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 Header Item Written Answers Nos 1-36
 Header Item Hospital Appointments Administration
 Header Item Neuro-Rehabilitation Services Provision
 Header Item Disabilities Assessments
 Header Item Hospital Overcrowding
 Header Item Primary Care Centres Staff
 Header Item Hospital Overcrowding
 Header Item UN Convention on the Rights of Persons with Disabilities
 Header Item Departmental Reports
 Header Item Child Care Services Provision
 Header Item Infectious Disease Epidemics
 Header Item Hospital Services
 Header Item Disability Services Provision
 Header Item Air Ambulance Service Provision
 Header Item Ambulance Service Provision
 Header Item Primary Care Centres Provision
 Header Item Mental Health Services Provision
 Header Item Hospitals Data
 Header Item Home Help Service Provision
 Header Item Mental Health Services Funding
 Header Item Hospitals Capital Programme
 Header Item Vaccination Programme

Thursday, 8 February 2018

Dáil Éireann Debate
Vol. 965 No. 3

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Written Answers Nos 1-36

 The following are questions tabled by Members for written response and the ministerial replies as received on the day from the Departments [unrevised].

  Questions Nos. 1 to 14, inclusive, answered orally.

Hospital Appointments Administration

 15. 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 improvement in waiting times expected during 2018 for the 15,000 plus children waiting over a year for an outpatient appointment; and if he will make a statement on the matter. [6419/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The most recent NTPF figures published for December 2017 show that there was a total of 41,678 people on the Outpatient waiting list for hospitals in the Children's Hospital Group. 65% of these children (26,958) are waiting up to 12 months and 35% (14,720) are waiting over 12 months for a first Outpatient appointment.

The HSE has confirmed there have been challenges in addressing the OPD waiting times due to consultant resourcing issues, arising from retirements, vacancies and demand in single-handed consultant services, such as allergy and immunology. In addition, the NTPF focus over the last two years has been on addressing Inpatient and Daycase waiting times. However, the HSE and NTPF are working together to develop Waiting List Action Plans for 2018. October's Budget announced a total 2018 allocation of €55m for the NTPF for 2018. This significant increase in funding more than doubles its 2017 total allocation of €20m.

It is acknowledged that the Outpatient Waiting Lists generally remains a challenge that needs to be addressed. It is worth noting that in 2016 the children's hospitals recorded that approximately 13% of patients did not attend their Outpatient appointment. This is something that must be tackled including through improved engagement with patients and families and ongoing validation of waiting lists. A number of steps, including the commencement of a national waiting list validation project by the HSE, are being taken to ensure the lists are accurate and these efforts are to intensify in the coming months.

Neuro-Rehabilitation Services Provision

 16. Deputy Barry Cowen Information on Barry Cowen Zoom on Barry Cowen asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to address the lack of a dedicated community neuro-rehabilitation team in counties Laois and Offaly. [6409/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Midlands Louth Meath Community Health Organisation 8 has a service arrangement with ABI Ireland to provide neuro-rehabilitation services in the Midlands area covering Laois/Offaly and Longford/Westmeath. Acquired Brain Injury Ireland is funded by the Health Service Executive and is a dedicated provider of community-based neuro-rehabilitation services for people with acquired brain injury and their families. The organisation works in communities across Ireland to support and empower people to rebuild their lives after a brain injury. ABI Ireland also campaigns, educates and advocates for the rights and needs of people with acquired brain injury.

ABI Ireland services provided in the Laois/Offaly and Longford/Westmeath area include community neuro-rehabilitation, residential neuro-rehabilitation, case management and group rehabilitation activities. Their community neuro-rehabilitation services are provided across the four Midland counties. With 4.5 Rehabilitation Assistants, the organisation supports more than 30 individuals with an acquired brain injury on a weekly basis. Each individual is supported to relearn and regain as much independence as possible. As their need for support decreases, these support hours are used to support the next individual requiring community neuro-rehabilitation.

