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 Header Item Written Answers Nos. 635-655
 Header Item Proposed Legislation
 Header Item Treatment Abroad Scheme
 Header Item Home Care Packages
 Header Item Health Services Staff Issues
 Header Item HSE Governance
 Header Item Hospital Services
 Header Item Hospital Waiting Lists
 Header Item Hospital Services
 Header Item Cancer Screening Programmes
 Header Item Health Services Provision
 Header Item Hospital Services
 Header Item Hospital Staff Issues
 Header Item Maternal Mortality
 Header Item Hospital Services
 Header Item Long-Term Illness Scheme Eligibility
 Header Item Health Screening Programmes

Tuesday, 18 December 2012

Dáil Éireann Debate
Vol. 787 No. 3

First Page Previous Page Page of 96 Next Page Last Page

Written Answers Nos. 635-655

Proposed Legislation

 635. Deputy Mattie McGrath Information on Mattie McGrath Zoom on Mattie McGrath asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his plans to amend the law in relation the involuntary admission; the feedback that has been provided to those who made submissions to the Mental Health Commission in relation to this matter; and if he will make a statement on the matter. [56731/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch The legislation which governs the involuntary admission of patients to approved centres is the Mental Health Act 2001. This Act is being reviewed at present in line with the commitment contained in the Programme for Government to review the Act "informed by human rights standards and in consultation with service users, carers and other stakeholders". The Government and I attach great importance to this review.

In June 2011, I established a Steering Group to oversee the first part of the review which included undertaking a public consultation exercise and identifying the key elements of the Act to be further examined. Over 100 submissions were made to the Steering Group and I can confirm that as part of this process, a submission was received from the person referred to by the Deputy. The Interim Report of the Steering Group on the Review of the Mental Health Act 2001 was published on 21 June 2012 and is available on my Department's website. I will also ask my officials to forward a copy of the aforementioned report to the person concerned. All of the submissions were individually acknowledged and recorded in the report.

In August this year, I announced the membership of an Expert Group to carry out the second and substantive phase of the review which is principally tasked with fleshing out the Steering Group recommendations. The Group is comprised of 15 people in total and includes expertise from a range of professionals and key stakeholder organisations.

The Expert Group has met on a number of occasions this year and is continuing its deliberations. The Group is expected to produce its report by the end of March, 2013.

Treatment Abroad Scheme

 636. Deputy Charlie McConalogue Information on Charlie McConalogue Zoom on Charlie McConalogue asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the reason a person (details supplied) in County Donegal is no longer being funded under the treatment abroad section; and if he will make a statement on the matter. [56790/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Home Care Packages

 637. Deputy James Bannon Information on James Bannon Zoom on James Bannon asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding a home care package in respect of a person (details supplied) in County Longford; and if he will make a statement on the matter. [56799/12]

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.

Health Services Staff Issues

 638. Deputy Willie O'Dea Information on Willie O'Dea Zoom on Willie O'Dea asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he has considered the fate of the agency workers who are currently employed by the Health Service Executive in the posts now to be taken by new graduate nurses; if he will consider these temporary contract workers as applicants for the new posts alongside the graduate nurses when advertising the new positions; and if he will make a statement on the matter. [56812/12]

 647. Deputy Patrick O'Donovan Information on Patrick O'Donovan Zoom on Patrick O'Donovan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if there is a proposal within his Department or the Health Service Executive to recruit 1,000 graduate entry nurses on temporary fixed two year contracts; if there is a possibility that recruitment of that nature will be made available to existing agency staff; and if he will make a statement on the matter. [56858/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 638 and 647 together.

The Health Service Executive will shortly be introducing an Employment Initiative/Placement Scheme for Graduate Nurses and Midwives. Under the scheme graduate nurses and midwives will be offered the opportunity to apply to take part in a two year placement programme in the public health services. In particular, the scheme has the potential to enable nurses with limited or no work experience post-graduation to gain such experience and to benefit from mentoring and skills development. The scheme is also intended to contribute to a reduction in expenditure on agency staffing and overtime in the health service.

The HSE is proceeding with arrangements to finalise the details of the scheme, including the eligibility criteria, and will be inviting applications early in 2013.

HSE Governance

 639. Deputy Gerry Adams Information on Gerry Adams Zoom on Gerry Adams asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if there have been changes in the management structure of the Health Service Executive in the north east region; if there has been a change in the management structure for the running of the Louth Meath Hospital Group; if the hospitals remain under the ambit of the area manager for the north east region; and if he will make a statement on the matter. [56816/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly In relation to this particular query, I have asked the Health Service Executive to respond directly to the Deputy in this matter.

