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 Header Item Written Answers Nos. 108-130
 Header Item National Children's Hospital
 Header Item Disabilities Assessments
 Header Item Primary Care Centres Provision
 Header Item Hospital Waiting Lists
 Header Item Community Care Provision
 Header Item Pharmaceutical Sector
 Header Item Medical Aids and Appliances Provision
 Header Item Hospital Services
 Header Item Hospital Waiting Lists
 Header Item Hospital Services
 Header Item Hospital Services
 Header Item Maternity Services
 Header Item Community Care Provision
 Header Item Community Care Provision
 Header Item Hospital Waiting Lists
 Header Item Hospital Waiting Lists
 Header Item Mental Health Services Staff
 Header Item Medicinal Products
 Header Item Health Screening Programmes
 Header Item Home Care Packages Provision

Tuesday, 2 July 2019

Dáil Éireann Debate
Vol. 984 No. 5

First Page Previous Page Page of 86 Next Page Last Page

Written Answers Nos. 108-130

National Children's Hospital

 108. Deputy Gino Kenny Information on Gino Kenny Zoom on Gino Kenny asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the steps he will take to ensure both the new children’s hospital and new national maternity hospital will be operated as public hospitals only in view of his recent comments regarding his support for a universal healthcare service; and if he will make a statement on the matter. [27803/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I can assure the Deputy that the vast majority of services in the new children’s hospital and the new maternity hospital will be public services.  However, as part of the National Consultants' Contract, negotiated in 2008, some consultants holding specific contracts are entitled to engage in private outpatient practice outside of their public commitment; this commitment must be conducted on site, in the hospital where the consultant holds his/her contract.  As a result, private outpatient clinics may be undertaken on a public hospital campus, however, these clinics must be held outside contracted hours.  The new hospitals will be obliged to provide such facilities for consultants holding such contracts, but it is proposed that the consultants will be required to pay a fee for the use of the rooms and other operational costs. 

The Report of the Independent Review Group established to examine private activity in public hospitals (the De Buitléir Report) has been received and is being examined in the Department. It is a comprehensive examination of private activity in public hospitals and contains a small number of recommendations. 

Detailed consideration of the Report by Department officials is ongoing and covers a range of issues, which have also been discussed in engagement with the Department of Public Expenditure and Reform and the Department of the Taoiseach.  It is intended that the De Buitléir Report will be published when this consideration is complete.

Disabilities Assessments

 109. Deputy Jackie Cahill Information on Jackie Cahill Zoom on Jackie Cahill asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the way in which he plans to address the increase in CHO 3 of the number of overdue first assessments under the Disability Act 2005; and if he will make a statement on the matter. [27752/19]

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on 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.

Primary Care Centres Provision

 110. Deputy John Curran Information on John Curran Zoom on John Curran asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if his attention has been drawn to the long delays in the delivery of primary healthcare centres in Lucan and Clondalkin; and if he will make a statement on the matter. [27645/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

  Question No. 111 answered with Question No. 53.

Hospital Waiting Lists

 112. Deputy Éamon Ó Cuív Information on Éamon Ó Cuív Zoom on Éamon Ó Cuív asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to provide enough resources to eliminate the long waiting lists for treatment at pain management clinics; and if he will make a statement on the matter. [27449/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.

The joint Department of Health/HSE/National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing waiting times for inpatient/day case treatment and outpatient appointments.

The Access Plan sets out the activity levels for the NTPF, who will supply additionality to HSE activity in order to reduce waiting times experienced by patients for a hospital appointment, operation or procedure.  

A key element of the Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments. For its part the NTPF will aim to deliver 40,000 first Outpatient appointments.

Furthermore, the Sláintecare Action Plan 2019 which was published by my Department, includes a specific workstream on Access and Waiting Lists. Sláintecare emphasises the need to invest in increased capacity while also shifting the balance of care from hospitals to community services for better health outcomes and a more sustainable health service. In addition, many of the other service reforms and enhancements included in Slaintecare will support timely access to care for patients in the coming years.

In line with Sláintecare objectives, my Department is working with the HSE and the NTPF, to develop medium-long term improvement initiatives for patient access to hospital procedures. This will include moving care to more appropriate settings and providing care at the lowest level of complexity. The HSE advise that one such example is a pilot scheme which commenced in January 2019 in Sligo University Hospital: the eight-week “Pain Management Education Programme” (PMEP) involves physiotherapy, psychology, and Pain Nurse-delivered education. 

The NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify outpatient waiting list proposals. To date in 2019, the NTPF have approved funding for pain management appointments in Tallaght, the Mater and St. Vincent’s hospitals, and welcomes proposals from all acute hospitals for initiatives to improve access for patients awaiting outpatient appointments.

  Question No. 113 answered with Question No. 88.

Community Care Provision

 114. Deputy Catherine Connolly Information on Catherine Connolly Zoom on Catherine Connolly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the reason 176 persons are waiting for home support for more than 12 months and a further 80 persons waiting for an increase in home support hours in County Galway as at 31 May 2019; the longest period of time a person is waiting for home support services in County Galway; the steps being taken to address the waiting list; and if he will make a statement on the matter. [27936/19]

Minister of State at the Department of Health (Deputy Jim Daly): Information on Jim Daly Zoom on Jim Daly As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Pharmaceutical Sector

 115. Deputy John Brassil Information on John Brassil Zoom on John Brassil asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when financial emergency measures in the public interest, FEMPI, cuts for pharmacists will be reversed; and if he will make a statement on the matter. [27811/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris In accordance with the provisions of Part 5 and Part 6 of the Public Service Pay and Pensions Act 2017, the Government is committed to developing a statutory basis for payments to primary care contractors, to replace FEMPI legislation, which expires at the end of this year.

  This new statutory basis will enable the determination of payments to contractors based on a range of considerations, including affordability and value for money.

  Preparatory work is underway in my Department on the development of that new statutory basis. 

Medical Aids and Appliances Provision

 116. Deputy Frank O'Rourke Information on Frank O'Rourke Zoom on Frank O'Rourke asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if the report from an organisation (details supplied) submitted in April 2019, will be considered as part of the HSE review into the extension of the FreeStyle Libre device to all persons with type 1 diabetes; and if he will make a statement on the matter. [27450/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Hospital Services

 117. Deputy Catherine Connolly Information on Catherine Connolly Zoom on Catherine Connolly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if the options appraisal for the model 4 hospital at Merlin Park, Galway will be completed by the end of July 2019; the cost to date of the options appraisal process; the anticipated overall cost of the process; and if he will make a statement on the matter. [27933/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris In relation to the particular query raised, as this is a service matter, I have asked the HSE to reply to the Deputy directly.

Hospital Waiting Lists

 118. Deputy Niall Collins Information on Niall Collins Zoom on Niall Collins asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the action he is taking to reduce outpatient waiting times; if his attention has been drawn to the fact that the number of patients waiting more than 18 months in University Hospital Limerick has increased by 7,776, 1,709%, since May 2016 and stood at 8,231 at the end of May 2019; and if he will make a statement on the matter. [27754/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.

The joint Department of Health/HSE/National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing waiting times for inpatient/day case treatment and outpatient appointments. 

The Access Plan sets out the activity levels for NTPF, who will supply additionality to HSE activity, in order to reduce waiting times experienced by patients for a hospital appointment, operation or procedure.  

A key element of the Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments. For its part the NTPF will aim to deliver 40,000 first Outpatient appointments. 

The NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify outpatient waiting list proposals. The NTPF has advised that to date in 2019, University Hospital Limerick has received approval for NTPF funding for additional Dermatology outpatient appointments for 1,400 long-waiting patients.

In addition, my Department is working with the HSE and NTPF, under the Access Plan, with the objective of developing medium-long term improvement initiatives for patient access to hospital procedures. This will include moving care to more appropriate settings and providing care at the lowest level of complexity such as providing ophthalmology in the community; maximising the use of Advanced Nurse Practitioner led clinics; and physiotherapists to manage orthopaedic clinics. 

With regard to overall measures being implemented at University Hospital Limerick to address Outpatient Waiting Lists, I have asked the HSE to respond to the Deputy Directly.

Hospital Services

 119. Deputy Eugene Murphy Information on Eugene Murphy Zoom on Eugene Murphy asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the status of the plans to develop a medical rehabilitation unit at Roscommon University Hospital; the stage of the project; if the project has been included in the capital plan of the HSE for 2020; the timeframe for completion of works; and if he will make a statement on the matter. [27967/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris 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.

