Mental Health Commission Reports

Ceisteanna (80, 127)

James Browne

Ceist:

80. Deputy James Browne asked the Minister for Health the way in which he plans to address the issues raised in the annual report of the Mental Health Commission and the inspector of mental health services; and if he will make a statement on the matter. [27743/19]

Amharc ar fhreagra

Pat Buckley

Ceist:

127. Deputy Pat Buckley asked the Minister for Health if his attention has been drawn to the recent annual report of the Mental Health Commission which found unacceptable failings in hygiene and maintenance at units across services; and his plans to improve conditions and strengthen mental health patients' rights. [27651/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 80 and 127 together.

Firstly, I would like to acknowledge the important work of the Mental Health Commission in holding our mental health services to account, and helping to improve standards across facilities and services. The Department of Health is committed to the Mental Health Commission’s vision of a mental health service underpinned by the human rights of service users. 

I welcome the positive trend towards greater compliance with Commission regulations by the 64 Approved Centres in 2018. I note that compliance across Approved Centres has improved from 76% in 2017 to 79% in 2018. I am glad to see that the Commission has registered significant progress between 2016 and 2018, with 32 Centres achieving good compliance and no Centres with poor compliance. 

However, I recognise that further improvements are needed. The Commission, in both the 2018 Annual Report and in the Inspector's Report, identified areas of low compliance in certain Approved Centres. In instances where the high standards are not being met, it is important that the Commission continues to work with the HSE to identify solutions and to put these in place. In this regard, the HSE, with the Commission, has developed Corrective and Preventative Action Plans for centres found to be non-compliant. 

The Department of Health will continue to monitor progress made by the HSE in improving compliance, to improve service delivery for mental health service users across the system.

Hospital Waiting Lists

Ceisteanna (81)

Thomas Byrne

Ceist:

81. Deputy Thomas Byrne asked the Minister for Health the reason for the significant increase in waiting times for outpatient appointments in Our Lady's Hospital, Navan since May 2016; and if he will make a statement on the matter. [27761/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.  

The joint Department of Health/HSE/National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing waiting times for inpatient/day case treatment and outpatient appointments.

 A key element of the Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments. For its part the NTPF will aim to deliver 40,000 first Outpatient appointments.

The NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify outpatient waiting list proposals. While the NTPF have already approved over 38,000 outpatient appointments, they advise that the impact of these initiatives may not be seen until the end of the year. Approximately 75% of outpatient appointments approved to date relate to 4 high-volume specialties, specifically Ophthalmology, ENT, Orthopaedics, and Dermatology.

In relation to the reason for the significant increase in waiting times for outpatient appointments in Our Lady’s Hospital Navan since May 2016, I have asked the HSE to respond to the Deputy directly.

Hospital Services

Ceisteanna (82, 516)

Catherine Connolly

Ceist:

82. Deputy Catherine Connolly asked the Minister for Health when the orthopaedic theatres at Merlin Park Hospital, Galway which have been closed since September 2017 will be reinstated; and if he will make a statement on the matter. [27934/19]

Amharc ar fhreagra

Éamon Ó Cuív

Ceist:

516. Deputy Éamon Ó Cuív asked the Minister for Health when full orthopaedic services will recommence in Merlin Park Hospital, Galway; when two operating theatres will be operating there again; and if he will make a statement on the matter. [28284/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 82 and 516 together.

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

Mental Health Services Provision

Ceisteanna (83)

Pat Buckley

Ceist:

83. Deputy Pat Buckley asked the Minister for Health the model he is planning for the crisis text line service for mental health; the other models this is based on; the rationale for choosing this model; and if he will make a statement on the matter. [27650/19]

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 Car Parks

Ceisteanna (84)

Gino Kenny

Ceist:

84. Deputy Gino Kenny asked the Minister for Health the moneys raised through public hospital car parking charges; the amount of this paid to the private companies that operate hospital car parks; the amount retained by the hospital; the way in which it is used; and if he will make a statement on the matter. [27805/19]

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.