All the services are clinically led by a Senior Clinical Psychologist and a Senior Occupational Therapist and supervised by a Local Services Manager. All staff are specifically trained to work with individuals with acquired brain injury. In 2017, ABI Ireland received funding of €1.2 million in 2017 from the HSE Midlands Louth Meath CHO 8.

The Deputy may be aware that the Programme for a Partnership Government includes a commitment to publish "a plan for advancing neuro-rehabilitation services in the community". The HSE has established a National Steering Group to develop an Implementation Framework for the National Neuro-rehabilitation Policy and Strategy. The Framework is scheduled for completion by June of this year.

Disabilities Assessments

 17. Deputy Niamh Smyth Information on Niamh Smyth Zoom on Niamh Smyth asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if the HSE's waiting times for assessment of need for children will be addressed. [6260/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The current Programme for Partnership Government commits to improving services and increasing supports for people with disabilities, particularly in the areas of early assessment and intervention for children with special needs.

Since the commencement of Part 2 of the Disability Act in June 2007 the HSE has endeavoured to meet its legislative requirements as set out in the Act. The number of applications received for assessment under the Act has increased each year since the Act was introduced in 2007.

The number of applications received in 2007 was 1,138 and this has risen steadily to 5,814 applications in 2017. Since the introduction of the Assessment of Need process a total of 43,521 completed applications were received by the HSE. In some complex cases, these statutory time-frames do not afford enough time to complete the necessary assessments. In addition, it is sometimes the case that an additional assessment is identified as necessary late in the process and it cannot be completed within the allotted time.

There have been significant year on year increases in the number of children applying for assessment which has led to delays in time frames and substantial work was undertaken in 2017 to address waiting times for Assessment of Need under the Disability Act (2005). All Community Healthcare Organisations have developed improvement plans to address areas of non-compliance with the statutory time frames and significant progress has been made in addressing waiting times for the commencement of the process. Additional resources have also been put in place in areas of particular difficulty.

In addition, a revised Standard Operating Procedure for Assessment of Need has been developed to ensure that there is a standardised approach to assessment across all areas. This procedure will be implemented from 1 April 2018. The procedure addresses the issue of eligibility for Assessment of Need and aligns this with the National Policy on Access to Services for Children and Young People with Disability and Developmental delay. The implementation of the Standard Operating Procedure for Assessment of Need is intended to support children with disabilities to access timely assessment and appropriate intervention.

Hospital Overcrowding

 18. Deputy Jim O'Callaghan Information on Jim O'Callaghan Zoom on Jim O'Callaghan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the reason for the 102% increase in overcrowding in St. Vincent’s University Hospital in January 2018 relative to January 2017; and if he will make a statement on the matter. [6444/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Tackling overcrowding in Emergency Departments (EDs) is a key commitment of the Government. Accordingly, as part of Budget 2018, €30 million in additional funding was provided in 2017, and a further €40 million is being made available in 2018, to manage the expected peak in demand for our health services over the winter period and strengthen capacity moving forward. Since the start of winter, 170 additional beds have opened nationally, including twenty two beds at St. Vincent’s University Hospital.

I am advised by the HSE that St. Vincent's Hospital is currently working with the Ireland East Hospital Group to address the current challenges in the ED, due in part to the presentation of a more acute, older cohort of patients this winter. According to data from the HSE, St. Vincent's Hospital has seen a 78% increase in trolley figures in January 2018, when compared to the same period last year.

The recent Health Capacity Review published by my Department identified pressures on hospitals arising from the increase in the population and the ageing of the population. This report will be used to inform the planning of added capacity in both hospitals and community services alongside reforms to achieve more and integrate service delivery.

Without losing sight of the distress for patients and front-line staff experiencing these challenges, it must be acknowledged that St. Vincent’s Hospital significantly improved their trolley performance in 2017, demonstrating a reduction in trolley numbers of 40%, when compared to 2016.

A very high priority is being given by St. Vincent's Hospital, in conjunction with the Ireland East Hospital Group and the local community health services, to improving on recent ED performance in order to regain progress made over the course of last year.

