Emergency Departments Waiting Times

Ceisteanna (61)

Jim O'Callaghan

Ceist:

61. Deputy Jim O'Callaghan asked the Minister for Health the reason to date in 2019 more than 1,100 persons over 75 years of age have endured emergency department wait times of more than 24 hours at St. Vincent's University Hospital. [48774/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The number of patients attending emergency departments across the hospital system continues to increase annually, with the result that the system is currently operating at close to full capacity. HSE figures show that for the first ten months of 2019, the number of patients attending St. Vincent’s University Hospital increased by 4.9% and the number of attendances of patients over the age of 75 increased by 3.5% compared to the same period in 2018. This reflects increasing demand for unscheduled care, especially by patients in the 75 years and over age group. Similarly, admissions in St. Vincent’s University Hospital increased by 5.8% and admissions of patients over the age of 75 increased by 1.3% compared to the same period last year.

There are a number of factors which may affect the waiting times for older patients. In particular, people in the older age category presenting to EDs are more likely to have complex needs and be admitted then the population generally.

The HSE Winter Plan was launched on Thursday 14 November in preparation for the anticipated increase in demand over the winter period. I have allocated an additional €26m to fund the implementation of the Plan. Nine Winter Action Teams, each aligned to a Community Healthcare Organisation and associated acute hospitals and Hospital Groups, have prepared Integrated Winter Plans. These plans 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. Each Action Team has set out a range of initiatives it will undertake within its area to implement the Plan.

I am confident that together with the more immediate measures being undertaken under the Winter Plan and the strategic approach undertaken by the Government under Sláintecare and Project Ireland that progress will be made in addressing the difficulties in the emergency departments.

Emergency Departments Services

Ceisteanna (62)

Bernard Durkan

Ceist:

62. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he continues to make progress in addressing the issue of overcrowding at accident and emergency departments in hospitals nationwide; the extent to which the issues affecting the situation have been identified and addressed; and if he will make a statement on the matter. [48819/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I acknowledge the challenges facing the emergency departments in our hospitals.

According to HSE, there was a 2.7% increase in ED attendances nationally this year up to the end of October 2019 compared to the same period last year. The number of attendances for patients in the over 75 age group also increased by 3.3% nationally. My Department has engaged extensively with the HSE this year to identify mitigating actions to bring down trolley numbers and waiting times in the ED in the face of growing demand.

The HSE Winter Plan was launched on Thursday 14 November in preparation for the anticipated increase in demand over the winter period. The Government allocated an additional €26m to fund the implementation of the Plan. Nine Winter Action Teams, each aligned to a Community Healthcare Organisation and associated acute hospitals and Hospital Groups, have prepared Integrated Winter Plans. These plans 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.

Each Action Team has set out a range of initiatives it will undertake within its area to implement the Plan. Specific funding has been allocated to support initiatives at local level. These include:

- Additional medical, nursing, therapies support, pharmacy and lab staff to improve patient experience time, improve senior clinical decision making, reduce length of stay, and facilitate weekend discharges;

- Additional Aids and Appliances to facilitate timely discharge;

- Additional home support hours to facilitate early hospital to community transfers;

- Communications to facilitate hospital avoidance and public health awareness;

- Implementing Frail Intervention Therapy Teams for admission avoidance and reduced admissions of patients over-75;

- Additional Flu testing kits to improve Patient Experience Time.

Steady progress is also being made in increasing bed capacity with the number of available inpatient beds expected to increase to above 11,000 following the investment planned in the National Service Plan 2019.

In addition to the immediate measures being undertaken in the Winter Plan the Government through the Sláintecare Strategy is addressing the issues of access to healthcare. The Sláintecare Action Plan for 2019 has a specific workstream on access and waiting lists. The Government is also increasing investment in health infrastructure and capacity in the system in line with Project Ireland 2040.

I am confident that together with the more immediate measures being undertaken under the Winter Plan and the strategic approach undertaken by the Government under Sláintecare that progress will be made in addressing the difficulties in the emergency departments.