Health Services Staff Remuneration

Ceisteanna (85)

Richard Boyd Barrett

Ceist:

85. Deputy Richard Boyd Barrett asked the Minister for Health his plans to deal with the outstanding issues with regard to pay and conditions across the health service in order that the shortages of staff can be addressed; and if he will make a statement on the matter. [27849/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Staff employed in the public health service are in receipt of a series of pay increases under the Public Service Stability Agreement.  This will see public servants receiving an average 7% increase in their salary over the lifetime of the Agreement.  By the end of 2020, the commitment is there to restore 90% of the pay reductions experienced under the FEMPI legislation.  Public health sector employees also benefit from a pension which is highly valuable to the employee as well as other benefits such as flexible working, sick-leave and maternity leave. 

In terms of recruitment to and retention of health service grades, the Public Service Pay Commission is continuing its work on assessing roles in the public service which have been identified as experiencing recruitment and retention issues.  The Commission has already made recommendations in relation to nurses, consultants and NCHDs and the Government has accepted these findings.

Given its analysis, the Commission proposed that the parties to the Public Service Stability Agreement jointly consider what further measures could be taken over time to address the pay differential between serving and new entrant consultants. The next step is to engage with the representative organisations of consultants. However, brokering an affordable solution will be a significant challenge, in particular within the context of budgetary pressures and broader public sector policy. While pay has a significant impact in recruitment and retention of consultants, a number of other factors are also important, including, inter alia, opportunities for career development, training opportunities and location. The Commission stated it was strongly supportive of the full implementation of the recommendations of the Strategic Review of Medical Training and Career Structures, the 'MacCraith' recommendations.

Concerning Nurses, the recent nursing agreement and the new Enhanced Practice Nurse/Midwife contract will see the financial position of nurses and midwives improve and should help to both recruit and retain nurses in the public health service. In relation to pay, the new Enhanced Practice Nurse and Midwife contract will deliver salary improvements for those that migrate to this new role ranging from between 2% - 11%. The Enhanced Nurse/Midwife Practice salary scale ranges between €35,806 to €47,201. The agreement will see improvements to a range of allowances, their extension to additional nurses and midwives, and a new allowance for those in medical surgical wards up to the maximum full year cost of €10m. It also includes a commitment to increase the number of Advanced Nurse Practitioners to a minimum of 2% of the nursing workforce. The HSE is currently working on a plan to deliver the implementation of the agreement.

Finally,  in relation to the industrial action which took place on 26 June 2019 by SIPTU support staff grades, I was pleased that talks between the parties resumed at the Workplace Relations Commission last Thursday.  While some progress was made, it was not possible to reach agreement on all issues.  As a result, the matter has now been referred to the Labour Court for an hearing on Wednesday, 3 July 2019.

Hospital Services

Ceisteanna (86)

Bobby Aylward

Ceist:

86. 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 to the rest of Ireland; and if he will make a statement on the matter. [27983/19]

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 and recruitment is progressing.

A mobile cath lab has 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.

The HSE has confirmed that this project has now been included in the HSE’s Capital Programme 2019 and that it is expected that the Planning Permission application will be lodged by the end of this year.

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. I asked his Department to address the implications of this recommendation by arranging for a National Review of Specialist Cardiac Services, which is underway.

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.

Drafting of the report will continue over the summer and it is expected that this work to be finalised in early September.

Abortion Legislation

Ceisteanna (87, 462)

Gino Kenny

Ceist:

87. Deputy Gino Kenny asked the Minister for Health if a definitive date will be provided for the introduction of exclusion safe zones for persons accessing abortion services at general practitioner surgeries or hospitals; and if he will make a statement on the matter. [27804/19]

Amharc ar fhreagra

Louise O'Reilly

Ceist:

462. Deputy Louise O'Reilly asked the Minister for Health when the legislation for exclusion zones will be ready. [28040/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 87 and 462 together.

It was my original intention to provide for safe access to termination of pregnancy services in the Health (Regulation of Termination of Pregnancy) Act 2018.  However, a number of legal issues were identified which necessitated further consideration and advice. 

In order to allow full consideration of these issues, Government approved the drafting of a separate piece of legislation.

Officials in the Department of Health are working with the Office of the Attorney General to examine the issue of safe access, including the current situation, and national and international rights and obligations in this area, and will be making a further submission to me in the coming weeks.

I will be happy to provide the Deputies with a further update as soon as one is available.