Primary Care Centres Staff

 19. 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 reason primary care centres (details supplied) will not be provided with additional new staff hires; the way in which these centres will now be staffed; if staff will be taken from the surrounding areas; if this will reduce services beyond the remit of the primary care centre; and if he will make a statement on the matter. [6367/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The shift of healthcare delivery towards primary care remains a key priority for the Government and, indeed, is one of the key features of Sláintecare. Primary care centres facilitate the shift from acute care to primary care because of the range of multi-disciplinary services they can provide and the role they can play in keeping people out of the acute hospital setting.

I understand that, prior to the construction or procurement of any new primary care centre, extensive dialogue takes place between HSE Estates and HSE local management to ensure that provisions are made in new centres for current and future staff. Furthermore, new centres will be capable of facilitating additional new staff that may be required as the plans for further shifts of activity to primary care are implemented.

The HSE has advised that both existing and newly recruited staff will be accommodated in the new primary care centres and services will continue to be provided to the geographical area of the Primary Care Teams and Networks.

It is important to note that in recent years, funding has been provided to recruit additional staff for the provision of primary care services. In 2016 funding of €4m was provided for the recruitment of up to 83 additional full-time speech and language therapy posts, almost all of which are now in place. Funding of €5m was also provided in 2016 for the recruitment of 114 assistant psychology posts and 20 staff grade psychology posts, the process for which is ongoing. More recently, in Budget 2018 funding was secured for the provision of additional occupational therapy posts.

Hospital Overcrowding

 20. 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 reason for the 115% increase in overcrowding in Naas hospital in January 2018 relative to January 2017; and if he will make a statement on the matter. [6437/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Tackling overcrowding in Emergency Departments (EDs) is a key commitment of the Government. Accordingly, €30 million in additional funding was provided in 2017, and a further €40 million is being made available in 2018, to manage the expected peak in demand for our health services over the winter period and to strengthen capacity moving forward. Since the start of winter, 170 additional beds have opened nationally, including eleven beds in Naas General Hospital.

I am advised by the HSE that Naas General Hospital is currently working with the Dublin Midlands Hospital Group to address the high level of overcrowding being experienced in the ED this month, which is due in part to increased incidence of respiratory illnesses. According to HSE reports, the hospital has seen a considerable increase in attendances and admissions by patients over 75 years, and an increase in the high acuity of patients being triaged in the ED.

UN Convention on the Rights of Persons with Disabilities

 21. Deputy Margaret Murphy O'Mahony Information on Margaret Murphy O'Mahony Zoom on Margaret Murphy O'Mahony asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the additional health service resources that will be required for the ratification of the UN Convention on the Rights of Persons with Disabilities. [6447/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The purpose of the UN Convention on the Rights of Persons with Disabilities is to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity.

It is intended that the final legislative amendments needed to enable Ireland to comply with the Convention will be contained in the Disability (Miscellaneous Provisions) Bill 2016 sponsored by the Minister for Justice and Equality and in a stand-alone Bill on deprivation of liberty.

The Department of Health is continuing to progress draft legislation to provide legislative clarity on the issue of deprivation of liberty which will add a new Part to the Assisted Decision-Making (Capacity) Act 2015.

Essentially, the deprivation of liberty provisions will set out a process which aims to ensure that people are not unlawfully deprived of their liberty. The provisions are intended to provide safeguards for older people and persons with a disability where they are living in, or it is proposed that they will live in, a residential facility and there is reason to believe they lack the capacity to decide to live there. It is intended that these safeguards will also apply to mental health facilities where such persons have mental health issues but are not suffering from a mental disorder and therefore cannot be involuntarily detained under the Mental Health Act 2001.

The approach taken in the draft legislation makes use of the decision making procedures, supports and safeguards that already exist under the Assisted Decision Making (Capacity) Act 2015 and also includes some additional safeguards specific to deprivation of liberty.

The deprivation of liberty provisions will have resource implications for the health services which will be quantified as proposals are being refined.

