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 Header Item Written Answers Nos. 262-271
 Header Item Orthodontic Service Provision
 Header Item Nursing Staff Provision
 Header Item Non-Consultant Hospital Doctors Recruitment
 Header Item National Children's Hospital Status
 Header Item Nursing Home Beds
 Header Item Nursing Home Beds
 Header Item HSE Properties
 Header Item Health Services Provision
 Header Item EU Directives

Thursday, 13 February 2014

Dáil Éireann Debate
Vol. 830 No. 3

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Written Answers Nos. 262-271

Orthodontic Service Provision

 262. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which orthodontic treatment remains available to meet requirements detected during school medical examinations; and if he will make a statement on the matter. [7374/14]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The HSE provides orthodontic treatment to those who have been assessed and referred for treatment before their 16th birthday. Where a course of orthodontic treatment commences while a child is in primary school the necessary treatment will continue after the child enters secondary school. Orthodontic referrals are generally received via the Public Dental Service primary school screening programme. Those who attend private schools or are home schooled are also included. An individual's access to orthodontic treatment is determined against a set of clinical guidelines called the Modified Index of Treatment Need. Patients with the greatest level of need, i.e. Grade 5 or Grade 4 are provided with treatment by the HSE.

Nursing Staff Provision

 263. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of fully qualified nurses currently employed on a permanent part-time or full-time basis throughout the health service; the number of assistants similarly employed at present; the extent to which this remains sufficient to meet requirements; and if he will make a statement on the matter. [7375/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I have asked the HSE to provide the Deputy with the data sought in relation to nurses and assistants. The HSE has the capacity to recruit where it is necessary to do so, notwithstanding the need to reduce the numbers employed across the public service. Arrangements are in place to allow the recruitment of front-line staff, including nurses and assistants, where there is an established service need. More generally, in order to mitigate the impact on front-line services of the reduction in employment numbers, the priority is to reform how health services are delivered in order to ensure a more productive and cost effective health system.

Non-Consultant Hospital Doctors Recruitment

 264. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which junior hospital doctors, on graduation, are likely to become available throughout the health service in the coming year; the extent, if any, to which this will differ from previous years; and if he will make a statement on the matter.  [7376/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Under the provisions of the Medical Practitioners Act 2007 it is a matter for the Health Service Executive (HSE) to assess, on an annual basis, the number of intern training posts required by the health service. My Department is in regular contact with the HSE in relation to the issue of intern places with the aim, in so far as is possible, of providing a sufficient number of intern places for Irish/EU graduates from Irish medical schools. In the past two years the HSE has embarked on a process of expanding the number of posts to meet the demand of the growing number of graduates from Irish Medical Schools. In 2012 the number of Intern posts available was 572, and in 2013 this increased to 640 positions. It is expected that in July this year the HSE will have 680 positions available. The additional Intern posts are created in a budget neutral fashion and are located throughout the country. HSE recruitment for the July 2014 Medical Intern intake is a two stage process, which began, with online applications, in October 2013. Stage 2 of the recruitment process will begin on 28 February 2014.

National Children's Hospital Status

 265. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding preliminary planning and preparation in respect of the proposed new children's hospital; when it is expected the project will start; if the current project is likely to benefit from the preparatory work undertaken in respect of a previous site at an estimated cost of €50 million; and if he will make a statement on the matter.  [7377/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The National Paediatric Hospital Development Board (NPHDB) is the body responsible for the planning, design, building and equipping of the new children's hospital capital project. The project is currently in the design procurement stage. A Procurement Open Day was held on 25 November last, the shortlisting of design teams is now being completed and this will be followed by the invitation to tender for those shortlisted. Decant planning, updating of the St James’s site masterplan and pre-application planning discussions have been ongoing in relation to the site. The aim is to have the site cleared by the end of this year, to have a planning decision and commence construction in Spring 2015, and to begin transition of services to the new children's hospital at the end of 2018. In parallel with the construction of the new children's hospital, the operational integration of the three existing children's hospitals is of critical importance in ensuring that the new hospital functions effectively from the outset. A Children's Hospital Group involving the three hospitals has been established, the core function of which is to integrate the three children's hospitals staff and service provision, well in advance of the new hospital being built.

In October 2013, the Minister for Public Expenditure & Reform announced that up to €200m would be made available for the new Children’s Hospital from the sale of the National Lottery, adding to the existing €450m Exchequer funding. The level of funding now in place underlines the Government’s commitment to this priority project. Also, philanthropic / non-Exchequer funding will be sought to the maximum and most appropriate degree. Estimated costs will be reviewed and refined at each stage as the project progresses. The total spent on the new children’s hospital to date is €41m. Much of the work that was done for the project on its previous site can be transferred to the new site, in particular health care planning and preparation of the design brief which has been updated for the project in its new location.

  Question No. 266 answered with Question No. 39.

Nursing Home Beds

 267. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which adequate provision remains to maintain the maximum number of nursing home beds at Maynooth Community Hospital, Maynooth, County Kildare; if, having regard to the competence, reliability and support for the existing unit, a further extension might be considered; and if he will make a statement on the matter.  [7379/14]

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.

