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 Header Item Written Answers Nos. 98-108
 Header Item Hospitals Capital Programme
 Header Item Mental Health Services Staff
 Header Item National Children's Hospital Expenditure
 Header Item HIV-AIDS Programmes
 Header Item Hospital Waiting Lists
 Header Item Accident and Emergency Departments
 Header Item Services for People with Disabilities
 Header Item Assisted Human Reproduction
 Header Item Air Ambulance Service Provision
 Header Item Hospital Accommodation Provision

Wednesday, 8 March 2017

Dáil Éireann Debate
Vol. 942 No. 1

First Page Previous Page Page of 96 Next Page Last Page

Written Answers Nos. 98-108

Hospitals Capital Programme

 98. Deputy Charlie McConalogue Information on Charlie McConalogue Zoom on Charlie McConalogue asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the additional resources he will allocate to Letterkenny General Hospital in view of the fact that the full capacity protocol has been implemented again on 28 February 2017; and if he will make a statement on the matter. [11817/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris There has been significant capital investment in Letterkenny Hospital in recent years; most of the works required to repair the flood damage sustained by the Hospital in August 2013 are now complete.

In addition, a significant number of other capital projects are operational. These include the: Medical Academy; Blood Science Laboratory; replacement of sterilisation equipment; expansion of the Recovery Unit; provision of additional space for expansion of the Dialysis Unit; and renovations to provide accommodation for a Pharmacy, Respiratory Lab, Cardiac Investigations facility, Medical Records and Mental Health.

Further projects are underway, or planned, such as the CCU and Haematology/Oncology Ward Restoration/Upgrade, and the Radiology & Interventional Suite Restoration/Upgrade, among others.

With regard to ED performance of Letterkenny University Hospital, data for 2016 from the HSE's Special Delivery Unit indicate that, patient experience times at the ED have been better than the national average, while trolley performance has been close to the national median.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.

Mental Health Services Staff

 99. Deputy Martin Kenny Information on Martin Kenny Zoom on Martin Kenny asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to provide adequate staffing for the child and adolescent mental health service in the Sligo-Leitrim region; and if he will make a statement on the matter. [12135/17]

Minister of State at the Department of Health (Deputy Helen McEntee): Information on Helen McEntee Zoom on Helen McEntee As this is a service issue, this question has been referred to the HSE for direct reply.

National Children's Hospital Expenditure

 100. Deputy Mattie McGrath Information on Mattie McGrath Zoom on Mattie McGrath asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the details of all moneys provided by the State toward the development of a national paediatric hospital since 2006, including all costs associated with development such as design, planning, land acquisition, consultation, media and public relations, board payments, bonuses and so on; if approvals have been sought for an increase in the original estimate for the current National Children's Hospital project; the details of the increase; if such an increase has been approved; and if he will make a statement on the matter. [10850/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris There has been much speculation about the cost of building this hospital. It is not accurate to compare the €650 million of Exchequer funding approved in 2014 for the core construction of the new children's hospital and two satellite centres with the full programme costs set out in the Final Project Brief. The costs set out in the Final Project Brief provide for the construction of the core hospital and satellite centres, including VAT provision, risk provision, all fees, decant, external works, enabling costs and project management costs. Importantly, it also includes commercial spaces (underground carpark and retail space), higher education facilities, the Children’s Research and Innovation Centre, and equipment.

The updated capital costs have now been incorporated into the Final Project Brief which has been submitted to my Department by the HSE and is currently under consideration. While I am not in a position to comment on contract prices and funding implications at this stage, the pricing proposed by the tenderers in the recently concluded tendering process for the main construction works took account of construction inflation (now running at higher than 9%), the extended project timeline, now scheduled to complete in 2021 and the final market cost of the build. As identified by my colleague the Minister for Expenditure and Reform and by the HSE, the new children’s hospital is a priority Government project. I intend to bring a Memorandum to Government in the coming weeks on the new children’s hospital. Full details of the costs and funding will be set out in the Memorandum for Government and will form the basis upon which the approval decision will be made. The costs and funding will span the period up to and including 2021, in line with project requirements.

The National Paediatric Hospital Development Board is the statutory body charged with delivery of the capital project, I have asked it to respond to you directly regarding all costs associated with the development of the project since 2006.

  Question No. 101 answered with Question No. 48.