Departmental Reports

 22. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when the proposed trauma strategy will be published; and if he will make a statement on the matter. [6396/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Trauma Steering Group was established by Government to bring about better outcomes for the 1,600 patients who suffer a major trauma in Ireland every year. The Steering Group was clinically led, chaired by Professor Eilis McGovern, and with key input from patients, and its recommendations are evidence based. The vision for a national trauma system set out in this major report is to prevent unnecessary deaths, to reduce disabilities and to significantly improve the patient's chances of attaining the fullest possible recovery. On 6 February 2018, Government approved the publication of the Report of the Trauma Steering group, A Trauma System for Ireland, and it is now available on my Department's website.

Child Care Services Provision

 23. Deputy Eamon Scanlon Information on Eamon Scanlon Zoom on Eamon Scanlon asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the status of the new diabetes centre at Sligo General Hospital; when works are due to commence; the proposed completion date of the building; and if he will make a statement on the matter. [6207/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The tender process for the Diabetes Day Centre is underway with short-listing of contractors due to be completed shortly. Once a contractor has been selected, funding approval will be required in order to progress with the appointment of the contractor. The project has a timescale of 9 months once building works commence.

Infectious Disease Epidemics

 24. Deputy Eamon Scanlon Information on Eamon Scanlon Zoom on Eamon Scanlon asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the training in place for medical professionals to deal with persons diagnosed with Lyme disease or presenting with the symptoms of same; the comparisons between accuracy of tests carried out here and those carried out in the EU and the United Kingdom including tests carried out that have provided negative results and subsequently proved positive; and if he will make a statement on the matter. [6108/18]

 64. Deputy John Lahart Information on John Lahart Zoom on John Lahart asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the assistance the health services offer persons with Lyme disease, specifically in respect of interventions and medical card assistance; and if he will make a statement on the matter. [6102/18]

 65. Deputy Bobby Aylward Information on Bobby Aylward Zoom on Bobby Aylward asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to implement a similar practice to that in Germany for the detection and treatment of Lyme disease; his views on whether testing mechanisms here are adequate; his further views on whether the non-recognition of test results taken abroad is a fair and proper practice; his plans to improve follow up care for persons following diagnosis; his views on whether current training for doctors is adequate; and if he will make a statement on the matter. [6092/18]

 181. Deputy Peadar Tóibín Information on Peadar Tóibín Zoom on Peadar Tóibín asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the diagnostic test for Lyme disease here; the difference between the test here and in Germany; his plans to include the German diagnostic test here; his further plans to include the German treatment approach to the disease here; and if he will meet with the representatives of the organisation that represents persons with the condition here (details supplied)  [6474/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I propose to take Questions Nos. 24, 64, 65 and 181 together.

Lyme disease is a bacterial infection transmitted to humans by bites from infected ticks infected. The infection is generally mild affecting only the skin but can occasionally be more severe and highly debilitating.

Lyme disease is diagnosed by medical history and physical examination and can be a difficult diagnosis to make in cases which do not develop the characteristic rash. The infection is confirmed by blood tests which look for antibodies produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease.

Laboratories in Ireland generally follow the laboratory testing recommendations of the US Centres for Disease Control and Prevention, the Infectious Disease Society of America, the European Federation of Neurological Societies, and the British Infection Association. Irish laboratories have their own quality assurance methods to make sure the tests are working correctly as well as being accredited by the Irish National Accreditation Body to perform the test correctly. In undertaking Lyme testing, it is essential that the results are interpreted in the light of the clinical condition of the patient. If the result of this initial screen is equivocal, the patient's samples are referred to the UK's Rare and Imported Pathogens Laboratory. This laboratory uses a two-tier system recommended by American and European authorities which involves a screening test followed by a confirmatory test.

Testing which is performed abroad may be performed in laboratories which have not met National or International Accreditation (Quality Standards). They tests may be more likely to give a “false positive” result.

