Emergency Departments Services

Ceisteanna (78)

Lisa Chambers

Ceist:

78. Deputy Lisa Chambers asked the Minister for Health the progress made in the provision of a modular unit for the emergency department in Mayo University Hospital; and if he will make a statement on the matter. [12205/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As 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.

Cancer Screening Programmes

Ceisteanna (79)

Stephen Donnelly

Ceist:

79. Deputy Stephen Donnelly asked the Minister for Health the position regarding the CervicalCheck delays; the number of women waiting for test results for more than four weeks; the length of time women are waiting; the projected commencement date for the HPV test; and if he will make a statement on the matter. [12196/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The increased volume of smear tests since the CervicalCheck issues arose in April 2018 has been significant, and includes women who have availed of the out of cycle tests, but also a greater number of women presenting for scheduled screening. This increased level of engagement with the programme is welcome. However, the increased demand has undoubtedly put pressure on lab capacity and turnaround times. 

The HSE has been working actively with the labs to manage this issue and to improve turnaround times for smear tests. In addition, the HSE is aiming to source additional screening capacity, which would improve the turnaround time of results. This is a priority concern for my Department and the HSE. 

The HSE advises that the CervicalCheck Programme has recently agreed with laboratories to prioritise those slides which originate from women who attended colposcopy, as this cohort of women are considered to have the most serious need. The HSE also advises that the natural history of cervical cancer would indicate that the disease would normally develop over a period of 10 to 15 years. Due to this very fact, it is important that any woman of screening age attends for cervical screening each and every time she is invited to participate. The HSE has advised that in this context, a delay in the return of cervical screening results, whilst undesirable, is not necessarily dangerous and poses a very low risk to women.

I have asked the HSE to introduce HPV testing as the primary screening method for the prevention of cervical cancer as soon as possible. Funding to implement the switch to HPV screening, and extend HPV vaccination to boys, has been allocated in Budget 2019.  The decision to switch to primary HPV screening follows on from a Health Technology Assessment carried out by HIQA. This found that it would be beneficial, both clinically and from a cost effectiveness perspective, to make this transition. The introduction of primary HPV screening is in line with developments in cervical screening internationally. Ireland will be among the first countries in the world to make this transition. Work is progressing across a range of workstreams including procurement, ICT and colposcopy services, pre-tender market engagement has been completed and a Prior Information Notice was published on 20 February.

I have asked the HSE to respond directly to the Deputy in relation to the specific number of women who are waiting more than four weeks for their results and the length of time women are waiting.

Disabilities Assessments

Ceisteanna (80)

Joan Collins

Ceist:

80. Deputy Joan Collins asked the Minister for Health the number of children in the Dublin 6, 6W and 12 areas diagnosed with a need for an ASD unit placement for primary schools through the assessment of needs diagnoses. [11957/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Part 2 of the Disability Act (2005) establishes a system for the assessment of the health needs of children and young people born on or after 1st June 2002 who are suspected of having a disability. Although the Act refers to education needs, it is clarified that this relates to adults only.  An Assessment of Need for a child provides a determination as to whether or not they have a disability.  Where the child is deemed to have a disability their Assessment of Need report will include:

1. A statement of the nature and extent of the disability

2. A statement of the health needs occasioned by the disability

3. A statement of the services required to meet these needs and the period of time for the provision of those services

4. A statement of the period in which a review of the assessment should be carried out.

The report does not always include a diagnosis.  During 2018 4,237 Assessment of Need reports were completed nationally.  27% of these indicated that the child/young person presented with an Autism Spectrum Disorder (ASD).  Assessments of Need are not required to identify the education needs of children and as such the HSE does not collect this data.  It should also be noted that not all children with an ASD diagnosis will require placement in an ASD class.

Access to special educational placements such as ASD classes is via the National Council for Special Education.  Your query regarding the numbers of applications for placement in primary level ASD classes should be directed to the NCSE or Department of Education & Skills. 

General Practitioner Contracts

Ceisteanna (81)

Stephen Donnelly

Ceist:

81. Deputy Stephen Donnelly asked the Minister for Health the status of negotiations to reverse FEMPI for general practitioners; if a schedule or timeline for full reversal has been agreed; if so, the timeline in this regard; and if he will make a statement on the matter. [12194/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Deputy will be aware that talks are ongoing with GP representatives on the development of modernised GP contractual arrangements.  The focus of the current phase of the talks is on developing a range of modernisation, reform and sustainability measures and the development of a chronic disease management programme.

This will enable GPs 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.

Talks between the State and the IMO resumed in October 2018 and there has been intensive engagement over recent weeks. While some progress is being made, there are a number of outstanding issues that need to be progressed before any agreement can be secured. The State’s negotiating team is keen to bring matters to a conclusion; however, any agreement must substantially benefit patients and provide value for money for the taxpayer.

