Written Answers Nos. 400-414
400. Deputy David Cullinane asked the Minister for Health if he will provide details of the total cost to the HSE of general practitioners providing Covid-19 testing to patients for 2021 and January 2022, by month and by the number of general practitioners or practices who received amounts greater than €10,000, €20,000 and €50,000; and if he will make a statement on the matter. [10720/22]
Amharc ar fhreagra402. Deputy David Cullinane asked the Minister for Health if he will provide details of all Covid-19 assessments carried out by general practitioners by telephone in each of the years 2020 and 2021 and in January 2022, by month and by the number of general practitioners or practices who received amounts greater than €10,000, €20,000 and €50,000; and if he will make a statement on the matter. [10722/22]
Amharc ar fhreagraI propose to take Questions Nos. 400 and 402 together.
Recognising the key role of general practice in the collective efforts to contain and mitigate the impact of Covid-19 on public health, a number of measures were put in place to support general practice during the pandemic. These measures included the payment of a fee by the HSE to GPs for the provision of remote consultations to patients who may have contracted Covid-19, including referral for testing if clinically required. In return, persons are not subject to any charge for a GP Covid-19 assessment or testing referral.
As the specific information requested relates to a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
401. Deputy David Cullinane asked the Minister for Health if he will provide details of the total cost to the HSE of general practitioners administering Covid vaccines to patients for 2021 and January 2022, by month and by the number of general practitioners or practices who received amounts greater than €10,000, €20,000, €50,000 and €100,000; and if he will make a statement on the matter. [10721/22]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
403. Deputy David Cullinane asked the Minister for Health if the target of 300 additional staff working in mental health as set out in budget 2022 will be met in 2022; the number of additional staff recruited to date; and if he will make a statement on the matter. [10723/22]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
404. Deputy David Cullinane asked the Minister for Health the cash ceiling that applies to the HSE set by his Department or the Department of Public Expenditure and Reform; and if he will make a statement on the matter. [10724/22]
Amharc ar fhreagraDue to the size of the annual budget operated by the HSE (> €20bn) it is to be expected that it maintains a certain cash balance to ensure that it always has sufficient funds to meet its outstanding financial obligations. The amount can vary on a month-by-month basis but in general the HSE holds, as a cash balance, several days' worth of funds in the case of an unexpected cash requirement. The cash position in the HSE is monitored on a weekly basis by my Department to ensure excessive cash holdings are not being built up
405. Deputy David Cullinane asked the Minister for Health the progression made on building the new national children’s hospital; the estimated completion date; the overall estimated cost of the project; the number of current outstanding claims or disputes between the contractor and the board; the number of disputes subject to legal action; if he will provide a brief explanation of each outstanding claim or dispute; and if he will make a statement on the matter. [10725/22]
Amharc ar fhreagraThe new Children’s Hospital (NCH) project comprises the main hospital on a shared campus at St James’s, the Outpatient and Urgent Care Centre at Connolly Hospital, Blanchardstown, and the Outpatient and Emergency Care Centre at Tallaght University Hospital.
In September 2021, the main contractor on the NCH project, BAM Ireland, substantially completed and handed over the paediatric outpatient and emergency care centre at Tallaght, in line with the contractor's schedule, and the facility opened on 15 November 2021, following a period of operational commissioning. The new facility will accommodate up to 17,000 outpatient and 25,000 emergency care attendances per year. Together with the Outpatient and Urgent Care Centre at Connolly Hospital, which opened in July 2019, these new facilities will improve access to urgent, emergency and outpatient care for a significant number of children. In 2021, there were over 13,300 outpatient attendances at Connolly and almost 11,400 patients presented for urgent care.
Work on the St James’s site is ongoing and progressing well with major milestones reached in 2021, including the completion of the concrete frame with over 150,000 cubic metres of concrete poured, the topping out of the building (where the highest point on the building was completed- a significant milestone in any construction project), the infill concrete slabs over the steelwork frame, the closing in of the concourse and approximately 17,000 square metres of glazing and 5,800 square metres of external façade installed.
To date, 86,000 square metres of internal partitions have been installed, with the equivalent of over 26 kilometres installed in 2021, and the fit out of most internal areas is now underway, including the south fingers comprising Outpatients, Cardiology Wards, and Therapies spaces, and the ‘Hot Block’ comprising Emergency Department, Critical Care and Theatres. Work in 2022 will be focused on the progression of the internal fit-out of the over 6,000 internal spaces.
The National Paediatric Hospital Development Board (NPHDB) has advised that the main contractor’s current programme schedule outlines completion can be achieved by December 2023 which would mean the NCH at St James’s could open in the second half of 2024, after the necessary commissioning period. The NPHDB is working to ensure that contractor will meet its own schedule.
In 2018, Government approved a capital budget of €1.433bn for the NCH project. This included the capital costs for the main hospital at St James's Hospital campus, the two satellite centres, equipment for the three sites, and the construction of the carpark and retail spaces. The capital budget has not yet been depleted and, to date, €924.4m of the €1.433bn budget has been drawn down for works on the project across the three sites.