Lyme disease can be very successfully treated using common antibiotics by General Practitioners. These antibiotics are effective at clearing the rash and helping to prevent the development of complications. Antibiotics are generally given for up to three weeks. If complications develop, intravenous antibiotics may be considered.

Medical training programmes at undergraduate or postgraduate level in Ireland provides specialist training in infectious diseases, including Lyme disease.

Hospital Services

 25. 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 his attention has been drawn to the fact that the repairs at Merlin Park University Hospital have been completed for some time while at the same time the process of procuring modular theatres is continuing; the reason for same; and if he will make a statement on the matter. [6373/18]

 89. Deputy Catherine Connolly Information on Catherine Connolly Zoom on Catherine Connolly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when full elective surgery will be restored in Merlin Park University Hospital in view of the fact that the repairs were completed some time ago; and if he will make a statement on the matter. [6374/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I propose to take Questions Nos. 25 and 89 together.

The Deputy will be aware that leaks in the roof of the building that houses Merlin Park University Hospital's orthopaedic theatres occurred last September, necessitating the closure of both theatres in the interest of patient safety. An engineer’s report found that, in order to secure the integrity of the building, a full repair to the membrane of the roof was required.

As the Deputy has noted, these repair works have been completed. However, an assessment by an expert clinical team has found that the existing theatre design does not meet current surgical standards.

The Saolta Healthcare Group management team considers that the best way to restore effective theatre capacity at Merlin Park University Hospital is to construct 2 modular theatres on the Merlin Park site and it has been agreed to progress the development of this modular build. The tender for the provision of modular facilities at the hospital is at the final stage of the procurement approval process and it is expected that a contract will be awarded in the coming weeks.

As an interim measure, some capacity for elective orthopaedic surgeries has been made available in University Hospital Galway. Between 20 October 2017 and 29 January 2018, 88 patients had procedures carried out in University Hospital Galway that would otherwise have been carried out in Merlin Park University Hospital .

Disability Services Provision

 26. 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 report on the waiting times for assessment for occupational therapy and speech and language therapy for children; the measures that will be taken to end waiting times; and if he will make a statement on the matter. [6381/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Demand for access to Occupational Therapy (OT) and Speech and Language Therapy (SLT) services is challenging as evidenced by the volume of clients being treated in 2017 and the number of referrals to the services. Over 335,000 OT clients were seen and almost 90,000 referrals were made to the service. Over 279,000 SLT clients were seen in 2017 with just over 52,000 referrals made to the service.

More specifically, addressing the issue of waiting times for children, the HSE has advised that as of end of December 2017 the number of clients awaiting a first time assessment for OT services was almost 16,000. The corresponding figure for children awaiting initial assessment for SLT was almost 11,500.

A number of measures have been put in place to improve waiting times for both SLT and OT services.

The HSE has established Service Review Groups for both SLT and OT to agree revised national models of primary care therapy provision that will be standardised across all Community Healthcare Organisations. I understand that these reports are in the process of being finalised.

Acknowledging the particular challenges in accessing OT services, I provided funding in Budget 2018 for additional OT posts. These posts, combined with the proposed new model of service provision, are expected to improve access to OT services and have a favourable impact on long waiters, including children.

Furthermore, funding of €4m was provided in 2016 for up to 83 additional full-time speech and language therapy posts to prioritise the longest waiting children. The HSE has advised that almost all posts are now in place. As a result of this initiative, total national waiting lists for under18s have decreased by nearly 7% from July 2016 - December 2017.

Air Ambulance Service Provision

 27. Deputy Lisa Chambers Information on Lisa Chambers Zoom on Lisa Chambers asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans for the expansion of the emergency aeromedical service; and if he will make a statement on the matter. [6424/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Programme for a Partnership Government committed to the expansion of the Emergency Aeromedical Services. In that context, the Department is engaging with the National Ambulance Service and a charity that delivers pre-hospital emergency care with a view to the establishment of a community based, charitably funded Helicopter Emergency Medical Service in the South. Over recent months there have been extensive discussions between all the parties to agree a service model, the aircraft to be deployed and in relation to clinical and operational governance arrangements.