Hospital Facilities

Ceisteanna (63)

Martin Heydon

Ceist:

63. Deputy Martin Heydon asked the Minister for Health the status of progress on a new endoscopy unit for Naas General Hospital; the next steps in the delivery of a new stand alone mental health unit to replace Lakeview on the site of the hospital; and if he will make a statement on the matter. [48865/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

A new endoscopy unit for Naas General Hospital is included for progression in the 2019 Capital Plan. An extension to planning permission was sought and has been extended for a further 5 years to December 2024. It is proposed to tender the works in 2020, with construction to commence early 2021 and to complete in late 2022.

The original development proposal for a new standalone mental health unit to replace Lakeview on the site of Naas General Hospital comprised the provision of an 8-bed intensive care unit at the existing 30 bed Lakeview Mental Health unit on the grounds of Naas General Hospital.

Following a review of the proposal, a significant expansion of the project scope is now proposed, with an associated increase in project value. This has meant the original design team’s engagement had to be terminated and a new procurement process undertaken.

The HSE has now appointed a new design team for this much expanded project.

The revised proposal is expected to deliver 50 bed spaces including a 9 bed intensive care area and significantly upgraded infrastructure. The timeframe for the completion of the new Acute Mental Health Unit project will be informed by the work of the project team and this work will be undertaken in conjunction with Naas General Hospital and the HSE.

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 final decision to proceed with the construction of a project cannot be made until the tender process has been completed and the costings reviewed to ensure that the proposal delivers value for money and remains affordable, and that sufficient funding is available to fund the project to completion, including equipping and commissioning costs.

Speech and Language Therapy Waiting Lists

Ceisteanna (64)

Thomas Byrne

Ceist:

64. Deputy Thomas Byrne asked the Minister for Health the measures being taken to improve waiting times for speech and language assessments in County Meath; and if he will make a statement on the matter. [48878/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Each child that presents to the Health Service Executive's (HSE) Speech and Language Therapy Service has an initial assessment to determine the individuals presenting need and requirements for therapy. The therapist in conjunction with the parents or carer will determine the severity of the child’s difficulties and prioritize for therapy accordingly.

Many children can have their speech and language needs adequately met through uni-disciplinary Speech and Language therapy services in Primary Care. Children with more complex needs requiring multi-disciplinary intervention, are referred to specialist disability services.

I have been advised by the HSE that the following measures are in place to reduce waiting times to access Speech and Language Therapy services in County Meath.

A cross divisional monthly Speech and Language referral forum is in operation. Between August and November 2019 this resulted in 99 children being moved from the Disability waiting list, to have their therapy service provided in Primary Care, where the waiting list is less lengthy. This ensures that children with complex needs continue to receive specialist Disability services but in a more timely manner, whilst those who can have their needs met in Primary Care benefit from the shorter waiting times.

Two vacant Speech and Language therapy posts were filled with both new staff starting work in November. The HSE expect that to see an improvement in waiting times in early 2020 following the induction of these two therapists. The HSE also allocated 1 WTE new Speech and Language Therapy post to County Meath under Progressing Disability for Children and Young People Progamme and this post has been assigned to the Trim Network where waiting times are longest.

The Speech and Language therapy services in County Meath monitor all staff’s statistics on a monthly basis (based on agreed caseloads), and are subject to review and supervison by the Speech and Language Therapy Manager. In addition the Speech and Language Therapy services in County Meath regularly review and update service models to ensure adherence to best, evidence-based practice.

The service have also implemented 'Parent Power', a programme of workshops that run regularly throughout the year to support parents in managing their child's communication at home whilst awaiting one to one Speech and Language Therapy. These workshops were designed based on solution focused interviews with a cohort of parents awaiting services, to ensure they would meet the needs of families in this area.

I acknowledge that timely access to Speech and language Therapy is vital for every child’s development and I understand how delays in accessing assessment and intervention are a source of great concern for both children and their families. While not addressing all needs, the filling of the new post and the two vacant posts along with the other initiatives I have outlined will have a significant positive impact in reducing waiting times for Speech and Language Therapy services in County Meath over the course of the next year.

