Louise O'Reilly
Ceist:48. Deputy Louise O'Reilly asked the Minister for Health if he will liaise with hospitals to ensure they do not use debt collection agencies to recover emergency department and hospital charges. [40976/19]
Amharc ar fhreagraDebt Collection
Ceisteanna (48)
Freagraí scríofa
Patient charges are a key element of the overall funding envelope of the Irish health system and are taken into account when agreeing the Annual Estimates and the subsequent preparation of the annual National Service Plan.
These charges typically include:
- Out-patient charges
- Emergency Department charges
- Daily in-patient charges
- Long-term stay charges
Cohorts of people are exempt from these charges. These include, but are not limited to:
- Persons with full eligibility
- Women receiving services in respect of motherhood
- Children up to the age of six weeks
- Children suffering from diseases prescribed under section 52 (2) of the Act
- Persons receiving services for the diagnosis or treatment of infectious diseases
In addition, patients who opt for private in-patient services in public hospitals are liable for a range of private accommodation charges. There are no exemptions from these charges.
Non collection of debts owed directly impacts on the affordability of services provided by the Health Service Executive in any year. It is therefore incumbent on the HSE to take all reasonable steps to pursue amounts owed for services delivered.
Debt collection agencies are engaged when normal billing arrangements have been unsuccessful.
Hospital Waiting Lists Action Plans
Ceisteanna (49)
Anne Rabbitte
Ceist:49. Deputy Anne Rabbitte asked the Minister for Health the 2019 targets in place for the outpatient waiting list in the Children’s Health Ireland Hospital Group; and if he will make a statement on the matter. [41209/19]
Amharc ar fhreagraFreagraí scríofa
Improving access to hospital appointments and procedures in a key commitment of Government. The HSE Management Data Report (MDR) reports on HSE activity against Key Performance Indicators as set out in the National Service Plan for 2019. Under the National Service Plan 2019, the target for all hospital groups, including Children’s Health Ireland (CHI), is for 80% of people to wait less than 52 weeks for a first Outpatient Department appointment.
The last published MDR figures are for June 2019 and report that 60% of patients waiting for a first Outpatient appointment at CHI hospitals are waiting 52 weeks or less. Furthermore, the NSP target for Outpatient Activity (including both new and return appointments) for CHI for 2019 is 145,766 appointments for the full year. The target to the end of June was 73,274 while actual activity to the end of June was recorded in the MDR as 55,528. In addition, the target for new:return appointments for CHI for 2019 is 1:2.3. As of the end of June, CHI reported a ratio of 1:2.4.
CHI has advised that it is committed to reducing waiting lists and supporting initiatives that ensure that children receive care appropriately and in a timely manner, and in 2019 a number of initiatives were put in place to address Outpatient Waiting Lists.
For example, the new paediatric outpatient and urgent care centre in CHI at Connolly opened on 31st July 2019. This new facility offers a range of services to children and their families in the local area as well as those in Dublin North city and county and the surrounding areas in Kildare and Meath. General Paediatric Clinics are held from 8am to 6pm Monday to Friday. CHI has advised that the opening of CHI at Connolly is having a positive impact on CHI OPD waiting lists. At the end of September 2019, there were 4,130 patients on CHI’s General Paediatric Outpatient waiting list, which is a 35% reduction when compared to the same period last year.
Furthermore, CHI at Connolly will provide a further 1,300 outpatient appointments between September and December 2019. CHI advise that they are currently in the process of expanding these clinics to provide a focus on the specific requirements for some patients including asthma, allergy, faltering growth and constipation. When fully operational, CHI at Connolly is expected to provide 17,000 outpatient appointments (General Paediatrics and Orthopaedic clinics) every year .
Management of referrals is a key enabler to reducing waiting lists, and in this regard CHI advise that they have initiated a referrals process whereby all referrals from the three children’s hospitals are managed centrally. The group is progressing its ICT requirements to have a single Patient Administration System across all CHI sites (the three children’s hospitals and CHI at Connolly).
