Pearse Doherty
Ceist:23. Deputy Pearse Doherty asked the Minister for Health the expected completion date and projected cost of the national children’s hospital; and if he will make a statement on the matter. [39624/19]
Amharc ar fhreagraNational Children's Hospital Expenditure
Ceisteanna (23)
Freagraí scríofa
I advised Government in December 2018 that the final cost of the design, build and equipment programme for which the National Paediatric Hospital Development Board is responsible was estimated to be €1,433 million.
There has been no change to this figure advised to Government.
The PwC report makes clear that the Guaranteed Maximum Price established through the two-stage tender process does not provide a contractual ceiling on the project’s cost and significant residual risks remain. These include national construction inflation in excess of 4%, any changes in scope, legislative changes and the Sectoral Employment Order.
The National Paediatric Hospital Development Board manages the project, actively monitoring the performance of the contract. It also has a focus on identifying and managing risks, preventing further cost increases to the greatest extent possible. It has, for example, a robust process in place for the assessment of claims by the Contractor in accordance with the Construction Contract. All claims are independently assessed and determined by the Employers Representative. Where there is a dispute on the validity of a claim, the Construction Contract sets out the dispute management process.
In relation to timelines, there has been references to construction delays on the project. As the Chair of National Paediatric Hospital Development Board advised the Joint Committee on Health in June, some delays have arisen to date. However opportunities to mitigate these delays will be taken throughout the remainder of the project.
The main Construction Contractor is currently reporting the project to be behind on certain elements of the construction, however, the National Paediatric Hospital Development Board has sought a revised programme timeline from the contractor setting out mitigation measures to bring construction back on line.
Substantial progress has already been made with the construction of the new children’s hospital and associated enabling works. The structural frame on the construction site is now reaching roof level in most advanced areas of the building, resulting in the building now being visible well above the hoarding. Basement excavation, with the exception of the temporary road, is now complete and piling is also complete.
It is intended that the main hospital will be completed by late 2022 and following a period of commissioning, open to patients in 2023.
Home Care Packages Administration
Ceisteanna (24)
Eamon Scanlon
Ceist:24. Deputy Eamon Scanlon asked the Minister for Health the action that will be taken to reduce the waiting list for homecare in counties Sligo and Leitrim in which the numbers waiting have seen a significant rise during 2019; and if he will make a statement on the matter. [41194/19]
Amharc ar fhreagraFreagraí scríofa
Home supports enable older people to remain in their own homes and communities, as well as facilitating timely discharge from hospital. At the end of August, preliminary data indicates that the HSE had provided over 1.1million hours of home support in CHO 1 which includes Sligo and Leitrim and 3,941 people were receiving the service. However, I acknowledge that in some cases access to the service may take longer than we would like and there were 226 people in Sligo and Leitrim waiting for new or additional service. This has slightly reduced to 215 people in September.
In line with commitments given in the Programme for Government we have made improved access to home support services a priority. In 2020 an additional investment of €52 million is being made which will provide over 19.2 million hours of home support. This is 1 million hours more than the 2019 target and represents a substantial increase in service provision.
While the existing home support service is delivering crucial support to many people across the country, it needs to be improved to better meet the changing needs of our citizens. Included in this investment is dedicated funding for the testing of the new statutory home-support scheme in 2020.
The design of the new scheme will involve the establishment of a model of service with a streamlined central system of administration to improve and simplify how people access home-support services. While the administration of the scheme will be centralised, the delivery of services will be co-ordinated at local level in line with a person’s assessed need. A core component of the Scheme and the testing phase will be the implementation of InterRAI, as the standardised assessment tool for determining need under the new scheme.
The testing phase will include a range of services with a focus on improving both cognitive and physical capacity and resilience to support people to live in their homes and in their communities. The core principles of Healthy Ireland, Positive Ageing, prevention and early intervention will underpin this approach.
Home Care Packages Administration
Ceisteanna (25)
John Brassil
Ceist:25. Deputy John Brassil asked the Minister for Health the action that will be taken to reduce the waiting list for homecare in County Kerry in which the numbers waiting have seen a significant rise during 2019; and if he will make a statement on the matter. [41223/19]
Amharc ar fhreagraFreagraí scríofa
Home supports enable older people to remain in their own homes and communities, as well as facilitating timely discharge from hospital. At the end of August, preliminary data indicates that the HSE had provided over 1.7 million hours of home support in CHO 4 which includes Cork and Kerry and 8,929 people were receiving the service. However, I acknowledge that in some cases access to the service may take longer than we would like and the latest information available shows that there are 70 people in Kerry waiting for new or additional service.
