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 Header Item Written Answers Nos. 62-71
 Header Item European Court of Human Rights Judgments
 Header Item Mental Health Services Funding
 Header Item Nursing Homes Support Scheme Expenditure
 Header Item Disability Services Funding
 Header Item Ambulance Service Response Times
 Header Item HSE Waiting Lists
 Header Item Mental Health Services Provision
 Header Item Hospital Services

Thursday, 13 February 2014

Dáil Éireann Debate
Vol. 830 No. 3

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Written Answers Nos. 62-71

European Court of Human Rights Judgments

 62. 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 has assessed the implications of the judgment of the European Court of Human Rights in a case (details supplied) for the 250 or so legal actions for medical negligence taken by survivors of symphysiotomy and pubiotomy. [6707/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I understand the HSE who is one of a number of defendants in these cases, will be taking appropriate legal advice in relation to the impact, if any, of the European Court of Human Rights Judgement. Accordingly. I am not in a position to make any further comment on this matter.

In relation to symphysiotomy, on 26 November 2013, the Government approved the appointment of retired Circuit Court Judge Yvonne Murphy to assist in setting out a possible course of action in relation to women who have undergone this surgical procedure. Judge Murphy has been asked to meet a number of key interested parties, particularly the support groups for the women, the State Claims Agency, and the hospitals' insurers. Judge Murphy and I met the three support groups - Survivors of Symphysiotomy, Patient Focus and Survivors of Symphysiotomy Limited - after the Government meeting on 26 November, to outline this plan to them.

On completion of her work, Judge Murphy will provide me with a report, setting out recommendations, as soon as possible. I hope then to be in a position to revert to Government with detailed proposals, so that a decision can be taken as early as possible regarding a way forward that will facilitate closure for the women concerned. Any proposals brought to Government will also take into account the findings of the independent research report in relation to the practice of symphysiotomy in Ireland that was commissioned by my Department, along with any other relevant information.

  Question No. 63 answered with Question No. 55.

Mental Health Services Funding

 64. Deputy Colm Keaveney Information on Colm Keaveney Zoom on Colm Keaveney asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the reason funding has been withdrawn from the National Service Users Executive in 2014; if this action is compatible with the implementation of A Vision for Change; and if he will make a statement on the matter. [6928/14]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch A Vision for Change recommended that a National Service User Executive (NSUE) be established to inform mental health policy makers and service providers on issues relating to user involvement and participation in planning, delivering, evaluating and monitoring services. Both, the HSE and I fully recognise the importance of ensuring service user involvement in the on-going development of our mental health services, have supported the establishment and development of the NSUE and collaborated closely with the NSUE in the delivery of its remit.

  However, since October 2012, the HSE has been pursuing with the NSUE issues regarding the governance and day to day management of the organisation raised with it by some NSUE Executive members and some staff of the NSUE. Unfortunately, the HSE has been unable to bring these matters to a satisfactory resolution to date due to the unavailability of key individuals from NSUE over an extended period of time. Arising in part out of that experience, I understand that the HSE having lost confidence in the capacity of the NSUE to operate in accordance with the financial regulations of the public service which apply to all publicly funded organisations, took the decision to cease the funding of the organisation from July 2013.

  In line with mental health policy, the HSE, in September 2013, commenced a consultation process with a range of stakeholders representing service users, family members and carers to seek to determine how the independent voices of service users, family members and carers will continue to be heard and heeded in the development and delivery of mental health services into the future.

  In addition, the HSE recently appointed an Interim Head of Service User Engagement and agreement has also been reached on the establishment of a Reference Group to provide service user, family member and carer input to new organisational structures.

Nursing Homes Support Scheme Expenditure

 65. Deputy Seamus Kirk Information on Seamus Kirk Zoom on Seamus Kirk asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he is satisfied that there are sufficient resources in place for the fair deal scheme; and if he will make a statement on the matter. [6931/14]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch The needs of our older people are, and will remain, a very high priority for me and for the Government, and the resources that are available will be applied to provide the best possible mix of supports and services.

  The Budget for long-term residential care in 2014 is €939m, a reduction of €35m on the 2013 position. The funding that is available for services for older people must be balanced across all of the various service areas in a way that achieves the best possible outcomes for the greatest number of service users and prioritises areas of greatest need as far as possible.