The central referrals team, through administrative and clinical validation are ensuring that all appointment slots are used appropriately and that where appropriate, patients are removed from the waiting list, which is assisting in the waiting list reduction.
Another example of innovation in referral pathways is the TORC project (Triage of Referral Clinics). This is one of a number of virtual clinics currently being held across CHI and involves the active triage of referrals, the provision of advice and commencement of treatment for patients. As a result, patients may then either not have to attend an outpatient clinic appointment or can begin their pathway of care prior to attendance. CHI advise that this has been very successful in achieving a discharge rate of up to 30% of patients contacted. In addition, patients can begin their diagnostics prior to attending an appointment which ensures the best use of resources and reduction in follow-up attendances for patients and their families.
CHI is continuing with a number of other initiatives including moving Dermatology referrals towards a more centralised structure together with a virtual clinic model in this specialty.
CHI continues to engage with the National Treatment Purchase Fund (NTPF) to secure funding for initiatives in 2019 to address access to patients for specialties including ENT, Ophthalmology, General Paediatrics, Orthopaedics and Gastroenterology.
CHI advises that recruitment of additional consultants for CHI specialties with the longest OPD waiting times (Allergy, Dermatology, Radiology, Gastroenterology, Rheumatology, Orthopaedics & ENT) is also underway following CHI securing additional National Service Plan funding in 2019. In appointing these positions, the multidisciplinary teams are also reviewing their current work practices and identifying new ways of working to ensure appropriate management of waiting lists.
Healthcare Infrastructure Provision
Ceisteanna (50)
Michael Moynihan
Ceist:50. Deputy Michael Moynihan asked the Minister for Health if he will provide a report on the works at St. Joseph's Community Hospital, Millstreet; the timeframe for its completion; and if he will make a statement on the matter. [41232/19]
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 St. Joseph's Community Hospital, Millstreet.
The Health Service Executive is responsible for the delivery of public healthcare infrastructure projects and has advised that planning permission has recently been granted. It is currently expected that works on site will commence in 2020.
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.
Cross-Border Health Initiatives
Ceisteanna (51, 88)
Joan Collins
Ceist:51. Deputy Joan Collins asked the Minister for Health the steps he will take to respond to the long delays for public patients applying for the cross-Border directive and the long delays for public patients on the remuneration of payments for their operations from the HSE; the number of persons that were working in the application section and remuneration section in May 2019; the number working in the section now; the number of patients waiting for clearance for their operations in May 2019; the number waiting now; the length of time it took to remunerate the costs to patients in May 2019; and the length of time it is taking now. [41161/19]
Amharc ar fhreagra
Catherine Connolly
Ceist:88. Deputy Catherine Connolly asked the Minister for Health the additional resources provided to the HSE to eliminate delays in the processing of applications and payments under the HSE cross-Border directive scheme; and if he will make a statement on the matter. [41179/19]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 51 and 88 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.
The HSE has advised that the scheme is operating with an increasing workload and currently has a backlog of up to 4 months claims/applications (approx. 3500 claims/applications).
Officials of my Department met with the HSE in July to discuss the issue of reimbursement delays for patients who have availed of the Directive. The HSE undertook to give consideration to measures which could be put in place in the short-term to address the significant backlog in processing applications, and to also examine current resourcing of the CBD office and to identify necessary actions to mitigate waiting times arising from current and future demand for the scheme. A report is awaited from the HSE on the measures it proposes to take to address the delays in reimbursement.
As the PQ refers to operational matters which HSE have operational responsibility for, I have also referred the Deputies question to them for direct reply.