In line with commitments given in the Programme for Government we have made improved access to home support services a priority. In 2020 an additional investment of €52 million is being made which will provide over 19.2 million hours of home support. This is 1 million hours more than the 2019 target and represents a substantial increase in service provision.
While the existing home support service is delivering crucial support to many people across the country, it needs to be improved to better meet the changing needs of our citizens. Included in this investment is dedicated funding for the testing of the new statutory home-support scheme in 2020.
The design of the new scheme will involve the establishment of a model of service with a streamlined central system of administration to improve and simplify how people access home-support services. While the administration of the scheme will be centralised, the delivery of services will be co-ordinated at local level in line with a person’s assessed need. A core component of the Scheme and the testing phase will be the implementation of InterRAI, as the standardised assessment tool for determining need under the new scheme.
The testing phase will include a range of services with a focus on improving both cognitive and physical capacity and resilience to support people to live in their homes and in their communities. The core principles of Healthy Ireland, Positive Ageing, prevention and early intervention will underpin this approach.
Cancer Screening Programmes
Ceisteanna (26)
Alan Kelly
Ceist:26. Deputy Alan Kelly asked the Minister for Health when the audit on cervical cancer screening will recommence; and the date from which the audit will commence. [41163/19]
Amharc ar fhreagraFreagraí scríofa
Since 2010, as part of quality assurance measures, CervicalCheck reviewed the screening history of every woman notified to it as having a diagnosis of cervical cancer, who had previously been screened by the programme. The objective of audit and quality review at CervicalCheck was to facilitate continued improvement and ongoing learning within the programme. Following the issues which arose in relation to the non-disclosure of audit findings, a decision was taken to pause the audit.
The Scoping Inquiry led by Dr Gabriel Scally made a number of recommendations, one of which was that “Audit should continue to be an important component of cervical screening as this complies with all good clinical practice. Common, robust and externally validated approaches to the design, conduct, evaluation and oversight of audits should be developed across the screening services.” (Recommendation 26).
This recommendation was accepted by Government, as were all of Dr Scally's recommendations and actions to implement these were set out in an implementation plan approved by Government and published on the website of my Department. As set out in the implementation plan, the HSE has established an Expert Group within the National Screening Service to review the clinical audit processes for interval cancers across all screening programmes. The Expert Group, which includes two patient representatives, will develop a report setting out recommendations for the operation of clinical audit processes across all screening programmes. The Expert Group is expected to complete its work at the end of this year, following which its recommendations will be implemented by the HSE. I expect that the detail requested by the Deputy regarding the timing of the recommencement of the audit, and how it will operate, will be informed by the Expert Group's work and this detail will become available once that work is complete.
Emergency Departments Waiting Times
Ceisteanna (27)
Niall Collins
Ceist:27. Deputy Niall Collins asked the Minister for Health the action that will be taken to reduce overcrowding in the emergency department in University Hospital Limerick; and if he will make a statement on the matter. [41196/19]
Amharc ar fhreagraFreagraí scríofa
The HSE TrolleyGAR count shows a 17% increase in patients waiting on trolleys in University Hospital Limerick ED for this year up to the end of September compared to the same period last year. In the month of September 2019, there were 897 patients counted on trolleys in University Hospital Limerick, which was a 28% increase compared to the previous month.
It is acknowledged that this is unacceptably high and the HSE are actively working with the University of Limerick Hospital Group to ease congestion in University Hospital Limerick with a focus on facilitating transfers to Level 2 hospitals, assistance from rehabilitation units and Community Health Organisation services, and prioritisation of diagnostics to aid inpatient discharges.
My Department is engaging extensively with the HSE this year to identify mitigating actions across the health service to bring down trolley numbers and waiting times in the ED in the face of growing demand.
Planning for winter 2019/20 has commenced and my Department is working with the HSE to finalise the Winter Plan in the coming weeks. Individual Community Healthcare Organisations (CHOs) and Hospital Groups are preparing Integrated Winter Plans that will focus on demand management and reduction, staffing availability, timely access to the most appropriate care pathway for patients as well as provide appropriate timely egress from acute hospitals. The Integrated Winter Plans will support the development of a single overarching strategic level Winter Plan for the HSE.
The Integrated Winter Plan for University Hospital Limerick will be delivered by a Winter Action Team whose membership will include the CEO of UL Hospital Group and the Chief Officer of CHO Midwest.
I understand that intensive work is underway between the UL Hospital Group and CHO Midwest in the context of recent Emergency Department pressures. Delayed Transfers of Care have decreased from a peak of 30 in the last week of August 2019 to 20 in the first week of October 2019. This joint working will continue throughout the winter period and beyond.
The winter plan and associated initiatives will be supported by an additional €26m in winter funding available nationally, which I have agreed with the Minister for Public Expenditure and Reform as part of this week's Budget. This funding will support access to the Fair Deal scheme and the availability of home care, transitional care, aids and appliances and other local actions to both facilitate timely hospital discharge and reduce congestion in EDs over the winter period.