Genetically Modified Organisms

Ceisteanna (65)

Brian Stanley

Ceist:

65. Deputy Brian Stanley asked the Minister for Health the future production and regulation of genetically modified foods here; and if he will make a statement on the matter. [41606/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Responsibility for the deliberate release, use of feed and food and the labelling and traceability of genetically modified organisms (GMOs) is divided between a number of Departments and their Agencies. Generally, responsibility for issues relating to the cultivation of GM crops rests with the Department of Communications, Climate Action and Environment (DCCAE), while the Department of Agriculture, Food and the Marine (DAFM) is responsible for GM animal feed and the coexistence of authorised GM crops alongside non-GM crops. The Department of Health’s remit relates to the safety of GM food.

The Department of Communications, Climate Action and Environment (DCCAE) has responsibility for policy matters in relation to EU Directives on the deliberate release of GMOs into the environment and the contained use of GMOs. It regulates the cultivation and field trials, of any EU-authorised GM crops. The Environmental Protection Agency advises DCCAE and is responsible for the implementation of Government policy in this area. In 2018, DCCAE obtained Cabinet approval to prohibit or restrict the cultivation of GM crops in Ireland, enabling Ireland to opt out of the cultivation of GMO crops approved for cultivation elsewhere in the EU.

DAFM is responsible for GM animal feeds, the coexistence of authorised GM crops alongside non-GM crops and the seed certification related to GM products. DAFM’s sole responsibility in relation to the deliberate release of GM crops relates to the implementation of coexistence measures in the event that commercial GM crops are authorised for cultivation alongside conventional crops. DAFM has advised that there is only one GM crop authorised for cultivation in the EU, namely GM maize ‘MON 810’, which is mainly grown in Spain for animal feed. MON 810 is not suited for cultivation in Ireland.

The Department of Health’s remit in this area relates to policy on the safety of food. The Food Safety Authority of Ireland (FSAI) provides scientific and technical advice; it is the Competent Authority responsible for the implementation of GM food legislation in Ireland. Under Regulation (EC) No. 1829/2003, only EU-authorised GM foods may be placed on the market in Ireland. Stringent traceability and labelling rules must be observed for the marketing of these foods. The FSAI coordinates annual checks to ensure that any authorised GM foods present on the Irish market are labelled as required. There is no indication at present that EU legislation related to GM foods will change in the immediate future.

GM crops, food and feed are subject to a comprehensive risk assessment by the European Food Safety Authority (EFSA) and subsequent regulatory votes by Member States before they are authorised for use in the EU. The risk assessment is designed to ensure GM crops and GM food and feed do not pose a risk to human health, animal health and the environment.

HSE Staff Recruitment

Ceisteanna (66)

Catherine Connolly

Ceist:

66. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 82 of 10 October 2019, the reason sanction has not been given by the HSE in respect of the 48 vacant posts in which interviews have been held, posts offered and accepted and for which the sanction remains outstanding; and if he will make a statement on the matter. [48891/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I am advised by the HSE that while there is no national recruitment embargo or moratorium in place, there is a priority requirement for all HSE services to maintain, or get to, an affordable staffing level that is sustainable in 2019 and 2020, while also prioritising the delivery of safe services.

In light of this, the HSE advise that they have introduced control measures relating to staffing and recruitment to ensure that they live within the available resources provided to them. This does mean that in some Hospital Groups and Community Healthcare Organisations non-critical replacement posts will be paused.

The HSE report that there is on-going capacity for recruitment of newly funded posts and replacement of critical clinical posts within frontline services throughout this period.

With regard to these posts specifically, I am advised by Community Healthcare West that once derogation is received from the appropriate National Directors Office, the HSE Recruitment Office will be instructed immediately to proceed with the appointments.

Nursing Homes Support Scheme Review

Ceisteanna (67)

Mattie McGrath

Ceist:

67. Deputy Mattie McGrath asked the Minister for Health the status of reforms of the nursing homes support scheme; and if he will make a statement on the matter. [48618/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The proposed policy change to the Nursing Homes Support Scheme (NHSS), to cap contributions based on farm and business assets at 3 years where a family successor commits to working the productive asset, has been approved by Government. The Department developed draft Heads of Bill while considering a number of complex ancillary policy and operational matters which may need to be addressed in the proposed legislation.

