Written Answers Nos. 51-70
51. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 1805 of 17 January 2024, if his Department has concluded its review of the SAR/PBC for the new emergency department, women and children's block at University Hospital Galway; the expected timeline for it to proceed to pre-tender stage; and if he will make a statement on the matter. [9509/24]
Amharc ar fhreagraThe Department of Health carried out a review of the Strategic Assessment Report (SAR) for the proposal for the new emergency department, women and children's block at University Hospital Galway and returned it with feedback to the HSE in June 2023.
The findings of this review were incorporated into a SAR/Preliminary Business Case (PBC) which was submitted to the Department by the HSE in November 2023.
In line with the requirements of the new Infrastructure Guidelines which have replaced the Public Spending Code, this SAR/PBC must be subject to a Departmental review, an external assurance process, and presentation to D/PENDPDR’s Major Project Advisory Group.
University Hospital Galway is proposing a number of capital projects of scale on its campus and therefore will require a programmatic approach to their delivery in order to ensure that any works do not adversely impact the delivery of healthcare on the congested campus. With this in mind, the SAR/PBC for the new emergency department, women and children's block has been returned to the Project Team and the Galway University Hospitals Capital Programme Oversight Board recently established by Saolta. They have been tasked with developing the SAR/PBC into a more integrated and strategic plan, incorporating the work of the Capital Programme Oversight Board master planning, from which all individual proposals will flow and be developed.
The timeframe for this process is dictated by the progress of the integrated masterplan under development by the Capital Programme Oversight Board and the outcome of the findings from the reviews that the updated SAR/PBC must be subject to.
52. Deputy Maurice Quinlivan asked the Minister for Health about the record number of patients being treated on hospital trolleys at University Hospital Limerick, and the immediate, medium- and long-term steps being taken to address this crisis. [7905/24]
Amharc ar fhreagraAs steps taken to address patients being treated on trolleys are a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
I am committed to improving access to acute services in the Midwest. This commitment has been underpinned by significant investment by this Government in capacity and staffing at University Hospital Limerick. Total staffing increased at the hospital by over 37% from December 2019 to November 2023, from 2,814 to 3,854. This represents 146 more doctors, 45 more consultants, 348 more nurses and midwives, and 84 more health and social care professionals. Since 2019 the budget for University Hospital Limerick increased by 45% - from €265 million in 2019 to €383 million last year.
We are also investing in additional bed capacity in the Midwest. 150 additional beds have been opened in the University of Limerick Hospital Group since 2020. 98 of these new beds are in University Hospital Limerick. We are building two further new 96-bed inpatient blocks. We have also funded additional services and infrastructure in local Model 2 hospitals to strengthen the overall health system in the Midwest. This includes €5.2 million in 2023 to expand Medical Assessment Units in Nenagh, Ennis and St. John's. These Units now operate 12 hours a day, 7 days a week.
I and my Department are continuing to engage with the HSE on the delivery of improvements at UHL.
53. Deputy Brendan Griffin asked the Minister for Health the current position in relation to non-elective surgeries in University Hospital Kerry; when such surgeries ceased; when they will re-commence; and if he will make a statement on the matter. [9580/24]
Amharc ar fhreagraI fully acknowledge the distress and inconvenience for patients and their families when elective procedures are cancelled, particularly for clinically urgent procedures. While every effort is made to avoid cancellation or postponement of planned procedures, the HSE has advised that planned procedures and operations can be postponed or cancelled for a variety of reasons including capacity issues due to increased scheduled and unscheduled care demand.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
In relation to the particular query raised, as this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
54. Deputy Fergus O'Dowd asked the Minister for Health if he will provide an update on the progression and timeline for the appointment of the members of the commission on care for older people; and if he will make a statement on the matter. [9516/24]
Amharc ar fhreagraOn 14 December 2023 Minister Donnelly and I announced the appointment of Professor Alan Barrett, Chief Executive of the Economic and Social Research Institute, as Chairperson of the Commission. I am pleased to advise the Deputy that the process for appointing the other members of the Commission is currently being finalised.
