Written Answers Nos 35-56
HSE Properties
35. Deputy Fiona O'Loughlin   asked the Minister for Health the timeframe for the refurbishment to the HSE-owned property on Drogheda Street, Monasterevin, County Kildare; and if he will make a statement on the matter. [40895/17]
80. Deputy Fiona O'Loughlin asked the Minister for Health the delays that are preventing the completion of the refurbishment to the HSE-owned property on Drogheda Street, Monasterevin, County Kildare; and if he will make a statement on the matter. [40896/17]
Minister for Health (Deputy Simon Harris): I propose to take Questions Nos. 35 and 80 together.
Your question has been referred to the Health Service Executive for direct reply as the management of the healthcare property estate is a service matter.
HSE Waiting Lists
36. Deputy Seán Haughey asked the Minister for Health the measures being taken to reduce the long waiting times for primary care ophthalmology appointments being experienced by persons under 18 in the Dublin north central local health area. [40965/17]
Minister for Health (Deputy Simon Harris): As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
HSE Funding
37. Deputy Joan Burton asked the Minister for Health the position regarding section 39 organisations, for example, hospices, in which staff took pay cuts during the financial emergency; if funding will be provided to ensure their pay is restored in line with section 38 organisations for staff enjoying the same terms and conditions as civil and public servants; and if he will make a statement on the matter. [40357/17]
Minister for Health (Deputy Simon Harris): Section 39 of the Health Act 2004, provides that the HSE may ‘..give assistance to any person or body that provides or proposes to provide a service similar or ancillary to a service that the Executive may provide.’. Such assistance may range from contributing to the expenses incurred by that person or body to allowing them the use of an HSE premises. Financial assistance is provided in the form of a grant and the value of such grants can vary from very high to very low value.
Where the HSE provides a grant to a voluntary provider under Section 39, the HSE puts in place a Service Level Agreement with the provider. This sets out the level of service to be provided for the grant which they receive. It is important to note that any individuals employed by these section 39 organisations are not HSE employees. The HSE has no role in determining the salaries or other terms and conditions applying to these staff. It is an accepted fact that the staff of these Section 39 organisations are not public servants. This means that they were not subject to the FEMPI legislation which imposed pay reductions or the provisions of the subsequent Public Service Agreements which provide for pay restoration.
It is a matter for Section 39 organisations to negotiate salaries with their staff as part of their employment relationship and within the overall funding available for the delivery of agreed services.
Occupational Therapy Waiting Lists
38. Deputy Barry Cowen asked the Minister for Health the way in which it is proposed to reduce the long waiting times being experienced by children in counties Laois and Offaly that are in need of an assessment for occupational therapy. [40972/17]
Minister for Health (Deputy Simon Harris): 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.
Hospital Waiting Lists
39. Deputy Clare Daly asked the Minister for Health if his attention has been drawn to the establishment of a "lets buy healthcare" scheme to purchase private healthcare for procedures that are not being carried out in the public system due to large waiting lists; and if he will make a statement on the matter. [40784/17]
Minister for Health (Deputy Simon Harris): It has recently come to the attention of my Department that a new commercially operated scheme entitled 'Lets Buy Healthcare' has been established.
I acknowledge that waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.
Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018.
In order to reduce the numbers of long-waiting patients, I asked the HSE to develop Waiting List Action Plans for 2017 in the areas of Inpatient/Daycase, Scoliosis and Outpatient Services. The Inpatient/Daycase Action Plan is being delivered through a combination of normal hospital activity, as well as insourcing and outsourcing initiatives utilising NTPF funding. Under the Inpatient/Daycase Plan, since early February, over 23,800 patients have come off the Inpatient/Daycase Waiting List.
The NTPF has advised that to date 5,901 patients have been authorised for treatment in private hospitals under its Initiatives, 2,235 patients have accepted an offer of treatment in a private hospital and that 1,112 patients have received their procedure. The NTPF has also indicated that 2,841 patients have been authorised for treatment in public hospitals under the Plan’s insourcing initiatives, 910 offers of treatment have been accepted and 285 patients have been treated.
