Cancer Screening Programmes

Ceisteanna (1530)

Michael Harty

Ceist:

1530. Deputy Michael Harty asked the Minister for Health the number of cervical smears rejected, that is, not processed by a laboratory (details supplied) due to the fact that the vial expired as a result of smears being stored for a prolonged period while extra capacity was sought and contracts signed with the laboratory; and if he will make a statement on the matter. [33282/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Smear test samples must be sent to the laboratory and made into slides within six weeks of the smear test date. After six weeks, the sample is deemed expired and cannot be processed. Although every effort is made to avoid these situations from happening, it is inevitable that cervical screening programmes will sometimes encounter these issues. In such cases, a woman and her GP are advised of the need for a repeat test in three months’ time by letter from CervicalCheck.

As the Deputy will be aware, since 1 May 2019, MedLab Pathology Ltd no longer processes new cervical screening samples from CervicalCheck and is concentrating on processing all outstanding tests. The HSE advised of an issue arising in the context of the transfer of laboratory services from MedLab to Quest, which resulted in a delay transferring some samples to slides.

During the transition period a number of samples were unfortunately not transferred to slides within the six-week time frame and were subsequently expired. As of the week of 1 July 2019, this issue affected approximately 434 samples, out of a total of 27,194 samples, representing a rate of 1.59%.

The HSE advises that it has written to the women affected, and their GP, to inform them of this issue and invite them to attend a repeat smear test at least three months after the date that their initial test was taken.

Rehabilitation Training Allowance Payments

Question No. 1532 answered with Question No. 1113.

Ceisteanna (1531)

James Browne

Ceist:

1531. Deputy James Browne asked the Minister for Health the cost of the provision of a rehabilitation training allowance for recipients of disability allowance in 2018; the number of persons who received the allowance in 2018; the number of persons who received the allowance in 2018 in County Wexford; his plans to reverse the decision to cease the provision of the allowance; and if he will make a statement on the matter. [33284/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The HSE’s New Directions policy seeks to reconfigure and personalise HSE funded adult day services to offer a flexible and individualised set of supports to enable each person to live a life of their choosing in accordance with their own wishes and needs.

Rehabilitative Training (RT) Programmes are designed to equip participants with basic personal, social and work-related skills. Approximately 2,300 people attend RT programmes, with 400 new attendees due to start this coming September.  Payable in addition to Disability Allowance, the RT Bonus payment is currently payable at a rate of €31.80 per week to attendees of these RT Programmes, who can attend for a period of up to 4 years.  The RT Bonus was introduced in 2001, aligned with a similar FÁS Training Bonus. This FÁS Training Bonus later became the Solas Vocational Training Programme payment, which was reduced in 2011 and discontinued in 2012.

Over the next four years, from September 2019, the RT Bonus will not apply to new attendees. The money that would have been spent on the bonus, estimated at approximately €3.7 million over the four years, will be redirected to address unmet need in day service provision for people with disabilities.  This measure will have no impact on current participants as their payments will continue until they complete their 4 year programme. Importantly, the phasing out of the RT Bonus will mean that HSE Community Healthcare Organisations will have some funding to reallocate towards increasing the number of days per week available to those who did not receive a full service during the recession, or who are on a waiting list for a day service. 

The phasing out of this Bonus payment by the HSE will ensure more people have access to a day service on an equitable basis, consistency in treatment of all day service users and maximise the use of finite resources.

As the Deputy's question also 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.

Question No. 1532 answered with Question No. 1113.

Respite Care Services Funding

Ceisteanna (1533)

Éamon Ó Cuív

Ceist:

1533. Deputy Éamon Ó Cuív asked the Minister for Health if an organisation (details supplied) that will have 39 school leavers graduating to adult services in September 2019 will be given extra funding for the provision of adult respite services for persons who will require same in view of the fact that no such funding has been provided to date; and if he will make a statement on the matter. [33292/19]

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.

Irish Sign Language

Ceisteanna (1534)

Robert Troy

Ceist:

1534. Deputy Robert Troy asked the Minister for Health if additional funding will be put in place to assist an organisation (details supplied) in continuing to provide essential services for its members; if his attention has been drawn to the fact that essential services will be withdrawn should his Department not put adequate funding in place as a matter of urgency; his views on whether it is acceptable that such a cut in funding is taking place after the passing of the Irish Sign Language Act 2017 confirming Irish Sign Language as the third national language; and the way in which the cut in funding will affect the ability to commence the Act. [33295/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

A commitment of €60,000 additional funding is being provided to the Irish Deaf Society under a cross-departmental initiative.

