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Tuesday, 21 May 2019

Written Answers Nos. 448-466

Health Services Provision

Ceisteanna (448)

Peter Burke

Ceist:

448. Deputy Peter Burke asked the Minister for Health the services available in Mullingar, County Westmeath for a person (details supplied); and if he will make a statement on the matter. [21982/19]

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.

Emergency Departments Data

Ceisteanna (449)

Thomas P. Broughan

Ceist:

449. Deputy Thomas P. Broughan asked the Minister for Health the number of persons that visited the accident and emergency department of Beaumont Hospital in 2017, 2018 and to date in 2019; the timeframe for the construction of a new accident and emergency department at the hospital; and if he will make a statement on the matter. [21991/19]

Amharc ar fhreagra

Freagraí scríofa

I wish to acknowledge the distress overcrowded Emergency Departments (EDs) cause to patients, their families and frontline staff working in very challenging working conditions in hospitals throughout the country.

This is a very busy period for our health services, with many hospitals reporting significant numbers of patient attendances. For the first quarter of 2019, the number of patients attending hospital EDs increased by 7.6%, and the number of ED admissions increased by 4.7% compared to the same period last year.

However, despite the significant increase in demand, our health services have managed better this winter than in previous years. While any patient on a trolley is a patient too many, figures from the HSE have shown a very significant reduction in the number of patients waiting on hospital trolleys so far this year.

In relation to the specific information requested, I have asked the HSE to provide this to the Deputy directly.

HSE Complaints Procedures

Ceisteanna (450)

Louise O'Reilly

Ceist:

450. Deputy Louise O'Reilly asked the Minister for Health the procedure to be followed for clients or relatives that have had a poor care experience with an outsourced company; the department of the HSE which deals with these complaints; the person or body within the public health system that has responsibility for handling complaints for outsourced companies working on HSE care packages; and if he will make a statement on the matter. [22007/19]

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.

Health Services Provision

Ceisteanna (451)

Clare Daly

Ceist:

451. Deputy Clare Daly asked the Minister for Health the reason a free foot assessment service for persons with diabetes has been withdrawn from north County Dublin; and the steps he will take to reinstate same. [22009/19]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Question No. 452 answered with Question No. 408.

Health and Social Care Professionals Regulation

Ceisteanna (453)

Declan Breathnach

Ceist:

453. Deputy Declan Breathnach asked the Minister for Health if consideration will be given to a mechanism to force a doctor already struck off the register for offences and misconduct to present themselves to answer new charges of misconduct leading to the death of a patient; his views on whether it is unfair that such charges be brought merely on the grounds that the doctor is already struck off; and if he will make a statement on the matter. [22021/19]

Amharc ar fhreagra

Freagraí scríofa

Under the Medical Practitioners Act 2007, complaints against registered medical practitioners are a matter for the Medical Council. I have no role in relation to such matters and am specifically precluded by section 9 of the Act from giving policy directions to the council in relation to the performance of its functions in the area of complaints concerning registered medical practitioners.

The Medical Council's remit, as set out in the Medical Practitioners Act 2007, provides the Council with the authority to investigate complaints against registered medical practitioners in Ireland. If a doctor has been struck off the Medical Council’s register following a Fitness to Practice inquiry they can no longer be placed on or apply for registration with the Medical Council. The Medical Council cannot investigate complaints against people who are not on the register.

In the situation where allegations have been made about a former registered medical practitioner, depending on the nature of the facts, another State body may decide to investigate, for example if allegations related to a matter of a criminal nature the Gardaí may decide to investigate.

It is an offence for a practitioner to practise unregistered. Section 105 of the Medical Practitioners Act 2007 provides the Medical Council with the power to inform the Gardaí, the Minister and, if necessary, to apply for an injunction in respect of a practitioner who is not on the register but continues to practise.

If a registered medical practitioner is struck off the register following a Fitness to Practice inquiry an alert is sent to all EU countries and to other jurisdictions as deemed necessary.