The General Scheme of Bill for the NHSS was approved by Government on 11 June 2019 and subsequently published. The changes to the Scheme will come into effect as soon as the legislative process is successfully complete. The Department will progress this as quickly as possible, however, the timeline for completion of the legislation will also depend on how it passes through the Houses. The General Scheme was sent to the relevant Joint Committee and the Department participated in pre-legislative scrutiny on 13 November 2019. The Department looks forward to the report of the Committee following from this engagement. In the meantime, engagements with the Office of the Attorney General will continue with a view to progressing the legislative development process.

It is intended that this proposed policy change, the 3 year cap, will be extended to eligible existing participants in long term residential care so that they are not disadvantaged, but that there would be no retrospective recoupment of contributions for those who have paid contributions over and above the 3 year period.

Disease Management

Ceisteanna (68)

Gino Kenny

Ceist:

68. Deputy Gino Kenny asked the Minister for Health his views on the length of time on average it is taking to diagnose endometriosis and the impact this has on women suffering from the disease including their mental, emotional and physical health and ultimately fertility; his further views on introducing a comprehensive endometriosis education programme for general practitioners and other medical professionals including referring patients to gynaecologists at the earliest opportunity to improve diagnosis; his plans to put in place supports for women with the disease; and if he will make a statement on the matter. [48737/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I am advised that the majority of cases of endometriosis are within the scope of a general gynaecologist to see, diagnose and treat. A GP referral to a gynaecologist is the standard pathway of care for the management of endometriosis in Ireland. This is similar to the pathway in place for the management of other gynaecological conditions.

Information provided by the HSE indicates that endometriosis is a difficult condition to diagnose and treat because of the variation of presentations, impacting the physical and mental wellbeing of patients at varying levels. Treatment may include pain medications, hormone treatment and surgical interventions. The time to diagnose endometriosis varies by patient due to its varying and ambiguous symptom presentation. The HSE's National Women & Infants Health Programme has advised that the best way to help the majority of patients with endometriosis is to improve access to gynaecology services.

As such, I am advised that the Programme has developed a plan to increase the capacity and reduce waiting times for women awaiting general gynaecology, which includes patients with endometriosis. The plan aims to re-orient general gynaecology service to an ambulatory (see and treat) model rather than the traditional outpatient referral model. The HSE anticipates that funding available to the Programme in 2020 will support the establishment of three ambulatory services and future sites are envisaged.

The Programme has advised that the provision of training in the management and diagnosis of endometriosis forms an integral part of the specialist medical training programme provided by the Institute of Obstetricians and Gynaecologists. In addition, some clinicians may have developed a subspecialty interest in the disease and may treat patients who have a more complex form of the disease.

Disability Services Provision

Ceisteanna (69)

Martin Heydon

Ceist:

69. Deputy Martin Heydon asked the Minister for Health the steps being taken to address increased demand for disability services in County Kildare due to the growing population and the growing number of complex cases requiring residential care; and if he will make a statement on the matter. [48866/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Government is committed to providing services and supports to people with disabilities, which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives.

Significant resources have been invested by the health sector in disability services over the past number of years. In 2019, over €1.9 billion was allocated to the HSE’s Disability Service Programme. This has funded a wide range of services and supports for people with disabilities, including over 8,300 residential places across the country.

The allocation for disability services will rise to over €2 billion in 2020, as compared to €1.9 billion this year. The additional €133.7million represents an increase of 7% on the 2019 Disability Services Budget. €25 million in additional funding has been provided for new service developments in 2020 with a specific focus on those with more complex needs, including:

- €5 million for emergency protocols to support people with disabilities who have high support needs.

- €5 million for intensive support packages for children and young people in response to the changing needs of service users and their families.

- €2m to support implementation of the Autism Plan, which includes a range of measures to improve services for people with Autism and their families.

In terms of CHO Area 7 specifically, every effort is being made to support families to keep their family member safe at home, within available resources. I am advised by the HSE that 13 new therapy posts were allocated to the region in 2019 to help address waiting lists for Assessment of Need and therapy interventions for children with complex disabilities. All of these posts are now filled. It is anticipated that further additional funding will be provided to the region in 2020 to support children with behaviours of concern to stay in their own homes and to facilitate the unblocking of 1 respite bed.

