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Tuesday, 26 Mar 2019

Written Answers Nos. 632-653

Services for People with Disabilities

Ceisteanna (632)

Brendan Griffin

Ceist:

632. Deputy Brendan Griffin asked the Minister for Health the services available for a care facility (details supplied) in County Kerry; and if he will make a statement on the matter. [12863/19]

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.

Mental Health Services Provision

Ceisteanna (633)

Róisín Shortall

Ceist:

633. Deputy Róisín Shortall asked the Minister for Health the steps being taken to address the issue of dual diagnosis (details supplied); and if he will make a statement on the matter. [12865/19]

Amharc ar fhreagra

Freagraí scríofa

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

Addiction Treatment Services

Ceisteanna (634)

Jack Chambers

Ceist:

634. Deputy Jack Chambers asked the Minister for Health the policy developed for the provision of services for persons with gambling addiction; the level of funding allocated to the HSE and other agencies for the provision of gambling addiction services for each of the years from 2015 to 2018 and to date in 2019; and if he will make a statement on the matter. [12877/19]

Amharc ar fhreagra

Freagraí scríofa

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.

Nursing Homes Support Scheme Administration

Ceisteanna (635)

Michael Healy-Rae

Ceist:

635. Deputy Michael Healy-Rae asked the Minister for Health the way in which farmers (details supplied) are being assessed for the fair deal scheme; and if he will make a statement on the matter. [12894/19]

Amharc ar fhreagra

Freagraí scríofa

The proposed policy change to the Nursing Homes Support Scheme (NHSS), to cap contributions based on farm assets at 3 years where a family successor commits to working the productive asset, has been approved by Government. My Department is working on the development of draft Heads of Bill while considering a number of complex ancillary policy and operational matters which may need to be addressed in the proposed legislation.

It is intended that this proposed policy change, the 3 year cap, will be extended to eligible existing participants in long term residential care so that they are not disadvantaged, but that there would be no retrospective recoupment of contributions for those who have paid contributions over and above the 3 year period.

A draft General Scheme of a Bill is currently with legal advisers for advice and legal quality control review. As the Deputy is aware, there is presently a focus on matters relating to Brexit, including planning and preparing in a legal and legislative context. Unfortunately, this is having some impact on progressing this particular matter at this time. However, subject to legal advice, I expect to bring the heads of bill to Government at the earliest opportunity. The changes to the Scheme will come into effect in 2019 subject to the legislative process.

Medical Internships

Ceisteanna (636)

Brendan Griffin

Ceist:

636. Deputy Brendan Griffin asked the Minister for Health the available placements with the HSE for a student (details supplied) studying medicine; and if he will make a statement on the matter. [12902/19]

Amharc ar fhreagra

Freagraí scríofa

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

Respite Care Services Provision

Ceisteanna (637)

Eamon Scanlon

Ceist:

637. Deputy Eamon Scanlon asked the Minister for Health the position regarding the provision of respite services in Tullaghan, County Leitrim; if the unit has been approved by HIQA; and if he will make a statement on the matter. [12905/19]

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.

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

Assisted Decision Making

Ceisteanna (638)

Willie Penrose

Ceist:

638. Deputy Willie Penrose asked the Minister for Health when Part 8 of the Assisted Decision-Making (Capacity) Act 2015 will be fully implemented and all sections enacted; and if he will make a statement on the matter. [12911/19]

Amharc ar fhreagra

Freagraí scríofa

Part 8 of the Assisted Decision-Making (Capacity) Act 2015 provides a legislative framework for advance healthcare directives (AHDs). An AHD is a statement made by a person with capacity setting out his or her will and preferences regarding treatment decisions that may arise in the future when he or she no longer has capacity.

Section 91 of the Act relates to the development of a code of practice to accompany the AHD provisions. On 17 October 2016 I established a multidisciplinary working group to prepare a detailed series of recommendations for the Director of the Decision Support Service (DSS), in relation to the code of practice under section 91(2) of the Act. In anticipation of the completion of that process, I commenced the remainder of section 91 on 17 December 2018 [S.I. No. 527 of 2018]. This will enable the Director of the DSS to progress the preparation of the code of practice on the AHD provisions, based on the working group’s recommendations, and in accordance with the specific process outlined in the Act. The multidisciplinary working group submitted its recommendations on the code of practice to the Director of the DSS on 21 December 2018.