There are a number of items not included in this investment figure as there was no price certainly for them and nor can there be, for some, for the duration of the project. These include construction inflation, the impact of Covid-19, statutory changes, any change in scope resulting in healthcare policy changes, and the Employment Order.
Additional costs in relation to the integration and transfer of the services of the three children’s hospitals to the new sites brings the total programme cost to €1.73 billion. This includes investment in ICT, including a new Electronic Health Record system, the Children's Hospital Integration Programme (the merging of three paediatric hospitals) including commissioning, and pre-2013 project expenditure relating to the former Mater project.
Brexit and the global pandemic have severely impacted supply chains and NCH project is not immune to these external challenges. Every effort is being taken to mitigate the risks but these externalities beyond the control of the contractor and the NPHDB make speculation and more definitive forecasting unwise.
The NPHDB has statutory responsibility for planning, designing, building, and equipping the new children's hospital. This includes assessment and defence of claims/ disputes submitted by the contractor under the construction contract. I have therefore referred this element of your question to the NPHDB for direct reply.
406. Deputy David Cullinane asked the Minister for Health the estimated cost and timeframe for delivery of the three planned elective-only hospitals; and if he will make a statement on the matter. [10726/22]
Amharc ar fhreagraIn December 2021 the Government agreed, subject to the necessary approvals and requirements under the Public Spending Code being met, a new National Elective Ambulatory Care Strategy. The development of additional capacity will be provided through dedicated, stand-alone Elective Hospitals in Cork, Galway and Dublin. The “Elective Hospitals Oversight Group”, under the joint governance of the Department of Health and Health Service Executive, has been guiding the development of the elective hospital proposals, following the process outlined in the updated Public Spending Code.
Following the approval of the new Strategy, Project Preliminary Business Cases for the three locations are being finalised for consideration and review by my Department. If approved internally, the Business Cases will be submitted to the Department of Public Expenditure and Reform’s recently introduced PSC External Assurance Process and Major Projects Evaluation after which further memoranda for Government could then be brought forward. While it is difficult to be certain about timelines, following these assurance steps I am hopefully we could proceed to approval-in-principle (Gate 1 of the Public Spending Code) in the coming period ahead.
While it is not possible to reveal preliminary costings at this stage, the individual Electives project proposals are following the provisions of the Public Spending Code as required to ensure value for money requirements are met for the evaluation, planning, and management of large public investment projects costing more than €100 million. If approved, the PBC will also be published as required by the PSC.
407. Deputy David Cullinane asked the Minister for Health if any of the planned elective only hospitals will provide more complex elective surgeries that require recovery beds; the location of such hospitals; and if he will make a statement on the matter. [10727/22]
Amharc ar fhreagraThe Cross Party Sláintecare Report in 2017 articulated a new vision for healthcare in Ireland, including the provision of elective only hospitals, providing protected capacity for elective care. The “Elective Hospitals Oversight Group”, under the joint governance of the Department of Health and Health Service Executive, has been guiding the development of the elective hospital proposals, following the process outlined in the updated Public Spending Code, setting out the value for money requirements for the evaluation, planning, and management of large public investment projects.
In December 2021 the Government agreed, subject to the necessary approvals and requirements under the Public Spending Code being met, a new National Elective Ambulatory Care Strategy which will change the way in which day case, scheduled procedures, surgeries, scans and outpatient services can be better arranged to ensure greater capacity in the future and help to address waiting lists. The development of additional capacity will be provided through dedicated, stand-alone Elective Hospitals in Cork, Galway and Dublin.
The Elective Hospitals will provide additional capacity and help address waiting lists, while being as flexible and adaptable as possible to facilitate a future phase, which would include some elective in-patient treatment. Day procedures offered in the first phase will include Gastrointestinal, Gynaecology, Ophthalmology, and Orthopaedics.
408. Deputy David Cullinane asked the Minister for Health the revenue generated by public hospitals for the carrying out of private healthcare in each of the years 2016 to 2021, by hospital and hospital group; and if he will make a statement on the matter. [10728/22]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
410. Deputy David Cullinane asked the Minister for Health the details of plans by the HSE to make a prior-year adjustment to any of its accounts of the past five years; the value of such adjustments; the reason for the adjustment; and if he will make a statement on the matter. [10730/22]
Amharc ar fhreagraThe issue of whether the HSE will need to make an adjustment in its 2021 accounts is a matter in the first instance for the HSE and the Comptroller and Auditor General who has responsibility for auditing the HSE’s accounts in the first instance. The HSE have advised than any adjustment will be technical in nature and will be less than €100 million in impact.
This position in relation to the reasons for and quantum of any adjustment as set out by the HSE is accepted and it is noted that the Comptroller and Auditor General has recently stated that he will undertake a full review of the requirement for any prior year adjustment as part of his audit of the 2021 accounts of the HSE together with considering controls to ensure that errors of this nature do not recur, as necessary.