Hospitals Capital Programme

Ceisteanna (88, 113)

Pat the Cope Gallagher

Ceist:

88. Deputy Pat The Cope Gallagher asked the Minister for Health if a capital budget for three Donegal community hospitals (details supplied) will be confirmed; when works will commence for the hospitals; if all works will be completed within the timeframe of the existing capital plan of his Department and the HSE; if budgets for the necessary works to guarantee the long stay accommodation units and residential care units in all three community hospitals are combined and the necessary investment is ring-fenced for these projects; and if he will make a statement on the matter. [27715/19]

Amharc ar fhreagra

Pat the Cope Gallagher

Ceist:

113. Deputy Pat The Cope Gallagher asked the Minister for Health the status of St. Joseph's Community Hospital, Ramelton Community Hospital and Lifford Community Hospital, County Donegal; the budgets in place to bring the hospitals up to HIQA standards and to future guarantee the residential care units of same; if all works will be completed within the lifetime of the existing capital plan 2016-2021; and if he will make a statement on the matter. [27716/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 88 and 113 together.

The overarching policy of the Government is to support older people to live in dignity and independence in their own homes and communities for as long as possible. The standard of care delivered to residents in public units is generally very high, but we recognise that many of our community hospitals are housed in buildings that are less than ideal in the modern context. It is important therefore that we upgrade our public bed stock and this is the aim of the Capital Investment Programme for Community Nursing Units.

The HSE is responsible for the delivery of health and personal social services, including the facilities at St. Joseph’s Community Hospital, Stranorlar, Ramelton Community Hospital and Lifford Community Hospital, Donegal. The HSE has advised the following in relation to these facilities.

The Community Nursing Unit programme provides for the retention of services at St. Joseph’s Community Hospital, Stranorlar and Ramelton Community Hospital with a requirement for refurbishment of both centres.

In the short term the HSE will invest minor capital in both units in 2019 and 2020 in order to deal with HIQA compliance issues and an agreed schedule of works is being finalised with HIQA.

The redevelopment of the Lifford unit on the existing site is not deemed viable. The need for additional beds and the potential to develop a new facility on a greenfield site will be reviewed further post 2021. The existing unit at Lifford will continue to operate in the intervening period.

Abortion Services Provision

Ceisteanna (89)

Louise O'Reilly

Ceist:

89. Deputy Louise O'Reilly asked the Minister for Health the hospitals in which abortion care is available; the hospitals in which it is unavailable; and if he will make a statement on the matter. [27660/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Health (Regulation of Termination of Pregnancy) Act 2018 was passed by the Houses of the Oireachtas on 13 December 2018 and signed into law by the President on 20 December 2018. 

Services for termination of pregnancy have been available since 1 January 2019. 

Additional resources have been allocated to provide for termination of pregnancy services this year.  In total €12 million was allocated in the budget for the provision of termination of pregnancy services in 2019.

I have made it clear to the HSE that termination of pregnancy services, under the Health (Regulation of Termination of Pregnancy) Act 2018, should be provided in all nineteen maternity hospitals.

All hospitals are providing terminations in emergency situations (when a woman’s life or health is at risk). Terminations in cases of fatal foetal abnormality are, generally, available in the larger tertiary hospitals, as in such cases particular expertise, only available in those hospitals, may be required.

Terminations up to 12 weeks of pregnancy are currently being provided in 10 maternity hospitals/units in the following Hospital Groups:

Ireland East Hospital Group

1. National Maternity Hospital - Holles Street

2. Midland Regional Hospital Mullingar

RCSI Hospital Group

3. Rotunda Hospital

4. Our Lady of Lourdes Hospital Drogheda

Dublin Midlands Hospital Group

5. Coombe Women and Infants University Hospital

Saolta Hospital Group

6. University Hospital Galway

7. Mayo University Hospital

 University of Limerick Hospitals

8. University Maternity Hospital Limerick 

South/South West Hospital Group

9. Cork University Maternity Hospital

10. University Hospital Waterford

There is regular ongoing engagement between the Department of Health and the HSE to facilitate the smooth running of the service and to resolve any issues that may arise.

The HSE has advised that additional maternity units are expected to begin providing termination of pregnancy services in the coming months.