These initiatives build upon the progress that has been made on increasing capacity in University Hospital Limerick. Since December 2017, an additional 25 beds have opened in University Hospital Limerick, including 8 which opened at the start of this year as part of the 2018/2019 Winter Plan.
A capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at University Hospital Limerick, with funding of €10 million allocated in 2019. The HSE have advised that the enabling works are complete, and the main contractor is now commencing work. This important project will go some way towards addressing the acknowledged lack of bed capacity in the region.
Furthermore, the National Development Plan includes a 96-bed replacement ward block in University Hospital Limerick and capital funding was provided in 2018 to progress the design phase of the project. A design team has been appointed for this project.
Respite Care Services
Ceisteanna (28)
John McGuinness
Ceist:28. Deputy John McGuinness asked the Minister for Health the reason for the significant fall in the number of overnights with or without day respite accessed by persons with a disability in counties Carlow and Kilkenny since 2015; and if he will make a statement on the matter. [41202/19]
Amharc ar fhreagraFreagraí scríofa
This Government’s on-going priority is the safeguarding of vulnerable people in the care of the health service. We are committed to providing services and supports for people with disabilities which will empower them to live independent lives.
As part of its on-going service provision, this year the HSE National Service Plan set a target of over 180,000 overnight and 42,500 day respite sessions to families in need right across the country.
As part of its service provision, South East Community Healthcare are committed to ensuring an equitable and fair approach to service delivery in line with budget allocation. This includes the annual delivery of disability services and the planning of services into the future.
The HSE and its funded agencies provide respite care to children with disabilities. Respite can occur in a variety of settings as determined by the needs of the family and within available resources. Overnight Respite Services for the parents of children with disability / complex care needs in Carlow were previously provided by Holy Angels in Carlow and St Patrick’s Centre Services in Kilkenny. These services ceased in January 2016 and November 2015 respectively.
The provision of respite services in Counties Carlow and Kilkenny, (as with other areas), has come under further pressure in recent years. There is currently increasing levels of “changing needs” due to the increase in the age of the disability population. The need for increased respite facilities is acknowledged and the HSE continues to work with agencies to explore various ways of responding to this need in line with the budget available.
As part of a €10m investment in Respite Services from the HSE National Service Plan 2019, South East Community Healthcare has delivered additional respite supports, including respite at a new adult house in Wexford; referrals for this service are accepted from all across the South East including Carlow/Kilkenny. While some agencies in the South East are currently experiencing staffing challenges to meet the respite needs of clients that have funded respite, I am informed that the respite house in Wexford accepted Out of County referrals of 154 bed nights from 1st January 2019 to 27th June 2019.
In addition, the Respite House in Tullow, Co. Carlow is currently going through the HQA registration process and is expected to open in due course.
To ensure the continued provision of respite services across the South East, a Task Force Group has been established to review respite services and ensure delivery in a fair and equitable way that meets the needs of the service users.
The HSE will continue to work with its funded partners to provide Disability Services, including respite, across the South East Community Healthcare area.
Hospital Consultant Data
Ceisteanna (29)
Thomas P. Broughan
Ceist:29. Deputy Thomas P. Broughan asked the Minister for Health the ratio of consultant doctors per capita across the member states of the EU; his plans to improve the ratio of consultants to population here; and if he will make a statement on the matter. [41177/19]
Amharc ar fhreagraFreagraí scríofa
The following table incorporating Eurostat data shows that the number of Specialist Medical Practitioners (consultant doctors) per 100,000 inhabitants In Ireland was 142.7 in 2017 compared with an EU average of 251.8. While it is acknowledged that the per capita position in Ireland is low compared with other EU Member States, Eurostat data covering other health professionals including General Practitioners and Generalist Medical Practitioners has also to be taken into account in making any direct comparison.
Nonetheless, the Government accepts that the ratio of consultant doctors per capita needs to be improved in Ireland and there has been ongoing improvement in recent years. The ratio in 2017 of 142.7 compares with 139.4 in 2016 and 127.8 in 2015. At the end of July 2019 there were 3,153 whole time equivalent consultants working in the public health services, the number having increased by 139 in the 12 months to the end of July 2019 and by over 600 in the past 5 years.
It is also recognised that there are significant difficulties in filling certain consultant posts, particularly in smaller hospitals, and in certain specialties, as identified by the Public Sector Pay Commission. The Government remains committed to a consultant delivered service and, to support achieving this objective, to engaging with the Consultants representative bodies in relation to new entrant consultants pay as recommended by the Pay Commission.
