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 Header Item Written Answers Nos. 489-505
 Header Item Primary Care Centres Provision
 Header Item Medical Card Applications
 Header Item Hospital Services
 Header Item Medical Card Applications
 Header Item Services for People with Disabilities
 Header Item Hospitals Discharges
 Header Item Home Help Service Provision
 Header Item Nursing Home Accommodation
 Header Item Health Services Regulation
 Header Item Health Services Staff Issues
 Header Item Ministerial Appointments
 Header Item Ministerial Appointments
 Header Item Ministerial Appointments
 Header Item Ministerial Appointments
 Header Item Ministerial Appointments
 Header Item Ministerial Appointments

Tuesday, 11 December 2012

Dáil Éireann Debate
Vol. 786 No. 1

First Page Previous Page Page of 109 Next Page Last Page

Written Answers Nos. 489-505

Primary Care Centres Provision

 489. Deputy Regina Doherty Information on Regina Doherty Zoom on Regina Doherty asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of doctors who have contracted to offer general practitioner services in the proposed primary care centre in Ashbourne County Meath; the number of staff and categories of staff who will work in this centre; the range of services that will be offered; if there will be dianostics available in the centre such as x-ray, endoscopy, dexa scanner and so on; if a minor surgery facility for day surgery will be available; if there will be a gym, physiotherapy and rehabilitation facilities in the building; the completion date for this project; if funding has been allocated and maintained in the capital budget for this project; the catchment area the centre intends to serve; the projected population; and if he will make a statement on the matter. [55338/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Delivery of health care services in the community is a service issue. Therefore your query has been referred to the Health Service Executive for direct reply.

Medical Card Applications

 490. Deputy Tom Fleming Information on Tom Fleming Zoom on Tom Fleming asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding a medical card in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [55339/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Hospital Services

 491. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if his attention has been drawn to the case of a person (details supplied) in County Donegal; if he will immediately review the care this person received at Letterkenny Hospital, County Donegal; and if he will make a statement on the matter. [55346/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly My Department has been in communication with the person concerned. The Health Service Executive (HSE) are dealing with the issues this individual has raised and I have sought a report on those issues from the HSE.

Medical Card Applications

 492. Deputy Brendan Griffin Information on Brendan Griffin Zoom on Brendan Griffin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if a medical card will be renewed in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [55352/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Services for People with Disabilities

 493. Deputy Catherine Murphy Information on Catherine Murphy Zoom on Catherine Murphy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the way adult services were funded for those with an intellectual disability in 2011 and 2012; if that funding system will remain in place in 2013; If it is intended that any future funding model will be reformed in such a way that the funding follows the client; the number of clients deemed to require such services in 2011 and 2012; the number that received such services; and if he will make a statement on the matter. [55359/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch HSE National Service Plans outline, as required in legislation, the type and volume of services to be provided each year in return for the resources made available by the Oireachtas.

  Expenditure on Disability Services amounts to approximately 10.5% of the €14 billion health budget. For 2011, the total outturn for specialist Disability Services, as outlined in the HSE National Service Plan 2012 was €1.576 billion.

  Expenditure on disability services provided for in the HSE National Service Plan 2012 was €1.541 billion.

  The range of specialist disability services provided to people with disabilities includes:

- Residential

- Respite

- Day

- Personal Assistant

- Home Support

- Multidisciplinary supports

  The funding situation for the disability sector in 2013 is not yet available pending the finalisation of the HSE's National Service Plan for 2013. Savings required globally from the Health Budget will have an impact on all services, including disability services, and it is expected that these will be outlined later this month when the Minister for Health approves the National Service Plan.

The commitment in the Programme for Government is to 'move a proportion of public spending to a personal budget model so that people with disabilities or their families have the flexibility to make choices that suit their needs best’'. It has not yet been determined whether this will require legislative change.

  The move towards a personal budget model is encompassed by the recommendations in the recently published Value for Money (VFM) and Policy Review of Disability Services, which addresses the wider area of individualised budgeting and person-centred supports and services. In that context, the Minister for Health intends that the actions recommended in the VFM Review will lay the groundwork for individualised budgeting, once sufficient analysis of the benefits is carried out in the Irish context and adequate financial management, resource allocation and governance structures are in place to ensure its long-term viability. The priority is to further improve current services, while expediting the analysis of the benefits to be gained from a person-centred supports model and developing the administrative and governance infrastructure necessary for a more accountable and individualised service.

  The remaining issues raised by the Deputy in relation to the number of clients deemed to require or who received such services in 2011 and 2012 are more appropriate for the Health Service Executive. Accordingly, the Department has asked the HSE to provide the details requested directly to the Deputy.