Primary Care Centres Administration

Ceisteanna (90)

Louise O'Reilly

Ceist:

90. Deputy Louise O'Reilly asked the Minister for Health if scanning facilities will be provided for the primary care centre in Balbriggan, County Dublin. [27656/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Home Help Service Provision

Ceisteanna (91)

John Curran

Ceist:

91. Deputy John Curran asked the Minister for Health the progress made to reduce the waiting list and waiting time for home support services in community healthcare organisation area 7, CHO 7; and if he will make a statement on the matter. [27646/19]

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.

Hospitals Policy

Ceisteanna (92)

Stephen Donnelly

Ceist:

92. Deputy Stephen Donnelly asked the Minister for Health the reason he has not made public the De Buitléir report on private practice in public hospitals; when he plans to do so; and if he will make a statement on the matter. [27891/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Report of the Independent Review Group established to examine private activity in public hospitals (the "De Buitléir Report) has been received and is being examined in my Department. It is a comprehensive examination of private activity in public hospitals and contains a small number of recommendations. 

Detailed consideration of the Report by my Department officials is ongoing and covers a range of issues, which have also been discussed in engagement with the Department of Public Expenditure and Reform and the Department of the Taoiseach. It is intended that the De Buitléir Report will be published when this consideration is complete. 

Mental Health Services Provision

Ceisteanna (93)

Margaret Murphy O'Mahony

Ceist:

93. Deputy Margaret Murphy O'Mahony asked the Minister for Health his plans to improve mental health services in the west County Cork local health office area; and if he will make a statement on the matter. [27896/19]

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.

HSE Expenditure

Ceisteanna (94)

Stephen Donnelly

Ceist:

94. Deputy Stephen Donnelly asked the Minister for Health the amount the HSE budget is overspent as at the end of quarter 2 of 2019; the projection for the full-year overspend; the additional spending commitments he has made during 2019; his plans to seek a supplementary budget or bring full-year healthcare expenditure in on budget; and if he will make a statement on the matter. [27888/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The HSE’s latest income and expenditure position at 30 April 2019 shows a revenue deficit of €116.2m which represents 2.3% of the available budget.  The main drivers of the deficit are acute hospitals, PCRS and demand-led schemes, disability services and the treatment abroad scheme. Current gross expenditure on the Health Vote, year to date, is 8.8% higher than the same period in 2018.  This percentage varies on a monthly basis during the year depending on spending under various headings but is, nonetheless, a matter of concern. 

Significant savings are profiled later in the year in line with the targets set out in the National Service Plan.  However, on present trends, taking account of the pressure in certain areas, the HSE would have a deficit at the end of 2019. This is a matter of concern for the Government. My Department is working with the HSE to gain further clarity on the  projected year end position and working to mitigate the deficit in so far as is possible, in co-operation with the Department of Public Expenditure and Reform. 

I have emphasised to the Executive the need to address health spending urgently by means of the following measures;

- Steps to ensure compliance with the staffing limits for 2019;

- A reporting and monitoring structure around agreed savings targets in the National Service Plan, with responsible managers providing a monthly report from Quarter 1;

- A mid-year review of the Health Service Executives performance on savings and staffing limits, with further interventions as necessary. 

In addition, the establishment of a new HSE Board governance structure, with strong competencies across key areas, will further contribute to strengthening the oversight and performance of the HSE pending its further reorganisation. The newly-appointed CEO to the Health Service Executive has also committed to strengthening the HSE’s leadership and focus on performance, in line with my own identification of an effective performance management and accountability system for the HSE as one of the priority issues for the new Board.

In addition, outside of the National Service Plan there are other financial commitments, including costs associated with contingency Brexit planning; costs of the Cervical Check ex-gratia scheme; and the recent nursing agreement.  

The National Service Plan requires the HSE to protect and promote the health and well-being of the population, having regard to the resources available to it, and making the most efficient and effective use of those resources. Implementation of the Service Plan is ongoing, and my Department understands that the position of the HSE is that protection of front-line service delivery is its priority.  I have emphasised the need for the Executive to meet its service targets in line with the National Service Plan.   

Health Screening Programmes

Ceisteanna (95)

Aindrias Moynihan

Ceist:

95. Deputy Aindrias Moynihan asked the Minister for Health the corrective and preventative actions put in place to ensure the diabetic retina screening programme delivers accurate and timely results to service users; and if he will make a statement on the matter. [27984/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Diabetic RetinaScreen, the National Diabetic Retinal Screening Programme is a government funded screening programme in Ireland that offers free, regular diabetic retinopathy screening to people with diabetes aged 12 years and older.