Budget 2020
Ceisteanna (52)
Bernard Durkan
Ceist:52. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he expects the health budget for 2020 in respect of both capital and current expenditure will be adequate to meet requirements in full without reference to supplementary budget later in the year. [41220/19]
Amharc ar fhreagraFreagraí scríofa
Budget 2020 sets out a budget of over €18.3 billion for health and social care services, the highest budget ever allocated. The Health budget increased by €1.2 billion on 2019, a substantial additional level of funding. The amount allocated follows an extensive process of engagement between my Department and the Department of Public Expenditure and Reform, which considered both the funding requirements and the fiscal position. These types of engagements are a normal part of the Budgetary process and happen with Departments across Government. All Departments put forward spending proposals but are required to operate within the amounts proposed by Government and determined by the Dáil.
The issue of health funding is a major policy challenge for both the Irish and international Governments. Despite welcome increases annually, the need for effective financial management remains crucial as the health service deals with a larger and older population, with more acute health and social care requirements, increased demand for new and existing drugs and the rising costs of health technology. The costs associated with these service pressures will increasingly need to be managed not solely through annual increased Exchequer allocations but also through improved efficiencies, productivity and value from within the funding base.
Both the additional funding allocated and additional value to be derived from improved efficiencies and productivity will be considered by the HSE in setting out its National Service Plan (NSP) 2020. Under legislation the HSE is required to set out the type and volume of health and social care services to be provided having regard to the funding available and I am confident that the NSP will clearly demonstrate this.
Newborn Screening Cards
Ceisteanna (53)
Gino Kenny
Ceist:53. Deputy Gino Kenny asked the Minister for Health the necessary steps that will be taken to increase new born screening from eight conditions to 40 as per best international practice; his views on whether the extension in newborn screening will significantly lower the possibility of babies being born with serious and often life-limiting conditions and the subsequent impact on their families; and if he will make a statement on the matter. [41159/19]
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.
It is correct that the number of conditions screened for by Member States (MS) in Europe does vary. This does not reflect major differences in the genetic background of populations or estimated prevalences but rather highlights different MS approaches to (1) the estimation of risks and benefits in their populations and (2) responding to the cultural demands and ethical difficulties arising from a lack of evidence to screen for many of these rare conditions. Detailed knowledge about the natural course of many rare diseases, their variants and specifically information on the medium and long term outcomes after early treatment initiation are still insufficient.
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.
Nursing Staff Data
Ceisteanna (54)
Stephen Donnelly
Ceist:54. Deputy Stephen Donnelly asked the Minister for Health the number of unfilled nursing posts by hospital, including the hospitals currently precluded for any reasons from hiring nurses; and if he will make a statement on the matter. [41266/19]
Amharc ar fhreagraFreagraí scríofa
I have asked the HSE to respond directly to the Deputy on this matter.
Abortion Legislation
Ceisteanna (55)
Peadar Tóibín
Ceist:55. Deputy Peadar Tóibín asked the Minister for Health the authority responsible for investigating and adjudicating on criminal and non-criminal breeches of the abortion legislation. [40898/19]
Amharc ar fhreagraFreagraí scríofa
As the Deputy will be aware, section 23 of the Health (Regulation of Termination of Pregnancy) Act 2018 sets out the offences under the legislation.
Section 23 states that it is an offence for a person, by any means whatsoever, to intentionally end the life of a foetus otherwise than in accordance with the provisions of the Act. It is also an offence for a person to prescribe, administer, supply or procure any drug, substance, instrument, apparatus or other thing knowing that it is intended to be used or employed with intent to end the life of a foetus, or being reckless about whether it might be used for that purpose. Finally, it is an offence for a person to aid, abet, counsel, or procure a pregnant woman to intentionally end or attempt to end the life of that pregnant woman’s foetus otherwise than in accordance with the provisions of the Act.
The investigation or prosecution of offences under the Health (Regulation of Termination of Pregnancy) Act 2018 are criminal matters for An Garda Síochána and, if prosecution is warranted, the Director of Public Prosecutions. The Minister for Health has no role in the investigation or prosecution of offences under the Act.