Hospital Deaths
40. Deputy Clare Daly asked the Minister for Health his views on the recent recommendation by a person (details supplied) that all direct maternal deaths in hospitals be subject to external review; and if he will make a statement on the matter. [40785/17]
Minister for Health (Deputy Simon Harris): My Department requested the HSE National Women & Infants Health Programme and Quality Assurance and Verification Division to review the National Maternity Hospital's investigation into a maternal death at the hospital, which occurred in May 2016. I can confirm that this review has now been received and is under consideration. The review remains confidential. Accordingly, it would not be appropriate to make any comment on this matter at this stage.
Hospital Groups
41. Deputy Jackie Cahill asked the Minister for Health his plans to remove South Tipperary General Hospital from the South South West Hospital Group. [40959/17]
Minister for Health (Deputy Simon Harris): I have no plans to move South Tipperary General Hospital out of the South South West Hospital Group.
As the Deputy may be aware, the report of the cross-party Committee on the Future of Healthcare was published on 1 June last. It made a number of recommendations in relation to Hospital Groups, including consideration of the current alignment of hospital groups and CHOs. I am giving consideration to these recommendations and possible future actions as part of wider consideration of the Slaintecare report. It is expected that a detailed response to the report will be submitted to Government in December. Any changes to the composition of Hospital Groups will be subject to my approval.
Hospitals Building Programme
42. Deputy John Lahart asked the Minister for Health the position regarding the construction of the proposed national children’s hospital satellite centre in Tallaght. [40954/17]
Minister for Health (Deputy Simon Harris): The new children’s hospital on a campus shared with St James’s Hospital will provide specialist and complex care for children and young people from all over Ireland, and with the Paediatric OPD and Urgent Care Centres at Connolly and Tallaght Hospitals, will be the regional hospital for the children of the Greater Dublin area, as well as Wicklow, Kildare and parts of Meath.
On 26 April 2017 the Government approved the investment required to enable the National Paediatric Hospital Development Board to award the construction contracts for the building of the main children’s hospital on the St James’s Hospital campus and the two Paediatric Outpatients and Urgent Care Centres on the Tallaght and Connolly Hospitals campuses. The construction contract for the building of the main children’s hospital and the satellite centres contract were signed in August. Confirmed dates for completion of the development of the new children's hospital and the paediatric outpatients and urgent care centres have now been agreed with the preferred contractor. The new children’s hospital will be completed by the middle of 2022. The Paediatric Outpatients and Urgent Care Centre at Connolly will open in 2019 followed by the second one at Tallaght in 2020 in advance of the opening of the main hospital in 2022. Site preparatory work has continued throughout the year and the construction phase of the project has now commenced.
The Paediatric Outpatient and Urgent Care Satellite Centres at Tallaght and Connolly Hospitals will improve geographic access to urgent care for children in the Greater Dublin Area. The two centres will support primary and community care through the provision of general community and paediatric clinics, including developmental paediatrics, multidisciplinary care for children with chronic stable conditions and other outpatient services. The centres will help to reduce Emergency Department and outpatient attendance at the new children’s hospital on a campus shared with St James’s.
Each Paediatric OPD and Urgent Care Centre will provide consultant-led urgent care, with 4-6 hour observation beds, appropriate diagnostics and secondary outpatient services including rapid access general paediatric clinics as well as child sexual abuse unit examination, observation and therapy rooms. Each centre is projected to deal with 25,000 urgent care and 15,000 outpatient attendances every year.
The centres will be open during the known busiest daytime and evening hours and closed during the night when departments are at their quietest. It is anticipated that the Paediatric OPD and Urgent Care Centres at Tallaght and Connolly will open from 08.00 to 24.00, diagnostic services from 08.00 to 20.00 and outpatient services from 08.00 to 18.00.
Occupational Therapy Waiting Lists
43. Deputy Dara Calleary asked the Minister for Health the way in which it is proposed to reduce the long waiting times being experienced by children in County Mayo that are in need of an assessment for occupational therapy. [40981/17]
Minister for Health (Deputy Simon Harris): 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.
