Written Answers Nos. 429-447
429. Deputy Alan Kelly asked the Minister for Health the amount in advance loans funding given to an organisation (details supplied) by the HSE in each of the past five years; the purpose of the funding; the reason the funding is not provided as part of the normal service agreement with the HSE; and if he will make a statement on the matter. [21871/19]
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 a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
430. Deputy Alan Kelly asked the Minister for Health the number and value of loans that have been advanced to each section 39 disability organisation since 2014, in tabular form; the reason for such loans; the reason the funding is not being provided as part of the HSE service agreement with these organisations; and if he will make a statement on the matter. [21872/19]
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 a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
431. Deputy Alan Kelly asked the Minister for Health the date, attendees and purpose of all meetings between his Department and RehabCare since 1 May 2016; and the date, attendees and purpose of all meetings between the HSE and RehabCare since 1 May 2016. [21873/19]
Amharc ar fhreagraI set out hereunder details regarding the attendees and purpose of all meetings between my Department and RehabCare since 1 May 2016. I have requested the HSE to respond directly to the Deputy regarding the date, attendees and purpose of all meetings between the HSE and RehabCare since 1 May 2016
Meeting 13 th December 2016 to discuss Disability Services, Wage Subsidy Scheme and Ratification of the UN Convention on the Rights of Persons with Disabilities.
Attendees:
Minister for Disabilities, Finian Mc Grath.
Rehab: Mo Flynn, Sonya Felton ,Kathleen O Meara.
Irish Wheelchair Association: Rosemary Keogh.
Dept of Health: Claire Collins.
Dept of Social Protection: Ciaran Diamond.
Meeting 23 rd February 2017 to discuss Rehab Group’s Five Year Strategic Plan
Attendees:
Minister for Health, Simon Harris.
Rehab: Kathleen O’Meara, Sonya Felton.
HSE : Marion Meany.
Department of Health: Grainne Duffy , Eimear Walshe &Tom Monks.
Meeting 7 th May 2019 to discuss Rehab Operational and Financial Stability
Attendees:
Ministers: Simon Harris, Minister for Health, Finian McGrath, Minister for Disabilities.
Rehab: Jimmy Tolan, Mo Flynn & Kathleen O Meara.
Ministerial Advisor: Joanne Lonergan, Minister Harris' Advisor.
HSE: Dean Sullivan, Pat Healy & David Walsh.
Dept of An Taoiseach : Philip O Callaghan.
Dept of Health Officials : Kathleen MacLellan, Dave O’Connor & Maurice O’Donnell
Meeting 15 th May 2019 to discuss Rehab Operational and Financial Stability
Ministers: Simon Harris, Minister for Health, Finian McGrath, Minister for Disabilities.
Rehab: Jimmy Tolan, Mo Flynn, & Kathleen O Meara.
HSE: Dean Sullivan, Pat Healy & David Walsh.
Ministerial Advisors: Joanne Lonergan, Minister Harris' Advisor; Gerry Maguire, Minister McGrath's Advisor.
Dept of An Taoiseach : Philip O Callaghan.
Dept of Health Officials : Patsy Carr, Susan Scally.
432. Deputy Alan Kelly asked the Minister for Health the status of services in Cappoquin health centre since the departure of the regular general practitioner there; the status of all patient records in the centre; and if he will make a statement on the matter. [21874/19]
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.
433. Deputy Aengus Ó Snodaigh asked the Minister for Health if a product (details supplied) will be placed on the list of medications that are covered under the medical card. [21878/19]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the pricing and reimbursement of medicines; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
434. Deputy Louise O'Reilly asked the Minister for Health the reason the centre of excellence promised for the Ennis region after the downgrading of Ennis and Nenagh hospitals has not been delivered; when it will be delivered; and if he will make a statement on the matter. [21887/19]
Amharc ar fhreagraAs this is a service issue, I have asked the HSE to reply to you directly.
435. Deputy Louise O'Reilly asked the Minister for Health the process which was undertaken before the downgrading of Ennis and Nenagh hospitals to ensure that University Hospital Limerick would have the necessary capacity to cope with the centralisation of emergency care in the region. [21888/19]
Amharc ar fhreagraAs this is a service issue, I have asked the HSE to reply to you directly.
436. Deputy Louise O'Reilly asked the Minister for Health his views on the research of a person (details supplied) which estimates that as many as 350 patients die each year as a direct result of overcrowding in hospitals; and the reason no perceived discernible action is being taken to combat hospital overcrowding. [21889/19]
Amharc ar fhreagraIreland is seeing a growing demand for unscheduled care, which is evident from the increased pressures on hospital Emergency Departments (EDs), particularly during peak periods such as winter.