Hospital Services

 120. Deputy Catherine Connolly Information on Catherine Connolly Zoom on Catherine Connolly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the alternative arrangements in place to treat patients of Merlin Park Hospital for orthopaedic procedures, including University Hospital Galway and other hospitals; the number of persons on the waiting list for orthopaedic surgeries by length of time; and if he will make a statement on the matter. [27935/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Reducing waiting time for patients for hospital operations and procedures is a key priority for Government. Last year saw considerable improvement in the number of patients waiting for procedures. As a result of increased activity and the ongoing collaboration between the HSE and the National Treatment Purchase Fund (NTPF), the number of patients waiting for an Inpatient or Day case procedure fell to 70,204 in December 2018, from a peak of 86,100 in July 2017. This represents a reduction of over 18% in the overall number of patients waiting for a procedure. The number of patients waiting more than 3 months fell by more than 17,700, or 31% in the same period from July 2017 to the end of December 2018.

  Budget 2019 announced that the Government had further increased investment in tackling waiting lists, with funding to the NTPF increasing from €55 million in 2018 to €75 million in 2019.

  The joint Department of Health, HSE, and NTPF Scheduled Care Access Plan 2019 was published in March. Under the Plan the HSE, in line with the National Service Plan, will deliver 1.155 million elective inpatient and day case discharges at a value of €1.4 billion in 2019. The Scheduled Care Access Plan includes:

  - detailed plans from the NTPF to fund 25,000 IPDC treatments; 5,000 Gastro Intestinal Scopes; and 40,000 outpatient first appointments.

  - Projections by year end to reduce the overall number of patients on the waiting list (excluding GI scopes) from just over 70,200 in Dec 2018 to under 60,000;

  - Within this overall reduction the number of patients waiting longer than 3 months will reduce from 40,200 at the end of 2018 to 31,000;

  - It is also projected that for ten identified high volume procedures, including hip and knee replacements, all clinically suitable patients waiting more than 6 months will be offered treatment in 2019. These 10 procedures account for over a third of the active inpatient day case waiting list and represent 60% of NTPF planned activity in 2019.

  The latest NTPF figures show that there 1,301 patients on the Galway University Hospital (GUH) IPDC Orthopaedics waiting list. Of these, 81% (1,053) are waiting 12 months or less.

  The GUH Orthopaedics IPDC Waiting List is contained in the following table.

  *Please note that patients listed for surgery at Merlin Park Hospital are captured under the GUH waiting list.

  In relation to the alternative arrangements in place to treat patients of Merlin Park Hospital for orthopaedic procedures, including Galway University Hospital and other hospitals, I have asked the HSE to respond to the Deputy directly.

   Galway University Hospitals IPDC Orthopaedics waiting list

0-3 mths 3-6 mths 6-9 mths 9-12 mths 12-15 mths 15-18 mths 18-24 mths 24-36 mths 36-48 mths 48+ mths Total
406 245 240 162 108 43 64 26 6 1 1301

Maternity Services

 121. Deputy Anne Rabbitte Information on Anne Rabbitte Zoom on Anne Rabbitte asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the status of the implementation of the recommendations of the review of maternity services in Portiuncula Hospital; and if he will make a statement on the matter. [27814/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Walker Report, which was the report of an external review into maternity services in Portiuncula University Hospital, was published on 3 May 2018.  The report made 35 key recommendations under five themes: Environment, Training, Clinical Care, Staffing, and Communication issues.  The HSE established an Implementation Group to progress these recommendations and I understand that to date significant progress has been made to implement these 35 recommendations. I am advised that as of March 2019,  95% of the recommendations were complete or nearly completed. 

I have asked the HSE to reply directly to you with regard to the current status of the implementation of the recommendations.