Hospital Staff

Ceisteanna (70)

Stephen Donnelly

Ceist:

70. Deputy Stephen Donnelly asked the Minister for Health when he is planning for safe staffing levels in hospitals to be reached for nurses, midwives and doctors including ceasing of the new entrant pay disparity for consultants; the timeline for same; and if he will make a statement on the matter. [48855/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I must clarify at the outset that the HSE's overriding requirement is to prioritise the delivery of safe services, within available resources, and frontline staffing numbers continue to grow in support of this priority.

Over the past five years the numbers of whole-time equivalent consultants, nurses and midwives working in the public health sector have increased significantly. In the consultant category there has been an increase of over 600 whole time equivalents in the past five years, while for nurses and midwives the figure is over 3,500.

This incremental growth in frontline staffing numbers is ongoing, and in the 12-month period to end October 2019, there continued to be increases with circa 150 additional consultants and 650 extra nurses and midwives.

Regarding consultants, the recommendations of the 2017 Sláintecare Report re-orientates the Irish health system towards one that prioritises fair and equal access to consultant led care for all patients. My Department recently published the de Buitléir report, following the establishment of a Group to examine how to give effect to the Sláintecare recommendation on the removal of private practice from the public hospital system. The recommendations of this report provide the pathway to deliver on the Sláintecare vision of a consultant delivered model of care and addressing issues with regard to safe staffing levels.

The Government is committed to the implementation of Sláintecare. In this regard, my Department, together with the Department of Public Expenditure and Reform and the HSE, recently met with both the IMO and the IHCA, and will be seeking to continue to engage with both bodies on Sláintecare and the de Buitléir report. As the Taoiseach outlined recently to the House, progress is being made between my Department, the Department of Public Expenditure and Reform and the Department of An Taoiseach on the approach to implement the de Buitléir recommendations. It is through the implementation of this major reform that issues in relation to Consultant recruitment, retention, pay and other conditions will be addressed.

Consultancy Contracts Expenditure

Ceisteanna (71)

Thomas P. Broughan

Ceist:

71. Deputy Thomas P. Broughan asked the Minister for Health the estimated costs of the external consultant reviews of major infrastructural projects such as the national children's hospital in 2019 and 2020. [45801/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In relation to the new children's hospital, the Department of Health incurred no cost for external consultant reviews in 2019, and has no planned external consultant reviews for the remainder of 2019 and for 2020 for which to provide estimated costs.

However, an independent review into the cost escalation associated with the new children’s hospital construction project was commissioned by the HSE and published on 9 April 2019. As such, I have referred this question to the HSE to provide details of any further external consultancy estimates which relate to this project.

Hospital Waiting Lists

Ceisteanna (72)

Louise O'Reilly

Ceist:

72. Deputy Louise O'Reilly asked the Minister for Health the waiting times for the National Rehabilitation Hospital; the number of persons on the waiting list for the hospital; and if he will make a statement on the matter. [48895/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

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

Home Help Service

Ceisteanna (73)

Robert Troy

Ceist:

73. Deputy Robert Troy asked the Minister for Health when the new statutory scheme will be introduced in view of the substantial deficit in the provision of home help hours. [48814/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

In 2020 the HSE will deliver over 19.2 million hours of home support. This represents a substantial increase of 1 million hours more than this year’s target. This investment is focused on enabling older people to remain at home, where they want to be, and reducing the current waiting lists for the service being experienced in almost all areas.

Of the additional €52m allocated in Budget 2020 for home support services, a proportion of this funding will be used to test a reformed model of service delivery in 2020 at pilot sites. My Department is currently working with the HSE to identify the pilot sites and to agree the approach to testing.

General Practitioner Services

Ceisteanna (74)

John Brassil

Ceist:

74. Deputy John Brassil asked the Minister for Health the action being taken to protect general practitioner services in Milltown, County Kerry; and if he will make a statement on the matter. [48762/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Government is aware of the workforce issues facing general practice, including the difficulties in filling certain GMS vacancies. I would like to assure the Deputy that the Government is committed to the continued development of GP capacity, that patients across the country have access to GP services, and has undertaken a number of measures to improve GP recruitment.