Hospitals Discharges

 494. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding patients awaiting discharge from hospital who no longer require hospital care but are seeking access to either a public nursing home bed or adequate home help support and or care packages [55363/12]

 495. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the level of progress achieved by his Department's special delivery unit and the Health Service Executive's clinical programme for elderly care in clearing the reported backlog of 600 persons, the majority of whom are over 65 years, who were awaiting discharge from hospital on 12 November 2012. [55364/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 494 and 495 together.

Data available from the Health Service Executive shows that, on 12 November, the number of delayed discharges nationally was 653; the average number of delayed discharges for the month of November was 656. On 3 December, which is the most recent data available, the number of delayed discharges nationally was 589, representing a decrease of 10.2% on the November average. Of these, a third (195) were awaiting discharge for under two weeks and a further 124 were awaiting discharge for under four weeks.

To address this issue, the SDU has worked with the Clinical Care Programme on the Elderly and the HSE on proposals for a joint Acute Hospital/Community Service transitional care initiative. This will speed up access and egress from acute care (reducing ED times, length of stay, and delayed discharges). The scheme commenced in the latter half of this year and involves the provision of home supports, transitional care beds and rehabilitation beds. So far under this initiative, which commenced in the latter half of the year, more than 6,500 home supports hour have been provided, more than 300 patients discharged to transitional care or rehabilitation beds and approximately 10,000 bed days have been saved within the acute hospital system.

This initiative is about improving the patient experience and outcomes for our frail older people. The initiative will also underpin significant savings in bed days through moving from acute beds to transitional and rehabilitation beds and through reduction in the average length of stay for patients in acute beds.

Home Help Service Provision

 496. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his plans for home help support provision and or care packages to delayed discharge patients who no longer require acute hospital beds [55365/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch Government policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible. Mainstream Home Help and enhanced Home Care Package services are core to not only realising the preferred wishes of many vulnerable older people, but also to reducing pressures elsewhere in the wider care system. The demand for these services, and for additional community based supports such as Meals-on-Wheels and Day or Respite Care, will continue as the demographics, and complex needs, of older people change.

The capacity of the Health Service Executive to provide approved levels of home support services is continually reviewed in the context of overall resources available at particular times.

In addition, the Special Delivery Unit, the HSE and the Department have been working on a joint Acute Hospital/Community Service "home to home" initiative. This joined up approach seeks to speed up access and egress from Acute Hospitals with the aim of reducing ED wait times, reducing length of stay, and significantly reducing delayed discharges, as well as significantly reducing the numbers going into Long Term Residential Care. The scheme commenced in the latter half of this year and involves the provision of home supports, transitional care beds and rehabilitation beds.In the wider context, the issue raised by the Deputy is being progressed by the Executive under its National Clinical Programme for Older People, one of the objectives of which is to improve the management of acutely ill frail older adults in acute hospitals.

The Government's intention is to continue to maximise the use of all of the above initiatives, in the overall context of health reform and resource availability.

Nursing Home Accommodation

 497. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will reconsider his policy for closing public nursing home beds in view of the fact that some 600 patients, the majority of whom are over 65 years of age, were being kept on hospital wards and are awaiting access to public nursing home beds and or adequate home help support [55366/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch In the National Service Plan the HSE anticipated that in 2012 a small number of public residential units would close, and further, that between 555-898 beds would close across a range of public units. Up to end October, a total of 504 beds have closed and it is not envisaged that the figure of 555 bed closures will be reached.

In the absence of reform, bed closures result in increased cost of care within the public system, undermining the viability of public units and reducing the overall number of older people who can be supported within the Fair Deal budget. As this is not a sustainable position, a more pro-active approach is needed, with a combination of actions required such as consolidation of services; changes in staffing, skill mix and work practices; provision of a variety of services including transitional care, and alternative options for service provision in the community. In that context, the Minister for Health requested the HSE to carry out a viability review of its public facilities. The review, which is just being finalised, aims to identify the maximum number of beds and public residential units that could be retained in each region, within existing financial and staffing resources. The review focused on a number of areas including the unit's ability to meet HIQA standards in terms of environmental matters such as the age and structure of the unit; staffing availability; and factors including location and stock.

The HSE is working closely with the Department to develop an overall sets of proposals for the Minister.

Health Services Regulation

 498. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his plans to independently regulate home help support and care packages providers; in view of the Willis Commission report findings on nursing education in the UK, which recommended that nurses should supervise and delegate work to healthcare assistants, who should also have clearly defined roles in the interest of patient safety  [55367/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch Government for National Recovery, 2011-2016 commits the Government to developing and implementing national standards for home support services, which will be subject to inspection by the Health and Information Quality Authority (HIQA).

  All relevant implications arising from this proposal will obviously have to be taken into account including, for example, recent reports by The Law Reform Commission or other relevant national or international reports relating to the issue of regulation of the home care sector.