Cannabis for Medicinal Use
44. Deputy Bríd Smith asked the Minister for Health the way in which the compassionate access programme to medicinal cannabis will help persons that can access medicinal cannabis in other European jurisdictions but not currently here; and if he will make a statement on the matter. [40920/17]
Minister for Health (Deputy Simon Harris): In February, I published the Health Products Regulatory Authority’s (HPRA) report ‘Cannabis for Medical Use – A Scientific Review’. On foot of the HPRA’s conclusions I announced that I would establish a cannabis for medical use access programme, for patients under the care of a consultant, for the following medical conditions:
- spasticity associated with multiple sclerosis resistant to all standard therapies;
- intractable nausea and vomiting associated with chemotherapy, despite the use of standard anti-emetic regimes;
- severe, refractory (treatment-resistant) epilepsy.
An expert group, chaired by Dr Mairín Ryan from HIQA was established in March to develop the operational, clinical and practice guidelines for this access programme.
The Expert Group conducted a targeted consultation on the draft guidelines and is due to finalise these guidelines shortly. Officials in my Department are working on secondary legislation to underpin the programme and on the logistics of sourcing suitable cannabis-based product supplies for the Irish market place.
Under the Cannabis Access Programme it will be the decision of a clinician, in consultation with their patient and the patient’s carers, as to the appropriate course of treatment for that patient. The Cannabis Access Programme is intended for patients who are resident in Ireland and who are under the care of an Irish-based consultant. However, where patients move from the care of a clinician in one jurisdiction, e.g. abroad, to that of another clinician in another jurisdiction, e.g. in Ireland, clinical treatment plans for such patients should be determined and directed between clinicians through normal healthcare professional communication pathways, regardless of where those clinicians are located. The sharing of such clinical information could help to ensure the treating consultant in Ireland has access to relevant professionally documented clinical and medication history for the patient they are treating and could assist in that consultant’s clinical decision making process.
Any consultant requiring information or clarification in relation to the Cannabis Access Programme, he or she should contact my Department directly.
Orthodontic Services Waiting Lists
45. Deputy Niamh Smyth asked the Minister for Health if he will address the waiting times for children waiting for orthodontic treatment; and if he will make a statement on the matter. [40766/17]
Minister for Health (Deputy Simon Harris): As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
Disabilities Assessments
46. Deputy Darragh O'Brien asked the Minister for Health the way in which it is proposed to reduce the number of overdue assessments of need under the Disability Act 2005 in the Dublin north local health area. [40982/17]
Minister of State at the Department of Health (Deputy Finian McGrath): 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 Provision
47. Deputy Billy Kelleher asked the Minister for Health when he plans to further extend eligibility for free general practitioner care. [40940/17]
Minister for Health (Deputy Simon Harris): The introduction of GP care without fees to all people over 70 and all children under 6 years of age which commenced in 2015 represents a major step forward in improving access, quality and affordability of health care in Ireland. The Programme for Government commits to extending in phases, and subject to negotiation with GPs, free GP care to all children under 18 years of age.
Legislative changes will be required for any such extension of GP care without fees to further cohorts of the population and the timetable is subject to the outcome of discussions with GP representatives on this and other contractual matters which are currently underway. As with any negotiation-type process, and given the range and complexity of the issues to be discussed, the engagement may take some time.
Hospital Facilities
48. Deputy John Brassil asked the Minister for Health if he will report on the provision of a dedicated obstetric theatre at university hospital Kerry. [40947/17]
Minister for Health (Deputy Simon Harris): In relation to the specific case raised, I have asked the HSE to respond to you directly.
Hospital Waiting Lists
49. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to the increase in the waiting list figures as reported by the NTPF recently; his plans to address this matter; and if he will make a statement on the matter. [40777/17]
Minister for Health (Deputy Simon Harris): I acknowledge that waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.
Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018.
In order to reduce the numbers of long-waiting patients, I asked the HSE to develop Waiting List Action Plans for 2017 in the areas of Inpatient/Daycase, Scoliosis and Outpatient Services. The Inpatient/Daycase Action Plan is being delivered through a combination of normal hospital activity, as well as insourcing and outsourcing initiatives utilising NTPF funding. Under the Inpatient/Daycase Plan, since early February, over 23,800 patients have come off the Inpatient/Daycase Waiting List.