Once completed the final code of practice can be published by the Director with my consent.

The development of the code of practice to accompany the AHD provisions is a key piece of work in facilitating the subsequent commencement of Part 8 in its entirety.

Hospital Services

Ceisteanna (639)

Michael Healy-Rae

Ceist:

639. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter (details supplied) regarding the review of scans at University Hospital Kerry; and if he will make a statement on the matter. [12913/19]

Amharc ar fhreagra

Freagraí scríofa

The Minister and the Department of Health were notified by the HSE in September 2017 of this patient safety issue, where cases of misdiagnosis / failure to diagnose occurred at University Hospital Kerry Radiology Department and the commencement of the look-back review. The Department and the Minister received regular updates on the progress of the review, including the publication of the report.

Throughout the review process, the Department continually sought and was assured by the HSE that open disclosure and direct contact with each patient was occurring, where clinically significant findings were identified through the Look-back Process.

The HSE has assured the Department that it is continuing to engage with and support the patients who have been impacted by these issues, and that open disclosure and follow up care as needed has occurred with all affected patients and their families.

The HSE has also confirmed that the implementation of the recommendations of the Report is underway.

While the Department of Health and the Minister are unable to comment on individual cases, the Minister has expressed his heartfelt sympathies to the patients and families involved and acknowledges this was a time of uncertainty for patients and their families.

The Deputy's question has been referred to the HSE for further reply.

Services for People with Disabilities

Ceisteanna (640)

Peadar Tóibín

Ceist:

640. Deputy Peadar Tóibín asked the Minister for Health the steps being taken to replace the travel schemes (details supplied) that were ceased in 2013 due to incompatibility with the Equal Status Acts; if an alternative scheme is available; the status of the interdepartmental group that was asked to develop detailed proposals, including eligibility criteria and administrative arrangements; the number of times the group met; when the last meeting took place; the outcome of the group; the findings of the report; and if he will make a statement on the matter. [12914/19]

Amharc ar fhreagra

Freagraí scríofa

The Deputy will be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in February 2013.

The Inter-Departmental Group referred to by the Deputy, was established on foot of a Government Decision in June 2013 and was chaired by the Department of An Taoiseach. The Group met eight times from June 2013 to September 2013. The Group set out initial proposals for consideration by Government for a statutory transport support payment scheme as a replacement for the discontinued Mobility Allowance and Motorised Transport Grant Schemes. In November 2013, the Government decided that the Minister for Health, in consultation with other relevant Ministers would progress the detailed preparatory work required for a new travel subsidy scheme and associated statutory provisions.

My colleague, the Minister for Health and I brought a Memorandum to Government in May 2018 on proposals for a new Transport Support Payment Scheme. Following consideration of the matter, it was decided to withdraw the Memorandum from the Cabinet Agenda at the time. I intend to revert to Government in due course with revised proposals to reflect the discussions at that Cabinet meeting and further discussions between myself and Minister Harris on the best way to progress the Transport Scheme.

It is important to note that the Disabled Drivers and Disabled Passengers scheme operated by the Revenue Commissioners, remains in place. This scheme provides VRT and VAT relief, an exemption from road tax and a fuel grant to drivers and passengers with a disability, who qualify under the relevant criteria set out in governing regulations made by the Minister for Finance. Specifically adapted vehicles driven by persons with a disability are also exempt from payment of tolls on national roads and toll bridges. Transport Infrastructure Ireland has responsibility for this particular scheme.

There are improvements in access to a range of transport support schemes available to persons with disabilities in the State and on-going work is being carried out by Government Departments, agencies and transport providers to further improve access to public transport services. Under the National Disability Inclusion Strategy, the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of public transport for people with a disability.