55. Deputy David Cullinane asked the Minister for Health for an update on the 49 recommendations made by the Mental Health Commission in their report on CAMHS, and how many of these recommendations have been addressed; and if he will make a statement on the matter. [9684/24]
Amharc ar fhreagraOf the 49 recommendations made by the MHC in their CAMHS report the HSE have reported to my Department that approximately 40 are in progress. A number of these recommendations relate to new service developments which are dependent on further investment.
Responsibility for 4 recommendations (Recs. 1, 2, 14 and 19) lie with the Department of Health. Broadly, these relate to:
Recommendation 1: The immediate and independent regulation of CAMHS by the MHC must be put in place to ensure that all children have access to evidence-based and safe services, regardless of geographical location or ability to pay.
- The Government recognises the importance of ensuring all mental health services, both inpatient and community, and both adult and child and adolescent, are fully registered, regulated, and inspected by the Mental Health Commission in its role as the independent regulator of mental health services.
- Under the Mental Health Act 2001, the Mental Health Commission registers, inspects, and regulates all inpatient mental health services, including inpatient CAMHS. The current Mental Health Act 2001 does not include any provisions for the registration or regulation of community mental health services and therefore, it is not considered that the Act provides the necessary legal basis to expand the Commission’s regulatory remit.
- The expansion of the Mental Health Commission’s role into regulating all community mental health services, including community CAMHS, is being addressed in the forthcoming Mental Health Bill. This new Bill is a complex and lengthy piece of legislation. It will provide the necessary legal underpinning to ensure that the Mental Health Commission can regulate all community services. Additionally, the Bill will overhaul the involuntary admission and detention process, modernise provisions related to consent to treatment, provide enhanced safeguards for people accessing inpatient treatment, and provide a new, discrete Part that relates exclusively to the care and treatment of children and young people.
- Drafting of this Bill has been prioritised and it is now in its final months of drafting. It will be introduced to the Oireachtas in the summer legislative session, which begins in April.
Recommendation 2: The implementation of these recommendations must be monitored by the MHC who must publish a yearly report on progress of implementation.
- The Mental Health Commission play a vital role in the independent monitoring of mental health services in Ireland. The Department welcomes the Commission’s focus on service improvement in CAMH services, particularly on foot of this report, however it is the role of the Department of Health to ensure that key performance metrics for HSE services are met, that investment is used for agreed service developments, and that policy recommendations are reviewed and enacted as appropriate. The functions of the Commission, as set out in section 33 of the Mental Health Act, do not include a function to oversee or monitor the performance of the HSE outside of services registered as approved centres nor do they grant an implementation function on the Commission. It is for the Minister and Department to either accept or not accept the recommendations arising from the Inspector’s report and for the Minister and Department to set any targets or goals for the implementation of any such recommendations, in consultation with the HSE and the Commission as appropriate.
- The Department of Health has a key role in policy development, service development, and performance management. Officials in the Department of Health meet with senior HSE executives every month in the context of performance monitoring. A standing item on the performance agenda is child and adolescent mental health services (CAMHS), as well as progression and publication of the HSE audits arising from the Maskey Report. The Department have reviewed the 49 recommendations and in collaboration with the HSE continues to discuss the recommendations from this report at performance meetings as deemed appropriate.
Recommendation 14: The budget allocated to CAMHS must be increased to develop adequately resourced teams and appropriate facilities within CAMHS.
- The HSE in their response to the Commission indicated that this was a matter for the Department of Health. It should be noted that the operational prioritisation and financial allocation of the HSE’s Budget is a matter for the HSE, which is reviewed and sanctioned by the Department as part of the annual estimates and National Service Plan processes.
- Year-on-year funding for mental health services increased from €1.221 billion in Budget 2023 to nearly €1.3 billion in 2024, and with a strong focus on investing in child and youth mental health. This is the fourth consecutive year of an increase for mental health services, and highlights in real terms the importance this Government places on the mental health of those living in Ireland.