Disability Definitions

Ceisteanna (454, 457)

John Lahart

Ceist:

454. Deputy John Lahart asked the Minister for Health if he will instruct the HSE to acknowledge that ME can lead to disability from mild to profound; if the HSE will add ME to its list of disabilities (details supplied); his views on whether access to assessment for home support and personal assistance should be through disability services not older person’s services; and if he will make a statement on the matter. [22022/19]

Amharc ar fhreagra

John Lahart

Ceist:

457. Deputy John Lahart asked the Minister for Health if the HSE will implement the international consensus criteria for myalgic encephalomyelitis in order that persons with ME can get a clear diagnosis as soon as possible; and if he will make a statement on the matter. [22025/19]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 454 and 457 together.

Chronic fatigue syndrome (CFS) / myalgic encephalomyelitis (or encephalopathy) (ME) is a not uncommon, complex debilitating disorder which is characterised by severe fatigue accompanied by a range of other symptoms.

There is currently no known, specific, medical diagnostic test to determine or confirm a correct diagnosis of ME and no specific treatment which works for all sufferers is currently available. Assessment and interventions need to be tailored to the individual. There are assessments/tests which can be carried out in primary care settings by a General Practitioner. Specialised tests may be required when considering differential diagnoses.

Treatment for ME is tailored to address the varying symptoms presented by those affected by ME. In general, these treatments are delivered within the context of primary care, with referrals into secondary care for specialist interventions in the areas of Neurology, Rheumatology, Pain Specialists, Endocrinology, Immunology, Cardiology, etc. The challenge in relation to ME is that it does not sit within one specialty, but crosses a number of specialties, with patients attending different Consultants for management of symptoms as they arise.

Waiting times for access to these services can be lengthy. However, there is currently work under way as part of the implementation of the Strategy for the Design of Integrated Outpatient Services 2016-2020, specifically as regards addressing how and where the patient is treated and the classification of referrals with corresponding clinically recommended time-frames. Consideration is also being given to condition specific referral forms. This work should see significant improvements with respect to access to appropriate services.

I have asked the Health Service Executive to also respond to you on this matter.

Disease Management

Ceisteanna (455, 456, 458, 459, 460, 461)

John Lahart

Ceist:

455. Deputy John Lahart asked the Minister for Health the criteria used here to diagnose the neurological disease myalgic encephalomyelitis (details supplied); and if he will make a statement on the matter. [22023/19]

Amharc ar fhreagra

John Lahart

Ceist:

456. Deputy John Lahart asked the Minister for Health his plans to develop guidelines for myalgic encephalomyelitis relevant to Ireland; if contemporary research will be referenced in relation to same rather than relying on same from the UK; and if he will make a statement on the matter. [22024/19]

Amharc ar fhreagra

John Lahart

Ceist:

458. Deputy John Lahart asked the Minister for Health if he will instruct the HSE to develop a clear pathway of care for persons with ME with prompt access to specialists and treatments; and if he will make a statement on the matter. [22026/19]

Amharc ar fhreagra

John Lahart

Ceist:

459. Deputy John Lahart asked the Minister for Health his plans to address the lack of specialist consultants for myalgic encephalomyelitis; his views on whether ME is a multisystem disease involving many areas with many debilitating symptoms which require patients to see many consultants; and if he will make a statement on the matter. [22027/19]

Amharc ar fhreagra

John Lahart

Ceist:

460. Deputy John Lahart asked the Minister for Health if he will designate myalgic encephalomyelitis as a reportable health condition in order to obtain robust official collection of data on the number of children, young persons and adults with the condition and the degrees of severity of the condition; and if he will make a statement on the matter. [22028/19]

Amharc ar fhreagra

John Lahart

Ceist:

461. Deputy John Lahart asked the Minister for Health if he will instruct the HSE to update its diagnostic and treatment procedures for persons with myalgic encephalomyelitis to reflect best international practice; if he will address the lack of specialist support within the health service for those suffering with the condition; and if he will make a statement on the matter. [22029/19]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 455, 456, and 458 to 461, inclusive, together.