Health Action Plan
Ceisteanna (30)
Stephen Donnelly
Ceist:30. Deputy Stephen Donnelly asked the Minister for Health the status of the scheduled care access plan 2019; and if he will make a statement on the matter. [41267/19]
Amharc ar fhreagraFreagraí scríofa
The joint Department of Health/HSE/National Treatment Purchase Fund Scheduled Care Access Plan, published in March of this year, set out ambitious targets to improve waiting times for patients to access hospital procedures and appointments.
Waiting list figures for the end of September 2019, due to be published by the National Treatment Purchase Fund (NTPF) this week, show that there are just under 68,000 people on the Inpatient Day Case Waiting List. This is a reduction of 6.5% (4,700) compared to September 2018, while the numbers waiting over 9 months have fallen by 16% (3,100), and the number waiting over 18 months have fallen by 19% compared to the same period last year.
The Outpatient waiting list remains a challenge, with figures for the end of September 2019 standing at almost at 569,000 an increase of over 53,000 (10%) in the last year. The GI Endoscopy waiting list shows 22,197 patients waiting, which is an increase of 4,669 (27%) since last September.
These figures highlight that scheduled care activity has, for much of the year, been running behind the levels set out in the Access Plan. Performance reflects the impact of the broader challenges being experienced across the health service this year, which include:
- The impact of the industrial action – the HSE advise that the strike action in January/February and June resulted in the cancellation of over 54,000 appointments across IPDC, OPD and GI scope procedures;
- Increased Emergency workload coupled with increased Delayed Discharges has reduced the HSE capacity to accommodate less urgent elective cases; and
- Increased referrals to the Endoscopy Programme as well as the increased demands on the service arising from the National Screening programmes.
As the numbers waiting are behind the activity targets set out in the Scheduled Care Access Plan 2019, I have directed the HSE to develop plans to recover as much lost activity as possible before the end of this year.
Budget 2020 announced that the Government has further increased investment in tackling waiting lists, with funding to the National Treatment Purchase fund (NTPF) increasing from €75 million in 2019 to €100 million in 2020. The year-on-year increases to the National Treatment Purchase Fund since Budget 2017 reflects this Government’s priority to improve waiting times for patients to access hospital treatment.
My Department is working with the HSE and NTPF to develop the Scheduled Care Access Plan 2020. In this regard, the HSE National Service Plan 2020 will set out a planned activity level for the year ahead, while the NTPF will work with the hospital system to provide additionality to reduce inpatient/day case waiting times, and with a particular focus on improving access to hospital outpatient services.
In 2020, the NTPF will further expand its list of targeted inpatient and daycase procedures to support further significant reductions in wait times as well as increasing funding towards supporting full packages of care for patients on the outpatient waiting lists, to include surgery or treatment where required.
Rehabilitative Training Allowance Payments
Ceisteanna (31)
Thomas P. Broughan
Ceist:31. Deputy Thomas P. Broughan asked the Minister for Health if he will restore the disability training allowance for new entrants; and if he will make a statement on the matter. [41178/19]
Amharc ar fhreagraFreagraí scríofa
The Government’s priority is to provide access to high quality day services to as many people with disabilities as possible. The HSE currently funds day services for over 27,000 people with disabilities, including day services and Rehabilitative Training Programmes.
The HSE’s New Directions policy seeks to reconfigure and personalise HSE funded adult day services and offers 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 Programmes are designed to equip participants with basic personal, social and work-related skills. Approximately 2,200 people attend Rehabilitative Training programmes, including the approximately 400 new school leavers who have commenced their Rehabilitative Training programme since September this year.
The Rehabilitative Training Bonus payment is currently payable at a rate of €31.80 per week. It was introduced in 2001, aligned with a similar FÁS Training Bonus that later became the Solas Vocational Training Programme payment. It is important to note that this payment was reduced in 2011 and discontinued in 2012, while to date the Rehabilitative Training Bonus has continued to be paid in the Health Sector.
Since September 2019, the Rehabilitative Training Bonus payment no longer applies to new attendees. Rather, the money that would have been spent on the bonus, estimated at approximately €3.7 million over four years, will be redirected to address unmet need in day service provision for people with disabilities.
This redirected funding, which the HSE has confirmed will be ring-fenced, will create approximately 148 additional full day placements or 370 additional enhanced day places nationally. Access will be targeted to those with a reduced service or no service arising from there being minimal or no investment in day services during the recession and will be based on priority need.
Each Community Healthcare Organisation will have the flexibility to redirect its own savings to address local service requirements, and the HSE has confirmed it will be reporting regularly to the Department of Health on the additional placements realised.
I wish to emphasise that current participants in Rehabilitative Training Programmes will not be affected, and their payments will continue until they complete their 4-year programme.