Hospital Services

 640. Deputy Dessie Ellis Information on Dessie Ellis Zoom on Dessie Ellis asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the reason a person (details supplied) in Dublin 11 has not had an urgent operation [56829/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I have been advised by the Health Service Executive that this patient was added to the waiting list in Beaumont hospital on 5 November 2012. I have been advised that the patient must have his medication adjusted prior to surgery and therefore his surgery date will be planned some weeks in advance. If the patient is concerned, or if there has been a change in his symptoms, he should contact his General Practitioner, who can discuss his case with the hospital.

In relation to the specific query raised by the Deputy and for further details on this case, as it is a service matter it has been referred to the HSE for direct reply.

Hospital Waiting Lists

 641. 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 further to Parliamentary Question No. 972 of 6 June 2012, if he will address the waiting lists for prosthetics in counties Kerry and Cork; the number on the waiting list today; the timeframe they are waiting; the reason clients from counties Kerry and Cork are the longest waiting in the country; the steps he proposes to take to remedy this unacceptable and unjust situation; and if he will make a statement on the matter. [56836/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I have been informed by the HSE that during 2012 they have taken corrective action to address the issue of waiting times for new and replacement prostheses and have succeeded in making significant progress in reducing the waiting times for prostheses. In March of this year the prosthesis budget for the Cork and Kerry area was increased by 20% to €420,000. This increase in funding was used to address the backlog of primary (i.e. first time) prosthesis requests and as a result the waiting time for sanctioning of primary prostheses is now under six weeks.

In July, further once off funding of €100,000 was provided to address the backlog of replacement prostheses. At present there are a total of 28 patients on a waiting list for a prosthesis, with a further 39 waiting on an ancillary prosthetic product. The longest waiter has been on the list since June of this year.

I am also advised that a HSE South Regional Prosthetics Group has been established since October of this year. It has a broad membership including consultant representation in rehabilitation medicine, orthopaedic, vascular and plastics services. This group is currently working on:

- A standardised application process

- Clinical input into the prioritisation process

- Standardised approach to repeat prescriptions for repairs, socks, accessories.

The benefits of this work, which is well underway, will include clarification and standardisation of the local processes. The establishment of a clinical prioritisation process will provide clinical governance on the allocation of available budget by ensuring that applications are prioritised on the basis of clinical need Representatives of the Prosthetics Group have met with service users recently to ensure that their views and concerns are addressed in the recommendations of the Prosthetics Group.

Hospital Services

 642. Deputy Áine Collins Information on Áine Collins Zoom on Áine Collins asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding a hospital appointment in respect of a person (details supplied) in County Cork [56848/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Improving access to outpatient services is the next priority for the Government. Building on work already undertaken by the HSE, the NTPF has now taken over the reporting of outpatient waiting time data. The collation and analysis of outpatient waiting time data in a standardised format will reveal the distribution of long waiters across all hospitals. In the first instance, this 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.

In parallel with reducing the numbers of longest waiters, the SDU will also work with the HSE Clinical Programmes to reform the structure, organisation and delivery of outpatient services to ensure that the right patient is seen and assessed by the right health professional at the right time.

Should the patient's general practitioner consider that the patient's condition warrants an earlier appointment, he/she would be in the best position to take the matter up with the consultant and hospital involved.

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.

Cancer Screening Programmes

 643. Deputy Dominic Hannigan Information on Dominic Hannigan Zoom on Dominic Hannigan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when the bowel cancer screening programme will commence; and if he will make a statement on the matter. [56854/12]

 644. Deputy Dominic Hannigan Information on Dominic Hannigan Zoom on Dominic Hannigan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the amount of funds that have been allocated in each of the next three years for the bowel cancer screening programme; and if he will make a statement on the matter. [56855/12]

 645. Deputy Dominic Hannigan Information on Dominic Hannigan Zoom on Dominic Hannigan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will extend the bowel cancer screening programme from the 60-69 age group to the 55-74 age group; and if he will make a statement on the matter. [56856/12]

 646. Deputy Dominic Hannigan Information on Dominic Hannigan Zoom on Dominic Hannigan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the ongoing plans for the budget for the bowel cancer screening programme on a multi-annual basis; and if he will make a statement on the matter. [56857/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 643 to 646, inclusive, together.

I am pleased to inform the Deputy that the national colorectal screening programme, BowelScreen, commenced in November. The programme has been introduced on a phased basis to men and women between the ages of 60-69 years.