This review will be undertaken within the statutory time frame i.e. by 21 May. Pending this, it would be premature to speculate further on this matter.
411. Deputy David Cullinane asked the Minister for Health the funding provided to recruit staff into the HSE in 2020; the target number of additional staff to be recruited in 2020; the actual number of staff recruited in that year; and if he will make a statement on the matter. [10731/22]
Amharc ar fhreagraDuring the planning process for 2020, affordable limits for staffing were used to ensure workforce growth in the HSE remained within the allocated budgets and in line with Government policy on public service numbers and costs. In the National Service Plan 2020, the affordable limit for December 2020 was identified as 121,311 WTE, excluding centrally held and development funding, and 123,701 WTE including centrally held and development funding. This equates to an increase of 1,494 WTE or 3,884 WTE over end 2019 levels. These were initial estimates of affordability limits which were to be further developed and finalised alongside the Department of Health in the finalisation of the Pay and Numbers Strategy 2020.
Due to the onset of the pandemic in early 2020, there was an immediate need to increase the health sector workforce on a temporary, emergency basis. Putting a limit on recruitment was no longer appropriate, and many recruitment avenues were utilised to ensure the health service was adequately staffed. The priority for the remainder of 2020 was therefore the need to expand the workforce to meet the demands of the health service.
2020 saw an increase of an additional 6,357 WTE, which is the largest annual increase in staffing since the foundation of the HSE.
412. Deputy David Cullinane asked the Minister for Health the funding provided to recruit staff into the HSE in 2021; the target number of additional staff to be recruited in 2021; the actual number of staff recruited in that year; and if he will make a statement on the matter. [10732/22]
Amharc ar fhreagraGiven the commitment to ensuring sufficient staffing levels to meet both COVID-related and long-term healthcare demand, Budget 2021 provided funding for a significant expansion of the workforce including making permanent funding available for some workers employed in 2020 on a temporary, emergency basis, and also allowing the workforce to grow further in 2021. The Pay and Numbers Strategy for 2021 identified a recruitment target of an additional 14,567 WTE across all staff categories and service areas in 2021.
The National Service Plan was underpinned by the assumption that there would be no greater than Level 3 COVID-19 measures and excluded a National Vaccination Programme rollout. The COVID-19 surge in Q1, coupled with significant demand for testing and tracing and unprecedented levels of COVID-19 related absence rates, significantly impacted the HSE’s ability to recruit in the first quarter. In addition, a National Vaccination Programme was rolled out with the immediate establishment of mass vaccination centres across the country, which required a large amount of external recruitment capacity. Through third party recruitment agencies, the HSE recruited approximately 3,000 people in COVID-19 vaccination centres and for test and trace operations. These recruits are excluded from recruitment targets as they are not directly employed by the HSE.
While the target of 14,567 was pursued strongly by the HSE, it was agreed mid-year that the targets under the Pay and Numbers Strategy for 2021 should be reduced given a shortfall in the beginning months of the year. The target was revised down to an additional 7,370 WTE by the end of 2021.
In 2021, there was an increase of 6,149 WTE. This is the second largest annual increase in staffing since the foundation of the HSE, after 2020. Recruitment targets not achieved in 2021 form part of recruitment targets for 2022 and are included in the upper recruitment target of approximately 10,000 in 2022.
413. Deputy David Cullinane asked the Minister for Health the funding provided to recruit staff into the HSE for 2022; the target number of additional staff to be recruited in 2022; his views on whether the higher target will be met; and if he will make a statement on the matter. [10733/22]
Amharc ar fhreagraBudget 2022 secured funding for up to an additional 10,000 WTE, reflecting the level of ambition and desire to invest in our health services. However, there are a range of targets set out in the draft National Service Plan. The targeted recruitment for this year continues to address any identified staff shortages across grades and service areas.
Discussions between the Department and HSE officials agreed that, due to the current challenging recruitment environment, 5,500 WTE is a more achievable target for 2022. The upper affordable limit of 10,000 WTE is not seen as undeliverable, but rather one that will be ambitious and challenging to achieve, given the risks affecting labour supply. It is worth noting that these recruitment targets are additional WTE and do not include the replacement of existing staff who retire/leave during the year.
The HSE identified the more realistic recruitment target of 5,500 WTE alongside a more challenging ‘stretch’ target of 10,000 WTE set out in the National Service Plan. The Department has been working closely with the HSE to assess potential savings and further decisions on how this funding will be used will be taken. Actual recruitment will, as always, be monitored by the HSE and the Department throughout the course of the year under the governance and oversight arrangements in place.
414. Deputy David Cullinane asked the Minister for Health if he will outline all of the additional funding that has been made available to Children’s Health Ireland and Cappagh Hospital for services in Crumlin Hospital, Connolly, Temple Street, Cappagh and Tallaght Hospitals for paediatric orthopaedics in each of the years 2017 to 2021 and to date in 2022, by year, hospital, by amount and the areas or items on which the additional funding is for; and if he will make a statement on the matter. [10734/22]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
