HSE Governance

Ceisteanna (1880)

Pat the Cope Gallagher

Ceist:

1880. Deputy Pat The Cope Gallagher asked the Minister for Health his plans for the regionalising of the HSE; the locations in County Donegal in which health services are to be administrated from; the impact the changes will have to service delivery within the county; if the changes will affect all aspects of the HSE current service and capital plan; if decision making as well as financial autonomy will be decentralised to the proposed regions; the timeline for the full implementation of same; and if he will make a statement on the matter. [34172/19]

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, nine Community Healthcare Organisations (CHOs) and six 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.

As a first step in this process, 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 line with the Sláintecare Report, there will be no disruption to Community Healthcare Networks, Primary Care Teams, GPs etc. The same hospitals will continue to serve the West/Northwest region. 

There will be no negative impact on service delivery; patients will continue to receive their services where they currently do and patient choice will not be limited to their region. As the current proposal is very much designed around current patient/service user usage patterns, I do not foresee any negative impact for patients. This includes access to cross-border services.

However, there will be positive impacts over time. The six health regions will ensure that services are more joined up as well as locally planned and delivered. This will make it easier for citizens to access services; it will make services easier to navigate; and it will ensure that more services are available closer to home. They will also, in time, provide a basis for equitable funding of services throughout the country. This will aid the management of the health budget.

While the regions will have devolved responsibility for decision making, they will operate within a national framework, including national policies and strategies, such as the National Trauma Strategy and the National Cancer Strategy and national organisation of certain services such as national clinical programmes, our screening programmes and ambulance services.

As agreed by Government, my Department will now progress the development of detailed policy proposals on reconfiguration of the HSE, including the establishment of regional health bodies (and timelines for the implementation of this reform), and bring these proposals back to Government for approval next year.

HSE Reports

Ceisteanna (1881, 1882)

Barry Cowen

Ceist:

1881. Deputy Barry Cowen asked the Minister for Health if he receives monthly or quarterly financial reports from the Health Service Executive; if so, if the reports are based on accrual method of accounting; when the last financial report was received from the HSE; and if he will make a statement on the matter. [34174/19]

Amharc ar fhreagra

Barry Cowen

Ceist:

1882. Deputy Barry Cowen asked the Minister for Health the year to date spend at the HSE and the year to date budget based on accrual method rather than cash payment at 30 June 2018; when the next financial report from the HSE will be received; and if he will make a statement on the matter. [34175/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 1881 and 1882 together.

The HSE accounts record items of current expenditure and exclude items of a capital nature and are prepared on an Accruals basis. This is a method of recording accounting transactions for revenue when earned and expenses when incurred, so a financial transaction for a period is recognised regardless of when the cash settlement occurs.

The HSE is required to provide monthly reports on expenditure to my Department, the most up to date of which was received in respect of May 2019. During the first five months of 2019 the HSE has reported a deficit of €169.4 million, with actual expenditure of €6,670.3 million against a budget of €6,500.9 million. The HSE publishes quarterly information on its website on an accruals basis.  The first quarter report  is available at https://www.hse.ie/eng/services/publications/?pageNumber=3.

Draft June reports will be submitted to the Department at the beginning of August, and the second quarter report will be published on the website in September.

Capital Expenditure Programme

Ceisteanna (1883)

Marc MacSharry

Ceist:

1883. Deputy Marc MacSharry asked the Minister for Health the status of capital projects within the remit of his Department; the amount spent on each project to date; and the anticipated completion date [34204/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

My Department does not undertake capital projects.

The Health Service Executive undertakes capital projects in the public health services with capital funding provided  by the Exchequer.

I have asked the Health Service Executive to provide the Deputy directly with the information requested in respect of capital projects over €5 million delivered and supported by the Health Service Executive.

