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 Header Item Written Answers Nos. 184-197
 Header Item Hospital Acquired Infections
 Header Item Hospital Services
 Header Item Hospital Services
 Header Item Hospital Services
 Header Item Health Screening Programmes
 Header Item Nursing Home Services
 Header Item Community Care Provision
 Header Item Hospital Staff Issues
 Header Item Health Services Provision

Wednesday, 19 December 2012

Dáil Éireann Debate
Vol. 787 No. 4

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Written Answers Nos. 184-197

  Question No. 184 answered with Question No. 55.

Hospital Acquired Infections

 185. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which steps are taken to prevent the spread of various hospital bugs including MRSA, all air borne and other infections; if the major cause or causes of such infections have been identified; if the visit of children to hospitals has been restricted; the extent to which normal preventative measures are enforced; and if he will make a statement on the matter. [57315/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I would like to assure you that the management of Healthcare Acquired Infections (HCAIs) is a key patient safety issue for my Department and a number of significant initiatives have been developed to address that important public health issue. Isolation precautions are used to reduce transmission of micro-organisms in healthcare and residential settings. These measures are designed to protect patients/residents, staff and visitors from contact with infectious agents.   There are two categories of isolation precautions: standard precautions and transmission-based precautions.

   Standard precautions are a set of basic infection prevention practices intended to prevent transmission of infectious diseases from one person to another. Because we do not always know if a person has an infectious disease, standard precautions are applied to every person every time to assure that transmission of disease does not occur. These precautions were formerly known as "universal precautions." Standard precautions include:

- Hand hygiene

- Personal protective equipment

- Environmental and equipment cleaning & disinfection

- Safe injection practices

  There are three types of transmission-based precautions;

- Contact precautions (for diseases spread by direct or indirect contact)

- Droplet precautions (for diseases spread by large particles in the air) and

- Airborne precautions (for diseases spread by small particles in the air).

  Each type of precautions has some unique prevention steps that should be taken, but all have standard precautions as their foundation. Each hospital should have mechanisms in place to detect clusters/outbreaks of infections in a timely manner and notify to public health. The outbreak control team then agrees the appropriate preventative measures that need to be implemented which may include visitor restrictions as appropriate.

Hospital Services

 186. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if members of the public have ready and easy access to all preliminary procedures preparatory to surgical or medical interventions with particular reference to obtaining the necessary appointments with consultants to ensure the minimisation of waiting times in all public hospitals; and if he will make a statement on the matter.  [57316/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Immediately following my appointment, I established the Special Delivery Unit, as set out in the Programme for Government. The aim of the SDU is to unblock access to acute services by improving the flow of patients through the system.

The initial focus for the SDU's Scheduled Care Team has been on waiting times for in-patient and daycase elective surgery. For adults, the target waiting time is that no-one should be waiting more than nine months for inpatient and day case treatments. By 13 December last, the number of adults waiting more than 9 months was just 434 compared with 3,706 patients waiting longer than nine months at the end of December 2011. For children, the target is that by the end of 2012 no child should be waiting for inpatient or daycase treatment for more than 20 weeks. Again, huge progress has been made towards this target – on 13 December, there were just 234 children waiting longer than 20 weeks compared with 1,759 at the end of December 2011.

Improving access to outpatient services is the next priority for the Government and for the SDU Scheduled Care Team. Building on work already undertaken by the HSE, the NTPF has now taken over the reporting of outpatient waiting time data. For the first time, clear and comprehensive data on this problem is being reported. In the first instance, the data now being collected will allow the SDU and NTPF to target their resources towards those patients who are waiting longest and ensure that they are seen and assessed. A maximum waiting time target has now been set of 12 months for a first time outpatient appointment by 30 November 2013.

Hospital Services

 187. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which patient numbers in public and private hospitals continue to be monitored with a view to ensuring that the public hospital system is not used as a means of direct or indirect support to the private area; and if he will make a statement on the matter. [57317/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly With regard to patient numbers in public hospitals, data is collected on each in-patient and daycase discharge from the public hospital system. With regard to patient numbers in the private system, the CSO Quarterly National Household Survey (QNHS) collects and publishes data on private hospital activity; note that this is survey data.

With regard to the issue of direct or indirect support from public hospitals to private hospitals, if the Deputy wishes to raise a particular issue in this regard I will be happy to address it.

  Question No. 188 answered with Question No. 20.

Hospital Services

 189. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number and nature of surgical and or medical procedures carried out in the public hospital sector in each of the past five years and to date in 2012; the extent of any trends emerging; and if he will make a statement on the matter. [57319/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.