Home Care Packages Data
Ceisteanna (56)
Jack Chambers
Ceist:56. Deputy Jack Chambers asked the Minister for Health the average waiting times for homecare package applications in west County Dublin; the number of open homecare package applications being considered in the area; the number of individual homecare packages being provided in the area; and if he will make a statement on the matter. [41305/19]
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.
Healthcare Infrastructure Provision
Ceisteanna (57)
Catherine Connolly
Ceist:57. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 66 of 2 July 2019, if the property transfer has been completed; the status of the design brief; if approval has been sought and granted for the appointment of a new design team for the project; and if he will make a statement on the matter. [41183/19]
Amharc ar fhreagraFreagraí scríofa
As the Health Service Executive is responsible for the delivery of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
National Children's Hospital
Ceisteanna (58)
Alan Kelly
Ceist:58. Deputy Alan Kelly asked the Minister for Health if aspects of the new national children's hospital have been redesigned; if so, the reason and areas redesigned; and if he will make a statement on the matter. [41164/19]
Amharc ar fhreagraFreagraí 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.
Since the conclusion of the GMP Process there has been no change to the design intent for the new children’s hospital. There has been some minor adjustments, as would be normal practice in a project of this size.
The National Paediatric Hospital Development Board made a submission to An Bord Pleánala on the 23rd May 2019 under section 146B of the Planning and Development Act for minor size alterations to internal floor areas which relate to building and fire regulation. There were some other minor amendments which related to elevations and the façade, reconfiguration of roof lights, the revision of plant area, all details on these amendments can be found on the An Bord Pleánala Website. At a meeting held on 6th August 2019, An Board Pleánala in accordance with the recommendation of the reporting inspector, decided that the proposed alterations would not result in a material alteration to the terms of the development.
Hospitals Inspections
Ceisteanna (59)
Catherine Connolly
Ceist:59. Deputy Catherine Connolly asked the Minister for Health the steps being taken to address the recurrent nature of non-compliance with regulations impacting on the quality and safety of care for residents, including cleaning, decontamination, infection control, nursing documentation, access to allied health care, risk management, residents rights and water quality at Merlin Park Hospital units 5 and 6 as identified by HIQA in recent reports; and if he will make a statement on the matter. [41181/19]
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.
Parking Charges
Ceisteanna (60)
Fiona O'Loughlin
Ceist:60. Deputy Fiona O'Loughlin asked the Minister for Health if he will carry out a review of car parking costs in health care facilities and primary care facilities nationwide; and if he will make a statement on the matter. [41175/19]
Amharc ar fhreagraFreagraí scríofa
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.
Medicinal Products Availability
Ceisteanna (61)
Maureen O'Sullivan
Ceist:61. Deputy Maureen O'Sullivan asked the Minister for Health the status of outstanding issues relating to the availability of tagrisso osimertinib for use in lung cancer treatment; and if he will make a statement on the matter. [41348/19]
Amharc ar fhreagraFreagraí scríofa
The HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies the criteria for decisions on the reimbursement of medicines.
In line with the 2013 Act and the national framework agreed with industry, if a company would like a medicine to be reimbursed by the HSE, the company must submit an application to the HSE to have the new medicine added to the reimbursement list.
Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).
I am advised by the HSE that it has received two applications for the reimbursement of Osimertinib (Tagrisso):
1) The treatment of adult patients with locally advanced or metastatic EGFR T790M mutation-positive non-small cell lung cancer (NSCLC).
In May 2018, the NCPE recommended that Osimertinib not be considered for reimbursement for this indication unless cost-effectiveness can be improved relative to existing treatments. Following the assessment and after a number of rounds of commercial negotiations, the HSE notified the applicant in February 2019 that it was minded to not approve reimbursement for this indication.