Primary Care Centres Provision

Ceisteanna (1884, 1885)

John Curran

Ceist:

1884. Deputy John Curran asked the Minister for Health the primary care services that will be made available at a location (details supplied) pending the delivery of the Boot Road primary care centre in Clondalkin village; and if he will make a statement on the matter. [34223/19]

Amharc ar fhreagra

John Curran

Ceist:

1885. Deputy John Curran asked the Minister for Health further to Parliamentary Question No. 110 of 2 July 2019, if tenders have not been sought by HSE estates for the construction work; if there will be a delay in contractors being onsite in Q3 2019 in view of the fact it is already Q3 2019; and if he will make a statement on the matter. [34224/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 1884 and 1885 together.

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.

Health Services

Ceisteanna (1886)

John Curran

Ceist:

1886. Deputy John Curran asked the Minister for Health the progress made to date regarding the development of a new statutory homecare scheme; and if he will make a statement on the matter. [34227/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Department of Health is currently engaged in the development of a new statutory scheme and system of regulation for home-support services. In preparation for the development of the statutory scheme, the Department commissioned the Health Research Board to carry out a review of the home-care systems in four European countries. In addition, the Department conducted a public consultation on home-care services, on which a report was published in 2018. These reports are available on the Department’s website and will help to ensure that the new scheme is informed both by international experience and by the views of stakeholders, including service-users.

The Sláintecare Implementation Strategy commits to the introduction of the statutory scheme in 2021.  As part of this, work is on-going to determine the optimal approach to the development of the statutory scheme within the broader context of the Sláintecare reforms and in 2019 work is focusing on the design of the scheme, the options for regulation, and a review of existing services. Stakeholder consultation will continue throughout the process of developing the new scheme.

Health Services Data

Ceisteanna (1887)

John Curran

Ceist:

1887. Deputy John Curran asked the Minister for Health the number of persons that received hepatitis C treatment in each of the years 2015 to 2018 and to date in 2019; and if he will make a statement on the matter. [34228/19]

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 HSE for direct reply to the Deputy.

Health Services Data

Ceisteanna (1888)

John Curran

Ceist:

1888. Deputy John Curran asked the Minister for Health the number of persons in receipt of home support services at 30 June 2019; the number that were approved and waiting for home support services in each CHO area at 30 June 2019; the number of persons waiting for more than one, three and six months, respectively for home support services; and if he will make a statement on the matter. [34230/19]

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.

Drug Treatment Programmes Policy

Ceisteanna (1889)

John Curran

Ceist:

1889. Deputy John Curran asked the Minister for Health his plans to review the protocols on the methadone strategy; his views on whether there are sufficient progression pathways for persons on the methadone programme to become drug free; and if he will make a statement on the matter. [34234/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Methadone is one of the medications used in opioid substitution treatment, along with suboxone. Methadone prescribing for opioid dependence is a key element of the harm reduction approach to opioid use set out in the National Drugs Strategy.

As of 30 June, 2019, 10,396 people were in receipt of methadone maintenance treatment.

A review of the methadone treatment protocol was published in December 2010. Arising from the review, the HSE implemented an opioid treatment protocol, so as to provide appropriate and timely substance treatment and rehabilitation services tailored to individual needs.

In 2016, the HSE published clinical guidelines for opioid substitution treatment. These guidelines are the first that specifically relate to opioid substitution treatment in HSE clinics and primary care settings.

Opioid substitution treatment supports patients to recover from drug dependence. HSE addiction services work within the national drugs rehabilitation framework to support progression pathways. The framework ensures that individuals affected by drug misuse are offered a range of integrated options tailored to meet their needs and to create rehabilitation pathways.

Methadone treatment it is an important tool to reduce harm and to aid people to recover from drug use. I am committed to improving the availability of this treatment and to supporting service users to access progression pathways.

Drug Treatment Programmes Data

Ceisteanna (1890)

John Curran

Ceist:

1890. Deputy John Curran asked the Minister for Health the number of persons on methadone treatment; the number on treatment for periods of five, ten and more than ten years, respectively; and if he will make a statement on the matter. [34235/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Hospitals Car Park Charges

Ceisteanna (1891)

John Curran

Ceist:

1891. Deputy John Curran asked the Minister for Health the steps he has taken to reduce hospital car parking charges for seriously ill children and their families; and if he will make a statement on the matter. [34236/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Hospitals which charge parking fees are cognisant of the financial implications parking costs can have on patients and their families, particularly those with long-term illnesses. Some hospitals have introduced a maximum daily fixed parking charge, thus capping this expense. I understand that some hospitals also provide reduced rate parking for long-term patients and visitors for whom the payment of the full rate would cause hardship.