The Deputy may wish to note that the HSE National Service Plan 2018 prioritises the expansion of aeromedical services. Additional development funding of €2.8m has been allocated to the National Ambulance Service this year, part of which has been earmarked for the expansion of the Emergency Aeromedical Service. I am hopeful that the new service will be introduced later this year and I await details of the final proposal.    

Ambulance Service Provision

 28. Deputy Catherine Connolly Information on Catherine Connolly Zoom on Catherine Connolly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris further to Parliamentary Question No. 89 of 15 November 2017, if the ambulance base has returned to UCHG; the status of discussions in respect of the base at Merlin Park University Hospital; and if he will make a statement on the matter. [6372/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Galway City Ambulance Base has been situated on a temporary site on the grounds of Merlin Park Hospital since the summer of 2014, to facilitate the construction of a car park on the grounds of the University College Hospital Galway. The relocation initially was to be of temporary duration of 6 – 8 months. However, due to other developments at University College Hospital Galway in the interim, the hospital is not in a position to accommodate the return of the Ambulance Base.

I am advised that while the temporary facility provided for the ambulance base is safe, there is a requirement to upgrade the facility as staff must now utilise this ambulance base for an extended period. Discussions are ongoing between the National Ambulance Service management, HSE Estates and National Ambulance Service staff regarding the temporary accommodation at Merlin Park in relation to refurbishment of the existing accommodation or the provision of suitable alternative solutions. Approximately €0.6m capital has been spent to date on the interim facilities at Merlin Park to accommodate the ambulance base.

The National Ambulance Service has been in contact with HSE Estates and hospital management in order to progress the improvements required for the temporary facility as well as the development of a permanent ambulance base on the grounds of Merlin Park. The National Ambulance Service has also engaged with staff on this issue. In relation to the new ambulance base at Merlin Park Hospital, the design team has been appointed and the project is currently in the latter stages of the design phase.

Primary Care Centres Provision

 29. 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 provision of a primary care centre in Ballaghaderreen; and if he will make a statement on the matter. [6404/18]

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.

Mental Health Services Provision

 30. Deputy James Browne Information on James Browne Zoom on James Browne asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when he expects the practice of admitting children and young persons to adult mental health units to cease. [6400/18]

Minister of State at the Department of Health (Deputy Jim Daly): Information on Jim Daly Zoom on Jim Daly The reduction in the numbers of children admitted to adult psychiatric units has been a priority for the HSE Mental Health Services over recent years.

The HSE has to allow for some operational flexibility surrounding emergency placements in Adult Units, particularly where very short-term placements take place. Full account is taken of all relevant factors such as the preferences of all those involved, and geographical factors relating to access or visiting. In this context, the HSE continues to closely monitor on a weekly basis all child admissions to adult units, with a view to minimising such admissions as much as possible.

I, and my Department officials, regularly meet with the HSE to review various mental health issues including the enhancement of age appropriate care for young people nationally, as additional mental health resources comes onstream. Relevant data is regularly published on the HSE website, and this is subject to monitoring by the Department of Health.

Bearing in mind all the circumstances, I am satisfied that, where children have to be placed short-term in adult mental health units, the Executive makes any special arrangements necessary, such as one-to-one care, to protect and monitor these young people. The Mental Health Commission is also notified of such admissions.

The Deputy will be aware that I am currently considering proposed legislative amendments in relation to the issue raised by him, and I will continue to work closely with all concerned on these proposals.

Hospitals Data

 31. Deputy Catherine Connolly Information on Catherine Connolly Zoom on Catherine Connolly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris further to Parliamentary Question No. 1639 of 16 January 2018, the arrangements for the provision of services to the 60 persons per week that were scheduled for orthopaedic procedure since 4 September 2017; the hospital in which they were scheduled; the cumulative number of persons awaiting orthopaedic services; and if he will make a statement on the matter. [6371/18]

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

Home Help Service Provision

 32. Deputy Mary Butler Information on Mary Butler Zoom on Mary Butler asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of extra home help hours that will be provided in 2018 relative to 2017; and if he will make a statement on the matter. [6408/18]

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.