Community Care Provision

 122. Deputy Éamon Ó Cuív Information on Éamon Ó Cuív Zoom on Éamon Ó Cuív asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to increase investment in home care and home care packages in order that those that choose to be cared for at home will have adequate supports; his further plans to introduce legislation ensuring a legislative right to homecare in circumstances in which it is necessary and is the best option in terms of patient outcome and choice; and if he will make a statement on the matter.  [27448/19]

Minister of State at the Department of Health (Deputy Jim Daly): Information on Jim Daly Zoom on Jim Daly Improving access to home support remains a priority for Government. Over the past four years we have seen a considerable increase of nearly €140 million in the budget which has grown from €306 million in 2015 to almost €446 million this year. In 2019, the HSE intends to provide 17.9 million home support hours to 53,000 people and intensive home care packages to 235 people, equating to a further 0.36m hours. 

Despite this significant level of service provision, the demand for home support continues to grow. The allocation of funding for home supports across the system, though significant, is finite and services must be delivered within the funding available. The HSE is required to deliver the service within the available budget, and this means ensuring the hours allocated to the service are affordable. This requires the HSE to manage the budget and service provision throughout the year to ensure a balanced budget for 2019.  

The development of a new, standalone statutory scheme and system of regulation for home-support services is a long-standing objective of the Government.  This is currently progressing in line with the Sláintecare Implementation Strategy which commits to the introduction of the new scheme in 2021. It is intended that the new statutory scheme will improve access to adult home support services on an affordable and sustainable basis while the introduction of a system of regulation will ensure public confidence in these services. 

Building on a review of the home care systems in 4 EU countries which was published in April 2017, the Department is currently engaged in a review of the policy goals, objectives and guiding principles of adult home support service provision in ten countries. This review will assist in identifying international good practices, the learning from which will be incorporated into the development of the new statutory scheme.

Community Care Provision

 123. Deputy Willie O'Dea Information on Willie O'Dea Zoom on Willie O'Dea asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the timeframe for introducing a statutory right to home care; and if he will make a statement on the matter. [27757/19]

Minister of State at the Department of Health (Deputy Jim Daly): Information on Jim Daly Zoom on Jim Daly The Department of Health is currently engaged in the development of a new statutory scheme and system of regulation for home-support services. In preparation for the development of the statutory scheme, the Department commissioned the Health Research Board to carry out a review of the home-care systems in four European countries. In addition, the Department conducted a public consultation on home-care services, on which a report was published in 2018. These reports are available on the Department’s website and will help to ensure that the new scheme is informed both by international experience and by the views of stakeholders, including service-users.

Work is currently being progressed in relation to a review of the management, operation and funding of current home care services in Ireland. This will provide a baseline for the design of an effective, sustainable service as part of the development of a statutory home care scheme. This review, which will be completed by the end of the year, will provide a baseline for the design of an effective, sustainable service as part of the development of a statutory homecare scheme.

 Work is on-going to determine the optimal approach to the development of the statutory scheme within the broader context of the Sláintecare reforms. The Department’s Sláintecare Implementation Strategy commits to the introduction of the statutory scheme in 2021. In 2019 work will focus on the design of the scheme, the options for regulation and a review of existing services. Further consultation will also be undertaken in 2019 (with key stakeholders and service-users) and will continue throughout the process of developing the new scheme.

Hospital Waiting Lists

 124. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the extent to which he is satisfied that issues affecting long waiting lists for various procedures in public hospitals, overcrowding at accident and emergency services and other contributory factors affecting the fast, efficient and effective delivery of public health services are fully addressed or are in the course of so being; and if he will make a statement on the matter. [27941/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I am committed to tackling the key challenges our health service faces in relation to long waiting times and hospital overcrowding. Improving timely access for patients to scheduled and unscheduled care is at the heart of Sláintecare. The Sláintecare Action Plan 2019 which was published by my Department, includes a specific workstream on Access and Waiting Lists. Sláintecare emphasises the need to invest in increased capacity while also shifting the balance of care from hospitals to community services for better health outcomes and a more sustainable health service. In addition, many of the other service reforms and enhancements included in Slaintecare will support timely access to care for patients in the coming years.

Last year saw considerable improvement in the number of patients waiting for procedures. As a result of increased activity and the ongoing collaboration between the HSE and the NTPF, the number of patients waiting for an Inpatient or Day case procedure fell to 70,204 in December 2018, from a peak of 86,100 in July 2017. This represents a reduction of over 18% in the overall number of patients waiting for a procedure. The number of patients waiting more than 3 months fell by more than 17,700, or 31% in the same period from July 2017 to the end of December 2018.