The recent Agreement on GP contractual reforms will see an increase in expenditure on GP services of €210 million annually by 2023, providing significant increases in capitation fees for participating GPs, and increases in supports for rural practices and practices in urban areas of deprivation.

In addition, the number of medical graduates undertaking GP training has increased from 120 in 2009 to 192 filled places in 2019, with a further increase expected next year. In a recent press release, the Irish College of General Practitioners stated it had received the highest ever number of applications for its 2020 GP training programme.

Currently there are 2,508 GPs contracted to provide services under the GMS Scheme and as at 1 November 2019, 22 panels, or less than 1%, are vacant.

In relation to the vacant GMS panel in Milltown Co Kerry, the HSE has repeatedly advertised this GMS list of 380 patients in an effort to put in place a permanent GP to serve the practice. However, the financial viability of a practice of this size is a challenge for GPs and it has not been possible to find a replacement.

As a result of this, the HSE wrote to the GMS patients served by this practice in early November 2019 advising them that the practice would close in December 2019 and providing them with information on how to find an alternative GP.

In light of the community reaction to this announcement, Cork Kerry Community Healthcare held a meeting with the local community and public representatives on Monday November 18 to listen to local concerns and to discuss any possible additional measures that could be taken to attract a GP to the GMS contract in Milltown. Cork Kerry Community Healthcare has also postponed the closure of the practice to early 2020 to provide time to the local community to work on possible additional measures.

National Children's Hospital Administration

Ceisteanna (75)

Stephen Donnelly

Ceist:

75. Deputy Stephen Donnelly asked the Minister for Health if the estimates to date for the annual operating costs of the national children’s hospital will be provided; the reason for changes in the estimates; the current estimate being used; if a revised estimate is being prepared; if so, when it will be ready; and if he will make a statement on the matter. [48852/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The most recent (Dec 2018) updated operating expenditure forecast for the new children’s hospital and urgent care centres when open is estimated at €366m for 2023.

These costings are subject to continuous revision in the light of nationally agreed pay increases, non-pay inflation and other external policy factors arising in the interim.

Operation costs beyond 2023 will be dealt with through the normal annual estimates process and will be affected by pay and non-pay inflation and normal service developments.

Hospital Waiting Lists Action Plans

Ceisteanna (76)

Marc MacSharry

Ceist:

76. Deputy Marc MacSharry asked the Minister for Health when he expects to see a reduction in the number of persons waiting more than a year for an outpatient appointment in Sligo University Hospital; and if he will make a statement on the matter. [48880/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

The latest published National Treatment Purchase Fund (NTPF) figures for October show that there are 16,705 patients on the Sligo University Hospital Outpatient waiting list. Of these, 63% (10,555) are waiting 9 months or less and 72% (12,103) are waiting 12 months or less.

The NTPF has advised my Department that they have approved a number of Outpatient proposals for Sligo University Hospital in 2019, providing up to 100 additional clinics for 1,088 patient appointments.

More broadly, 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.

My Department is working with the HSE and National Treatment Purchase Fund to develop the Scheduled Care Access Plan 2020. The National Service Plan 2020 will set out HSE planned activity level for the year ahead, while the NTPF will work with the hospital system to provide additionality to improve access to inpatient/daycase treatment and with a particular focus on hospital outpatient services.

In this regard, I would encourage all hospital groups and individual hospitals to engage with the NTPF to identify waiting list proposals for the remainder of this year and for 2020.

Ambulance Service

Ceisteanna (77)

John Brassil

Ceist:

77. Deputy John Brassil asked the Minister for Health the reason for the significant deterioration in ambulance turnaround times in Kerry University Hospital between September 2017 and September 2019. [48763/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Occupational Therapy Waiting Lists

Ceisteanna (78)

Dara Calleary

Ceist:

78. Deputy Dara Calleary asked the Minister for Health when progress will be made on reducing waiting times in County Mayo for occupational therapy assessments especially for those under 18 years of age; and if he will make a statement on the matter. [48874/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Healthcare Infrastructure Provision

Ceisteanna (79)

Pat the Cope Gallagher

Ceist:

79. Deputy Pat The Cope Gallagher asked the Minister for Health his plans for each community hospital in County Donegal; his future plans for each of the community hospitals; if funding is ring-fenced for each of the projects proposed; the timeline for the delivery of each of the planned improvements; and if he will make a statement on the matter. [48527/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the Health Service Executive is responsible for the delivery of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to the community hospitals in Donegal.