Agreement on the delivery of service improvements and contractual reform would facilitate a very significant increase in the resourcing of general practice on a multi-annual basis.

In line with the long-established approach to such processes, and by agreement of the parties concerned, I am not in position to give further details while engagement between the parties is under way.

National Children's Hospital Expenditure

Ceisteanna (82)

Mattie McGrath

Ceist:

82. Deputy Mattie McGrath asked the Minister for Health if he will provide a timeline of events of when his attention was drawn to the fact that the cost associated with the development of the national children’s hospital was escalating beyond that which was approved in March 2017. [8182/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I was advised by my officials in September 2017 of a potential cost overrun of €61m, related to a number of factors (including programme alignment, resequencing of works at OPD urgent care centres and fire certificate requirements).  This was monitored through 2017 and 2018 with a view to offsetting the potential cost increases through a variety of measures. 

I was next briefed on potential cost escalation on Monday 27 August 2018 following a meeting with Department officials and the Chair and CEO of the National Paediatric Hospital Development Board (NPHDB) on Friday 24 August 2018. 

A further  note was provided to me on 7 September 2018 updating me on the emerging position on foot of  briefing provided to the Department by the NPHDB.

Further updates were provided on 1 October and again on 9 November 2018. The NPDHB Report on the Process to Guaranteed Maximum Price was submitted to the HSE on 12 November 2018 and submitted to my Department by the HSE. That report set out the confirmation of the GMP process which informed the preparation of the Memo that I brought to Government on 18 December 2018.

Hospital Facilities

Ceisteanna (83)

Charlie McConalogue

Ceist:

83. Deputy Charlie McConalogue asked the Minister for Health when the short-stay ward will open in Letterkenny University Hospital; the preparations the HSE has under way to ensure it is open promptly; and if he will make a statement on the matter. [12020/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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 2018 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. The National Development Plan 2018-2017 provides for the full 2,600 beds over its lifetime.

Over the past 18 months, an additional 241 beds have been opened nationally.

The HSE Winter Plan includes the opening of an additional 75 beds in early 2019, including 5 acute inpatient beds in Letterkenny University Hospital. The plan also seeks to ensure that the health system is as prepared as possible for the increase in demand on services over the winter months, within existing capacity and financial parameters.  

Further to that, the National Service Plan 2019 provides for the preparation of 202 additional beds, to be operational in Q1 2020, including 15 inpatient beds in Letterkenny University Hospital.

In relation to the Deputy's query, as this is a service matter, I have asked the HSE to reply to the Deputy directly.  

Home Care Packages Administration

Ceisteanna (84)

John Curran

Ceist:

84. Deputy John Curran asked the Minister for Health the progress that has been made to reduce the waiting list and time for home support; and if he will make a statement on the matter. [12080/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Health Services

Ceisteanna (85)

Frank O'Rourke

Ceist:

85. Deputy Frank O'Rourke asked the Minister for Health his plans to ensure that a system that has been provided to a person (details supplied) is retained by the person; and if he will make a statement on the matter. [11798/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service matter it has been referred to the HSE for reply to the Deputy.

Respite Care Services Provision

Ceisteanna (86)

Declan Breathnach

Ceist:

86. Deputy Declan Breathnach asked the Minister for Health if there will be an improvement in the provision of respite facilities in County Louth during 2019; and if he will make a statement on the matter. [12409/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar 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. 

The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.

As the Deputy's question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

HSE Expenditure

Ceisteanna (87)

Stephen Donnelly

Ceist:

87. Deputy Stephen Donnelly asked the Minister for Health if the HSE is operating within budget to date in 2019 including the current and capital expenditure budgets; if not, the areas in which the budget is overrunning; and if he will make a statement on the matter. [12195/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The HSE’s monthly financial reporting is against a monthly budget that is based on annual profiles determined as part of the annual process of preparing the organisations detailed operational plans.

The 2019 operational plans are currently being finalised by the HSE and final figures on year to date performance will not be available until the plans are signed off.

In overall terms, cash drawdown to date is in line with the increased allocation for the year, with early indications that the main areas currently experiencing expenditure challenges are Acute Hospitals, Social Care Disability Services, Primary Care Reimbursement Service and Older Person Services.

The total HSE capital specifically for buildings and equipment in 2019 is €642m. Capital expenditure is operating within budget year to date and will be monitored in line within total annual capital allocation.

Industrial Disputes

Ceisteanna (88)

Barry Cowen

Ceist:

88. Deputy Barry Cowen asked the Minister for Health the status of the dispute with a union (details supplied); and if he will make a statement on the matter. [5978/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Representatives of my Department, the HSE and the Department of Public Expenditure and Reform have been engaged in intensive talks with representatives of the INMO in relation to the recent Labour Court recommendations that were issued in relation to the nursing dispute. 