When fully implemented the programme will offer free screening to men and women aged 55-74 every two years. As 50% of cancers within this age group are found in people aged 60-69 the programme has begun with this latter age group cohort (a population of approximately 500,000). It is anticipated that the first screening round will take up to three years to complete. Over time the phasing of the programme will allow development of colonoscopy capacity to cater for the full 55-74 year age group. The estimated cost of the programme in 2013, based on an uptake rate of 60% among the target population is €4.3m with further costs in subsequent years as the programme expands. The programme has been shown through a Health Technology Assessment to be cost effective as it will very quickly reduce mortality among the screened population. 2013 funding will be prioritised in the HSE's Service Plan. While a multi-annual budget has not been set aside for the Programme, it will continue to be prioritised into the future.

I regard the colorectal screening programme as a national priority and I am committed to supporting it as it develops.

  Question No. 647 answered with Question No. 638.

Health Services Provision

 648. Deputy Derek Nolan Information on Derek Nolan Zoom on Derek Nolan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if there is a national strategy in relation to tackling Lyme Disease here; the treatment available here for the disease; if his attention has been drawn to the distress caused to sufferers of the disease; his plans to pursue any type of awareness campaign for the symptoms of Lyme Disease; and if he will make a statement on the matter. [56861/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Lyme disease (also known as Lyme borelliosis) is an infection caused by a bacterium called Borrelia burgdorferi which is transmitted to humans by bites from ticks infected with the bacteria. The infection is generally mild affecting only the skin, but can sometimes be more severe involving other organs. Ramblers, campers and those who work in such areas especially if they come into contact with large animals are at greatest risk of being bitten by ticks and of going on to develop the disease. Lyme disease is normally treated using antibiotics such as doxycycline or amoxicillin for up to three weeks. If complications develop, intravenous antibiotics may be required.

  The Health Protection Surveillance Centre (HPSC) has also produced a leaflet "Protecting Yourself Against Tick Bites and Lyme Disease" which may be downloaded from their website provides members of the general public and media with advice on minimising the risk of Lyme disease.

  Lyme Disease was added to the list of notifiable diseases in Ireland on 21 September 2011. This will provide valuable information for estimating the incidence of Lyme disease in Ireland into the future.

Hospital Services

 649. Deputy Eric Byrne Information on Eric J. Byrne Zoom on Eric J. Byrne asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when an appointment will be made in respect of a person (details supplied); and if he will make a statement on the matter. [56897/12]

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 this question has been referred to the HSE for direct reply.

Hospital Staff Issues

 650. 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 if the promised podiatry post at Kerry General Hospital, that was sanctioned in April 2012 will now be filled and the date of same; and if he will make a statement on the matter. [56898/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The HSE National Clinical Programme for Diabetes - which includes the care of children and adolescents with diabetes - was established within the Clinical Strategy and Programmes Directorate. The purpose of the Programme is to define the way diabetic Clinical Services should be delivered, resourced and measured; and a clinician has been appointed to lead on the development of the programme. One of the objectives of the National Diabetes Programme is to develop a footcare screening and treatment service to prevent foot ulceration and subsequent lower limb amputation. In relation to the specific queries raised by the Deputy, as these are local service issues, they have been referred to the HSE for direct reply.

Maternal Mortality

 651. Deputy Clare Daly Information on Clare Daly Zoom on Clare Daly asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly in relation to recent statements he has made in the press about Ireland having one of the lowest rates of maternal mortality in the world, if he will confirm that the recently published first Confidential Maternal Death Enquiry in Ireland Report for the Triennium 2009 – 2011 records that the maternal death rate in Ireland is at best average in comparison with other EU countries and that data on maternal mortality figures are incomplete due to ongoing deficiencies in data collection systems. [56899/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Ireland had the 13th lowest rate of maternal mortality out of 178 countries reporting data. Maternal mortality is a rare occurrence in Ireland. It must be understood that since there are usually fewer than 5 such deaths per year, rates can appear to fluctuate significantly from year to year. For example, an increase in deaths from 2 to 4 in a given year would lead to an apparent 100% increase in the maternal mortality rate. Because of this, reports based on data from different years can appear to be contradictory.

It is generally recognised internationally that official vital statistics can result in an underestimate of maternal deaths. In particular, indirect obstetric deaths resulting from previous existing disease or diseases which developed during the pregnancy may be missed in the official statistics. For this reason, Ireland established a Confidential Maternal Death Enquiry (MDE) system in 2009. In doing so, it linked itself with the United Kingdom’s Confidential MDE which has been acknowledged as a gold standard for maternal death enquiry in recent decades. The recently published report of Ireland’s Confidential MDE for the period 2009 to 2011 cannot be compared with civil registration-based rates of other EU countries which do not have MDE systems. Comparison with the UK’s MDE for the period 2006 to 2008 showed Ireland with a rate about 30% lower than the UK. Again, however, caution must be exercised in interpreting this data since, even when aggregating 3 years of data (i.e. 2009 to 2011), numbers of deaths remain small and the rates will be subject to significant fluctuation.