- CAMHS receives €146.5 million in dedicated funding annually. In addition to this, approximately €110 million in funding is provided by the Government to community-based mental health organisations/NGOs each year to deliver supports and services. A significant proportion of this is dedicated to supporting young people. I recently announced a further €10 million in funding for mental health to support the delivery of clinical programmes and youth mental health. This again highlights the Government’s recognition of mental health as a central component to overall health, and to reform youth mental health care in line with the policies Sharing the Vision and Connecting for Life.
- Examples of service initiatives under Budget 2024 for Mental Health include:
- Additional staffing for CAMHS teams to improve access to services and reduce waiting lists.
- Expansion of multi-disciplinary CAMHS Hubs Teams to complement traditional service models.
- Further development of specialist mental health teams providing essential services.
- A new Youth Mental Health app.
Recommendation 19: The Draft Overarching National Standards for the Care and Support of Children using Health and Social Care Services, jointly produced by MHC and HIQA should be finalised at Ministerial level and implemented in practice.
- Separate to the MHC Report process, HIQA and the MHC developed the Draft Overarching National Standards for the Care and Support of Children using Health and Social Care Services standards and submitted them for Ministerial approval in July 2022. These high-level draft standards relate to all children using the health service (i.e., Acutes, Disability, Primary Care, Mental Health etc.) and are designed to complement any current standards or guidelines.
- Officials in the Department have met with Minister Butler in relation to the standards to consider the impacts around legislation, monitoring, future resource provision, and draft standards that are wider than just mental health.
Further detailed consideration of these recommendations will continue.
56. Deputy Pearse Doherty asked the Minister for Health if he can provide assurances that vital services such as physiotherapy and occupational therapy service, and current bed numbers, will remain at Saint Joseph's Community Hospital in Donegal in the long term; and if he will make a statement on the matter. [9710/24]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
57. Deputy Bernard J. Durkan asked the Minister for Health the progress throughout the hospital building programme including, Naas Hospital and all others throughout the country; and if he will make a statement on the matter. [9590/24]
Amharc ar fhreagraAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
58. Deputy Duncan Smith asked the Minister for Health to provide an action plan for the increasing of staffing and resources for community disability network teams in order to tackle waiting lists and provide services; and if he will make a statement on the matter. [9479/24]
Amharc ar fhreagraI wish to advise the Deputy that this is a matter for the Department of Children, Equality, Disability, Integration and Youth.
59. Deputy Patricia Ryan asked the Minister for Health the measures he and his Department have in place to address the severe shortage of GPs in the south Kildare area, to address the fact that there is an almost two week wait to obtain a GP appointment; and if he will make a statement on the matter. [9740/24]
Amharc ar fhreagra64. Deputy Thomas Pringle asked the Minister for Health what steps are being taken to increase the number of GPs available in the country; if all options are being taken to recruit from abroad to fill the gap in service; how the increase in population has increased the demand for services as well; and if he will make a statement on the matter. [9413/24]
Amharc ar fhreagraI propose to take Questions Nos. 59 and 64 together.
GPs are self-employed practitioners and therefore may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.
The Government is aware of the workforce issues currently facing general practice, and that these challenges limit access to GP services in certain areas and can impact on the timely provision of care. While some issues are specific to certain areas, there is undoubtedly a general increase in demand for GP services due in part to demographics and our aging population.
The Government has implemented a range of measures in recent years to increase the number of GPs practicing in the State so that patients across the country have access to GP services.
Under the 2019 GP Agreement additional annual expenditure provided for general practice was increased by €211.6m. This provided for significant increases in capitation fees for participating GMS GPs, and new fees for additional services and increased practice supports. The GP Agreement 2023 further increased GP capitation fees, increased the existing subsidy rates for practice staff, and introduced a grant support for additional staff capacity as well a practice staff maternity leave support.
These measures make general practice in Ireland a more attractive career choice for doctors. Figures released by the ICGP show that 1,311 medical graduates applied for GP training in 2024, a notable increase on the previous year and higher than any other year.