Diabetic RetinaScreen uses specialised digital photography to look for changes that could affect sight. Results are delivered in compliance with quality standards as outlined in the ‘Standards for Quality Assurance in Diabetic Retinopathy Screening’.  As with other national screening programmes, quality assurance is paramount and all essential elements are in place to ensure risks to patients are minimised and that the best clinical outcomes for patients are maximised.

Hospital Services

Ceisteanna (96)

Dara Calleary

Ceist:

96. Deputy Dara Calleary asked the Minister for Health his plans for Belmullet District Hospital and a nursing unit (details supplied); the way in which it is planned to address concerns in relation to staffing and bed numbers; and if he will make a statement on the matter. [27751/19]

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 Staff

Ceisteanna (97)

Michael McGrath

Ceist:

97. Deputy Michael McGrath asked the Minister for Health the action being taken to address the fact that four of the seven permanent radiation oncology posts at Cork University Hospital are either vacant or filled on a temporary basis while one of the five medical oncology posts is also vacant; and if he will make a statement on the matter. [27808/19]

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.

Hospitals Capital Programme

Ceisteanna (98)

Margaret Murphy O'Mahony

Ceist:

98. Deputy Margaret Murphy O'Mahony asked the Minister for Health the status of upgrades to a number of community hospitals (details supplied) in County Cork; the timeframe for the completion of each; and if he will make a statement on the matter. [27897/19]

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.

National Maternity Strategy Implementation

Ceisteanna (99)

Stephen Donnelly

Ceist:

99. Deputy Stephen Donnelly asked the Minister for Health if relevant parties will be informed that the new maternity hospitals are to have no dedicated facilities for private patients further to an unanimous adoption of a Private Members' motion on maternity care by Dáil Éireann; if the relevant parties will commence the planning and design phases for the Coombe hospital, Rotunda Hospital and University Maternity Hospital, Limerick; the capital spend by year allocated for the building of these maternity hospitals and centres; and if he will make a statement on the matter. [27892/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Project Ireland 2040 provides €10.9 billion for health capital developments across the country. This unprecedented health capital investment will support existing Government priority projects and policies, including funding to support implementation of the National Maternity Strategy. The funding which will be made available over the next decade will enable us to provide an appropriate environment within all our maternity hospitals/units to facilitate the delivery of a modern, safe, quality service where the woman’s need for privacy and dignity is respected. 

It is important that we carefully plan all projects to meet population health needs and achieve value for money.  This work is ongoing. While I am not in position to outline the year on year provisions for the the individual maternity hospital projects at this stage, this will be considered through the process of the determination of service priorities and in the context of the finalisation of the Health Capital Plan.

The first new maternity hospital will be built on the St Vincent's University Hospital campus. I can assure the Deputy that the vast majority of services in the new hospital will be public services.  However, as part of the National Consultants' Contract, negotiated in 2008, some consultants holding specific contracts are entitled to engage in private outpatient practice outside of their public commitment; this commitment must be conducted on site, in the hospital where the consultant holds his/her contract. As a result, private outpatient clinics may be undertaken on a public hospital campus, however, these clinics must be held outside contracted hours. There is an obligation to provide such facilities for consultants holding such contracts, but it is proposed that the consultants will be required to pay a fee for the use of the rooms and other operational costs. 

Finally, I should perhaps also confirm that there will be no designated private in-patient bedrooms in the new maternity hospital. 

Hospital Waiting Lists

Ceisteanna (100)

John Lahart

Ceist:

100. Deputy John Lahart asked the Minister for Health the action he is taking to reduce outpatient waiting times; if his attention has been drawn to the fact that the number of patients waiting more than 18 months in Tallaght Hospital has increased by 7,676, 676.9%, since May 2016 and stood at 8,810 at the end of May 2019; and if he will make a statement on the matter. [27766/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.

The joint Department of Health/HSE/National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing waiting times for inpatient/day case treatment and outpatient appointments.

The Access Plan sets out the activity levels for the NTPF, who will supply additionality to HSE activity, in order to reduce waiting times experienced by patients for a hospital appointment, operation or procedure.  