The reason for this action is therefore to bring equity and consistency between people with a disability attending HSE funded rehabilitative training programmes who receive the payment, and those attending similar HSE funded Day Services or in other State schemes such as further education and training, who do not.
Home Care Packages Data
Ceisteanna (32)
Willie Penrose
Ceist:32. Deputy Willie Penrose asked the Minister for Health if he will provide a breakdown of the regional variations in the eligibility and allocation of services relating to publicly funded homecare; and if he will make a statement on the matter. [30437/19]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Mental Health Services Staff
Ceisteanna (33)
Lisa Chambers
Ceist:33. Deputy Lisa Chambers asked the Minister for Health the action being taken to address issues with staffing levels in mental health services in County Mayo; and if he will make a statement on the matter. [41190/19]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter I have asked the Health Service Executive to response directly to the Deputy as soon as possible.
Hospitals Funding
Ceisteanna (34)
Aindrias Moynihan
Ceist:34. Deputy Aindrias Moynihan asked the Minister for Health when a budget will be allocated for the redevelopment of Macroom Community Hospital; and if he will make a statement on the matter. [41367/19]
Amharc ar fhreagraFreagraí scríofa
The Health Service Executive recently published its Capital Plan for 2019-2021. The plan includes capital funding for the Community Nursing Unit programme and also sets out the current status of all projects within the programme, including the refurbishment and extension of Macroom Community Hospital.
The Health Service Executive is responsible for the delivery of public healthcare infrastructure projects and has advised that the planning application has recently been lodged with Cork County Council.
It is important to recognise that all capital development proposals must progress through a number of approval stages, in line with the Public Spending Code, including detailed appraisal, planning, design and procurement before a firm timeline or funding requirement can be established.
The delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages, which can impact on the timeline for delivery.
Hospital Overcrowding
Ceisteanna (35)
Alan Kelly
Ceist:35. Deputy Alan Kelly asked the Minister for Health the immediate steps he will take to alleviate the record overcrowding in University Hospital Limerick; and if he will make a statement on the matter. [41162/19]
Amharc ar fhreagraFreagraí scríofa
The HSE TrolleyGAR count shows a 17% increase in patients waiting on trolleys in University Hospital Limerick ED for this year up to the end of September compared to the same period last year. In the month of September 2019, there were 897 patients counted on trolleys in University Hospital Limerick, which was a 28% increase compared to the previous month.
It is acknowledged that this is unacceptably high and the HSE are actively working with the University of Limerick Hospital Group to ease congestion in University Hospital Limerick with a focus on facilitating transfers to Level 2 hospitals, assistance from rehabilitation units and Community Health Organisation services, and prioritisation of diagnostics to aid inpatient discharges.
My Department is engaging extensively with the HSE this year to identify mitigating actions across the health service to bring down trolley numbers and waiting times in the ED in the face of growing demand.
Planning for winter 2019/20 has commenced and my Department is working with the HSE to finalise the Winter Plan in the coming weeks. Individual Community Healthcare Organisations (CHOs) and Hospital Groups are preparing Integrated Winter Plans that will focus on demand management and reduction, staffing availability, timely access to the most appropriate care pathway for patients as well as provide appropriate timely egress from acute hospitals. These Integrated Winter Plans will support the development of a single overarching strategic level Winter Plan for the HSE.
The Integrated Winter Plan for University Hospital Limerick will be delivered by a Winter Action Team whose membership will include the CEO of UL Hospital Group and the Chief Officer of CHO Midwest.
I understand that intensive work is underway between the UL Hospital Group and CHO Midwest in the context of recent Emergency Department pressures. Delayed Transfers of Care have decreased from a peak of 30 in the last week of August 2019 to 20 in the first week of October 2019. This joint working will continue throughout the winter period and beyond.
The winter plan and associated initiatives will be supported by an additional €26m in winter funding available nationally, which I have agreed with the Minister for Public Expenditure and Reform as part of this week's Budget. This funding will support access to the Fair Deal scheme and the availability of home care, transitional care, aids and appliances and other local actions to both facilitate timely hospital discharge and reduce congestion in EDs over the winter period.
These initiatives build upon the progress that has been made on increasing capacity in University Hospital Limerick. Since December 2017, an additional 25 beds have opened in University Hospital Limerick, including 8 which opened at the start of this year as part of the 2018/2019 Winter Plan.
A capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at University Hospital Limerick, with funding of €10 million allocated in 2019. The HSE have advised that the enabling works are complete, and the main contractor is now commencing work. This important project will go some way towards addressing the acknowledged lack of bed capacity in the region.
Furthermore, the National Development Plan includes a 96-bed replacement ward block in University Hospital Limerick and capital funding was provided in 2018 to progress the design phase of the project. A design team has been appointed for this project.