The number of doctors entering GP training has been increased significantly in recent years, with 286 new entrants in 2023 and 350 places planned for new entrants for this year. Annual intake to the GP training scheme has been increased by over 80% from 2015 to 2023, and the number of new entrant places to be available this year is a 22% increase on last year's intake.
Furthermore, GP recruitment is ongoing under the joint non-EU GP Training Programme between the HSE and ICGP. 112 non-EU GPs were recruited last year under the training programme, of which 84 were in practice by the end of January. I have secured funding to recruit up to 250 more non-EU GPs to Ireland this year. The placement of GPs under the programme is targeted to rural and underserviced areas.
Finally, my Department and the HSE have commenced a Strategic Review of General Practice. The review, with input from key stakeholders, is examining the issues affecting general practice including issues related to GP capacity. The Review will examine the possible use of salaried GPs and others ways to bring GPs to underserved areas. When completed, a report will be presented to me setting out the measures necessary to deliver a more sustainable general practice into the future.
60. Deputy Colm Burke asked the Minister for Health the Government's position in respect of the European Union's revision of pharmaceutical legislation given that EU Parliamentary Committee votes are expected in March 2024; if he supports proposals to reduce regulatory data protection for manufacturers; to outline the impact that such a reduction will have on patients; and if he will make a statement on the matter. [9698/24]
Amharc ar fhreagraOn the 26 April 2023 the EU Commission published its proposal to revise the general pharmaceutical legislation - this is in the form of a Directive and a Regulation. This is the first full revision of the pharmaceutical legislation in over 20 years and is significant to all stakeholders involved in the medicines’ ecosystem.
The aim of the pharmaceutical revision is described as ensuring access to affordable, available medicines, while maintaining the competitiveness of the EU pharma industry sector, combating antimicrobial resistance, and providing for compliance measures which reinforce environmental protections (the ‘3 A’s and 3C’s’).
Ireland is currently deliberating these legislative proposals with national stakeholders to inform the national position. My Department is the lead Government department tasked with responding and engaging nationally and at EU level, as the proposal is negotiated by all EU-27 and progresses through the ordinary legislative process.
Belgium, during its Presidency, have confirmed that they will focus their efforts in January and February on shortages/security of supply. They will then move to deliberate on the theme incentives during the planned Working Party meetings taking place in March.
To recognise the importance of this EU file, I established the Cross Government and Cross Agency Pharmaceutical Strategy Working Group (PSWG) to support the development of Ireland’s response to the proposal from a national perspective and facilitate this position to be informed by a whole of government view.
The PSWG continues to meet to discuss this package regularly and is actively involved in considering the detail of the proposed package of legislative measures, ensuring a well informed and balanced Irish position.
The Department of Health conducted a consultation exercise on shortages with key external stakeholders from various backgrounds at the end of 2023 to help in informing the national position and this will feed into the Irish negotiation mandate.
The Department just completed a consultation on incentives and again this information will feed into the preparation of an Irish position. RDP is included in this review. Officials in the Department have started reviewing and analyzing this data. It is vital that the Irish position is fully considered and a balance is found that ensures improved access to medicines to patients in Ireland while also addressing industry concerns.
I look forward to working collectively with all stakeholders as the package continues to be deliberated in Europe and I would like to thank key stakeholders for their continued engagement with this important file.
61. Deputy Alan Dillon asked the Minister for Health for an update on the re-commencement of construction at Ballyhaunis Primary Care Centre; and if he will make a statement on the matter. [9724/24]
Amharc ar fhreagraAs the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to respond to the Deputy directly, as soon as possible.