  Primary legislation and resources will be required for the introduction of a statutory regulation system for home care services. The question of possible changes to legislation, including regulation, inspection and complaints procedures for Home Care services for older people is at present under consideration. The Department is examining this matter in the overall context of the licensing of Health Care providers. Legislation is currently being prepared and various options are being considered, including the complex legal issues involved, and the need to prioritise legislation across the Social Care area overall.

  It should be noted that statutory regulation or licensing is only one way of improving the safety and quality of services and that other measures have or are being taken to improve Home Support services delivered by, or on behalf of, the Health Service Executive (HSE). This approach includes a new public Procurement Framework for Home Care services (with quality and screening requirements); new National Quality Guidelines for Home Support Services, and new National Home Help Guidelines. These various measures, taken together, have been designed to improve relevant aspects of HSE Home Care provision nationally, pending progression of the legislative proposals raised by the Deputy.

Health Services Staff Issues

 499. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the provision of further education courses specifically for healthcare assistants over and above the FETAC level 5 healthcare support course [55368/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly As this is a service matter, this Parliamentary Question has been referred to the Health Service Executive for direct reply.

Ministerial Appointments

 500. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when he plans to fill the four seats vacant since May on the board of Health Information and Quality Authority; if he will outline the process that is being undertaken to fill the posts; and if he will make a statement on the matter. [55378/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Earlier this year, I instructed my officials to seek nominations, through the Public Appointments Service, for the filling of vacancies on the Health Information and Quality Authority Board. I am currently giving further consideration to the filling of these vacancies.

Ministerial Appointments

 501. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if it is his intention to fill the seven vacancies on the Hepatitis C and HIV Compensation Tribunal; if so, if he will outline the process that is being undertaken to fill these posts; and if he will make a statement on the matter. [55379/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I appoint the members of the Hepatitis C Compensation Tribunal in accordance with Section 3 of the Hepatitis C Compensation Tribunal Act l997.

The Tribunal carries out judicial type functions and is therefore very different to a typical State Board. It hears claims in relation to persons infected with Hepatitis C or HIV through the administration within the State of infected blood or blood products. Claims are dealt with by the Tribunal by way of an in camera oral hearing before two members of the Tribunal and the Chairperson. The Tribunal was set up in order that claimants could have their cases heard in a confidential, person centred, fashion. Ministerial appointments to the Tribunal are made on the advice of the Attorney General and I have received the Attorney's advice in relation to the seven vacancies. I intend to appoint members as quickly as possible.

Ministerial Appointments

 502. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when he will fill the five seats on the board of the Health Research Board; if he will outline the process that is being undertaken to fill these posts; and if he will make a statement on the matter. [55380/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly There are currently five vacancies on the Health Research Board. The HRB vacancies were advertised on the Public Appointments Service (PAS) website and on the Department’s website. I expect to be in a position to formally appoint members to the Board this week.

Ministerial Appointments

 503. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when the six posts on the board of the Food Safety Authority will be filled; if he will outline the process that is being undertaken to fill these posts; and if he will make a statement on the matter. [55381/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Earlier this year, I instructed my officials to seek nominations, through the Public Appointments Service, for the filling of vacancies on the Food Safety Authority of Ireland Board. I am currently giving further consideration to the filling of these vacancies.

Ministerial Appointments

 504. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the status of the vacancy on the board of the Voluntary Health Insurance; if he will outline the process that is being undertaken to fill this posts; and if he will make a statement on the matter. [55382/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly There is one vacancy on the Voluntary Health Insurance Board. This vacancy arises from the appointment of a serving Board member as Chairman of the Board in September 2012.

In accordance with Government policy regarding appointments to State Boards, an advertisement for this position was placed on my Department's web-site on 28 September 2012. Expressions of interest were sought by persons with skills and experience which are relevant to the functions of the Voluntary Health Insurance Board.

The closing date for receipt of expressions of interest has now passed, and I am now in receipt of details and experience of all applicants. I propose to give full consideration to all applications shortly, having regard to the particular functions of the VHI, ensuring that the overall composition of the Board contains an appropriate mix of skills and experience in such areas as corporate governance, legal expertise, and financial expertise.

When the selection process is complete, approval of the Central Bank of Ireland in the context of its Fitness and Probity regime will be sought for the proposed appointee prior to appointment.

Ministerial Appointments

 505. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding the vacancy on the Options Board; if he will outline the process that is being undertaken to fill this post; and if he will make a statement on the matter. [55383/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White I understand that the Deputy is referring to the Opticians Board. A nomination has been received from the Irish College of Ophthalmologists to fill the vacancy. This is currently under consideration and it is expected that an appointment will be made shortly.


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