The NTPF has advised that to date 5,901 patients have been authorised for treatment in private hospitals under its Initiatives, 2,235 patients have accepted an offer of treatment in a private hospital and that 1,112 patients have received their procedure. The NTPF has also indicated that 2,841 patients have been authorised for treatment in public hospitals under the Plan’s insourcing initiatives, 910 offers of treatment have been accepted and 285 patients have been treated.
Under the Outpatient Plan, since early February, more than 84,200 patients have come off the Outpatient Waiting List .
Hospitals Data
50. Deputy Lisa Chambers asked the Minister for Health the number of surgeries that have been cancelled at Mayo university hospital from 1 January 2017 to 31 August 2017, by month; the type of surgery involved; if it was elective surgery or not; and if he will make a statement on the matter. [40949/17]
Minister for Health (Deputy Simon Harris): I fully acknowledge the distress and inconvenience for patients and their families when elective procedures are cancelled.
Maintaining scheduled care access for all patients is a key priority for hospitals, and balancing this with emergency demand at times is challenging. However, all efforts are made by hospitals to limit cancellations particularly for clinically urgent procedures.
Cancellation of elective procedures can occur for a variety of exceptional reasons including cancellations because a bed or the clinical team are not available, cancellations by the patient or because the patient may not be fit for surgery at the time.
Based on data provided by the NTPF, collated from reports by hospitals, approximately 3,400 elective procedures, on average, are cancelled per month. However, this must be seen in context. In 2016, typically in a month, there were approximately 53,000 admissions to acute hospitals on a daycase and an inpatient basis.
It is essential that hospitals continue to improve how they manage, and balance, the demand for emergency care with the planning of elective procedures, to minimise the impact on patients. In addition, the HSE continues to improve its processes to minimise the number sessions lost when patients cancel or do not attend for their procedures.
The Department of Health has commenced a Health Service Capacity review in line with the Programme for Government commitment, the findings of which are due to be published before the end of the year.
In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
HSE Staff Data
51. Deputy Eugene Murphy asked the Minister for Health the number of agency and bank staff employed by the HSE in each CHO area in tabular form. [40788/17]
Minister for Health (Deputy Simon Harris): I have asked the HSE to respond to the Deputy directly on this matter.
Autism Support Services
52. Deputy Éamon Ó Cuív asked the Minister for Health if he will report on the services being provided for adults with autism and intellectual disabilities in County Galway; and if he will make a statement on the matter. [40951/17]
Minister of State at the Department of Health (Deputy Finian McGrath): 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.
Medicinal Products Availability
53. Deputy John Curran asked the Minister for Health the position regarding persons that have been using the drug, Respreeza, for many years and that will now be refused this drug; the care or support he plans to offer these persons; and if he will make a statement on the matter. [40775/17]
Minister for Health (Deputy Simon Harris): The HSE has carefully considered the pricing and reimbursement of human alpha1-proteinase inhibitor (Respreeza) through its decision making processes which are aligned with the statutory criteria set out in the Health (Pricing and Supply of Medical Goods) Act 2013.
Following a detailed review process over the past 18 months, the HSE has written to CSL Behring, the manufacturers of human alpha1-proteinase inhibitor, advising them that the HSE will not support reimbursement at this time.
The HSE concluded that there is not enough evidence to suggest that patients will derive a clinically meaningful benefit from this treatment.
The HSE was also required to consider cost effectiveness and deemed that the current price was not a cost effective use of resources.
I am aware that there are a number of patients on a compassionate access scheme which is operated by CSL Behring and that the company is planning to terminate access to this treatment scheme.
I consider this action by the company as unethical and as I have stated previously, there should be no link between compassionate use schemes and reimbursement decisions and manufacturers should be frank with patients and clinicians on the operation of such schemes.
On my request, the HSE has sought assurances from the hospital that appropriate care arrangements are in place in the event that the access programme is discontinued, and that appropriate ethical guidelines have been and continue to be followed in relation to all aspects of the clinical trial and access programme.
It is the responsibility of both the company and the investigator (clinician) to ensure that they have considered and made arrangements for the patients, including in circumstances where the product is not reimbursed by the HSE. I would expect that the company would honour any commitments made to patients in this regard.