The funding is a once-off grant for the purpose of developing a Business Plan and implementation strategy setting out a clear and detailed pathway to financial sustainability. Pobal are assisting in the oversight of the additional funds and related activities.

Primary Care Strategy

Ceisteanna (1535)

Brendan Griffin

Ceist:

1535. Deputy Brendan Griffin asked the Minister for Health his views on a matter regarding the primary care centre strategy (details supplied); and if he will make a statement on the matter. [33296/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The HSE has responsibility for both the provision and the maintenance and operation of Primary Care Centres (PCCs).  

Currently, PCCs are being delivered with a combination of direct build by the HSE or via an operational lease arrangement.  With regard to Tralee, the HSE is entering into an operational lease for the delivery of the PCC.

Under this method, the HSE leases the accommodation from a developer who was selected to build the PCC to the HSE’s specifications. A pharmacy is a permitted use as part of the overall development with some restrictions.  These stipulate that the pharmacy must have a separate entrance to the PCC and that there are no commercial links between the pharmacy and the GPs operating from the centre.

It is understood that there are a number of other tenants in the Centrepoint building in Tralee where the PCC will be located, and the relationship between them and the landlord is a purely commercial matter.  As such, questions of state support or state aid to a particular pharmacist do not arise, while the occupants of the PCC will be HSE staff, including nurses and therapists.

Public Health Policy

Ceisteanna (1536, 1537)

Marc MacSharry

Ceist:

1536. Deputy Marc MacSharry asked the Minister for Health if he has held meetings with the Minister for Transport, Tourism and Sport or other Ministers to discuss the possibility of incentivising persons to combine public transport with walking and cycling. [33297/19]

Amharc ar fhreagra

Marc MacSharry

Ceist:

1537. Deputy Marc MacSharry asked the Minister for Health his views on launching new promotional campaigns, incentive schemes or both to encourage persons to combine public transport usage with active modes of transport such as walking and cycling to promote public health. [33298/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 1536 and 1537 together.

Encouraging members of the public to walk, cycle, and/or take public transport is an important part of supporting opportunities for physical activity in daily life, particularly given that many people spend considerable time at work and commuting to work.

Promoting greater levels of physical activity, including through active travel, is a key theme under the Healthy Ireland initiative and the National Physical Activity Plan.

The ongoing Healthy Ireland communications campaign seeks to raise public awareness of Healthy Ireland as the place to go for trusted sources of information and supports, to help people get started on making healthy changes, including being more physically active.

In addition, officials from my Department have met with colleagues from the Department of Transport, Tourism and Sport and the National Transport Authority with a view to developing a promotional campaign of the type referred to by the Deputy.

Discussions are ongoing as to how best to progress this.

National Dementia Strategy

Ceisteanna (1538)

Robert Troy

Ceist:

1538. Deputy Robert Troy asked the Minister for Health the reason no county has a minimum standard of supports and services in place for dementia patients and their carers; and if funding for extra support services for same will be approved in budget 2020. [33333/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The aim of the National Dementia Strategy, which was published in December 2014 and is being implemented by the National Dementia Office, is to improve care, services and supports for people with dementia.

The HSE currently provides approximately €9 million per annum for intensive home care packages, including €7.9 million for dementia-specific packages. Since the packages were introduced at the end of 2014, 443 dementia-specific intensive homecare packages have been delivered, with 201 active at the end of March 2019. 

A total of €426 million has been allocated for home support services in 2019, which also benefit people with dementia. Over 17.9 million home support hours will be delivered to over 53,000 people this year.

The HSE provides in the region of €12 million in annual funding to a range of organisations who deliver dementia-specific respite, home care, day care, cognitive stimulation therapy, social clubs and supports for family carers around the country.    The HSE also provides €400,000 per annum to support the Dementia Adviser Service, which spans 12 counties, and is operated by the Alzheimer Society of Ireland. This funding supports 7 of the 9 dementia adviser posts delivering the service.

Last week, I launched a €1 million fund for community and voluntary groups to continue to support older people to stay well and remain connected with their local community. Approximately €250,000 of this funding will be dedicated to dementia related initiatives. 

The level of funding available for the Department of Health in 2020 and the quantum of services to be provided by the HSE, including for any measures to enhance dementia services, will be considered as part of the national Estimates and budgetary process and National Service Planning.