Mental Health Services Funding

 33. Deputy Peter Fitzpatrick Information on Peter Fitzpatrick Zoom on Peter Fitzpatrick asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his main achievements in 2017 regarding the funding provided in recent years for mental health; and his service priorities for 2018. [6202/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris In 2017, we achieved much in relation to the provision of mental health services, helped in no small part by the substantial increase in mental funding over the last few years. Since 2012, the Government has increased the Mental Health Budget by almost €200 million, or 28%, to over €910 million today.

Budget 2018 made allowance for an additional €57.5 million for Mental Health Services for 2018. This includes pay-related costs of €22.5 million and €20 million to further progress the new initiatives commenced in 2017.

In 2017, we continued to develop counselling services across both primary and secondary care, including the provision of three new Jigsaw youth mental health services in Cork, Dublin and Limerick.

Community Mental Health Teams and out-of-hours services saw continued development and improvement. Funding of €4.5 million was approved to expand upon services available to ensure a seven-over-seven service.

Psychiatry of Later Life saw improved services and will see further enhancement in 2018 at a consistent level across all areas including appointment of agreed new staffing.

€1 million was allocated in 2017 to start three specialist perinatal hubs in Galway University Hospital, Cork University Maternity Hospital and University Maternity Hospital Limerick and to expand the small existing teams in the three Dublin based maternity hospitals. A further €2 million has been allocated for 2018 to complete each of these six hub teams.

The Eating Disorder Clinical Care Programme, which was developed in 2017, was launched in January 2018. Three major hub teams for both adult and CAMHS received approval through 2017 New Development funding allocation with further hubs and mini-hub teams to be put in place over the next four to five years. Two new additional mental health clinical programmes, ADHD in Adults and Children, and Dual Diagnosis of those with Mental Illness and Substance Misuse commenced development in 2017.

Substantial funds were allocated to minor capital works as well as to major capital works at Lakeview, Kerry and Blackwater House. €2 million was also allocated for Homeless Mental Health services.

In staffing terms, funding was provided for an additional 70 Undergraduate Psychiatric Nurse training places, and 114 Assistant Psychologist and 20 Psychologist posts in the Primary Care Mental Health Services.

2018 will see continued improvement and expansion of the above-mentioned services and programmes to ensure mental health services are delivered in a timely, clinically effective and standardised safe manner.

Hospitals Capital Programme

 34. Deputy Brian Stanley Information on Brian Stanley Zoom on Brian Stanley asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if a plan will be put in place for the renovation and extension of Abbeyleix hospital, County Laois to have it included in the capital programme for funding; and if he will make a statement on the matter. [6203/18]

 36. Deputy Brian Stanley Information on Brian Stanley Zoom on Brian Stanley asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to ensure that the HSE honours its commitment given to local Teachtaí Dála and the hospital committee to use Abbeyleix hospital, County Laois for a step-up and step-down facility and to cater for respite patients and those in need of transitional beds; and if he will make a statement on the matter. [6204/18]

Minister of State at the Department of Health (Deputy Jim Daly): Information on Jim Daly Zoom on Jim Daly I propose to take Questions Nos. 34 and 36 together.

  As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Vaccination Programme

 35. Deputy Eamon Ryan Information on Eamon Ryan Zoom on Eamon Ryan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the reason the typical flu shot available here is a trivalent vaccine in view of the fact that increasingly common Yanmagata B strain is not protected against by this vaccine; and if he or the HSE plan to move to a quadrivalent vaccine before the 2018 flu season. [6383/18]

 39. Deputy John Curran Information on John Curran Zoom on John Curran asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to promote increased uptake of the flu vaccine across all categories of persons and not only those deemed at risk; and if he will make a statement on the matter. [6294/18]

 46. Deputy John Curran Information on John Curran Zoom on John Curran asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to increase the provision of the seasonal flu vaccine across all categories of persons to lower the risk of flu outbreak in communities; if his department has carried out a cost-benefit analysis of providing the vaccine to all groups; and if he will make a statement on the matter.  [6293/18]

 81. Deputy Eamon Ryan Information on Eamon Ryan Zoom on Eamon Ryan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the additional steps other than increased spending on public information and awareness campaigns taken by his Department and the HSE to counteract an expected particularly bad flu season. [6382/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I propose to take Questions Nos. 35, 39, 46 and 81 together.