Health Services

Ceisteanna (641)

Niamh Smyth

Ceist:

641. Deputy Niamh Smyth asked the Minister for Health when funding will be increased for sepsis diagnosis and awareness (details supplied); the status of same; and if he will make a statement on the matter. [12946/19]

Amharc ar fhreagra

Freagraí scríofa

In 2014, the National Clinical Effectiveness Committee (NCEC) in the Department of Health has published a National Clinical Guideline on Sepsis “Sepsis Management, National Clinical Guideline No.6”. This National Clinical Guideline has been accredited by the UK National Institute for Health and Care Excellence (NICE) and is available on the Department of Health website. The Guideline is an adaptation of the Surviving Sepsis Campaign Guideline and the Sepsis 6 bundle, aligning these internationally recognised guidelines with the structures and functions of the Irish healthcare system. It informs pathways of care for patients with sepsis within all Irish medical disciplines.

This Guideline is currently being updated, which includes a review of the most recent international peer-reviewed evidence on the diagnosis and treatment of sepsis.

Alongside this National Clinical Guideline, the HSE National Sepsis Programme was established in 2014. As part of this Programme, funding has been provided for the appointment of a National Clinical Lead for sepsis in Ireland and the appointment of a number of senior nurses to coordinate the National Sepsis Programme. The funding for these posts has been critical in driving the achievements of the National Programme and its activities in promoting sepsis diagnosis and awareness. Since 2015, the National Sepsis Programme has continued to be funded as part of the HSE annual National Service Planning process.

The National Sepsis Programme carries out important work to support the implementation of the National Sepsis Clinical Guideline, by bringing a focus on sepsis awareness and the promotion of early recognition of sepsis. While the initial focus of the HSE National Sepsis Programme was on raising awareness among healthcare staff, initiatives to raise awareness in the community have now commenced. These activities include sepsis awareness events in the community, such as at the National Ploughing Championships, education programmes with the Gardaí, and media features on national radio and TV. Additional community information sessions have taken place in shopping centres, public lectures in universities and with community groups.

Furthermore, with regard to promoting greater awareness regarding sepsis and its diagnosis, the HSE National Sepsis Programme has recently published a set of information materials on sepsis. These are now available on the HSE website (sepsis/programme documents and resources) and include a patient information booklet, patient information leaflet and educational tools for healthcare staff. The HSE National Sepsis Programme plans to circulate these new materials to healthcare establishments, including GP surgeries.

The HSE National Sepsis Programme also publishes a sepsis report every year and organises an annual Sepsis Summit, which brings together healthcare providers, patients and carers. A series of videos of patient experiences of sepsis has been compiled for the sepsis summit, which are used to raise awareness and are available on the HSE website.

Services for People with Disabilities

Ceisteanna (642)

Mary Butler

Ceist:

642. Deputy Mary Butler asked the Minister for Health when 2019 applications for funding under section 39 will be accepted, considered and approved; and if he will make a statement on the matter. [12948/19]

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.

Medical Aids and Appliances Provision

Ceisteanna (643)

Seán Sherlock

Ceist:

643. Deputy Sean Sherlock asked the Minister for Health when a child (details supplied) will be fitted for orthotics; and the reason the County Cork waiting list for children is still merged with the adult waiting list. [12950/19]

Amharc ar fhreagra

Freagraí scríofa

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

Nursing Home Inspections

Ceisteanna (644)

Bernard Durkan

Ceist:

644. Deputy Bernard J. Durkan asked the Minister for Health the number of the 120 complaints about nursing homes in County Cork sent to HIQA in the past two years that resulted in action being taken; the specific action in each case; the person or body that took the action; if individual complaints were specifically investigated; if so, the details of same; the outcomes of these investigations; and if he will make a statement on the matter. [12951/19]

Amharc ar fhreagra

Freagraí scríofa

The Health Information and Quality Authority (HIQA) is responsible for the monitoring, inspection and registration of designated centres for older people, such as nursing homes, in Ireland.

