Amharc ar fhreagraThe legal framework for patients' private property accounts is provided for under section 9 of the Health (Repayment Scheme) Act 2006. Section 18 (3) of that Act provides that the Comptroller and Auditor General is entitled to audit these accounts.
As the other matters raised by the Deputy relate to service issues this question has been referred to the HSE for direct reply in relation to those matters.
174. Deputy John McGuinness asked the Minister for Health if an operation will be arranged at WUH for a person (details supplied); if the matter will be expedited; and the reason the person has had to wait for nine years. [52294/18]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
175. Deputy Patrick O'Donovan asked the Minister for Health the status of the resolution of the issue concerning women who had vaginal mesh implants; and when progress will be made on same. [52300/18]
Amharc ar fhreagraAs Minister for Health, I requested Dr Tony Holohan, Chief Medical Officer (CMO) to draft a report on the use of Uro-Gynaecological in the surgical treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) in women. The report covers the clinical and technical issues involved in ensuring both:
1. the safe and effective provision of mesh procedures in urogynaecology and
2. an appropriate response to women who suffer complications as a result of undergoing such procedures.
This report has now been completed and was published on the Department of Health website on 21 November 2018.
Synthetic mesh devices have been widely used in the surgical treatment of SUI and POP in women over the past two decades. However, controversy about the safety of mesh devices has arisen in many countries because of concerns about the frequency and severity of complications associated with their use.
Preparation of the report has involved consultation and engagement with national and international bodies. The report has been informed by review of international reports and safety reviews of mesh surgery which have been published in recent years. The report has also been informed by the personal experiences of women who have suffered complications following mesh surgery.
I acknowledge the bravery, commitment and dignity shown, by the women he met and by those women who have written to him concerning this issue, in sharing what were harrowing, deeply personal experiences.
The Report identifies that for many women, surgical procedures using synthetic mesh devices have provided a more effective and less invasive form of treatment than traditional SUI and POP procedures. However, mesh devices are associated with significant and severe complications in a minority of women. These are of concern given the difficulties of mesh implant removal.
The Report makes 19 recommendations including:
- the development of patient information and informed consent materials;
- surgical professional training and multidisciplinary expertise in units carrying out mesh procedures;
- the development of clinical guidance;
- the development of information systems to monitor the ongoing use of mesh devices;
- ensuring the reporting of mesh related complications; and
- ensuring timely, appropriate and accessible care pathways for the management of women with complications.
The HSE was also asked by the Chief Medical Officer on 24 July to pause all mesh procedures where clinically safe to do so, until a number of key recommendations are implemented.
Following the publication of the report, the Department wrote to the HSE to request that it prepare a detailed Implementation Plan for the complete set of recommendations set out in the CMO’s Report, working in conjunction with other stakeholders.
The HSE has a published a dedicated webpage about vaginal mesh implants, including contact information for women suffering complications, which I hope is a useful resource. This can be found at:
hse.ie/eng/about/who/acute-hospitals-division/woman-infants/vaginal-mesh-implants/vaginal-mesh-implants.html.
177. Deputy Pat The Cope Gallagher asked the Minister for Health the reason Letterkenny University Hospital is not included in the priority list of hospitals in the 2018 winter plan proposals of the HSE and his Department; if his attention has been drawn to the fact that LUH had full capacity protocols exercised on 87% in 2018 to date which is one of the highest nationally; if his attention has been further drawn to the fact that the hospital is at crises level; and if he will make a statement on the matter. [52307/18]
Amharc ar fhreagra178. Deputy Pat The Cope Gallagher asked the Minister for Health the extra resources and provision he plans to make available for Letterkenny University Hospital to deal with the impending increase of numbers which will avail of the hospital services between December 2018 and the end of February 2019; and if he will make a statement on the matter. [52308/18]
Amharc ar fhreagraI propose to take Questions Nos. 177 and 178 together.
My Department has engaged extensively with the HSE throughout the year to ensure the most effective response to the challenges faced by the health service this winter.
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 runs until the 31 of March 2019, includes a four-week period of focused action from 17 December to the 13 of January. During this period, 9 key hospital sites of concern which were identified on the basis of pressures experienced in previous winters, will be targeted with a suite of enhanced actions including:
- Extended opening hours for Local Injury Units, Minor Injury Units and key Primary Centres;
- ‘Winter Ready’ clinics in the Community targeting at-risk groups;
- Increased diagnostic access for GPs and extending hours of service in hospitals;
- Enhanced Senior Decision-Making across the Hospital.
Furthermore, the National Treatment Purchase Fund (NTPF) will be providing support to the Winter Plan, including the provision of diagnostics and hospital treatment for patients. This support will commence on 10 December and continue until the end of January 2019. The NTPF support will be made available for patients presenting at the 9 “key sites of concern” identified by the HSE, as well as 5 additional sites, including Letterkenny University Hospital.
A central 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.
Increasing capacity is a key priority for this Government. The Winter Plan will also seek to increase bed capacity in Q1 2019, with an additional 75 acute beds nationally, including 5 additional acute beds in Letterkenny University Hospital. Over the past 12 months, an additional 240 beds have been opened and work is nearing completion on a further 78 beds which are due to open in 2019. In addition to Winter funding, €10 million is being made available in 2019 to increase acute bed capacity. Further details will be included in the National Service Plan 2019. Taken together, these initiatives will increase the number of available in-patient beds in the acute hospital system to over 11,000, a threshold last seen in 2009.
In relation to the particular query raised about the provision of extra resources to Letterkenny University Hospital, and the rationale for the selection of the key sites of concern, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
179. Deputy Brendan Griffin asked the Minister for Health when an autism assessment report will be carried out in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [52314/18]
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 service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
180. Deputy Stephen S. Donnelly asked the Minister for Health the financial supports available for non-medical costs for families of sick children; and if he will make a statement on the matter. [52320/18]
Amharc ar fhreagraThe Department of Health has no role in the provision of non-medical financial supports.
You may with to contact my colleague Minister Regina Doherty T.D., as assistance may be available through the Department of Employment Affairs and Social Protection's (DEASP) which operates a number of schemes including exceptional needs payments, through designated persons, formerly known as Community Welfare Officers (CWOs).
181. Deputy Robert Troy asked the Minister for Health if an appointment for a person (details supplied) will be scheduled. [52325/18]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
182. Deputy Eugene Murphy asked the Minister for Health if an orthopaedic consultant appointment for a person (details supplied) will be expedited; and if he will make a statement on the matter. [52327/18]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
183. Deputy Bernard J. Durkan asked the Minister for Health the reason a medical card has been withdrawn in the case of a person (details supplied); if a decision to cancel their card will be reviewed with a view to reinstatement; and if he will make a statement on the matter. [52335/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
184. Deputy Martin Kenny asked the Minister for Health the cost of hiring a machine from the UK for Our Lady's Children's Hospital, Crumlin, for a procedure (details supplied); the number of times it is hired in a year; and if he will make a statement on the matter. [52351/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly, as soon as possible.
185. Deputy Louise O'Reilly asked the Minister for Health the support services available to stroke survivors in the community in each of the CHO areas; and if he will make a statement on the matter. [52361/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