  The priority for 2014 is the development of an integrated model of care with a strong emphasis on home care and other community services. This is seen as a first step in aligning the model of care more towards the community, in line with Government policy and the expressed wishes of older people. In this regard, €23m has been transferred from the Nursing Homes Support Scheme budget to community services.

  This €23m will be used as follows:

  - €10m to provide 190 Intensive Home Care Packages (IHCPs) to benefit 250 people annually.

  - €3m to commission 25 intermediate/transitional care beds to benefit 650 people & 20 beds for complex cases to benefit 130 people.

  - €10m to address funding shortfalls in the provision of public short stay beds, maintaining current provision of 1,860 beds.

Disability Services Funding

 66. Deputy John Browne Information on John Browne Zoom on John Browne asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his response to the recent statement by the Disability Federation of Ireland that health service funding for disabilities should be organised on a multi-annual basis to improve and facilitate proper planning; and if he will make a statement on the matter. [6944/14]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch The level of funding available for the health budgets are considered as part of the annual estimates and budgetary process. Pending completion of the national estimates, budgetary and service planning process it is not possible to predict the service levels to be provided for the disability sector.

Ambulance Service Response Times

 67. 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 if there is a specific module in the Health Information and Quality Authority review of ambulance services focusing on the circumstances which led to a 50-minute delay in an ambulance attending the scene of an accident involving a person (details supplied) on 30 December 2013; and if he will make a statement on the matter.  [6841/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly In line with standard procedures following events with an adverse outcome, the tragic incident referred to in the Deputy's question has been the subject of a review by the National Ambulance Service (NAS). Following the review in this particular instance, the NAS has established an escalation process with Letterkenny General Hospital, to address any capacity, activity or other challenges which may impede service delivery.

In general, HIQA does not investigate individual incidents. However, at my request, HIQA has agreed to bring forward the review of pre - hospital emergency care, which had been due to commence in Q2 2014. The Authority will review the governance arrangements of pre-hospital emergency care services to ensure the timely assessment, diagnosis, initial management and transport of an acutely ill patient to an appropriate healthcare facility. Planning for the review has now commenced and HIQA is currently in the process of designing an Assessment Framework against the National Standards for Safer Better Healthcare.

HSE Waiting Lists

 68. Deputy Richard Boyd Barrett Information on Richard Boyd Barrett Zoom on Richard Boyd Barrett asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of public patients on public waiting lists that were sent to private beds and private consultants in public hospitals in 2012 and 2013; the amount the Health Service Executive paid to these private consultants in public hospitals in 2012 and 2013; and if he will make a statement on the matter. [6957/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly In relation to the detailed information requested by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy.

Mental Health Services Provision

 69. Deputy Denis Naughten Information on Denis Naughten Zoom on Denis Naughten asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will review the plans for the provision of acute mental health facilities nationally; and if he will make a statement on the matter. [6700/14]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch In the context of a developing community mental health services, “A Vision for Change” recommends a ratio of 17 acute in-patient beds per 100,000 population, and also that these beds include acute in-patient provision for General Adult, Psychiatry of Old Age, Mental Health and Intellectual Disability (MHID), and Eating Disorders, for that population.

Community mental health team capacity for General Adult, Psychiatry of Old Age, and MHID, is therefore being enhanced, arising from investment in mental health services over 2012 -13 and continuing this year. The objective of the HSE, having regard to the stage of development of community mental health team provision, is to reduce adult acute in-patient capacity to 20:100,000.

By the end of 2014, the HSE expects to be close to completion of the planned reduction in adult acute in-patient beds to circa. 20 beds per 100,000 people. As such, I have no plans at present to review the provision of acute mental health facilities nationally.

I am satisfied that the approach now being adopted best reflects implementation at local level of the widely agreed policy "A Vision for Change", and reflects also what is practicable in line with service and resource priorities recently agreed under the HSE Service Plan 2014 for continued improvements overall to our mental health services.

Hospital Services

 70. Deputy Finian McGrath Information on Finian McGrath Zoom on Finian McGrath asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will provide an update on the cystic fibrosis service at Beaumont Hospital as there is an urgent need to develop this service; and if he will make a statement on the matter.  [6897/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly As this is a service matter, I have asked the HSE to respond directly to the Deputy.

  Question No. 71 answered with Question No. 16.


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