Since the commencement of the Winter Plan 2018/2019 on 1 December, there was a 6.3% increase in ED attendances from the 1 December to the 31 March 2019 compared to the same period last winter, but a 13% reduction in the number of people counted on trolleys.
In addition to the optimisation of existing resources, the HSE invested an additional €30 million specifically in winter initiatives. The HSE Winter Plan sought to ensure that the health system was as prepared as possible for the increase in demand on services over the winter months, within existing capacity and financial parameters.
The HSE are currently undertaking a review of performance across all Hospital Groups and Community Health Organisations (CHO’s) over the winter period. The review will consider planning, implementation and performance at Group and CHO level.
The existing HSE review of winter 2018/2019 will be extended to include an Expert Review and Analysis of ED activity and relative performance of sites. In this context, the HSE’s initial focus will be on the 9 individual focus sites and their relevant CHOs as well as comparative performance with a number of other sites that performed well in 2018/2019.
Nationally, between January and March 2019, the number of patients recorded as waiting on trolleys in acute hospitals nationally at 8am was 28,962, a decrease of 4,050 (12.3%) compared to the same period in 2018 (33,012).
The HSE's provisional figures show 9,708 people were recorded on trolleys in the month of April which was 0.8% lower than March (9,789) of this year.
It is important to put the trolley figures in context. The hospital system is currently operating at close to full capacity. The number of patients attending Emergency Departments continues to increase year on year, with approximately 1.3 million attendances in 2018, up 3.5% on 2017. This reflects increasing demand for unscheduled care, especially by patients in the 75 and over age group.
The Health Service Capacity Review published last year was crystal clear on the need for a major investment in additional capacity in both hospital and community – combined with a wide scale reform of the manner and the location of where health services are provided.
As set out in Sláintecare, moving care options for patients closer to their homes and into their local communities is a key part of the solution.
Increasing capacity is a priority for Government. An additional 241 acute hospital beds opened under the Winter Initiative 2017/2018, and the National Service Plan for 2019 provides for a comprehensive capacity programme. A capacity programme for 2019 has been agreed, which provides for the following increases in capacity:
- 78 additional beds, including a 40-bed modular build in South Tipperary General Hospital, and a 30-bed ward in Our Lady of Lourdes Hospital Drogheda;
- 75 acute beds and 70 community beds as part of the Winter Plan;
- preparation of 202 beds by quarter 4 2019 with a view to bringing this extra capacity into operation in the first quarter of 2020;
- preparation of the proposed opening of a 60-bed modular build in University Hospital Limerick.
The number of available inpatient beds is expected to increase to above 11,000 following the investment planned in the National Service Plan 2019.
437. Deputy Louise O'Reilly asked the Minister for Health if all additional capacity in the Limerick, Clare and Tipperary region will be considered to relieve the pressure on University Hospital Limerick (details supplied). [21890/19]
Amharc ar fhreagraThe Emergency Department in UHL is one of the busiest in the country, with the number of patients attending growing year on year. UHL was identified as one of the 9 sites requiring additional investment, focus and support as part of this year's Winter Plan. The problem of overcrowding in hospitals requires a full system, patient focused response. Recognising this, in the Winter Plan, the HSE sought to maximise the use of existing resources across hospital groups and CHOs and to target additional investment at both hospital and community services and supports.
Increasing capacity is a priority for the Government. Since 2017, an additional 25 beds have opened in UHL, including 8 as part of this year's Winter Plan.
The Capacity Programme for 2019 provides for the following increases to capacity, as set out in the National Service Plan 2019:
- 78 additional beds, including a 40-bed modular build in South Tipperary General Hospital, and a 30-bed ward in Our Lady of Lourdes Hospital Drogheda;
- 75 acute beds and 70 community beds as part of the Winter Plan, of which 60 acute beds and 19 community beds have already opened;
- preparation of 202 beds by quarter 4 2019 with a view to bringing this extra capacity into operation in the first quarter of 2020;
- preparation of the proposed opening of a 60-bed modular build in University Hospital Limerick.
Funding has been provided in the National Service Plan 2019 to facilitate the opening of the modular build at South Tipperary General Hospital. The HSE advise that €4.5 million for 2019 has been ring-fenced for this development to be ready for operational use by the end of Q3 2019 and that staff recruitment is underway.
Furthermore, a capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at UHL, with funding of €10 million allocated in 2019. Enabling works commenced in March 2019, and the HSE advise that the main works are expected to start at the end of May 2019.
In addition, the National Development Plan includes a 96-bed replacement ward block in Limerick and capital funding was provided in 2018 to progress the design phase of this project.