The recent MDE report for Ireland makes a number of very valuable recommendations both with respect to clinical care and in the area of improved ascertainment of cases. A key recommendation for improving completeness of official statistics is the inclusion of a question on pregnancy status at time of death on the Coroner’s Death Certificate along the same lines as is already included on the Medical Death Notification Form.

Hospital Services

 652. Deputy Clare Daly Information on Clare Daly Zoom on Clare Daly asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will confirm that the Health Service Executive commissioned KPMG Independent Review of Maternity and Gynaecology Services in the greater Dublin area, published in 2008, found a 30% shortfall in necessary obstetric, midwifery, neonatal and theatre staff to meet international standards for safe care; and if in view of recorded recent maternal deaths in hospitals in the greater Dublin area, those staff shortages have been dealt with in full [56900/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly A comprehensive review of maternity and gynaecology services in the greater Dublin area was completed in 2008. The KPMG Independent Review of Maternity and Gynaecology Services in the Greater Dublin area identified the need to increase consultant and midwife staffing levels and recommended the recruitment of additional staff across the three Dublin sites. The staff numbers required, as outlined in the KPMG report, were based on the current model of service provision, the report noted that this would need to be reconsidered and a detailed manpower plan developed as and when the future service model is implemented, taking into account workforce needs, demand, configuration with other obstetric/gynaecology units and related acute services staffing (eg anaesthetics) and primary care services (eg community midwifery). The report also noted that Dublin’s model of stand alone maternity hospitals is not the norm internationally and recommended that the Dublin maternity hospitals should be co-located with adult acute services and that one of the three new Dublin maternity facilities should be built on the site of the new national paediatric hospital. Maternity and paediatric service co-location has advantages for infants with congenital malformations, for foetal medicine or complications which require neonatal surgery. Maternity and adult service co-location has advantages for mothers in providing on-campus rapid and ready access to non-obstetric specialist expertise, and to specialist surgery and intensive care in the case of major obstetric emergency.

In this context the proposal in 2008 was that the National Maternity Hospital be relocated to St Vincent's, the Coombe to Tallaght and the Rotunda to the Mater, and the maternity hospitals have been working with the relevant adult sites to progress this. There will be early discussions with the maternity hospitals regarding their maternity /adult co-location plans in the context of the recent Government decision to build the new children’s hospital on the St James's campus. Notwithstanding this, I am committed to the intent of the report - that the Dublin maternity hospitals be located alongside adult acute services - while also bearing in mind the need to plan for the provision of tri-located paediatric, adult and maternity services, as is the intention in relation to the new children’s hospital.

In 2009 the HSE received an additional service development funding, including additional funding for the three Dublin maternity hospitals, to address priority needs associated with demographic pressures for maternity services. That funding was allocated to hospitals primarily to support the provision of additional staff in priority areas as follows:

- Consultant Obstetric & Gynaecologist posts;

- Midwifery Teams to initiate/extend Early Transfer Home/ DOMINO/antenatal/postnatal community outreach schemes;

- Hospital midwives/neonatal nurses;

- Anaesthetics.

Management and delivery of maternity services is the responsibility of the Health Service Executive. In relation to the query on staff shortages, I have forwarded the question to the HSE who will respond directly to the Deputy regarding the progress made in recent years in addressing the staffing requirements of the Dublin maternity services.

Long-Term Illness Scheme Eligibility

 653. Deputy Eric Byrne Information on Eric J. Byrne Zoom on Eric J. Byrne asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will concede to the request of sufferers from Crohn's disease that it should be added to the long term illness scheme in view of the fact that this is a life long debilitating illness and costly for those without medical cards; and if he will make a statement on the matter. [56916/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White There are no plans to extend the list of conditions covered by the Long Term Illness Scheme.

Under the Drug Payment Scheme, no individual or family pays more than €132 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines. In addition, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the Health Service Executive can take into account medical costs incurred by an individual or a family. Those who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of general practice consultation.

Health Screening Programmes

 654. Deputy Dara Calleary Information on Dara Calleary Zoom on Dara Calleary asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will consider extending the 100% subsidy currently available to GMS patients who avail of osteoporosis screening facility at Mayo General Hospital and Clinic to patients who can avail of a screening service across other regions of County Mayo in view of the large distances involved in travelling within the county; his views on the provision of osteoporosis screening in County Mayo; and if he will make a statement on the matter. [56918/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Provision of osteoporosis screening is a service matter for the Health Service Executive, therefore, the question has been referred to the HSE for direct reply to the Deputy.

  Question No. 655 answered with Question No. 628.


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