Hospital Waiting Lists Action Plans

Ceisteanna (80)

Dara Calleary

Ceist:

80. Deputy Dara Calleary asked the Minister for Health when he expects to see a reduction in the number of persons waiting more than a year for an outpatient appointment in Mayo University Hospital; and if he will make a statement on the matter. [48873/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

The latest published National Treatment Purchase Fund (NTPF) figures for October show that there are 8,629 patients on the Mayo University Hospital Outpatient waiting list. Of these, 60% (5,198) are waiting 12 months or less. The Mayo University Hospital Outpatient waiting list has decreased by 1% when compared to the same period last year.

The NTPF has advised my Department that they have approved a number of Outpatient proposals for Mayo University Hospital in 2019, providing up to 83 clinics for 1,065 patient appointments.

More broadly, 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.

My Department is working with the HSE and NTPF to develop the Scheduled Care Access Plan 2020. The National Service Plan 2020 will set out HSE planned activity level for the year ahead, while the NTPF will work with the hospital system to provide additionality to improve access to inpatient/daycase treatment and with a particular focus on hospital outpatient services.

In this regard, I would encourage all hospital groups and individual hospitals to engage with the NTPF to identify waiting list proposals for the remainder of this year and for 2020.

General Practitioner Services Provision

Ceisteanna (81)

Paul Murphy

Ceist:

81. Deputy Paul Murphy asked the Minister for Health his plans to ensure a general practitioner service is provided in Fettercairn, Tallaght, Dublin 24. [48837/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this question relates to a service matter, I have arranged for it to be referred to the HSE for direct reply to the Deputy.

Hospital Equipment

Ceisteanna (82)

Robert Troy

Ceist:

82. Deputy Robert Troy asked the Minister for Health when the second MRI scanner at the Midlands Regional Hospital, Mullingar, will be operational; and when necessary works to accommodate the scanner will be completed (details supplied). [48818/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the Health Service Executive is responsible for the delivery of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.

Disability Services Provision

Ceisteanna (83)

John McGuinness

Ceist:

83. Deputy John McGuinness asked the Minister for Health his plans to improve paediatric health and disability services in counties Carlow and Kilkenny; and if he will make a statement on the matter. [48871/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

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

General Practitioner Services

Ceisteanna (84)

John McGuinness

Ceist:

84. Deputy John McGuinness asked the Minister for Health the measures being taken to meet the demand for general practitioner services in counties Carlow and Kilkenny, with many persons unable to access them on a regular basis; and if he will make a statement on the matter. [48872/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Government is aware of the workforce issues facing general practice, including the difficulties in filling certain GMS vacancies. I would like to assure the Deputy that the Government is committed to the continued development of GP capacity to ensure that patients across the country continue to have access to GP services and has taken a number of measures to improve GP recruitment.

The recent Agreement on GP contractual reforms will see an increase in expenditure on GP services of €210 million annually by 2023, providing significant increases in capitation fees for participating GPs, and increases in supports for rural practices and practices in urban areas of deprivation.

Improved family friendly arrangements are an important feature of the revised contractual arrangements, with an increase in the locum rate for maternity and paternity cover, and an increase in the paternity leave allowance from 3 days to 2 weeks. This is in recognition of the need to ensure that general practice is compatible with doctors’ family commitments.

In addition, the number of medical graduates undertaking GP training has increased from 120 in 2009 to 192 filled places in 2019, with a further increase expected next year. In a recent press release, the Irish College of General Practitioners stated it had received the highest ever number of applications for its 2020 GP training programme.

I am confident that the measures outlined in the Agreement with GPs on contractual reform and service developments will make general practice more sustainable and a more attractive career option for doctors, thus increasing GP capacity and helping to ensure that all patients have access to GP services.

In relation to the availability of GP services in Carlow and Kilkenny, as this is an operational issue I have asked the HSE to reply to the directly to the Deputy in relation to this issue.

