Houses of the Oireachtas

All parliamentary debates are now being published on our new website. The publication of debates on this website will cease in December 2018.

Go to oireachtas.ie

 Header Item Written Answers Nos. 84 - 98
 Header Item Human Rights Cases
 Header Item Emergency Departments Waiting Times
 Header Item Mental Health Services Provision
 Header Item Tobacco Control Measures
 Header Item Patient Transfers
 Header Item Home Care Packages Provision
 Header Item Hospital Facilities
 Header Item Mental Health Services Funding
 Header Item Multi-annual Budget Plans
 Header Item Health Services Charges
 Header Item Health Services Provision
 Header Item Health Services Staff Recruitment
 Header Item Ambulance Service
 Header Item Hospital Groups
 Header Item Mental Health Services Funding

Thursday, 2 June 2016

Dáil Éireann Debate
Vol. 911 No. 3

First Page Previous Page Page of 60 Next Page Last Page

Written Answers Nos. 84 - 98

Human Rights Cases

 84. Deputy Paul Murphy Information on Paul Murphy Zoom on Paul Murphy asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his views on the conclusions of the recent United Nations universal periodic review of human rights which criticised Ireland’s abortion laws; and if he will make a statement on the matter.  [13688/16]

Minister of State at the Department of Health (Deputy Marcella Corcoran Kennedy): Information on Marcella Corcoran Kennedy Zoom on Marcella Corcoran Kennedy I view the Universal Periodic Review as an important peer review process by which the international community holds each UN Member State to account in relation to our individual human rights record. I am proud of our own domestic record of protecting and promoting human rights and of our contribution to advancing human rights at an international level.

  During the Review process a number of Member States had questions about the termination of pregnancy in Ireland. As the Deputy will be aware termination of pregnancy is regulated by constitutional and statute law.

  Article 40.3.3 of the Irish Constitution (Eighth Amendment) provides as follows:

  ‘The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.’

The Protection of Life During Pregnancy Act 2013, was enacted following the judgment of the European Court of Human Rights in the A, B and C v Ireland case. The Act provides for guidance in relation to terminations that are lawful under our Constitution – essentially these circumstances are where there is a real and substantial risk to the life of the mother, which can only be averted by a termination of pregnancy.

  The Government have made a commitment in the most recent Programme for Government to establish a Citizen’s Assembly to make recommendations to the Dáil on further constitutional changes and they will consider the Eighth Amendment as part of this work.

Emergency Departments Waiting Times

 85. Deputy Sean Sherlock Information on Seán Sherlock Zoom on Seán Sherlock asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his views on new statistics which highlight that nearly 50,000 patients are leaving emergency departments annually, due to long waiting times; and his plans to tackle unacceptably long waiting times in emergency departments.  [13742/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Pressures on Emergency Departments have been rising, given an ageing and growing population.

ED attendances have been significantly higher this year, particularly in Quarter 1. To date, the HSE has reported an average increase in attendances of nearly 6% compared with the same period last year. Despite attendance increases, TrolleyGar numbers in Quarter 1 2016 are similar to those for 2015. Furthermore, figures for May 2016 show total numbers of patients on trolleys are approximately 18% lower than in May 2015, with numbers waiting over 9 hours approximately 24% lower.

The HSE maintains records on service users who register at an ED and choose to leave without actively discharging themselves. Figures for March 2016 indicate that 3.9% of ED patients ‘did not wait’ to complete their episode of care, which is within the internationally accepted safe target of less than 5%.

It is important to note that patient experience times have improved in April 2016 with 67.6% of patients being admitted or discharged within 6 hours and 81.7% within 9 hours.

Reducing the wait times for patients attending EDs is a priority for this Government. Investments in capital expansion are ongoing (new EDs have been completed in the Mater and Wexford Hospitals and are planned in Beaumont and Galway). 366 extra beds have been opened or re-opened. A review of bed capacity in our health service, coupled with a review of Medical Assessment Unit hours are further key commitments intended to alleviate ED overcrowding.

Mental Health Services Provision

 86. Deputy Imelda Munster Information on Imelda Munster Zoom on Imelda Munster asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to support the introduction of intensive care rehabilitation units to provide appropriate care for mental health patients who present a greater challenge and are unsuited to the existing acute setting. [13722/16]

Minister of State at the Department of Health (Deputy Helen McEntee): Information on Helen McEntee Zoom on Helen McEntee The provision of new facilities, or other non-capital initiatives, to enhance forensic mental health provision nationally is core to modernising mental health services in line with A Vision for Change. To-date, some €160m ring-fenced funding has been provided since 2012 to improve all aspects of mental health care, including prioritising Phase 1 of a major new infrastructural development at Portrane to replace the existing Central Mental Hospital (CMH) at Dundrum.