HIV-AIDS Programmes

 102. Deputy Ruth Coppinger Information on Ruth Coppinger Zoom on Ruth Coppinger asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will expedite the availability of pre-exposure prophylaxis, PrEP, to prevent HIV transmissions, in view of the continuing rise in infections in 2016 and the fact that ten persons a week are now contracting HIV and the effectiveness of PrEP in dramatically reducing HIV transmissions in the UK; and if he will make a statement on the matter.  [12072/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The use of PReP is only one component of comprehensive HIV prevention. The World Health Organisation( WHO) supports a combination of approaches to prevent the sexual transmission of HIV, including correct and consistent condom use, reduction in the number of sexual partners, HIV testing and counselling, delaying sexual debut, and prompt treatment for STIs (STIs).

Condoms, when used correctly and consistently, are highly effective in preventing HIV and other sexually transmitted infections (STIs). A large body of scientific evidence shows that male latex condoms have an 80% or greater protective effect against the sexual transmission of HIV and other STIs. .

The National Sexual Health Strategy 2015-2020 was launched in October 2015. The strategy was developed in response to a recommendation of the National AIDS Strategy Committee on the need to establish clear leadership within the health sector around the area of sexual health. The Strategy contains 71 recommendations that address all aspects of sexual health and a Sexual Health Action Plan for 2015-2016 that contains 18 priority actions for immediate attention.

One of the priority actions identified in the Action Plan for 2016 is to 'Prioritise, develop and implement guidance to support clinical decision making for STI testing, screening and treatment and on the appropriate use of antiretroviral therapy in HIV prevention’. An Implementation Group has now been established within the HSE as an outcome of this action. This group will make recommendations on the appropriate use of HIV pre-exposure prophylaxis (PrEP) in the overall context of the national approach to HIV prevention. Any decision concerning the availability of PrEP will be made following the completion of this work.

Hospital Waiting Lists

 103. Deputy Joan Collins Information on Joan Collins Zoom on Joan Collins asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of persons on the waiting list for scoliosis surgery in Galway University Hospital for six, 12, 18, 24 and 48 months; and the reason a person (details supplied) is still waiting for surgery.  [12034/17]

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 respond to you directly.

Accident and Emergency Departments

 104. Deputy Bríd Smith Information on Bríd Smith Zoom on Bríd Smith asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will report on measures he will take to address the concerns and issues of nursing staff in public hospitals and the current crisis in the hospital accident and emergency departments.  [12059/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As Minister I, and my Department, are aware of the concerns that many nurses have in relation to the provision of services in our EDs and in the wider health services. I welcome the recent decision by the Irish Nursing and Midwifery Organisation (INMO) to defer their planned industrial action and ballot their members on the terms as negotiated at the WRC. I would also take this opportunity to acknowledge the crucial role nurses play on a daily basis in delivering our health services and providing patients with effective, compassionate and dignified care.

Recent data from the HSE indicates that in 2016 there was circa 5% increase in Emergency Department attendances nationally. In addition, early January 2017 saw continued significant pressure on our EDs due to high demand, increased incidence of flu mainly affecting older people, as well as on-going bed capacity constraints due to staff shortages.

As the Deputy may be aware, in September 2016, the HSE launched the ‘Winter Initiative Plan 2016-2017’ which provided €40 million of additional funding for winter preparedness and to assist hospitals to deal with increased demand. In January 2017, in response to significant pressures in our EDs in the early New Year, a series of enhanced measures were added to this Initiative.

So far, the Initiative has delivered 90 newly-opened additional beds. Also since the start of the initiative delayed discharges have reduced nationally from 638 in September to 517 on 28 February, freeing up hospitals beds to alleviate ED pressures. In addition, over 4,440 patients have availed of aids and appliances and circa 1000 additional homecare packages and 615 additional transitional care beds have been provided, enabling patients to be discharged from hospital sooner.

A key element of the Winter Initiative has been for the HSE to work with hospitals to develop key improvement actions and Winter Plans at each site aimed at preparing for the expected increased demand during the winter period. Learning from this Winter Initiative will be used to improve planning for future years and along with my Department, every week, I meet with senior officials from the HSE, including the Director General, to monitor progress on the Winter Initiative and ED Performance.

Services for People with Disabilities

 105. Deputy Eamon Scanlon Information on Eamon Scanlon Zoom on Eamon Scanlon asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will ensure that the HSE does not reduce the availability of services at the Solas respite centre for children in County Sligo.  [12086/17]

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

The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.

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.

Assisted Human Reproduction

 106. Deputy Fiona O'Loughlin Information on Fiona O'Loughlin Zoom on Fiona O'Loughlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the anticipated timeframe for providing supports for those persons undergoing IVF and associated treatments; and if he will make a statement on the matter. [11819/17]

 117. Deputy Fiona O'Loughlin Information on Fiona O'Loughlin Zoom on Fiona O'Loughlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the details of plans in his Department to support persons enduring fertility issues who require a number of cycles of IVF; and if he will make a statement on the matter. [11818/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I propose to take Questions Nos. 106 and 117 together.