A key element of the Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments. For its part the NTPF will aim to deliver 40,000 first Outpatient appointments.

The NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify outpatient waiting list proposals and to date in 2019, Tallaght Hospital  has received approval for NTPF funding for a number of Outpatient initiatives:

Outpatient appointments

Patient Nos.

Vascular Diagnostic

100

Urology

400

Rheumatology

192

Orthopaedics

120

Neurology

437

Gynaecology

400

General Surgery

160

ENT

1,020

Dermatology

200

Pain Medicine

(See & treat)

150

In addition, my Department is working with the HSE and NTPF, under the Access Plan, with the objective of developing medium-long term improvement initiatives for patient access to hospital procedures. This will include moving care to more appropriate settings and providing care at the lowest level of complexity such as providing ophthalmology in the community; maximising the use of Advanced Nurse Practitioner led clinics; and physiotherapists to manage orthopaedic clinics. 

With regard to overall measures being implemented at Tallaght Hospital to address Outpatient Waiting Lists, I have asked the HSE to respond to the Deputy Directly.

National Cervical Screening Programme Inquiry

Ceisteanna (101)

Alan Kelly

Ceist:

101. Deputy Alan Kelly asked the Minister for Health the date a person (details supplied) found out that a laboratory in Manchester was not accredited to perform cervical cancer screening; and if he will make a statement on the matter. [27724/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In the Supplementary Report of the Scoping Inquiry, which was published on 11 June, Dr. Scally confirmed that the number of laboratories involved in CervicalCheck work was greater than was originally thought, 16 in total, and the use of many of these laboratories was not approved in advance by CervicalCheck, nor was it known to it. The report also finds that, on the basis of the information available to the Inquiry, the use of additional laboratories did not result in a reduction of the quality of the screening provided to Irish women and there is no evidence to suggest deficiencies in screening quality in any laboratory.

As the Deputy is aware, Dr. Scally expressed concern about accreditation in relation to one laboratory in Salford, UK. This is ancillary to the main MedLab facility in Dublin. The performance data of this ancillary lab was included in that reviewed by the Inquiry in mid-2018, when it concluded that there was no reason, on quality grounds, why existing contracts for laboratory services should not continue. The Inquiry notes this lab has also been subject to a quality assurance visit by HSE staff. The provision of screening by this laboratory is being phased out, noting that MedLab is now focused on clearing its backlog of slides, and all new slides being read by either Quest Diagnostics or the Coombe. Accreditation is one important element in providing assurance about quality, of course, but notwithstanding that there is a concern about accreditation, the key issue is whether there was any deficiency in screening quality. Dr. Scally says there is no evidence of any such deficiency.

I am not aware of the specific dates involved in relation to the accreditation of the laboratory in Manchester and I would emphasise the independence of Dr Scally's work in this regard. However, when the Deputy raised this issue at Dáil statements on 19 June, I undertook to follow up with Dr Scally on the Deputy's behalf. I have been advised that Dr. Scally wrote to the Deputy on 23 June to provide an answer to his queries.

National Children's Hospital

Ceisteanna (102)

Richard Boyd Barrett

Ceist:

102. Deputy Richard Boyd Barrett asked the Minister for Health if he will revise his plan to allow a private section in the new children's hospital further to his comments to a newspaper on 23 June 2019 (details supplied); and if he will make a statement on the matter. [27848/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The vast majority of services in the new children’s hospital will be public services. However, as part of the National Contract for Consultants negotiated in 2008, some consultants holding specific contracts are entitled to engage in private outpatient practice outside of their public commitment and this commitment must be conducted on site, that is, in the hospital they are contracted with. As a result, private outpatient clinics may be held on the public hospital campus but these clinics must be held outside contracted hours. The new children's hospital is obliged to provide such facilities for consultants holding such contracts. The proposal is for consultants to pay a fee for use of the rooms and other operational costs.

The Report of the Independent Review Group established to examine private activity in public hospitals has been received and is being examined in my Department. It is a comprehensive examination of private activity in public hospitals and contains a small number of recommendations. When the recommendations have been examined and considered in my Department and by other relevant Government Departments, it is intended to bring proposals to Government and to publish the Report thereafter.