Emergency Departments Waiting Times

Ceisteanna (85)

Niall Collins

Ceist:

85. Deputy Niall Collins asked the Minister for Health the reason to date in 2019 more than 1,640 persons over 75 years of age have endured emergency department wait times of more than 24 hours at University Hospital Limerick. [48771/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Figures provided by the HSE show that for the first ten months of 2019, the number of patients attending University Hospital Limerick decreased by 1.1% and the number of attendances of patients over the age of 75 decreased by 1.5% compared to the same period in 2018. Similarly, admissions in University Hospital Limerick decreased by 11.3%.

Notwithstanding the decrease in attendances and admissions at UHL there has been an increase of 16% of the number of patients waiting on trollies as compared to this time last year. There are a number of factors which may affect the waiting times for older patients. In particular, people in the older age category presenting to EDs are more likely to have complex needs and be admitted then the population generally. Consequently, a higher number of these patients may have to be accommodated on trolleys, pending their admission to a ward. There are also issues around delayed discharges of care which can cause congestion within hospital emergency departments. In the case of UHL there has been an increase of 185% in the number of delayed discharges of care.

The HSE Winter Plan was launched on Thursday 14 November in preparation for the anticipated increase in demand over the winter period. The Government allocated an additional €26m to fund the implementation of the Plan. Nine Winter Action Teams, each aligned to a Community Healthcare Organisation and associated acute hospitals and Hospital Groups, have prepared Integrated Winter Plans. These plans 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. Each Action Team has set out a range of initiatives it will undertake within its area to implement the Plan.

In relation to UHL a capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at the Hospital, 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.

I acknowledge the challenges that are facing the emergency departments in our hospitals. In addition to the immediate measures being undertaken in the Winter Plan, the Government through the Sláintecare Strategy and the investment being made in accordance Project Ireland 2040, is addressing the issues of access to healthcare and capacity in the system.

I am confident that together with the more immediate measures being undertaken under the Winter Plan and the strategic approach undertaken by the Government under Sláintecare and Project Ireland that progress will be made in addressing the difficulties in the emergency departments.

Mental Health Services Provision

Ceisteanna (86)

James Browne

Ceist:

86. Deputy James Browne asked the Minister for Health the measures being taken to improve mental health services for adults and children with intellectual disabilities; and if he will make a statement on the matter. [48758/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The needs of adults and children with intellectual disabilities are generally best met in services such as HSE Primary Care and HSE Disability services.

However, people may have mild, moderate or severe mental health difficulties in addition to their intellectual disability, which can mean their treatment needs are more complex. The HSE service best suited to an individual patient is determined by the level of the intellectual disability and of the mental health difficulty.

The mental health policy, A Vision for Change, recommended the development of mental health intellectual disability (MHID) teams, to provide population-wide coverage and ensure fair and equal access to mental healthcare for people of all ages with an intellectual disability.

In 2017, the HSE’s national mental health service, in co-operation with social care services, initiated a new service improvement programme, to develop both adult and CAMHS MHID services nationally, and to further the operationalisation of A Vision for Change for this speciality.

Increased Government investment in mental health has enabled this person-centred MHID team model of care, to ensure consistent service delivery. This model is being adopted nationally and will augment existing mental health teams, as needed.

Since 2012, the Government has added €315 million to the mental health budget. This is an increase of 45% over this time. This investment has enabled the enhancement of specialist mental health services in areas such as MHID, eating disorders and ADHD.

A Vision for Change also recommended the development of acute beds and day hospital services for MHID treatment. 10 beds have been specifically dedicated for MHID in the new 170-bed state-of-the-art complex in Portrane, which will replace the Central Mental Hospital in Dundrum. The new facility will modernise the forensic mental health service in Ireland. The complex will also contain a 10 bedroom forensic child and adolescent mental health unit and a 30 bedroom intensive care rehabilitation unit will be co-located on the site.

Investment in acute MHID services will continue to be prioritised and developed as part of the HSE MHID service improvement programme, in conjunction with HSE social care and Section 38 and 39 voluntary agencies. The development of innovative acute treatment services, including therapeutic respite for children with intellectual disabilities and significant mental health and behavioural support needs, will also be explored.