The 2013 Act provides for a period of representations after such notifications, before the HSE can make its final decision. The HSE have received representations from the manufacturer and these are under consideration by the HSE leadership team in advance of a final reimbursement decision.
2) The first-line treatment of adult patients with locally advanced or metastatic NSCLC with activating epidermal growth factor receptor (EGFR) mutations.
In respect of the second indication, a health technology assessment was completed on 6 August 2019 with the NCPE recommending that Osimertinib not be considered for reimbursement unless cost effectiveness can be improved relative to existing treatments. The HSE will assess this application for reimbursement in line with the 2013 Health Act.
Hospital Consultant Remuneration
Ceisteanna (62)
Stephen Donnelly
Ceist:62. Deputy Stephen Donnelly asked the Minister for Health when he anticipates a full reversal of new entrant pay disparity for consultants; and if he will make a statement on the matter. [41265/19]
Amharc ar fhreagraFreagraí scríofa
The Public Sector Pay Commission in its Report published in September 2018 identified difficulties in attracting consultant applications for many posts at present and acknowledged that the pay rates for new entrants had been highlighted as a factor in this. The Commission proposed that the Parties to the Public Service Stability Agreement jointly consider what measures could be taken, over time, to address the pay differential.
Following on from the Report of the Commission, I recently published the De Buitléir Report. This Group was established to examine how to give effect to the Sláintecare recommendation on the removal of private practice from the public hospital system. To achieve this objective it recommends pay parity being confined to those who would take up a Sláintecare Type A contract, i.e. the contract that only allows holders engage in public practice. It stated that implementation of this approach would result in a phased reduction in private practice as the proportion of consultants with contracts allowing them engage in private practice would decline over time.
In publishing the De Buitléir Report I noted that I would be consulting with key stakeholders on its recommendations. Arrangements are being progressed in relation to engaging with the consultants representative bodies on progressing Sláintecare, the De Buitléir Report and the Report of the Public Service Pay Commission. A meeting with the IMO is due to take place next week.
Health Services
Ceisteanna (63)
Maureen O'Sullivan
Ceist:63. Deputy Maureen O'Sullivan asked the Minister for Health the status of work to address the issues in relation to dual diagnosis. [41347/19]
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.
Hospital Overcrowding
Ceisteanna (64)
Michael McGrath
Ceist:64. Deputy Michael McGrath asked the Minister for Health the measures being taken to alleviate overcrowding in Cork University Hospital in which the figures recorded in September 2019 were the worst recorded for September since an organisation (details supplied) commenced keeping records; and if he will make a statement on the matter. [41225/19]
Amharc ar fhreagraFreagraí scríofa
According to provisional HSE TrolleyGAR data, there was a 36.5% increase in patients counted waiting on trolleys at 8am in Cork University 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 789 patients counted on trolleys in Cork University Hospital, which was a 15.3% decrease compared to the previous month.
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 Plans for Cork University Hospital will be delivered by a Winter Action Team whose membership will include the CEO of South South West Hospital Group and the Chief Officer of Cork Kerry Community Healthcare.
The Health Service Capacity Review published last year highlighted the need for a major investment in additional capacity. An additional 40 beds have opened in Cork University Hospital since 2018, including 8 that opened in January as part of the Winter Plan 2018/2019.
Question No. 65 answered with Question No. 45.
Hospital Discharges
Ceisteanna (66)
John Brassil
Ceist:66. Deputy John Brassil asked the Minister for Health the initiatives being taken to reduce the number of delayed discharges in University Hospital Kerry; and if he will make a statement on the matter. [41224/19]
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.
Healthcare Infrastructure Provision
Ceisteanna (67)
Brian Stanley
Ceist:67. Deputy Brian Stanley asked the Minister for Health the progress to date on the planned refurbishment and extension of Abbeyleix Hospital; and the timescale for the project. [41168/19]
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.