Finally, the HSE have advised that the review of the Winter Plan currently underway will include an independent expert review of clinical, analytical and management capability in University Hospital Limerick and CHO Mid-West and the other 8 individual focus sites and their relevant CHOs.
In relation to the particular query, as to whether all additional capacity in the Limerick, Clare and Tipperary region will be considered to alleviate the pressure on UHL, I have asked the HSE to respond to the Deputy directly.
438. Deputy Eugene Murphy asked the Minister for Health if access to a dietician will be provided for a person (details supplied); and if he will make a statement on the matter. [21891/19]
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.
439. Deputy Clare Daly asked the Minister for Health the body to which concerned families can refer for accountability in circumstances in which a post mortem report contains serious inaccuracies; and if he will make a statement on the matter. [21899/19]
Amharc ar fhreagraA coroner is an independent official with legal responsibility for the investigation of sudden and unexplained deaths. Coroners are appointed for particular districts within a local authority area by the local authority (the coroner for the Dublin district is appointed by the Minister for Justice and Equality). While the coroner system is subject to the general supervision of the Minister, coroners are independent in their function. The principal legislation that governs the role and responsibilities of coroners is the Coroners Act 1962 as amended.
440. Deputy Michael Healy-Rae asked the Minister for Health the status of medical equipment for a person (details supplied); and if he will make a statement on the matter. [21918/19]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for reply to the Deputy.
441. Deputy Clare Daly asked the Minister for Health if his attention has been drawn to a recent case of CPE on a children’s ward in University Hospital Limerick; and his views on the fact that the hospital is not fully equipped to prevent the spread of CPE in view of this latest case. [21966/19]
Amharc ar fhreagraThe prevention and control of healthcare associated infections (HCAIs) and Antimicrobial Resistance (AMR) has been a significant patient safety and public health priority for the Department of Health for numerous years. The activities to address this are outlined in Ireland’s National Action Plan on Antimicrobial Resistance, 2017-2018, which was published in October 2017.
Over the last eighteen months, a number of measures have been put in place through the work of the National Public Health Emergency Team (NPHET):
- The HSE has implemented strong governance arrangements for healthcare associated infections (HCAIs) and AMR.
- The Health Protection Surveillance Centre has also driven enhanced surveillance of HCAIs, including the production of monthly surveillance reports on CPE.
- The Department of Health has provided additional funding for prioritised posts in both the acute and community sectors to build capacity or infection prevention and control. These have included posts for the national antimicrobial resistance team, additional posts for laboratory/screening activities, and infection prevention and control teams including posts for University Hospital Limerick.
- A suite of publicly available guidance documents have been developed by the Expert Group convened by the NPHET which provide expert advice to hospitals and the community health care services regarding actions that should be taken regarding CPE screening and control of spread of CPE.
- A dedicated HSE communications resource and website with focused information and education tools is in place.
While the number of newly diagnosed CPE patients has slightly increased, this is in the context of substantially increased screening activity over the past year.
The Department, in recognising the challenges of CPE for the health system, dedicated funding for HCAIs/AMR in 2018, which provides for a full year cost of €2 million. This included resourcing for University Hospital Limerick. A further €5 million has been allocated in 2019. The HSE has prioritised work programmes for this funding in line with HCAI/AMR risk. A number of posts are now in place and recruitment continues.
The Department will continue to engage with the HSE and other stakeholders to ensure that AMR, HCAIs and CPE in particular remain a priority.
Regarding the specific case the Deputy has referred to, I have requested that the HSE reply directly.
442. Deputy Catherine Martin asked the Minister for Health if funding from the National Lottery to organisations supporting polio survivors has been cut; if so, the reason therefor; and if he will make a statement on the matter. [21972/19]
Amharc ar fhreagraMy Department administered a National Lottery Discretionary Fund up to and including 2016 from which once-off grants were paid to community and voluntary organisations providing a range of health related services. My Department no longer operates a National Lottery Fund.
The HSE operates a similar scheme and continues to provide grants to health agencies and other organisations from National Lottery funds. Accordingly I have asked the HSE to consider the matter and respond directly to the Deputy.
443. Deputy Catherine Martin asked the Minister for Health when the national donor conceived person register will be established with regard to the Children and Family Relationships Act 2015; and if he will make a statement on the matter. [21974/19]
Amharc ar fhreagra444. Deputy Catherine Martin asked the Minister for Health when the appropriate legislative, regulatory and operational mechanisms are expected to be implemented in order to allow the commencement of Parts 2 and 3 of the Children and Family Relationships Act 2015. [21975/19]
Amharc ar fhreagraI propose to take Questions Nos. 443 and 444 together.