Home Care Packages Administration
Ceisteanna (36)
Shane Cassells
Ceist:36. Deputy Shane Cassells asked the Minister for Health the action that will be taken to reduce the waiting list for homecare in County Meath in which the number waiting has seen a significant rise during 2019; and if he will make a statement on the matter. [41211/19]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
National Dementia Strategy
Ceisteanna (37)
Mary Butler
Ceist:37. Deputy Mary Butler asked the Minister for Health the new measures being put in place to support persons with dementia and their families; and if he will make a statement on the matter. [41221/19]
Amharc ar fhreagraFreagraí scríofa
The aim of the National Dementia Strategy, which was published in December 2014, is to improve care, services and supports for people with dementia. Implementation of the Strategy is being led by the National Dementia Office in the HSE.
The HSE currently provides about €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, 459 dementia-specific intensive homecare packages have been delivered, with 193 active at the end of July 2019. The HSE has previously committed to continue funding the delivery of intensive home care packages to people with dementia. This funding is in addition to annual service level agreements with a range of organisations which deliver dementia-specific respite, home care, day care, cognitive stimulation therapy, social clubs and supports for family carers around the country.
I am pleased to say that in line with the continued rollout of the Sláintecare Implementation Plan, €10 million has been secured in Budget 2020 to enhance Community Services including allied health professionals, with a full year investment of €60m for 2021. As well as providing for up to 1,000 therapists, nurses and other professionals in the community, this funding will also facilitate the recruitment of additional dementia advisers, whose information, advice and signposting service is highly valued by people with dementia and their families and carers.
Newborn Screening Cards
Ceisteanna (38)
Louise O'Reilly
Ceist:38. Deputy Louise O'Reilly asked the Minister for Health when the chair of the National Screening Committee will be appointed; and if he and the new chair will ensure that newborn screening services are expanded to test for a greater range of conditions; and if an expanded programme will be operational in 2020. [40980/19]
Amharc ar fhreagraFreagraí scríofa
A National Screening Committee is being established and will hold its first meeting before the end of 2019, as per recommendation 5, contained within the Scally Review (2018). The Committee’s role will be to undertake an independent assessment of the evidence for screening for a particular condition against internationally accepted criteria and make recommendations accordingly.
I appointed Professor Niall O’Higgins as Chair of the Committee in July 2019 and asked that, as part of its initial body of work, the Committee prioritise a review of the national newborn blood-spot screening programme and look specifically at how Ireland should best proceed with an expansion in line with international best practice.
Ireland, very much like the UK has always evaluated the case for commencing a national screening programme against international accepted criteria – collectively known as the Wilson Junger criteria. The evidence bar for commencing a screening programme should and must remain high. This ensures that we can be confident that the programme is effective, quality assured and operating to safe standards.
There is no doubt that newborn screening programmes have the potential to be rapidly transformed by new technologies and new therapies but this highlights the need to continue with a robust, methodologically sound and detailed analysis of the evidence in each and every case against the Wilson and Junger criteria.
Any future potential changes to the National Newborn Bloodspot Screening Programme will be incorporated as part of the Committee’s work programme. I cannot pre-empt the outcome of the deliberations of the Committee on this topic but I would anticipate that the number of conditions meeting the criteria for a population based screening programme will increase over the coming years.
Departmental Reviews
Ceisteanna (39)
Mary Butler
Ceist:39. Deputy Mary Butler asked the Minister for Health the status of the national cardiac review; and if he will make a statement on the matter. [41222/19]
Amharc ar fhreagraFreagraí scríofa
The National Review of Specialist Cardiac Services commenced in January 2018 under the Chairmanship of Professor Phillip Nolan and a Steering Group was formed from nominations from interested stakeholders representing medical, professional/technical staff, nursing and patient representatives. The aim of the 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. 13 Steering Group meetings have taken place with a further two meetings scheduled to take place this year. A large volume of its work has been completed.
To date the National Review has completed a public consultation survey, collated and analysed information on activity levels in each of the Hospital Groups and all hospitals within each Group. A successful and well attended stakeholder consultation was held in November 2018. The Health Research Board - Collaboration in Ireland for Clinical Effectiveness Reviews (HRB-CICER) has completed an Evidence Review of Specialist Cardiac Services looking at (i) international standards for PCI centres (ii) international models that might be applicable to the Irish Healthcare system and (iii) the relationship between volume and patient outcomes for PCI. The Evidence Review has provided important guidance for the Steering Group thus far and arising from discussions at the Steering Group they have been asked to complete one additional evidence review question. Site visits to Percutaneous Coronary Intervention (PCI) centres commenced earlier this year and will be complete this month. These site visits have included meetings with stakeholders in clinical, administrative, nursing and allied health professional roles. In addition two international site visits are being planned to review and benchmark against established cardiology networks.