62. Deputy Willie O'Dea asked the Minister for Health when a health facility (details supplied) will be fully operational and construction works complete; and if he will make a statement on the matter. [9666/24]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
63. Deputy Fergus O'Dowd asked the Minister for Health when he expects an inquiry into the national Covid response to commence; and if he will make a statement on the matter. [9515/24]
Amharc ar fhreagra65. Deputy Robert Troy asked the Minister for Health if he will look at finding a new location for an ambulance base for Athlone; and if he will make a statement on the matter. [9661/24]
Amharc ar fhreagraAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
66. Deputy Duncan Smith asked the Minister for Health to outline any provisions that ensure that people have dentists in their locality that accept medical cards; and if he will make a statement on the matter. [9480/24]
Amharc ar fhreagraThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. Services available annually and on demand include an examination including preventative elements, two fillings, emergency extractions, and a scale and polish. More complex care, such as dentures, and a broader range of treatments for patients with additional needs and high-risk patients are available subject to the approval of the local HSE Principal Dental Surgeon.
To support practitioners to provide care under the Scheme, I approved and funded a range of measures that were put in place on 1 May 2022 to introduce and reintroduce elements of preventative care and increase the fees paid to dental contractors for most treatment items by 40-60%. In 2023, 154,864 additional treatments were provided under the DTSS, with over 26,700 extra patients treated when compared with 2022.
In the longer term, the Government is committed to reforming dental services, including the DTSS, through the implementation of the National Oral Health Policy (NOHP), Smile agus Sláinte. The HSE's Strategic Reform Lead is driving policy implementation across the organisation and moving forward with developing new services for both adults and children in line with the Policy.
The Policy also contains a range of strategic workforce planning actions to increase workforce capacity and support dental practitioners working in rural and other underserved areas through mentoring schemes and long-distance and accessible continuing professional development programmes. To support this work, my Department is currently finalising a workforce census for oral healthcare.
67. Deputy James O'Connor asked the Minister for Health the latest details of a capital project (detail supplied) from his Department; and if he will make a statement on the matter. [9657/24]
Amharc ar fhreagraAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
68. Deputy David Cullinane asked the Minister for Health the number of consultant orthopaedic surgeons in the State and on the island who are sufficiently qualified and skilled to undertake kyphectomies; if he has examined treatment abroad options for children requiring kyphectomies; his plans to address service deficits in this area; if he has sought for the Health Service Executive or Children's Health Ireland to undertake an international search to recruit an additional consultant capable of delivering such a service; and if he will make a statement on the matter. [9681/24]
Amharc ar fhreagraChildren’s Health Ireland has advised that there are currently six surgeons that have traditionally performed kyphectomies. Three of these surgeons are actively doing kyphectomies. CHI has advised that there are no new surgeon posts being advertised as CHI deems there are an adequate number of surgeons capable of performing kyphectomies.
A dedicated Paediatric Spinal Surgery Management Unit has been established in Children's Health Ireland and the Clinical Specialty Lead for Spinal Surgery commenced in post in January 2024. This Unit, which is coordinated cross-city, is focusing on the management and delivery of spinal surgery, including reform of the waiting lists.
I also intend to convene a dedicated stakeholder taskforce, with an independent chair, for these services. This Taskforce will include all stakeholders, including patient representatives and clinicians. I met with some patient advocacy groups on the 19th of February to discuss the terms of reference for this taskforce. Patient advocates were clear about what they want this new Taskforce to do and, in collaboration with the advocacy groups, work is progressing on drafting these terms of reference.
I committed €19 million under the Waiting List Action Plans to tackle waiting lists for Scoliosis and Spina Bifida. This investment has supported an increase in the number of spinal procedures undertaken in both 2022 and 2023, with 509 and 464 procedures carried out respectively, compared to 380 in 2019. I will continue to drive progress on Scoliosis and Spina Bifida services as priority areas under the Waiting List Action Plan 2024.
69. Deputy Pádraig O'Sullivan asked the Minister for Health the level of expenditure by the HSE on orphan medicines in 2023; and if he will make a statement on the matter. [9460/24]
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.
70. Deputy Gino Kenny asked the Minister for Health the progress to date on seeking alterative accommodation on the campus of Cherry Orchard Hospital for the remaining patients who are presently residing at the willow/sycamore units on the COH campus; and if he will make a statement on the matter. [9506/24]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