Chronic fatigue syndrome (CFS) / myalgic encephalomyelitis (or encephalopathy) (ME) is a not uncommon, complex debilitating disorder which is characterised by severe fatigue accompanied by a range of other symptoms.

There is currently no known, specific, medical diagnostic test to determine or confirm a correct diagnosis of ME and no specific treatment which works for all sufferers is currently available. Assessment and interventions need to be tailored to the individual. There are assessments/tests which can be carried out in primary care settings by a General Practitioner. Specialised tests may be required when considering differential diagnoses.

Treatment for ME is tailored to address the varying symptoms presented by those affected by ME. In general, these treatments are delivered within the context of primary care, with referrals into secondary care for specialist interventions in the areas of Neurology, Rheumatology, Pain Specialists, Endocrinology, Immunology, Cardiology, etc. The challenge in relation to ME is that it does not sit within one specialty, but crosses a number of specialties, with patients attending different consultants for management of symptoms as they arise.

Waiting times for access to these services can be lengthy. However, there is currently work under way as part of the implementation of the Strategy for the Design of Integrated Outpatient Services 2016-2020, specifically as regards addressing how and where the patient is treated and the classification of referrals with corresponding clinically recommended time-frames. Consideration is also being given to condition specific referral forms. This work should see significant improvements with respect to access to appropriate services.

Question No. 457 answered with Question No. 454.
Questions Nos. 458 to 561, inclusive, answered with Question No. 455.

Hospital Appointments Status

Ceisteanna (462)

Robert Troy

Ceist:

462. Deputy Robert Troy asked the Minister for Health if an appointment will be scheduled for a person (details supplied). [22041/19]

Amharc ar fhreagra

Freagraí scríofa

Under 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.

General Practitioner Contracts

Ceisteanna (463)

Éamon Ó Cuív

Ceist:

463. Deputy Éamon Ó Cuív asked the Minister for Health if doctors involved in the general medical scheme can charge patients for a routine blood test in circumstances in which they have a medical card; and if he will make a statement on the matter. [22077/19]

Amharc ar fhreagra

Freagraí scríofa

Under the terms of the current GMS contract, GPs are required to provide eligible patients with  ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess." There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition.

The HSE has advised GPs that where a blood test forms part of the investigation or necessary treatment of a patient’s symptoms or conditions, this should be free of charge for patients who hold a medical card or GP visit card. Notwithstanding this, I am aware that some GPs are charging GMS patients for phlebotomy services in some circumstances.

This is a matter of concern for me as it has long been the position, under successive Governments, that no user charges should apply to GP services provided to GMS  and GP visit card patients. If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient should report the matter to their HSE Local Health Office.

Disability Services Provision

Ceisteanna (464)

Jackie Cahill

Ceist:

464. Deputy Jackie Cahill asked the Minister for Health the services available to a person (details supplied) for respite physiotherapy and so on; and if he will make a statement on the matter. [22098/19]

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

General Practitioner Services Provision

Ceisteanna (465)

Niamh Smyth

Ceist:

465. Deputy Niamh Smyth asked the Minister for Health the status of the provision of a full-time general practitioner service in areas (details supplied); and if he will make a statement on the matter. [22114/19]

Amharc ar fhreagra

Freagraí scríofa

As this question relates to a service matter, I have arranged for it to be referred to the HSE for direct reply to the Deputy.

Disability Services Provision

Ceisteanna (466)

Michael McGrath

Ceist:

466. Deputy Michael McGrath asked the Minister for Health the intervention services available to a child (details supplied) in County Cork; his plans to provide services for them; and if he will make a statement on the matter. [22124/19]

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.

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