An additional workstream is being undertaken by the Health Intelligence Unit of the HSE with regards to Geospatial analysis and mapping of networks of cardiac services from a national perspective.
The Chair is targeting that the National Review of Specialist Cardiac Services will be completed before the end of the year and I would expect to be informed of any change to that timeline.
Hospital Equipment
Ceisteanna (40)
Maurice Quinlivan
Ceist:40. Deputy Maurice Quinlivan asked the Minister for Health if funding will be provided for a new MRI machine for University Hospital Limerick in order to address overcrowding in the hospital; and if he will make a statement on the matter. [40959/19]
Amharc ar fhreagraFreagraí scríofa
According to provisional HSE TrolleyGAR data, there was a 17% increase in patients waiting on trolleys year to date in UHL ED in September 2019 compared to the same period last year. In the month of September 2019, there were 897 patients counted on trolleys in UHL, which was a 28% increase compared to the previous month.
It is acknowledged that this is unacceptably high and the HSE are actively working with the University Limerick Hospital Group to ease congestion in UHL with a focus on facilitating transfers to Level 2 hospitals, assistance from rehabilitation units and Community Health Organisation services, and prioritisation of diagnostics to aid inpatient discharges.
UL Hospital Group have reported that indications for an MRI scan have greatly increased over the last 15 years and that an additional MRI scanner would have an immediate benefit in faster discharge of patients and reducing admissions. Proposals for funding of a second MRI machine and replacement of the existing scanner have been made by UHL. The HSE will have to consider the proposal in the context of the budget process.
Hospital Overcrowding
Ceisteanna (41)
Martin Heydon
Ceist:41. Deputy Martin Heydon asked the Minister for Health if his attention has been drawn to overcrowding at Naas General Hospital; and the supports being provided to help alleviate same. [41370/19]
Amharc ar fhreagraFreagraí scríofa
According to provisional HSE TrolleyGAR data, there was a 2.8% decrease in patients counted waiting on trolleys at 8am in Naas General Hospital ED for the year to date as of the end of September 2019 compared to the same period last year. In the month of September 2019, there were 395 patients counted on trolleys in Naas, which was a 25.8% decrease compared to August 2019.
My Department is engaging extensively with the HSE this year to identify mitigating actions across the health service to bring down trolley numbers and waiting times in the ED in the face of growing demand.
Planning for winter 2019/20 has commenced and my Department is working with the HSE to finalise the Winter Plan in the coming weeks. Individual Community Healthcare Organisations (CHOs) and Hospital Groups are preparing Integrated Winter Plans that will focus on demand management and reduction, staffing availability, timely access to the most appropriate care pathway for patients, and appropriate timely discharge from acute hospitals. These Integrated Winter Plans will support the development of a single overarching strategic level Winter Plan for the HSE.
The Integrated Winter Plan for Naas General Hospital will be delivered by a Winter Action Team which will include the CEO of the Dublin Midlands Hospital Group and the Chief Officer of CHO 7.
The Health Service Capacity Review published last year highlighted the need for a major investment in additional capacity, and an additional 8 beds opened in Naas General Hospital in December 2017 as part of the Winter Initiative 2017/2018.
Health Services Reform
Ceisteanna (42)
Denis Naughten
Ceist:42. Deputy Denis Naughten asked the Minister for Health the steps he is taking to implement the reform of trauma services; and if he will make a statement on the matter. [41171/19]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
Healthcare Infrastructure Provision
Ceisteanna (43)
Brian Stanley
Ceist:43. Deputy Brian Stanley asked the Minister for Health the progress to date on the new buildings and renovation of St. Vincent’s Hospital, Mount Mellick; and the timeline for the project. [41169/19]
Amharc ar fhreagraFreagraí scríofa
The Health Service Executive recently published its Capital Plan for 2019-2021. The plan includes capital funding for the Community Nursing Unit programme and also sets out the current status of all projects within the programme, including the replacement unit in Mountmellick, County Laois.
The Health Service Executive is responsible for the delivery of public healthcare infrastructure projects and has advised that the project is currently at design stage. A planning application for this project is to be made in early 2020 with works on Phase 1 expected to commence in 2021.
It is important to recognise that all capital development proposals must progress through a number of approval stages, in line with the Public Spending Code, including detailed appraisal, planning, design and procurement, before a firm timeline or funding requirement can be established.
The delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages, which can impact on the timeline for delivery.