Budget 2019 announced that the Government had further increased investment in tackling waiting lists, with funding to the NTPF increasing from €55 million in 2018 to €75 million in 2019.

The joint Department of Health, HSE, and NTPF Scheduled Care Access Plan 2019 was published in March. Under the Plan, the HSE in accordance with the National Service Plan, will aim to deliver 1.155 million elective inpatient and day case discharges at a value of €1.4 billion in 2019. The Scheduled Care Access Plan also includes:

- detailed plans from the NTPF to fund 25,000 IPDC treatments; 5,000 Gastro Intestinal Scopes and 40,000 first outpatient appointments.

- Projections by year end to reduce the overall number of patients on the Inpatient/Day Case waiting list (excluding GI scopes) from just over 70,200 in Dec 2018 to under 60,000;

- Within this overall reduction the number of patients waiting longer than 3 months will reduce from 40,200 at the end of 2018 to 31,000;

-It is also projected that for ten identified high volume procedures, all clinically suitable patients waiting more than 6 months will be offered treatment in 2019. These 10 procedures account for over a third of the active inpatient day case waiting list and represent 60% of NTPF planned activity in 2019. 

A key element of the Scheduled Access Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments.

 While the meeting of short-term targets is always welcome, more can be achieved and, in this regard, the HSE, Department of Health and NTPF, under the Access Plan, will work together with the objective of developing medium-long term improvement initiatives for patient access to hospital procedures. This will include moving care to more appropriate settings and providing care at the lowest level of complexity such as providing ophthalmology in the community; maximising the use of Advanced Nurse Practitioner led clinics; and physiotherapists to manage orthopaedic clinics.

With regard to unscheduled care, Ireland is seeing a growing demand, which is evident from the increased pressures on hospital Emergency Departments (EDs), particularly during peak periods such as winter. This is a very busy period for our health services, with many hospitals reporting significant numbers of patient attendances. For the first five months of 2019, the number of patients attending hospital EDs increased by 4.9%, and the number of ED admissions increased by 3.3% compared to the same period last year.

Despite the significant increase in demand, our health services have managed better for the first five months of 2019 than in the previous year, and the numbers of patients waiting on trolleys nationally were 6.8% lower than the same period last year.

The HSE are undertaking a review of performance across all Hospital Groups and Community Health Organisations over the winter period, which has now been extended to include a review by an independent expert group.

The group will carry out a comparative analysis of unscheduled care performance across the nine hospital sites and the relevant Community Healthcare Organisations that were the subject of specific focused support through Winter 2018/2019. The terms of reference and membership of the group have been agreed and are now published on the HSE website.

The Health Service Capacity Review published last year was crystal clear on the need for a major investment in additional capacity in both hospital and community – combined with a widescale reform of the manner and the location of where health services are provided.

Increasing capacity is a priority for Government. Since 2017, an additional 241 acute hospital beds opened, and the National Service Plan for 2019 provides for a comprehensive capacity programme. The number of available inpatient beds is expected to increase to above 11,000 following the investment planned in the National Service Plan 2019.

Hospital Waiting Lists

 125. Deputy Marc MacSharry Information on Marc MacSharry Zoom on Marc MacSharry asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the action he is taking to reduce outpatient waiting times; if his attention has been drawn to the fact that the number of patients waiting more than 18 months in Sligo University Hospital has increased by 1,901, 2,924.6%, since May 2016 and stood at 1,966 at the end of May 2019; and if he will make a statement on the matter. [27747/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures. 

The joint Department of Health/HSE/National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing waiting times for inpatient/day case treatment and outpatient appointments. 

The Access Plan sets out the activity levels for the NTPF, who will supply additionality to HSE activity, in order to reduce waiting times experienced by patients for a hospital appointment, operation or procedure.  

A key element of the Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments. For its part the NTPF will aim to deliver 40,000 first Outpatient appointments. 

The NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify outpatient waiting list proposals. The NTPF has advised that to date in 2019, Sligo University Hospital has received approval for NTPF funding for 224 additional Neurology Outpatient appointments and 864 additional ENT Outpatient appointments. 

