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 Header Item Hospital Staff (Continued)
 Header Item Other Questions
 Header Item Hospital Services
 Header Item Services for People with Disabilities

Thursday, 13 February 2014

Dáil Éireann Debate
Vol. 830 No. 3

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Deputy David Stanton: Information on David Stanton Zoom on David Stanton On a point of order, has the time limit for questions changed? The last question took eight and a half minutes.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt There is no change in that regard. I take full responsibility for trying to keep people to six minutes but I can only do my best. We will get to the Deputy's question as soon as we can.

Other Questions

Hospital Services

 6. Deputy Joan Collins Information on Joan Collins Zoom on Joan Collins asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the reason persons (details supplied) have not been included in the transfer of patients to the Mater Private Hospital; the cost to the Health Service Executive of dealing with this situation to date; and if he will indicate when the serious issue of orthopaedic services in Tallaght hospital will be addressed. [6705/14]

Deputy Joan Collins: Information on Joan Collins Zoom on Joan Collins I thank the Minister for taking this question, as I have been trying to follow up this issue for over a year. A number of people have come to us querying access to spinal surgery in Tallaght. Last May, we received a letter from the chief executive indicating that a patient had been waiting for seven months for a procedure. There was an apology for this and the letter indicated that the hospital had lost two spinal surgeons. As there was significant demand, an appointment could not be given, but it was indicated that if funding was given by the HSE for the spinal services as requested, the hospital would be in a position to move patients more quickly through the system. Will the Minister provide an update on that issue and the transfer of the patients to the Mater Private?

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I have been advised by the HSE that Tallaght hospital has entered into a service level agreement with the Mater Private Hospital, approved by the HSE, for the provision of spinal surgery. Under this agreement, 630 patients who had been awaiting an outpatient spinal appointment for more than 12 months were transferred to the Mater Private and will be reviewed by specialist surgeons there. In addition, 31 non-complex deformity spinal patients who were waiting longer than eight months for surgery have had their procedure carried out in the Mater Private under this agreement and a further 42 complex deformity spinal patients are being reviewed by the Mater Private to assess their surgical requirements. I am advised that the cost of this as approved by the HSE is €346,500.

With regard to the two patients referred to by the Deputy, the HSE has advised that outpatient appointments with the treating clinician at Tallaght hospital were scheduled for these patients on 6 February and 10 February, and that both patients attended and are being actively managed. These patients had not been waiting longer than the target time of 12 months. The hospital in Tallaght has recently appointed a second consultant orthopaedic surgeon who specialises in pelvic acetabular trauma. In addition, a new upper limb orthopaedic surgeon has been recruited and is due to take up post in a number of weeks. Tallaght hospital is also working with the Mater Misericordiae University Hospital and the HSE to explore solutions that can address spinal service needs across both hospitals and this process will be informed by the ongoing work of the national clinical care programme for orthopaedics in developing a national model of care for spinal patients.

Deputy Joan Collins: Information on Joan Collins Zoom on Joan Collins I thank the Minister for his reply and it is good to hear that there will be two spinal surgeries. The issue has been ongoing for a year and the Minister should have been aware of it. The chief executive indicated that the hospital had applied for surgeons through the HSE and there were problems. One of the people referred to by the Minister, I hope, was on the list for seven months last May, meaning that the person has been waiting at least a year and a half for an appointment with the hospital. I am glad to hear we are moving nonetheless. Given the cost involved, it is not a great result that these people have had to be moved to the Mater Private, but it is good that patients will be seen, which is the main issue. I will be keeping an eye on the matter over the next period.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly We all agree that the priority is for patients to be seen as quickly as possible, and sometimes that requires us to use public funding to purchase services in the private sector. I do not have an ideological or other issue with that but I want to see the issue fixed in the public sector. I should point out to the Deputy that it takes quite a while to get a consultant surgeon, a consultant respiratory physician or any other consultant. They are generally working elsewhere and have contracts of employment. The job they apply for here would only be advertised once it is approved, and after that there would be an interview process. Following that, people often have to work out their contracts as they would not want to leave their employers high and dry and they must give reasonable notice. On average, it takes anywhere between nine and 18 months to get a consultant into a post once approved. It seems a long time but that is the reality with which we deal.

I should put to bed, as I indicated earlier, the idea that somehow we are having grave difficulty in this regard. In specific areas and in some specialties there are difficulties recruiting consultants but, as I mentioned, there are well over 100 extra consultants in the system compared with a few years ago.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin I wish to clarify the grouping of questions. My question, No. 37, is related.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt That is not a matter for the Chair. Does the Deputy wish to put a supplementary question as Deputy Joan Collins does not wish to do so?

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin What is being done to address the overall serious position of Tallaght hospital? I notice the recent statement by the Irish Nurses and Midwives Organisation calling for more nurses to be appointed. It has reflected on the 2012 HIQA report and the current situation, which is described as being worse. These are front-line staff. The 2012 HIQA report was quite alarming, to put it mildly, but we have been advised that the current position is worse. The statement indicates "the hospital is dangerous and staff fear that another adverse event will happen". Is the recruitment embargo a factor? I believe it is. Will more nurses be appointed to Tallaght hospital?

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I accept the Deputy is concerned about the embargo, which is not an unreasonable position. I have made it clear that over 700 nurses were recruited last year. The embargo - or employment control framework - remains in place but, as I have stated on many occasions, it has never been implemented so rigidly as to not allow us recruit where we felt it was necessary.

One of the big problems in the health service is the skill mix. I have asked why some model four hospitals - the big tertiary hospitals - have nine nurses per health care assistant but in others it is 2.8 nurses per health care assistant. Why are consultants doing work that advance nurse practitioners or GPs could be doing? I hope we are all familiar with the fact that in orthopaedics, to which the Deputy's question relates, as physiotherapists review all the referrals, over 50% can be dealt with by a physiotherapist and a patient does not have to see the consultant surgeon. We are changing many things.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Deputy Finian McGrath has tabled Question No. 7 but he is not here. I know he has had a bereavement, as a relative in Galway has died. I extend my sympathies to him.

  Question No. 7 replied to with Written Answers.

Services for People with Disabilities

 8. Deputy Seán Kyne Information on Seán Kyne Zoom on Seán Kyne asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the progress in implementing the new policy system to empower persons with a disability or their families to choose educational options, particularly post graduation from secondary level and in consideration of the serious and distressing delays experienced in summer and autumn of 2013 and previous years. [6851/14]

Deputy Seán Kyne: Information on Seán Kyne Zoom on Seán Kyne I ask the Minister the progress on implementing the new policy to empower persons with disabilities or their families to choose educational options, particularly post-graduation from school.

Deputy Kathleen Lynch: Information on Kathleen Lynch Zoom on Kathleen Lynch This is good news but unfortunately the issue does not get much publicity or air time. I share the Deputy's concern about issues in recent years relating to the provision of day services and training places to young people with disabilities leaving school. For that reason, I asked the Health Service Executive to put new structures in place to ensure available places are identified as early as possible and a more effective communications process is put in place with young people and their families. The placement of 850 school leavers and 482 rehabilitative or life-skills training graduates last year, within limited resources, was a significant achievement by the HSE and the service providers. My colleague, the Minister for Health, advised the HSE that priority was to be given in the 2014 national service plan to the provision of new services for school leavers requiring specific supports. Accordingly, an additional €7 million has been earmarked to address priority needs for new places for school leavers and for those graduating from rehabilitative or life-skills training.

The HSE established a national oversight group in October last year that includes umbrella organisations representing disability agencies.

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