I have made it clear I want to see progress made in this area and I am working with my Department and the HSE in this regard. In March 2018, I requested the HSE to conduct a review of hospital car parking charges with a view to establishing clear national guidelines in the area. My Department and the HSE are currently engaging on a draft implementation plan to accompany the review report.

Psychological Services Waiting Lists

Ceisteanna (1892)

John Curran

Ceist:

1892. Deputy John Curran asked the Minister for Health the number of persons by CHO area waiting for a psychology appointment in primary care; the number waiting zero to 12, 12 to 26, 26 to 52 and more than 52 weeks, respectively; and if he will make a statement on the matter. [34238/19]

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 Capital Programme

Ceisteanna (1893)

Pat the Cope Gallagher

Ceist:

1893. Deputy Pat The Cope Gallagher asked the Minister for Health if no financial commitment is being made in 2019 for major improvement works on St. Joseph's Community Hospital, Stranorlar and Ramelton Community Hospital other than for minor works; the status of the major investment plans to bring the two hospitals up to the full HIQA standards required for residential care units, long stay residential units, dementia units and medical assessment units; if no commitment is provided for either in the 2019/2020 budgets for the major improvement works; and if he will make a statement on the matter. [34249/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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 and Ramelton Community Hospital.

The HSE have advised my Department 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.

Hospital Accommodation Provision

Question No. 1895 answered with Question No. 1809.

Ceisteanna (1894)

Pat the Cope Gallagher

Ceist:

1894. Deputy Pat The Cope Gallagher asked the Minister for Health the status of the short stay ward at Letterkenny University Hospital which opened in January 2019; the capacity and use of the hospital; if it is fully staffed and all 21 beds are in use; and if he will make a statement on the matter. [34250/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Health Service Capacity Review published last year was 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.

An additional 267 acute hospital beds opened under the Winter Initiative 2017/2018, and the National Service Plan for 2019 provides for a comprehensive capacity programme. The main elements of the 2019 capacity programme are:

- the provision of 75 acute beds and 70 community beds under the Winter Plan 2018/19, including 5 beds that opened in Letterkenny University Hospital in June 2019;

- 47 additional beds, including a 40-bed modular build in South Tipperary General Hospital, 4 HDU beds in Cork University Hospital, and 3 HDU beds in the Mater which are due to open by Q4 2019;

- preparation of 202 beds during 2019, including a further 15 beds in Letterkenny University Hospital, with a view to bringing this extra capacity into operation in Q1 of 2020;

- commencement of works on a 60-bed modular ward in University Hospital Limerick.

With regard to the specific questions the Deputy has asked, as this is a service matter, I have asked the HSE to respond directly.

Question No. 1895 answered with Question No. 1809.

HSE Governance

Ceisteanna (1896, 1897, 1898, 1899, 1901, 1903, 1904, 1905, 1906)

Jack Chambers

Ceist:

1896. Deputy Jack Chambers asked the Minister for Health the consultation process with each hospital group prior to the announcement of the six regional health areas; and if he will make a statement on the matter. [34316/19]

Amharc ar fhreagra

Jack Chambers

Ceist:

1897. Deputy Jack Chambers asked the Minister for Health the name of each clinical director from each hospital group that was consulted in the design of the six regional health areas; and if he will make a statement on the matter. [34317/19]

Amharc ar fhreagra

Jack Chambers

Ceist:

1898. Deputy Jack Chambers asked the Minister for Health the name of each person involved in the design of the six regional health areas; and if he will make a statement on the matter. [34318/19]

Amharc ar fhreagra

Jack Chambers

Ceist:

1899. Deputy Jack Chambers asked the Minister for Health the clinical specialties which were engaged with from each hospital group on the design of the six regional health areas; and if he will make a statement on the matter. [34319/19]