Between the period 1 January 2017 to 11 March 2019 HIQA received 132 concerns relating to designated centres for older persons in Co. Cork. In the case of 39 of these concerns, HIQA requested the provider of the service to conduct an immediate investigation into the concern. HIQA subsequently followed up with the provider to ensure that appropriate and satisfactory action had been taken to address the issue, and has confirmed that appropriate action was taken in all 39 cases. No further follow-up is required. 88 of the 132 concerns were followed up by HIQA inspectors on inspection, a further four were reclassified as general queries, and one concern was judged to be outside HIQA’s remit.

HIQA does not have the legal remit to investigate individual concerns; however, all unsolicited information received about services is assessed against the regulations and the national standards. This information is risk-rated and used to support HIQA's inspection programme.

If there is a serious risk to the health and welfare of service users, HIQA will undertake escalated regulatory action in relation to that service, up to and including the cancellation of registration.

Cannabis for Medicinal Use

Ceisteanna (645)

Seán Sherlock

Ceist:

645. Deputy Sean Sherlock asked the Minister for Health further to Parliamentary Questions Nos. 341 to 343, inclusive, of 19 February 2019, the progress made on the issues raised. [12954/19]

Amharc ar fhreagra

Freagraí scríofa

My Department intends to introduce a Cannabis for Medical Use Access Programme.

In the period since the PQs that the deputy has referred to were answered, on 19th February and 12th March respectively, Department Officials have continued to work intensively to bring this development forward.

While the arrangements that will enable this programme to begin are being finalised, it is open to a registered medical practitioner to apply for a Ministerial Licence under the Misuse of Drugs Act 1977. Such a licence, if granted, enables them to legally prescribe medical cannabis for a named patient. It is important to note that the decision to prescribe such treatment is a clinical decision for the prescribing doctor.

Until acceptable medical cannabis products are available for use in Ireland, patients who are the subject of a licence are obtaining their cannabis products from a pharmacy in the Netherlands. This is necessary because Netherlands government policy does not permit cannabis oil products to be commercially exported.

I am aware that a UK company may provide a service which involves it collecting cannabis products from the Netherlands for persons authorised to use it under the UK medical cannabis regime.

I have been informed that this UK Company may be acting as the patient’s “nominated representative” in the collection of their personally prescribed medical cannabis products. No similar Irish entity is known to provide this service, but it is certainly open to any patient to engage a representative on their behalf in this regard.

One licence has been granted to a commercial entity for the importation of products containing medical cannabis, into Ireland. No information is available as to the plans that this company has to import cannabis products to Ireland for medical use.

Nursing and Midwifery Board of Ireland

Ceisteanna (646)

Clare Daly

Ceist:

646. Deputy Clare Daly asked the Minister for Health the number of conferences, nationally or internationally, attended by representatives of the Nursing and Midwifery Board of Ireland in the period from June 2016 to June 2018; the persons who attended in each case; and the cost of attendance in each instance, broken down by flights, accommodation and expenses. [12955/19]

Amharc ar fhreagra

Freagraí scríofa

As this question refers to operational matters, it has been referred to the Nursing and Midwifery Board of Ireland for attention and direct reply to the Deputy.

Health Services Staff

Ceisteanna (647)

Micheál Martin

Ceist:

647. Deputy Micheál Martin asked the Minister for Health if he has received correspondence from a person (details supplied). [12956/19]

Amharc ar fhreagra

Freagraí scríofa

I can confirm that there has been ongoing correspondence between my Department and the person in question in relation to an apology from the Medical Council.

One of the provisions in the recently published Regulated Professions (Health and Social Care) (Amendment) Bill 2019 will be to amend each of the five health professional regulatory Acts to provide for the right of appeal to the High Court where a minor sanctions of advice, admonishment or a censure in writing has been imposed on a practitioner, and to provide for confirmation by the Court of the minor sanctions. There is currently no right of appeal across all five Acts for the minor sanctions

Section 10 of the Medical Practitioners Act 2007 protects from personal liability in civil proceedings those who, in good faith, perform functions under the Act. This is an important protection. By amending the Act to provide for the right of appeal by the Court, registrants, who have been the subject of disciplinary proceedings, will have the opportunity to have a finding which they consider to be wrong, examined by the Courts. This is also an important protection.