Nursing Home Beds

 268. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which adequate provision remains to maintain the maximum number of nursing home beds at St. Brigid’s nursing home, Crooksling; if, having regard to the competence, reliability and support for the existing unit, a further extension might be considered; and if he will make a statement on the matter.  [7380/14]

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.

HSE Properties

 269. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which title has been clarified in respect of buildings and land at St. Brigid's Hospital, Crooksling; and if he will make a statement on the matter.  [7381/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Management of the health care property portfolio is a service matter. Therefore your question has been referred to the Health Service Executive for direct reply.

Health Services Provision

 270. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which parents of children suffering with narcolepsy continue to receive adequate back-up support and services; and if he will make a statement on the matter.  [7382/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I note that early indications from scientific and medical research into narcolepsy suggest that the prognosis for children may be better that previously indicated and that they should, with appropriate medication and supports, be able to reach their potential. The HSE and the Department of Education and Skills continue to provide a range of services and supports to individuals diagnosed with narcolepsy following pandemic vaccination regardless of age, on an ex-gratia basis. These services and supports which are co-ordinated by the HSE National Advocacy Unit are intended to provide that individuals receive tailored assistance to address their specific requirements, where appropriate. It is acknowledged that treatment and individual medical needs may need to be reassessed over time to take account of changes in their condition or circumstances.

The ex-gratia health supports include clinical care pathways to ensure access to rapid diagnosis and treatment, multidisciplinary assessments led by clinical experts, counselling services for both the individuals and their families, discretionary medical cards for those who have been diagnosed have been provided to allow unlimited access to GP care and any prescribed medication, ex-gratia reimbursement of vouched expenses incurred in the process of diagnosis and treatment, including travel expenses for attending medical appointments; physiotherapy, occupational therapy assessments, dental assessments and dietary services all on a needs basis. Regional co-ordinators have been appointed to assist individuals to provide advice, information and access to local services.

On the education side, the National Educational Psychological Services (NEPS) engaged with all of the schools being attended by children with narcolepsy to provide guidance and assistance on the condition and the supports available. These include special education home tuition, the provision of supplemental learning support/resource teaching support on a needs basis and the provision of Special Needs Assistants (SNA) support if required. Furthermore, reasonable accommodations, including special examination centres and rest breaks were provided for students who sat state exams in last June. Similar arrangements will be available on a needs basis to students sitting state exams in future years. The Department of Education and Skills issued circulars providing information to schools on the nature, likely symptoms, possible effect of the condition of narcolepsy on students and the supports available for students.

With regard to third level, students diagnosed with narcolepsy following pandemic vaccination can access the Disability Access Route to Education (DARE) scheme, which is a college/university scheme which offers enhanced access routes to third level education. All health and educational services and supports will continue to be provided on an ex-gratia basis. Those services and supports will be reassessed on an ongoing basis to take account of the individual's condition and circumstances.

EU Directives

 271. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the extent to which the various public hospitals throughout the country continue to be affected by the working time directive; and if he will make a statement on the matter. [7383/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Considerable progress has been made over the last 12 months on progressing compliance with the provisions of the Working Time Directive in respect of NCHDs. Data from the HSE shows that average working hours for NCHDs in 2009 was 60 hours a week, 54 hours per week in 2012 and 51.4 hours in the third quarter of 2013. The HSE is focused on advancing implementation of the Directive. Intensive negotiations conducted at the Labour Relations Commission in September and October resulted in agreement on a joint approach, involving hospital management, the IMO and NCHDs to achieving EWTD compliance. The agreement focused in particular on steps to be taken in the period up to the NCHD rotation on 13 January 2014 to progress 24 hour compliance. At a meeting between the HSE and the IMO on 6 February the progress made by the acute hospitals on achieving compliance with the agreed maximum 24 hour shift target was assessed. While the majority of hospitals have made significant progress, arising from that assessment the Director of Acute Hospitals will be imposing fines on a minority of hospitals where sufficient progress has not been achieved. This is in accordance with the terms of the agreement reached at the LRC by the HSE and the IMO last Autumn.

NCHD recruitment and retention is required in order to facilitate the achievement of EWTD compliance. Achievement of full compliance will also require reorganisation of the delivery of certain services within Hospital Groups. The number of NCHDs in the public health system has increased by over 200 in recent years and now exceeds 4,900. However, there are international shortages of NCHDs in certain categories and specialties. There are also some hospitals to which it has been difficult to attract NCHDS, for a range of reasons including training opportunities and rural location.

I set up the MacCraith Group to undertake a Strategic Review of Medical Training and Career structure last Summer. The Group is to make recommendations aimed at improving the retention of medical graduates in the public health system, planning for future service needs and achieving the maximum benefit from investment in medical education and training. The Group provided an Interim Report in December 2013 focusing on training and is now examining career structures and pathways following training with a view to preparing a report by the end of March 2014. It will provide the final report by the end of June 2014.


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