Amharc ar fhreagra

Jack Chambers

Ceist:

1901. Deputy Jack Chambers asked the Minister for Health when he expects the regional health areas to commence; and if he will make a statement on the matter. [34321/19]

Amharc ar fhreagra

Jack Chambers

Ceist:

1903. Deputy Jack Chambers asked the Minister for Health the consultation with the HSE in the design of the six regional health areas; and if he will make a statement on the matter. [34323/19]

Amharc ar fhreagra

Jack Chambers

Ceist:

1904. Deputy Jack Chambers asked the Minister for Health if concerns have been expressed regarding the care of patients in the design of the regional health areas; and if he will make a statement on the matter. [34324/19]

Amharc ar fhreagra

Jack Chambers

Ceist:

1905. Deputy Jack Chambers asked the Minister for Health if there was an external procurement in the design of the regional health areas; and if he will make a statement on the matter. [34325/19]

Amharc ar fhreagra

Jack Chambers

Ceist:

1906. Deputy Jack Chambers asked the Minister for Health the healthcare professionals that are involved in the design of the regional health areas; and if he will make a statement on the matter. [34326/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 1896 to 1899, inclusive, 1901, and 1903 to 1906, inclusive together.

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, nine Community Healthcare Organisations (CHOs) and six 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 part of this process, my Department undertook a public consultation on the alignment of CHOs and Hospital Groups. The consultation process found that a large majority of respondents are in favour of alignment. The Department of Health also consulted with the European Observatory on Health Systems and Policies to learn from the reorganisation of health services in other countries.

My Department’s detailed analysis work was based primarily on patient flow. This analysis, conducted in partnership with the HSE concluded that the six new regional health areas represent the least change and disruption necessary to achieve optimal alignment of health and social care services at regional level. This means that patients will continue to access services as they currently choose to do around the country.

No external services were procured in determining the new regional areas.

Having determined the optimal configuration for the new health areas nationally, my Department will immediately begin the process of engaging with stakeholders across the system, including the public and health staff, both clinical and managerial. This will be a key pillar of the development of detailed policy proposals on the roles and responsibilities of the new regions (including timelines for the implementation of this reform), which I intend to bring to Government for approval in the next 12 months.

Ministerial Meetings

Question No. 1901 answered with Question No. 1896.

Ceisteanna (1900)

Jack Chambers

Ceist:

1900. Deputy Jack Chambers asked the Minister for Health the number of scheduled meetings he has had with the Sláintecare unit in the past 12 months; the agenda of each; and if he will make a statement on the matter. [34320/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I can confirm that there were 18 scheduled official meetings with the Sláintecare unit, or where members of the Sláintecare unit were present, over the past 12 months. Members of the Sláintecare unit and I have held meetings whenever our busy diaries have allowed. These meetings provided updates on the key reform initiatives within the Sláintecare strategy, and discussions on the deliverables within the Sláintecare Action Plan.

Question No. 1901 answered with Question No. 1896.

Health Services Staff Data

Questions Nos. 1903 to 1906, inclusive, answered with Question No. 1896.

Ceisteanna (1902)

Jack Chambers

Ceist:

1902. Deputy Jack Chambers asked the Minister for Health the number of staff in the Sláintecare unit; the job description of each staff member; the grade of each staff member; and if he will make a statement on the matter. [34322/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Sláintecare Programme Implementation Office (SPIO) has a staff of 16.  This is broken down into 1 Executive Director, 3 Principal Officers, 4 Assistant Principal Officers, 3 Administrative Officers, 1 Higher Executive Officer and 4 Executive Officers.

Overall direction of SPIO lies with the Executive Director. The three Principal Officers oversee and drive the reform initiatives of the four workstreams detailed in the Sláintecare Action Plan. The Assistant Principal Officers provide programme management and financial management expertise. The Administrative Officers, the Higher Executive Officer and the Executive Officers all provide assistance in overseeing the deliverables of the Action Plan and work across the four workstreams.  

Questions Nos. 1903 to 1906, inclusive, answered with Question No. 1896.