In Ireland the National Immunisation Advisory Committee (NIAC) an independent committee of the Royal College of Physicians of Ireland which comprises experts in a number of specialties including infectious diseases, paediatrics, and public health makes recommendation on vaccination policy in Ireland. Their recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. NIAC is considering the need to expand the current recommendations for influenza vaccine, including the potential community wide benefit of extending recommendations to include all children.

Influenza vaccine is most effective when circulating viruses are well-matched with viruses contained in vaccines. Due to the constant evolving nature of influenza viruses, the WHO Global Influenza Surveillance and Response System – a system of National Influenza Centres and WHO Collaborating Centres around the world – continuously monitors the influenza viruses circulating in humans and updates the composition of influenza vaccines twice a year. For many years, WHO has updated its recommendation on the composition of the vaccine (trivalent) that targets the three most representative virus types in circulation (two subtypes of influenza A viruses and one influenza B virus) and since the 2013–2014 northern hemisphere influenza season, a fourth component is recommended to support quadrivalent vaccine development. Quadrivalent vaccines include a 2nd influenza B virus in addition to the viruses in trivalent vaccines

The influenza vaccine purchased by HSE is based on WHO advice on the composition of influenza virus vaccines for use in the 2017/8 northern hemisphere Flu season issued on 2 March 2017. It recommended that trivalent vaccines for use in the 2017-2018 northern hemisphere influenza season contain the following:

- an A/Michigan/45/2015 (H1N1)pdm09-like virus;

- an A/Hong Kong/4801/2014 (H3N2)-like virus; and

- a B/Brisbane/60/2008-like virus.

This season (2017/18) the HSE procured the trivalent inactivated Influenza vaccine (Split Virion) BP seasonal influenza vaccine for all those in the recommended at risk groups and health care workers and carers. The trivalent vaccine used in Ireland is the most widely used influenza vaccine in Europe. Initial evidence suggests that the vaccine provides higher protection against the Influenza A strains than recent years (H3N2 & H1N1). While it is less effective against the B strains predominating this year, people who received the flu. Vaccination remains the most effective means of preventing infection by seasonal influenza viruses and can reduce severe disease that can lead to hospitalisation and death. The composition of whichever vaccine is purchased in future years will be based on the advices of the WHO, which makes recommendations on the composition of both trivalent and quadrivalent vaccines for the northern hemisphere influenza season.

The HSE Communications Plan was launched on the 2 October with an initial focus on Health Care Workers,

- Radio adverts commenced on the 9 October and will run for three weeks. There were further radio ads over the holiday period when the ILI rates exceeded the baseline threshold for the first time.

- People aged 65s and over and pregnant women were the primary audiences for the radio campaign, which also reached medically at risk groups and Health Care Workers as they make up a more generic radio audience.

- Digital advertising and promotions targeted risk groups, the over 65s, pregnant women and healthcare workers and likewise there will be an option for further campaign when flu levels go above the threshold.

- The HSE “Under the Weather”gives advice to people on what to do if they suspect they are developing influenza.

- Health is one of the themes of the cross-sectoral ‘Be Winter Ready’ campaign which launched on 8 November 2017.

The HSE reviews and updates its influenza plans, including the communications strategy, taking into account the lessons learned from previous years and with a view to targeting it to key groups to get the greatest impact in terms of people receiving the influenza vaccine..

  Question No. 36 answered with Question No. 34.


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