Child and Adolescent Mental Health Services Data

Ceisteanna (1539)

Fiona O'Loughlin

Ceist:

1539. Deputy Fiona O'Loughlin asked the Minister for Health the waiting times involved from when a child in care requiring psychological assessment is referred from Tusla to the HSE; and if he will make a statement on the matter. [33338/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Hospital Waiting Lists Action Plans

Ceisteanna (1540)

Fiona O'Loughlin

Ceist:

1540. Deputy Fiona O'Loughlin asked the Minister for Health the plans in place to deal with the large waiting list of patients requiring spinal surgery at Tallaght hospital; and if he will make a statement on the matter. [33342/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Reducing waiting time for patients for hospital operations and procedures is a key priority for Government. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.

 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/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 NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify waiting list proposals. The NTPF welcomes proposals from all acute hospitals for initiatives to improve access for patients on waiting lists.

With regard to overall measures being implemented at Tallaght Hospital to address spinal surgery waiting lists, I have asked the HSE to respond to the Deputy Directly.

Cross-Border Health Services Provision

Ceisteanna (1541, 1542)

Fiona O'Loughlin

Ceist:

1541. Deputy Fiona O'Loughlin asked the Minister for Health the number of staff in the cross-Border directive unit; the number of these who are HSE and agency staff, respectively; and if he will make a statement on the matter. [33354/19]

Amharc ar fhreagra

Fiona O'Loughlin

Ceist:

1542. Deputy Fiona O'Loughlin asked the Minister for Health if a submission has been received seeking additional resources for the cross-Border directive unit; if so, the number of staff who have been requested; when the submission was received; and if he will make a statement on the matter. [33355/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 1541 and 1542 together.

The HSE is responsible for the operation of the Cross Border Directive and the management of the HSE Cross Border Directive (CBD) office is an operational matter for the HSE. I have, therefore, asked the HSE to respond directly to the Deputy.

It should be noted that the numbers of persons availing of the Directive has been increasing steadily for a number of years with a corresponding increase in the workload for the CBD office. I am aware that the HSE is currently considering a business case, and other interim steps, to address issues which have arisen with regard to the processing of reimbursements.

Cross-Border Health Services Provision

Ceisteanna (1543)

Fiona O'Loughlin

Ceist:

1543. Deputy Fiona O'Loughlin asked the Minister for Health if the cross-Border directive will be affected by Brexit; and if he will make a statement on the matter. [33356/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The HSE operates the EU Cross Border Directive (CBD) in Ireland. Patients in Ireland can seek to be referred to another EU/EEA member state, including Northern Ireland, for medical treatment that is available in the public health service in Ireland, including certain dental services. The patient may access the overseas service in either the public or private health sector of the EU/EEA member state they choose to receive the service in. The patient pays for the treatment and claims reimbursement from the HSE at the cost of that treatment in Ireland or the cost of it abroad, whichever is the lesser. 

It is important to emphasise that at present there are no changes to patient care in the UK and Northern Ireland under the CBD, as the UK continues to be a full member of the EU. Indeed, until the UK formally withdraws from the European Union, it remains a full Member with all its existing rights and obligations. 

Nevertheless, as part of a whole of Government response to Brexit, my Department is working to ensure a comprehensive and coordinated set of preparations to ensure continuity of health services post-Brexit. This includes the enactment of the Withdrawal of the United Kingdom from the European Union (Consequential Provisions) Act 2019. This legislation contains provisions which, if required, will allow me to make Orders and Regulations to enable necessary healthcare arrangements to be maintained between Ireland and the UK in a no-deal scenario, including certain dental service.

Hospital Appointments Status

Ceisteanna (1544)

Robert Troy

Ceist:

1544. Deputy Robert Troy asked the Minister for Health if an appointment will be scheduled for a person (details supplied); and if he will make a statement on the matter. [33359/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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.

Ambulance Service Provision

Ceisteanna (1545)

Robert Troy

Ceist:

1545. Deputy Robert Troy asked the Minister for Health his plans to provide a replacement ambulance to St. Joseph's Care Centre, County Longford; and if his attention has been drawn to the fact that the vehicle on site has service of over 800,000 km and is expected to complete daily round trips to Dublin. [33363/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

HSE Staff Recruitment

Question No. 1547 answered with Question No. 1529.