Brexit Issues
Ceisteanna (68)
Bernard Durkan
Ceist:68. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he remains assured of the continued uninterrupted supply of all medicines in the aftermath of Brexit; and if he will make a statement on the matter. [41219/19]
Amharc ar fhreagraFreagraí scríofa
As part of the whole-of-government response to Brexit, the Department of Health has established dedicated structures to manage the approach to preparing for the UK’s exit from the EU. The Department, the Health Products Regulatory Authority (HPRA) and the Health Service Executive (HSE), with the full support of stakeholders, are implementing a comprehensive and coordinated set of preparations to ensure continuity of treatment and care for patients in Ireland in the event of a ‘no deal’ Brexit.
I refer Deputy Durkan to Chapter 24 of the Government’s Contingency Action Plan for Brexit, updated in July 2019, which specifically details work underway in this area.
Ireland is unlikely to face general medicine shortages in the period immediately after 31 October. Any emerging supply issues will, in the first instance, be dealt with from existing supplies held within the domestic distribution chain, which has already has additional stocks of medicines routinely built into it. This is different to the wholesaling model which operates in the UK. The pharmaceutical industry and wholesalers have provided assurances that they are confident that they will have sufficient stocks to bridge any initial issues at ports, should they occur.
As a result there is no need for hospitals, pharmacists or patients to order extra quantities of medicines, or for doctors to issue additional prescriptions, as doing so could disrupt existing stock levels and hamper the supply of medicines for other patients. Patients should continue to fill their prescriptions and take their medications as they normally would.
My department, the HSE and the HPRA have facilitated ongoing engagements with manufacturers and suppliers of medicines and medical devices, to ensure that they are Brexit-ready, to discuss any potential issues that could affect supply to Ireland and to identify solutions to maintain supply to the market.
As a result of these measures undertaken at industry, national and EU level, Brexit is not expected to have an immediate impact on the supply of medicines in Ireland. However, given the size of our market, Brexit may cause those with a small share of a particular medicine market to consider the ongoing viability of supply to Ireland. However, it is considered that any such products are unlikely to be critical to continuity of care, as there are and will be alternative suppliers or therapeutic alternatives available.
Unfortunately, medicine shortages are a feature of modern health systems, but Ireland has a multi-stakeholder system in place to prevent and manage shortages when they occur. Any shortages currently affecting the Irish market are not directly attributable to Brexit.
The HPRA has worked with stakeholders, including the HSE, to develop an effective approach to the management of medicine shortages in Ireland. In 2018 the HPRA launched the “Medicine Shortages Framework”, which is built in a pragmatic and collaborative approach involving the wide range of stakeholders within the medicine supply chain. The HPRA coordinates all stakeholders to share information in order to prevent or mitigate the impact of medicine shortages when they occur. The health system is therefore well placed to anticipate and respond to any additional shortages, should they arise because of Brexit.
As an additional safeguard, consideration continues to be given to those categories of medicines which are considered most essential to public health. The HSE and HPRA are continuing to undertake criticality assessments, seeking additional and updated assurances from stakeholders, including pharmaceutical manufacturers, wholesalers and healthcare professionals, to verify contingency planning to date and, where necessary, identify clinically appropriate alternatives for those products most critical to public health with potential to be vulnerable to supply issues.
Manufacturers and suppliers of medicines have been asked to further review their supply chain for products that travel from or through the UK, determine any products or services that are certified for compliance with EU standards by a UK body and communicate any potential vulnerabilities to the Department of Health, HPRA or HSE. No major issues have been identified through this process.
While there can be no absolute guarantees following a no deal Brexit, significant work has been undertaken to mitigate potential vulnerabilities and risks to provide this high level of assurance around continuity of care and treatment for patients in Ireland. Work on this will continue up to, and in the months following, Brexit. This will include ongoing monitoring of supplies in Ireland and engagement with industry to adapt supply chains, where necessary, to minimise any potential disruption.