Officials in my Department are working towards putting in place a number of important administrative and operational arrangements that are essential for the implementation of Parts 2 & 3. This includes the establishment of the National Donor-Conceived Person Register (the “Register”), the purpose of which is to vindicate the rights of a donor-conceived child to access information on their genetic heritage. This is based on the principles of the UN Convention on the Rights of the Child concerning the right of a child to an identity and internationally regarded as best practice. However, as the Register will contain personal and potentially sensitive information about the various parties to a DAHR procedure, and particularly about the children born as a result of the procedures, robust data protection measures must be put in place prior to the establishment of the Register.
The commencement of Parts 2 & 3 of the Act also requires consent forms relating to the parties to a DAHR procedure (donors and intending parents) to be prescribed by regulations. The Department of Health is liaising with the Office of the Parliamentary Counsel in relation to the drafting of those regulations.
As you will no doubt be aware a technical amendment was required to section 27 (5) of the Act in order to ensure that a certificate can be issued in the context of all donor assisted human reproduction procedures performed under Part 2 of the Act. This amendment was included in the Civil Registration Bill 2019, which is the responsibility of the Minister for Employment Affairs and Social Protection. This Bill passed Report Stage in the Seanad this week.
It is my intention to commence Parts 2 & 3 of the Children and Family Relationships Act 2015 before the summer recess.
445. Deputy Timmy Dooley asked the Minister for Health if the use of surgical mesh is suspended in view of circumstances in the UK; if he is considering launching a full inquiry into this issue; and if he will make a statement on the matter. [21978/19]
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 Mesh 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 was published on the Department of Health website on 21 November 2018. Preparation of the report involved consultation and engagement with national and international bodies, including the Health Products Regulatory Agency (HPRA); the relevant professional training bodies, the Institute of Obstetricians and Gynaecology (IOG) and the Royal College of Surgeons in Ireland (RCSI); the Continence Foundation of Ireland (CFI) and the Health Service Executive (HSE), as well as colleagues in other jurisdictions. The report was informed by review of international reports and safety reviews of mesh surgery which have been published in recent years.
The report was informed by the personal experiences and concerns of women who have suffered complications following mesh surgery, including through written representations to me and my Department, those concerns raised in Parliamentary Questions on this subject, and the issues raised by the Mesh Survivors Ireland group at its meeting with me on 14 June 2018. I acknowledge the bravery, commitment and dignity shown by the women I met and by those women who have written to me concerning this issue, in sharing what were often harrowing, deeply personal experiences.
The CMO’s 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.
In advance of the report’s completion, the HSE was requested in May 2018 to begin work immediately on the development of national standardised patient information and informed consent materials and the clarification and development of treatment pathways and appropriate referral services for women suffering serious 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.
A Synthetic Mesh Devices Advisory Group has been convened by the HSE, to advise on and progress all of the recommendations. The Group includes three patient representatives, as well as representatives of the HPRA, the IOG, the RCSI, the CFI and all Hospital Groups to advise on and action all of the recommendations above.
I am informed that an ongoing work programme for the clarification and development of treatment pathways and appropriate referral services for women suffering from mesh-related complications is being progressed through this Group. This work includes identifying the appropriate specialist clinical expertise and facilities required at hospital group level and nationally to provide comprehensive aftercare services. Pending the completion of this, the HSE is also examining the need to look at sourcing services from abroad to address any immediate shortfalls identified, either through utilisation of the treatment abroad scheme or by commissioning services from abroad.
The HSE has 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 on the HSE website.
As was requested by the Secretary General of my Department in November 2018, the HSE has prepared an Implementation Plan for the complete set of recommendations set out in the CMO’s Report, which was approved by the Leadership Team in the HSE and published on the HSE website on 26 April 2019, which I hope provides further clarity on this issue.
I am informed that the HSE has advised that a detailed progress report on implementation of the recommendations will be provided to my Department by 30 June 2019.
At my recent meeting with the Mesh Survivors Ireland Group on 7 March 2019 I agreed to continue engagement with them on a pathway forward, to ensure that the ongoing clinical management of this patient group is in line with international best practice and emerging evidence.
446. Deputy Joe Carey asked the Minister for Health further to Parliamentary Question No. 332 of 2 April 2019, when a person (details supplied) will be seen; and if he will make a statement on the matter. [21979/19]
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.
447. Deputy Billy Kelleher asked the Minister for Health if the in loco parentis rule being applied by the HSE in respite care has been revised; and if he will make a statement on the matter. [21980/19]
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.