Ceisteanna (1546)

Martin Ferris

Ceist:

1546. Deputy Martin Ferris asked the Minister for Health the reason a person (details supplied) who applied for, was interviewed and was offered a senior sonographer position at Midlands Regional Hospital has now been told that their start date has been delayed due to the HSE recruitment freeze; and if he will make a statement on the matter. [33381/19]

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.

Question No. 1547 answered with Question No. 1529.

Disability Support Services Funding

Ceisteanna (1548)

Thomas P. Broughan

Ceist:

1548. Deputy Thomas P. Broughan asked the Minister for Health his plans to commit to a multi-annual investment programme of €211 million per annum in each of the years 2020 to 2024 to fund community services for persons with intellectual, physical, sensory and neurological disabilities including personal budgets, personal assistant services, home supports, respite care, day services, residential and community services supports and adult therapies; and if he will make a statement on the matter. [33386/19]

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.

Medical Card Reviews

Ceisteanna (1549)

Thomas P. Broughan

Ceist:

1549. Deputy Thomas P. Broughan asked the Minister for Health his views on making medical needs of citizens the primary condition for the granting of medical cards, rather than other factors such as income, in budget 2020; and if he will make a statement on the matter. [33387/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the Deputy is aware, the HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.

Nevertheless, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines.  The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE  affords applicants the opportunity to furnish supporting documentation to fully take account of all the relevant circumstances that may benefit them in the assessment including medical evidence of cost and necessary expenses. 

The HSE  also has a system in place for the provision of medical cards in response to emergency situations i.e. in circumstances where persons are in need of urgent or on-going medical care that they cannot afford and also for persons in palliative care who are terminally ill. These medical cards are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant. With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are followed up with a full application within a number of weeks.

HSE Regional Service Plans

Question No. 1551 answered with Question No. 1464.

Ceisteanna (1550)

Thomas P. Broughan

Ceist:

1550. Deputy Thomas P. Broughan asked the Minister for Health the way in which the creation of regional structures in the HSE will lead to better front-line resources for patients and better overall efficiencies and will avoid additional layers of management; and if he will make a statement on the matter. [33388/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

A clear governance and accountability framework was identified as a key building block of Sláintecare by the Committee on the Future of Healthcare. As part of its recommendations in this area, the Committee called for 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 6 Hospital Groups are in place on an administrative basis to plan and deliver community and acute care services respectively. 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 underpinned by population based planning, as envisaged under the Sláintecare programme.

In this regard, the Sláintecare report recommended that “further analysis and consultation should be undertaken to identify how alignment can best be achieved with minimal disruption to key structures including at community healthcare network level”.

As a first step in this, I announced the areas for six new regional bodies last week. This is an important step in signalling the future shape of the health service.

In parallel, work is progressing in my Department on the development of detailed policy proposals on reconfiguration of the HSE, including the establishment of regional health bodies. These regional bodies will have clearly defined populations and can plan, resource and deliver health and social care services for the needs of its population.  It will result in improved accountability and governance in terms of finance and performance. It will also empower front-line staff and allow for the devolvement of decision-making power from the HSE to each local region.

Equally, I am committed to this new structure involving a more streamlined national centre and a sharing of expertise. It will also avoid duplication of personnel and support functions between CHOs and Hospital Groups.

Question No. 1551 answered with Question No. 1464.

Child and Adolescent Mental Health Services Data

Ceisteanna (1552)

Eamon Scanlon

Ceist:

1552. Deputy Eamon Scanlon asked the Minister for Health the number of children and adolescents waiting for an appointment for child and adolescent mental health services in community healthcare organisation 1, CHO1, to date by periods (details supplied); the number of priority cases in each period; and if he will make a statement on the matter. [33399/19]

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.

Child and Adolescent Mental Health Services Data

Ceisteanna (1553)

Eamon Scanlon

Ceist:

1553. Deputy Eamon Scanlon asked the Minister for Health the number of vacancies for a consultant psychiatrist in child and adolescent mental health services in community healthcare organisation 1, CHO1; and if he will make a statement on the matter. [33400/19]

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.

Respite Care Services Provision

Ceisteanna (1554)

Eamon Scanlon

Ceist:

1554. Deputy Eamon Scanlon asked the Minister for Health the action he is taking to address the disparity in the provision of respite care in the north west; the number of respite care facilities operating in community healthcare organisation 1, CHO1, for children and adults; and if he will make a statement on the matter. [33401/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

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

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