Hospital Appointments Delays
Ceisteanna (69)
John Lahart
Ceist:69. Deputy John Lahart asked the Minister for Health the plans in place to reduce waiting times for an outpatient appointment in Tallaght hospital in which the numbers waiting over a year have seen a more than four-fold increase since the end of 2015; and if he will make a statement on the matter. [41214/19]
Amharc ar fhreagraFreagraí scríofa
I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.
Waiting list figures for the end of September, due to be published by the National Treatment Purchase Fund (NTPF) later this week, show that there are 32,955 people waiting for an outpatient appointment at Tallaght Hospital. Of those waiting, 37% receive their appointment in 6 months or less and 57% are waiting 12 months or less. Urology, ENT, dermatology and gynaecology account for over 67% of the patients waiting over 12 months for an outpatient appointment at Tallaght Hospital.
More broadly, the NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify outpatient waiting list proposals. In addition, my Department has established a Working Group comprised of representatives from the HSE, NTPF, and Departmental officials, to examine ways of improving access for patients waiting for scheduled care. Part of this work includes developing initiatives which will move care to the most appropriate setting, and at the lowest level of complexity. Urology, ENT, dermatology, and gynaecology are some of the specialties being examined as part of this process.
Budget 2020 announced that the Government has further increased investment in tackling waiting lists, with funding to the 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 reflect 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 lists, with a particular focus on improving access to hospital outpatient services. In 2020, the Department will also be asking the HSE and NTPF to work together with the Sláintecare Implementation Office with the aim of driving sustainable improvements to service provision.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
Hospital Services
Ceisteanna (70)
Mick Barry
Ceist:70. Deputy Mick Barry asked the Minister for Health his plans for the opening of a HIV clinic in Cork University Hospital; and if he will make a statement on the matter. [41355/19]
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 (71)
Eugene Murphy
Ceist:71. Deputy Eugene Murphy asked the Minister for Health the reason a design team has still not been appointed in relation to the multi-million euro development proposed for the Sacred Heart Hospital, County Roscommon; the further reason a timeframe for completion of works cannot be provided in view of the fact that the project was announced in January 2016 and was originally due to be completed in 2021; and if he will make a statement on the matter. [41166/19]
Amharc ar fhreagraFreagraí scríofa
The Health Service Executive recently published its Capital Plan for 2019-2021 outlining 250 projects to be progressed over the three-year period.
The Capital Plan provides for €220m capital funding to the Community Nursing Unit programme over the period 2019 to 2021 and also sets out the current status of all projects within the programme, including new development at the Sacred Heart Hospital, Roscommon.
The Health Service Executive is responsible for the delivery of public healthcare infrastructure projects and has advised that the tender documents are being prepared for the appointment of a design team. It is intended to proceed with the tender process later this year, once the new Framework for Design Teams has been completed.
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.
Question No. 72 answered with Question No. 11.
General Practitioner Contracts
Ceisteanna (73)
Ruth Coppinger
Ceist:73. Deputy Ruth Coppinger asked the Minister for Health if he will introduce an extra weighting when allocating resources to general practitioners to take into account the additional demand on services in deprived communities; and if he will make a statement on the matter. [41360/19]
Amharc ar fhreagraFreagraí scríofa
I am pleased that we have recently been able to conclude an agreement with the Irish Medical Organisation on a major package of GP contractual reforms which will benefit patients and make general practice a more attractive career option for doctors.
The outcome of the talks process is a comprehensive service development and reform agreement in return for significant phased increases in funding for general practice services provided by GPs to medical card and GP visit card patients.
As part of the deal, it has been agreed that the GP rural practice allowance will be increased in 2020 and that targeted funding of €2 million will be set aside to provide additional support to practices in deprived urban areas. The full details in relation to how the latter arrangements will operate, including the most appropriate basis on which to determine the extent of deprivation as it relates to the provision of GP services, is currently being developed by the HSE in consultation with my Department and the IMO.