In addition, my Department is working with the HSE and NTPF, under the Access Plan, with the objective of developing medium-long term improvement initiatives for patient access to hospital procedures. This will include moving care to more appropriate settings and providing care at the lowest level of complexity such as providing ophthalmology in the community; maximising the use of Advanced Nurse Practitioner led clinics; and physiotherapists to manage orthopaedic clinics. 

With regard to overall measures being implemented at Sligo University Hospital to address Outpatient Waiting Lists, I have asked the HSE to respond to the Deputy Directly.

Mental Health Services Staff

 126. Deputy Michael McGrath Information on Michael McGrath Zoom on Michael McGrath asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans in place to increase psychiatry of later life staffing levels in CHO 4 which are currently at barely a third of the level recommended under A Vision For Change; and if he will make a statement on the matter. [27809/19]

Minister of State at the Department of Health (Deputy Jim Daly): Information on Jim Daly Zoom on Jim Daly As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

  Question No. 127 answered with Question No. 80.

Medicinal Products

 128. Deputy Maureen O'Sullivan Information on Maureen O'Sullivan Zoom on Maureen O'Sullivan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the way in which Ireland was represented at the meeting of the 72nd World Health Assembly held on 20 to 28 May 2019 in Geneva; the stance Ireland took on an issue (details supplied); the policy Ireland will continue to pursue; and if he will make a statement on the matter. [27956/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I am informed that the Irish delegation to the 72nd session of the World Health Assembly was led by the Irish Permanent Representative to the United Nations and other International Organisations at Geneva. The delegation included officials from the Department of Health and the Department of Foreign Affairs and Trade.

  Securing affordable and sustainable access to new and innovative medicines is a challenge that is not unique to Ireland. Many countries are battling with the same issues. Ireland has been at the forefront of international engagement on this critical issue, trying to build consensus with our EU partners across a number of forums.

  In March 2019, Italy presented a draft resolution on improving the transparency of markets for medicines, vaccines and other health related technologies. This proposed a number of actions relating to pharmaceutical policy, including that the World Health Organisation would support member states in collecting, analysing and creating standards for information on prices, reimbursement costs, clinical trials outcome data and costs of relevant policy developments.

On 28 May 2019, the resolution was adopted by consensus at the 72nd  session of the World Health Assembly, with Germany, Hungary and the UK abstaining.

  I welcome Italy’s commitment to addressing the challenges which exist in accessing new and innovative medicines.  Mutual cooperation between member states represents one of the best opportunities we have to tackle medicine expenditure and to deliver new and innovative treatments to our patients.

  The Programme for Government is committed to “drive down costs to provide new treatments, drugs etc” and to “look at opportunities for leveraging purchasing power either through national or European initiatives”.   

  Ireland has been actively involved in international collaboration for the last number of years, working to build consensus at a European level on this key issue. In particular, Ireland's membership of the Beneluxa Initiative offers an important platform from which to deliver the shared objective of securing access to high cost, innovative treatments. 

Health Screening Programmes

 129. Deputy Aindrias Moynihan Information on Aindrias Moynihan Zoom on Aindrias Moynihan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will request a review on the way in which the diabetic retina screening programme delivers results to service users; and if he will make a statement on the matter. [27985/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Diabetic RetinaScreen, the National Diabetic Retinal Screening Programme is a government funded screening programme in Ireland that offers free, regular diabetic retinopathy screening to people with diabetes aged 12 years and older.

Diabetic RetinaScreen uses specialised digital photography to look for changes that could affect sight. Results are delivered in compliance with quality standards as outlined in the ‘Standards for Quality Assurance in Diabetic Retinopathy Screening’.  As with other national screening programmes, quality assurance is paramount and all essential elements are in place to ensure risks to patients are minimised and that the best clinical outcomes for patients are maximised.

In accordance with Part 9 of the Health Act 2004, should any individual with a complaint in relation to the operation of the programme should in the first instance make their complaint known directly to the service itself to ensure that it can be investigated appropriately.

Home Care Packages Provision

 130. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the extent to which home care packages are being made available to persons that might otherwise need hospitalisation; the number approved in each of the regions in the past three years to date; the extent of the funding required or pending; and if he will make a statement on the matter.  [27942/19]

Minister of State at the Department of Health (Deputy Jim Daly): Information on Jim Daly Zoom on Jim Daly As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.


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