Services for People with Disabilities

Ceisteanna (648, 649, 650)

Seán Sherlock

Ceist:

648. Deputy Sean Sherlock asked the Minister for Health the number of children awaiting stage 1, assessment officer component, of the assessment of needs under the Disability Act 2005, in each county; the length of time they are waiting; and the age range and gender, in tabular form. [12960/19]

Amharc ar fhreagra

Seán Sherlock

Ceist:

649. Deputy Sean Sherlock asked the Minister for Health the number of children awaiting stage 2, clinical assessment, of the assessment of needs under the Disability Act 2005, in each county; the length of time they are waiting; and the age range and gender, in tabular form. [12961/19]

Amharc ar fhreagra

Seán Sherlock

Ceist:

650. Deputy Sean Sherlock asked the Minister for Health the number of children awaiting to move from stage 1 to stage 2 of the assessment of needs under the Disability Act 2005, in each county; the length of time they are waiting; and the age range and gender, in tabular form. [12962/19]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 648 to 650, inclusive, together.

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 Groups

Ceisteanna (651, 652, 653)

David Cullinane

Ceist:

651. Deputy David Cullinane asked the Minister for Health his plans to align the south-east CHO area with hospital groups; the Department examining the issue; the consultation being carried out with hospital management, existing hospital groups and clinicians; and if he will make a statement on the matter. [12965/19]

Amharc ar fhreagra

David Cullinane

Ceist:

652. Deputy David Cullinane asked the Minister for Health his plans to restructure hospital groups to align University Hospital Waterford with St. Vincent’s University Hospital, Dublin; and if he will make a statement on the matter. [12966/19]

Amharc ar fhreagra

David Cullinane

Ceist:

653. Deputy David Cullinane asked the Minister for Health his plans to link University Hospital Waterford academically with UCD as opposed to UCC; and if he will make a statement on the matter. [12967/19]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 651 to 653, inclusive, together.

The report of the cross-party Oireachtas Committee on the Future of Healthcare, Sláintecare, identifies four core building blocks that underpin a well-functioning health system. The first of these building blocks is a clear governance and accountability framework. As part of its recommendations in this area, the Committee called for the establishment of a HSE Board, the HSE to become a more strategic and patient-focused ‘national centre’ carrying out national level functions, and the establishment of regional bodies with responsibility for the planning and delivery of integrated care at a regional level.

As the Deputy will be aware, 9 Community Healthcare Organisations (CHOs) and 7 Hospital Groups were established on an administrative basis in recent years to plan and deliver community and acute care services respectively. These structures are not geographically aligned. While significant progress has been made by these structures, there is broad consensus that having separate and un-aligned structures for acute and community care impedes the development of a more integrated health service as envisaged under the Sláintecare programme.

To address these issues, the Sláintecare report recommends the geographic alignment of CHOs and hospital groups to support population based health planning and delivery, the design of the new regional bodies and ultimately the introduction of a form of regional health resource allocation. To support decisions on geographic alignment, the Sláintecare report further recommends “further analysis and consultation …to identify how alignment can best be achieved with minimal disruption to key structures including at community healthcare network level”.

As set out in the Sláintecare Implementation Strategy and the recently published 2019 Sláintecare Action Plan, I am committed to the development of a new system of health structures and governance as called for in the Sláintecare report. The Strategy and the Action Plan set out a number of actions that will lead to the development of a new system of health structures and governance comprising a leaner national centre with responsibility for national planning, strategy and standard setting, complemented by regional integrated care organisations with responsibility for the planning and delivery of services at a regional level.

In line with the Sláintecare report recommendation, my Department undertook a public consultation regarding the geographical alignment of CHOs and Hospital Groups in 2018. In addition, my Department has carried out further detailed analysis work to determine the optimal geographical alignment of CHOs and Hospital Groups which can be achieved with minimal disruption, and which will ultimately be the geographical areas of the proposed new regional integrated care organisations. My Department is finalising proposals in this regard, and I hope to bring these proposals to Government shortly. This will take account of the 2018 consultation process and other planned engagement with key stakeholders, including CHOs, Hospital Groups and academic partners.

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