Health Screening Programmes

 190. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of referrals for further psychological or medical attention following school medical examinations in each of the past five years and to date in 2012; the full extent to which the procedures required received attention within reasonable time; and if he will make a statement on the matter. [57320/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The policy on school health examinations forms part of the Best for Health for Children guidelines, produced in 1999 and revised in 2006. These guidelines were produced after rigorous evaluation of international literature, and a review of good practice in Ireland and abroad.

New governance structures are also being put in place in relation to child health screening and surveillance in the HSE which will further improve the quality assurance of the process. The World Health Organisation in 2007, in a review of child health in Europe, commended the Best Health for Children approach adopted by Ireland as an example of good practice.

As the number of referrals for further psychological or medical attention following school medical examinations is a service matter the question has been referred to the HSE for direct reply.

Nursing Home Services

 191. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which he has carried out an evaluation of the various public nursing homes throughout the country with a view to ensuring the retention of the maximum number of such facilities to meet current and future requirements in the public health sector; and if he will make a statement on the matter. [57321/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch There are at present 129 public units providing residential care (long-term and short-term) for older people in Ireland. The Health Service Executive has recently completed a review of each of these units. The review has focused on a number of areas including each unit’s ability to meet the Health Information and Quality Authority standards in terms of staffing availability; environmental matters such as the age & structure of the home; and factors including location and stock.

The review will provide a basis for discussions between the Department and the HSE with a view to developing an overall set of proposals for the future delivery of residential care to my colleague Minister Reilly.

  Question No. 192 answered with Question No. 15.

Community Care Provision

 193. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which community care facilities are likely to be made available to older persons in the future with particular reference to those with a higher degree of mobility; and if he will make a statement on the matter. [57323/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch As this is a service matter it has been referred to the Health Service Executive for direct reply.

Hospital Staff Issues

 194. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he is satisfied regarding the availability of an adequate supply of junior hospital doctors in 2013, 2014 and thereafter; the extent to which this supply will relate to the number of doctors qualifying in each of the years; and if he will make a statement on the matter. [57324/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Under the provisions of the Medical Practitioners Act 2007 it is the responsibility of the Health Service Executive, in co-operation with the medical training bodies and after consultation with the Higher Education Authority, to undertake appropriate medical practitioner workforce planning for the purpose of meeting specialist medical staffing and training needs of the health service on an ongoing basis. It must also assess on an annual basis the number of intern training posts and the number and type of specialist medical training posts required by the health service.

In 2006 the Government agreed a programme of reform of medical education and training which resulted in a significant increase in the intake of Irish and EU medical students with the objective of achieving self-sufficiency in terms of medical staffing.

In July 2012 there were 572 medical intern posts available in Ireland, an increase of almost 70 posts since 2007. The intern year is recognized as the first year of postgraduate training. It is anticipated that in 2013 a further increase in intern places will be required to cater for the number of doctors graduating from medical schools in that year. The HSE in co-operation with my Department is developing a strategy to cater for next year's intake of interns.

I have asked the HSE to reply directly to the Deputy in regard to their assessment of the number of junior hospital doctors required in the future.

Health Services Provision

 195. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which the relevant authorities within his Department or within the Health Service Executive have examined the need for the upgrading of health centres throughout the country in the coming year in keeping with population demands; and if he will make a statement on the matter. [57325/12]

 197. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if his attention has been drawn to the need to upgrade the health centres in north west Kildare with particular reference to the growing centres of population; the extent to which the current health centres require upgrading in line with demographic trends; his plans to address this issue; and if he will make a statement on the matter. [57327/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 195 and 197 together.

The upgrade and refurbishment of health centres including those located in north west Kildare are considered by the Health Service Executive in the context of its roll-out of primary care infrastructure. There are always more construction projects than can be funded from the Exchequer's capital health care allocation. The Executive is required to prioritise infrastructure projects within its overall capital envelope taking into account the existing capital commitments and costs of completion over the period. The method and timescale for the delivery of primary care infrastructure is dependent on a number of factors; it is a dynamic process constantly evolving to take account of changing circumstances, including the feasibility of implementation. Work is underway on the Executive's multi-annual Capital Plan 2013-2017 and consideration of projects for inclusion in this Plan is an evolving process. The draft Plan will be submitted to my Department in due course. My Department will then review the proposals and follow up with the HSE where further details may be required. The draft Capital Plan 2013-2017 will require my approval with the consent of the Minister for Public Expenditure and Reform.

  Question No. 196 answered with Question No. 15.

  Question No. 197 answered with Question No. 195.


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