Cannabis for Medicinal Use
Ceisteanna (44)
Gino Kenny
Ceist:44. Deputy Gino Kenny asked the Minister for Health the date for the commencement of the medical cannabis access programme; if there are outstanding issues in relation to its commencement; and if he will make a statement on the matter. [41158/19]
Amharc ar fhreagraFreagraí scríofa
As the Deputy is aware, I have signed legislation which will allow for the operation of the Medical Cannabis Access Programme (MCAP) on a pilot basis for five years.
Commercial medical cannabis suppliers whose cannabis products meet the specified requirements set out in the legislation, and which have been listed in Schedule 1 of the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations, will be able to supply these products into Ireland.
Once suitable medical cannabis products are made available by suppliers, the MCAP will make it possible for a medical consultant to prescribe, in line with the published clinical guidance, a listed cannabis-based product for a patient under his or her care for the three medical conditions specified in the Programme, where the patient has failed to respond to standard treatments.
The Department of Health will make this information available on their website.
As yet no medical cannabis products are available for use under the MCAP. It is expected that it will take some time for suppliers to put arrangements in place to have their products made available on the Irish market.
However I am pleased to say that there are a number of suppliers who have expressed an interest.
The medical decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. As Minister for Health I have no role in this clinical decision-making process.
Pending full operation of the MCAP and for medical indications not included in the MCAP, doctors may continue to use the Ministerial licensing route to prescribe medical cannabis for their patients, should they wish to do so.
Full information on how to apply for a Ministerial Licence is available on the Department's website.
Abortion Legislation
Ceisteanna (45, 65)
Joan Collins
Ceist:45. Deputy Joan Collins asked the Minister for Health the timeline for the drafting and introduction of legislation on safe access zones. [41176/19]
Amharc ar fhreagra
Mick Barry
Ceist:65. Deputy Mick Barry asked the Minister for Health if he will report on progress on legislation for safety zones around services that provide for the termination of pregnancy and related information; and if he will make a statement on the matter. [41356/19]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 45 and 65 together.
It is my absolute intention that people can access termination of pregnancy services safely.
My Department and An Garda Síochána have been closely monitoring the situation since termination of pregnancy services commenced in January this year. As part of our examination of the issue, I recently met with the Commissioner of An Garda Síochána. As the Deputy will be aware, I also met with Oireachtas members to discuss safe access and I plan to meet with the Oireachtas members again in the coming weeks to provide a further update.
My Department has also advised health service providers of existing legislation in place to protect them and to protect patients.
The result of the referendum last year gave the Government a strong mandate to introduce termination of pregnancy services and it remains my priority that legislation is fully implemented so that all women in Ireland can access these services quickly, easily and safely.
National Maternity Strategy Expenditure
Ceisteanna (46)
Louise O'Reilly
Ceist:46. Deputy Louise O'Reilly asked the Minister for Health if new funding will be released for the national maternity strategy for 2020; and if targeted funding will be allocated to help hire more consultant gynaecologists in order to reduce gynaecological waiting lists which are at nearly 30,000. [40978/19]
Amharc ar fhreagraFreagraí scríofa
I can confirm that additional development funding will be provided to the HSE National Women & Infants Health Programme in 2020 to support the continued implementation of the National Maternity Strategy. The funding will enable us to build manpower capacity in maternity services, including the recruitment of additional consultant obstetricians/gynaecologists, in order to provide for the continued roll out of the new model of integrated care.
As announced in Budget 2020, the Government has further increased investment to tackle waiting lists, with funding to the National Treatment Purchase fund (NTPF) increasing from €75m in 2019 to €100m in 2020. The year-on-year increases to the NTPF, since Budget 2017, reflect this Government’s priority to improve waiting times for patients to access hospital treatment.
My Department is working with the HSE and the NTPF to develop the Scheduled Care Access Plan 2020. In this regard, I would encourage all hospital groups and individual hospitals to engage with the NTPF to identify waiting list proposals, including for gynaecology services, for the remainder of this year and for 2020.
The Access Plan 2020 will be developed in parallel to the HSE National Service Plan (NSP) 2020. The NSP will set out a planned activity level for the year ahead, while the NTPF will work with the hospital system to provide additionality to improve access to inpatient/day case treatment and procedures and with a particular focus on improving access to hospital outpatient services. In 2020, the NTPF will further expand its list of targeted in-patient and daycase procedures to support further significant reductions in wait times, as well as increasing funding towards supporting full packages of care for patients on the outpatient waiting lists, to include the surgery or treatment where required.
Health Services Staff Recruitment
Ceisteanna (47)
Dara Calleary
Ceist:47. Deputy Dara Calleary asked the Minister for Health when essential positions in therapy services in County Mayo will be filled; and if he will make a statement on the matter. [41193/19]
Amharc ar fhreagraFreagraí scríofa
I have asked the HSE to respond directly to the Deputy on this matter.