At the conclusion of engagement between all sides on 11th March, agreement was not reached between the parties.

Health Service Management remains available for further discussion with nursing unions.  Health Service Management is committed to upholding the recommendation issued by the Labour Court and accepted by the Government.

Departmental Budgets

Ceisteanna (89)

Bernard Durkan

Ceist:

89. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he remains satisfied regarding the adequacy of the budget of his Department to meet in full the current expenditure costs associated with the running of the comprehensive health service; and if he will make a statement on the matter. [12338/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The 2019 National Service Plan set out a budget of over €16.05 billion for the HSE, the highest budget ever allocated. The HSE current expenditure budget was increased by over €848 million on the 2018 Supplementary budget, a substantial additional level of funding. The amount allocated follows an extensive process of engagement between my Department and DPER, which considers both the funding requirements as submitted by the HSE and the fiscal position. These types of engagements are a normal part of the Budgetary process and happen with agencies across Government. All public bodies put forward spending proposals but all such bodies, including the HSE, are required to operate within the amounts proposed by Government and determined by the Dáil. While increased resources contribute to health service improvement, there are also ways in which improvements can be achieved within the current resources. The HSE has my full support in achieving these improvements as part of our shared reform agenda.

Since I have come to office the allocation to the HSE has increased by €2.56 billion or 19%. More resources are always welcome in contributing to the development of services but there is also a responsibility on the HSE to seek greater value from the very substantial existing resources at its disposal.

The services to be provided in 2019 are as set out in the National Service Plan, and levels are typically equal to or higher than planned or delivered in 2018. The additional funding provided in Budget 2019 for new developments will support new or expanded levels of services across priority service areas. I expect the HSE to operate within the funding provided to it in 2019.

Healthcare Infrastructure Provision

Ceisteanna (90)

Pat Buckley

Ceist:

90. Deputy Pat Buckley asked the Minister for Health the status of plans for the future of Midleton Community Hospital; and if he will make a statement on the matter. [12389/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As 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.

Hospital Services

Ceisteanna (91)

Bobby Aylward

Ceist:

91. Deputy Bobby Aylward asked the Minister for Health his plans to implement 24-7 cardiac care services for those living in the south east; his views on whether there is an equal provision of cardiac services in the region in comparison with the rest of the country; and if he will make a statement on the matter. [12015/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In 2016, the Herity Report concluded that the needs of the effective catchment population of University Hospital Waterford (UHW) 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 and five staff (Grade IV Admin, Porter, Senior Cardiac Physiologist, Senior Radiographer and Staff Nurse) have now been recruited on an 8am to 8pm working day basis. Furthermore, the recruitment of a cardiologist to facilitate an increase in the operating hours of the existing cath lab is also being progressed by the HSE.

A mobile cath lab has also been deployed at UHW since October 2017 to conduct diagnostic cardiac procedures pending the recruitment of the additional staff required to extend the opening hours of the existing cath lab.

I remain committed to the provision of a second cath lab in University Hospital Waterford and I asked the HSE to consider the cost of progressing the project to design, planning and construction stages in the context of the HSE’s Capital Plan for 2019.

I am please to advise the Deputy that the HSE has confirmed that this project has now been included in the HSE’s Capital Programme 2019 and has been granted a capital allocation for 2019 to appoint the design team and to progress the design of the project.

The Herity Report 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. The Minister for Health asked his Department to address the implications of this recommendation by arranging for 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.

General Practitioner Services

Ceisteanna (92)

Thomas Pringle

Ceist:

92. Deputy Thomas Pringle asked the Minister for Health if he will address the ongoing frustration experienced by general practitioners in rural areas in trying to address waiting lists for appointments while FEMPI cuts of up to 40% still remain; and if he will make a statement on the matter. [12169/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Government is aware of workforce issues facing general practice, including the influence of demographic factors, and has implemented a number of measures to improve recruitment and retention in general practice.

These include changes to the entry provisions to the GMS scheme to accommodate more flexible GMS contracts, and to the retirement provisions for GPs under the GMS scheme allowing GPs to hold GMS contracts until their 72nd birthday. An enhanced support package for rural practices has also been introduced with improved qualifying criteria and an increased financial allowance of €20,000 per annum. 257 GP practice units encompassing 347 individual GPs are now in receipt of financial supports under this framework, a significant increase on the 167 GPs who received a rural practice allowance prior to the introduction of the 2016 measures. In addition, GP training places have been increased from 120 in 2009 to 193 filled in 2018.

It is acknowledged that there are many challenges in general practice.  That is why Government remains committed to engaging with GP representatives on the development of a package of measures and reforms to modernise the current GMS contract. 

Talks between the Department of Health, the HSE and the Irish Medical Organisation as the established GP representative body are continuing. Agreement on the delivery of these service improvements and contractual reforms has the potential to facilitate a substantial increase in the resourcing of general practice on a multiannual basis.