In February 2016, the Health Research Board (HRB) was engaged to conduct a comprehensive review of international public funding models for assisted human reproduction (AHR). This HRB evidence review is due to be published in the near future. The HRB evidence review will be analysed by officials in the Department of Health in the context of considering policy options for a potential public funding model for AHR treatment.

The final evidence review will be published on the websites of both the Department of Health and the HRB.

Separately to the evidence review being conducted by the HRB, officials in the Department of Health are currently drafting the General Scheme of legislative provisions on AHR and associated research. It is intended that the General Scheme will be completed by the end of June 2017. This comprehensive piece of legislation will regulate a range of practices for the first time, including: gamete (sperm or egg) and embryo donation for AHR and research; surrogacy; pre-implantation genetic diagnosis (PGD) of embryos; posthumous assisted reproduction; and stem cell research. The General Scheme will also provide for an independent regulatory authority for AHR.

Once the General Scheme has been completed, a memo will be submitted for Government approval, and once approved by Government, the General Scheme will be submitted to the Joint Oireachtas Committee on Health for pre-legislative scrutiny.

It should be noted that while IVF treatment is not currently provided by the Irish public health service, there is some support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme. In addition, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Scheme administered by the HSE. Medicines covered by the High Tech Scheme must be prescribed by a consultant/specialist and approved by the HSE ‘High Tech Liaison Officers’. The cost of the medicines is then covered, as appropriate, under the Medical Card or Drugs Payment Scheme.

Air Ambulance Service Provision

 107. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the contingencies that are in place to ensure that transport for paediatric cardiac and liver transplants are guaranteed in view of the fact that staffing difficulties have meant that transport of and timelines for Priority 1 children cannot be guaranteed at this time; if any firm arrangements or contracts have been put in place to guarantee the use of these services should the need arise aside from the five options that have been explored or liaisons that have been made with other contractors; and if he will make a statement on the matter. [11889/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris A Service Level Agreement (SLA) is in place between the Department of Defence and the Department of Health/HSE in relation to the provision of air (inter hospital) ambulance services. In accordance with the SLA, inter hospital air ambulance services are provided using the duty aircraft on an as available basis. Therefore the service is, and always has been, dependent on the availability of suitable aircraft and crew.

  The Department of Defence has advised my Department that in the coming months, availability of aircraft will be restricted due to a shortage of pilots and difficulties arising from the loss of Air Traffic Control personnel. I understand however, that every effort is being made to address the personnel shortages faced by the Air Corps.

  The restrictions notified are particularly problematic for paediatric transplant patients who require urgent transfer to the UK when organs become available. I am assured that the HSE has taken every step possible to ensure that contingency arrangements are in place in light of the reduced Air Corp availability. The contingency plans in place include access to the Irish Coast Guard resources and private air ambulance services.   

  Our Lady’s Hospital, Crumlin has confirmed that the families involved have been apprised of the current transport challenges and every assistance possible is being given to these families. My Department will continue to engage with the Department of the Defence, the National Ambulance Service and all relevant agencies to explore all options to improve the service.

Hospital Accommodation Provision

 108. Deputy Lisa Chambers Information on Lisa Chambers Zoom on Lisa Chambers asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if prefabs will be used to provide additional capacity at Mayo University Hospital; and if he will make a statement on the matter. [12094/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The HSE has put in place a National Framework for the provision of temporary alternative accommodation, as just one part of a broad range of measures undertaken under the Winter Initiative Plan 2016-2017. Under the Framework, consideration will also be given to managed temporary patient accommodation solutions which are staffed. The HSE advises that the next stage will be for a mini-tender to be coordinated in the coming weeks to request proposals in relation to temporary patient accommodation solutions.

Decisions in relation to the opening of temporary alternative accommodation in specific locations and information on associated costs will be made based on the outcome of this procurement process and the submissions made by Hospitals and Hospital Groups.

With regard to the ED at Mayo University Hospital, it was designed to accommodate approximately 25,000 patients per annum. Emergency presentations now number approximately 37,000.

In light of the ED escalation process, the Hospital has used its Acute Medical Assessment Unit (AMAU) for admitted patients awaiting a bed; this has impacted on effective patient flow.

Given the incremental increases in ED attendances since the time of construction, Mayo University Hospital has raised the issue of additional capacity, to manage both unscheduled and scheduled care effectively.

The HSE advises that Mayo University Hospital has put forward a short term proposal regarding the procurement of a modular unit through the National Framework, to expand capacity in order to facilitate effective functioning of the AMAU.

With regard to ED performance, patient experience times and trolley numbers at Mayo University Hospital ED were better than the national average during 2016.


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