National Cervical Screening Programme Inquiry

Ceisteanna (103)

Bríd Smith

Ceist:

103. Deputy Bríd Smith asked the Minister for Health the laboratories from which the 221 false readings came in the CervicalCheck screening programme; and if he will make a statement on the matter. [27925/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the Deputy will be aware from previous responses on this issue, the HSE has advised that analysis was required in order to make the requested data available. 

The requirement for analysis reflected the complexities involved in this work. For example, some women may have had multiple smears, not necessarily read in the same lab; slides may have changed by one grade or multiple grades which is a complexity that would not be shown by a simple breakdown across labs; labs dealt with different regional populations and in the early years of the programme it was dealing with an unscreened population, which is a further complexity.

An expert was identified to carry out this work in late 2018, and I understand that the report is nearing finalisation, including through engagement between the HSE and patient representatives.

Home Help Service

Ceisteanna (104)

Michael Moynihan

Ceist:

104. Deputy Michael Moynihan asked the Minister for Health if he is satisfied that information indicating that there is no person waiting for home support hours in the north Cork local health office area is accurate; and if he will make a statement on the matter. [27773/19]

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 Waiting Lists Action Plans

Ceisteanna (105)

Brendan Smith

Ceist:

105. Deputy Brendan Smith asked the Minister for Health the measures in place to reduce waiting times for orthopaedic assessments and procedures for patients in counties Cavan and Monaghan; and if he will make a statement on the matter. [27812/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.

The National Treatment Purchase Fund (NTPF) has provided my Department with data on the number of patients resident in Cavan and Monaghan who were present on an Inpatient/Daycase and Outpatient Orthopaedics waiting list, broken down by hospital.

The data shows that there are 76 patients from Cavan/Monaghan on the IPDC Orthopaedics waiting list, which represents 0.8% of the National orthopaedics waiting list. 43% of the patients from Cavan & Monaghan are listed on the Cappagh Hospital IPDC orthopaedics Waiting list. The Cappagh Hospital IPDC Orthopaedic waiting list has decreased by 5% when compared to the same period last year and 96% of patients are waiting 9 months or less.

The NTPF data also shows that there are 2,122 patients from Cavan/Monaghan on the Outpatient Orthopaedic waiting list, which represents 3% of the National orthopaedics waiting list. 73% of the patients from Cavan/Monaghan are on the Cavan General Hospital Outpatient Orthopaedics waiting list, and of these 61% of patients are waiting 12 months or less.

More broadly, Budget 2019 announced that the Government has further increased investment in tackling waiting lists, with funding to the National Treatment Purchase Fund (NTPF) increasing from €55 million in 2018 to €75 million in 2019. The joint Department of Health/HSE/National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing waiting times for inpatient/day case treatment and outpatient appointments. The plan places a strong focus on ten high-volume Inpatient/Day Case procedures, including hip/knee replacements. When combined with HSE activity, it is projected that the NTPF will be in a position to offer treatment to all clinically suitable patients waiting more than 6 months for one of these high-volume procedures.

A key element of the Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments. For its part the NTPF will aim to deliver 40,000 first Outpatient appointments.

The NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify outpatient waiting list proposals. While the NTPF have already approved over 38,000 outpatient appointments, they advise that the impact of these initiatives may not be seen until the end of the year. Approximately 75% of outpatient appointments approved to date relate to 4 high-volume specialities, specifically Ophthalmology, ENT, Orthopaedics, and Dermatology.

In addition, my Department is working with the HSE and NTPF, under the Access Plan, with the objective of developing medium-long term improvement initiatives for patient access to hospital procedures. This will include moving care to more appropriate settings and providing care at the lowest level of complexity such as providing ophthalmology in the community; maximising the use of Advanced Nurse Practitioner led clinics; and physiotherapists to manage orthopaedic clinics.

Ambulance Service

Ceisteanna (106)

Pat Casey

Ceist:

106. Deputy Pat Casey asked the Minister for Health the status of the review of ambulance services in Arklow and west County Wicklow; and if he will make a statement on the matter. [27759/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service issue, I have asked the HSE to reply to you directly.

Disability Services Provision

Ceisteanna (107)

Martin Heydon

Ceist:

107. Deputy Martin Heydon asked the Minister for Health if his attention has been drawn to the waiting times for disability services for children in south County Kildare; and if he will make a statement on the matter. [27966/19]

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.  

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.