National Maternity Hospital Expenditure
54. Deputy Bríd Smith asked the Minister for Health if he will clarify reports on the funding status for the new maternity hospital; and if he will make a statement on the matter. [40918/17]
Minister for Health (Deputy Simon Harris): The Government is fully committed to proceeding with and completing the new National Maternity Hospital, which is a vital project for women and babies in Ireland. This project constitutes the largest single investment ever to be made in maternity services in Ireland. The new development will cater for up to 10,000 births per annum and will include state of the art obstetrics, neonatal and gynaecology care facilities.
Now that planning permission has been granted, the project will move to tender. The final cost of the project will become clearer once the tender process is complete. The mid-term capital review is underway. As part of this planned process, my Department has sought funding for existing and additional projects, including the new National Maternity Hospital, as have other departments as part of the normal process.
Medicinal Products Availability
55. Deputy Billy Kelleher asked the Minister for Health his views on the recent assertion that Irish persons have the worst access to newly launched medicines. [40941/17]
Minister for Health (Deputy Simon Harris): Medicines play a vital role in improving the overall health of Irish patients. Securing affordable access to existing and new medicines in a timely manner is a key objective of the Irish Health Service. However, the challenge is delivering on this objective in an affordable and sustainable way in line with the resources allocated by the Dáil and the relevant legislative provisions. Expenditure on medicines represents one of the largest areas of expenditure across the health service and will continue to grow in the years ahead as our health service continues to meet the needs of our citizens.
Under the community pharmacy schemes over 70 million prescription items will be dispensed in 2017 at an estimated cost of approximately €1.7 billion - taking account of fees and ingredient cost. In addition, the HSE will spend in excess of €0.5 billion on medicines in our hospitals, nursing homes and other settings. Expenditure on the high tech scheme, the scheme through which the majority of new medicines are funded, has increased by over 80% since 2012, and will continue to increase significantly in 2018 as demand for existing treatments grows and new drugs are approved by the HSE. Since 1 August 2016, the HSE advise that 36 new treatments have been made available to Irish patients.
The Department and the HSE are engaging in a number of initiatives which have lead and will continue to lead to better access to medicines for patients, value for the taxpayer and the cost- effective provision of medicines in Ireland. Key initiatives include reference and generic substitution, under the Health (Pricing and Supply of Medical Goods) Act 2013, the four year Framework Agreement on the Supply and Pricing of Medicines with IPHA, the Medicines Management Programme and National Drugs Management Programme within the HSE, and the development of a National Biosimilar Medicines Policy. Ireland is also participating in a number of voluntary EU forums to explore possible areas for collaboration including price negotiations and joint procurement.
However, access to medicines is not solely a funding issue. A significant barrier to accessing new medicines is the price being sought by some manufacturers for their products. The solution to increased access is multi-facetted and is not simply a matter of allocating more funding for medicines at the expense of other health or public services. The health service must continue to seek better value and lower costs for both existing and new treatments.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. This Act gives full statutory powers to the HSE to assess and make decision on the reimbursement of medicines, taking account of expert opinion as appropriate. There is also an increased level of engagement and commercial negotiations between the HSE and manufacturers in an effort to reduce the price to affordable levels. So while this process is resource intensive, it is clear that as a result of such a robust and scientific process, Ireland is paying significantly less for medicines and the ability to invest is enhanced.
Hospital Waiting Lists Action Plans
56. Deputy Louise O'Reilly asked the Minister for Health the reason the scoliosis waiting list targets were missed; the steps he is taking to address the problem; and if he will make a statement on the matter. [40780/17]
Minister for Health (Deputy Simon Harris): The HSE is actively implementing the action plan they developed to ensure that no child will be waiting over 4 months by year end and are focussed on maximising all available capacity both internally and externally to achieve this target.
Additional nurses are now in post in both Crumlin and Temple Street. An additional consultant orthopaedic surgeon commenced in Crumlin in early September. Up to 22 September the two children's hospitals have already exceeded the number of surgeries undertaken in the whole of last year. Since February 2017, patients are also being transferred for treatment to the Mater, Cappagh, and Stanmore in the UK. To date, 23 surgeries have been completed in these hospitals.
The HSE has completed an international tender for paediatric spinal fusion procedures and three hospitals have been successful. These hospitals will commence patient reviews immediately with a view to commencing treatment in October 2017 for patients whose families take up the offer of having procedures carried out in overseas hospitals. |
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