The State’s negotiating team is keen to bring matters to a conclusion; however, any agreement must substantially benefit patients and provide value for money for the taxpayer.

Hospital Services

Ceisteanna (93)

Aindrias Moynihan

Ceist:

93. Deputy Aindrias Moynihan asked the Minister for Health his plans to increase ophthalmology services at the South Infirmary Victoria Hospital, County Cork; and if he will make a statement on the matter. [12402/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Primary Care Centres Provision

Ceisteanna (94)

Fiona O'Loughlin

Ceist:

94. Deputy Fiona O'Loughlin asked the Minister for Health if work has commenced on the construction of the Athy primary care centre; and if he will make a statement on the matter. [12322/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.

Hospital Services

Ceisteanna (95)

Catherine Connolly

Ceist:

95. Deputy Catherine Connolly asked the Minister for Health the steps taken to reinstate the helipad and helicopter service of Galway University Hospital; and if he will make a statement on the matter. [12077/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is an operational matter, I have asked the HSE to reply to you directly.

Long-Term Illness Scheme

Ceisteanna (96)

Gino Kenny

Ceist:

96. Deputy Gino Kenny asked the Minister for Health if he will implement a review of the long-term illness scheme in view of the fact that it is almost 50 years since it has been updated; if he will consider the addition of fibromyalgia and ME to the scheme; and if he will make a statement on the matter. [12400/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Long Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of thalidomide. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.  

There are no plans to extend the list of conditions covered by the Scheme at this time.

However, I wish to inform the Deputy that it is proposed that the LTI Scheme would be included as part of a review of the basis for existing hospital and medication charges, to be carried out under commitments given in the Sláintecare Implementation Strategy. 

Hospital Services

Ceisteanna (97)

Martin Heydon

Ceist:

97. Deputy Martin Heydon asked the Minister for Health his plans to extend Naas General Hospital day care and mental health services; and if he will make a statement on the matter. [12392/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar 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 Facilities

Ceisteanna (98)

Alan Kelly

Ceist:

98. Deputy Alan Kelly asked the Minister for Health when the new 60 bed unit in University Hospital Limerick will be opened and operational. [11794/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Emergency Department in University Hospital Limerick is one of the busiest in the country, with the number of patients attending growing year on year.

Limerick was identified as a one of 9 sites requiring additional investment, focus and support as part this year’s Winter Plan. The problem of overcrowding in hospitals requires a full system, patient focused response.  Recognising this, in the Winter Plan investment is targeted at both hospital and community services and supports.  This includes additional home support packages and transitional care beds to support people to leave hospital and return home.

It is widely agreed that a key part of the solution for Limerick is additional beds.

Over the past 18 months, an additional 23 beds have opened in Limerick, including 5 as part of this year’s Winter Plan.

A Capital Allocation of €2 million has been granted in recent weeks and the HSE advise that this will facilitate the completion of enabling works for the 60 bed modular ward in 2019.

Hospitals Capital Programme

Ceisteanna (99)

Thomas P. Broughan

Ceist:

99. Deputy Thomas P. Broughan asked the Minister for Health the impact of the cost overruns for the national children's hospital on important capital projects at Beaumont Hospital in 2019 and 2020; and if he will make a statement on the matter. [11797/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Government recently outlined how the €99m necessary this year for the timely provision of the new children’s hospital will be accommodated with a minimum of disruption to the scheduled rollout of key infrastructure projects under Project Ireland 2040.

The new children’s hospital is a vital and much needed project. The Government has examined the funding pressures associated with delivering this important project. In meeting these funding pressures, Government has examined all projects and programmes across Government and has made adjustments to ensure that the much-needed new children’s hospital will be delivered and will facilitate delivering the overall investment programme, as set out in Project Ireland 2040.

Projects that are currently in construction and are contractually committed will not be affected.

The Health Service Executive is currently developing its Capital Plan for 2019. The HSE Capital Plan will determine the projects that can progress in 2019 and beyond having regard to the available capital funding, the number of large national capital projects currently underway and the relevant priority of each project.

The requirements of the new children's hospital and other health capital projects including capital proposals at Beaumont Hospital, currently at various stages of development, are being considered as part of this process. Once the HSE has finalised its Capital Plan for 2019, it will then be submitted to me for consideration.

National Children's Hospital Administration

Ceisteanna (100)

Mick Wallace

Ceist:

100. Deputy Mick Wallace asked the Minister for Health if a public benchmarking analysis was completed prior to the issuing of the tender for the national children’s hospital; if so, the person or body that conducted the analysis; and if he will make a statement on the matter. [10616/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The National Paediatric Hospital Development Board (NPHDB) has statutory responsibility for planning, designing, building and equipping the new children's hospital.  I have referred your question to the NPHDB for direct reply.