  Intensive work has taken place in recent times by the HSE in relation to the detailed planning and design associated with the new capital projects for the National Forensic Mental Health Service. This multi-million project is being delivered in two Phases.

  Phase One comprises the following core project requirements at St. Ita’s, Portrane:

  - 120-bed National Forensic Hospital (to replace the CMH);

  - New 10-bed Mental Health Intellectual Disability Forensic Unit;

  - New 10-bed Child and Adolescent Mental Health Forensic Unit.

  Enabling works recently commenced on site at Portrane, with a view to starting construction on the main works later this year. It is intended to complete construction in late 2018, and to have the modern new facility operational around mid 2019, when associated equipping and staffing resource issues are finalised.

  Phase Two involves the provision of three 30 bed Intensive Care Rehabilitation Units (ICRUs) to be located at Portrane, Galway and Cork envisaged upon completion of Phase 1 of the project. A fourth ICRU is intended for Mullingar, if conversion plans for an existing facility prove feasible. The existing HSE Capital Programme allows for completion of Phase I of the project (i.e. the Portrane facilities), with Design Work only to be progressed on Phase II. The Department of Health, and the HSE, will continue to progress as appropriate the ICRU initiatives, in the context of evolving service priorities and resource availability.

Tobacco Control Measures

 87. Deputy Brendan Howlin Information on Brendan Howlin Zoom on Brendan Howlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will confirm that he and his team of Ministers are fully committed to implementing the Tobacco Free Ireland policy by 2025; and if he has rejected any proposals to roll back measures currently in place on smoking in the workplace.  [13744/16]

Minister of State at the Department of Health (Deputy Marcella Corcoran Kennedy): Information on Marcella Corcoran Kennedy Zoom on Marcella Corcoran Kennedy I would like to assure the Deputy that I, together with my Ministers of State, are fully committed to implementing the recommendations of Tobacco Free Ireland.  There are no proposals to amend the provisions of the Public Health (Tobacco) Acts in respect of the existing smoke free provisions. In fact Tobacco Free Ireland seeks to enhance and further extend smoke free areas into the future. An example of this is the legislation commenced on the 1st January of this year which makes it illegal for someone to smoke a tobacco product in a car where a child is present.

Patient Transfers

 88. Deputy Frank O'Rourke Information on Frank O'Rourke Zoom on Frank O'Rourke asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the funding being provided for the Health Service Executive patient transfer scheme in 2016; and if he will make a statement on the matter. [13761/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.

Home Care Packages Provision

 89. Deputy Willie Penrose Information on Willie Penrose Zoom on Willie Penrose asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will ensure that there will be no reduction in home help and home care packages for elderly persons and persons with a disability in 2016; the total funding available for home help and home care packages; and if there is a funding shortfall within the Health Service Executive for the provision of these vital supports. [13735/16]

Minister of State at the Department of Health (Deputy Helen McEntee): Information on Helen McEntee Zoom on Helen McEntee Home care services are key to facilitating older people to remain in their homes and communities for as long as possible and the strengthening of home care services is an objective to which this Government is committed.

  In 2016, the HSE has a core provision of €324m for home supports (these include Home Help, which provides support with routine tasks of daily living, and Home Care Packages, which provide a higher level of support and cater for clients with higher dependencies). Service levels are being maintained this year and there has been no reduction in the resources available for these home supports in 2016.

  The HSE’s National Service Plan for this year provides for a target of 10.4 million Home Help Hours to support about 47,800 people. It also provides for 15,450 Home Care Packages, 130 Intensive Home Care Packages for clients with very complex needs and 313 transitional care beds. A further 60 clients with dementia will be supported with co-funding from Atlantic Philanthropies under the Irish National Dementia Strategy.

Hospital Facilities

 90. Deputy James Lawless Information on James Lawless Zoom on James Lawless asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if the following issues in Naas Hospital, County Kildare, can be addressed, in view of the recent expansion of the hospital to include a second wing: the extra resources and personnel needed to deal with this extra capacity; the inadequate number of theatre nurses in the hospital; if operations are being cancelled due to theatre nurses being redeployed in the hospital due to staff shortages; and if he will make a statement on the matter.  [13757/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.

Mental Health Services Funding

 91. Deputy Brendan Ryan Information on Brendan Ryan Zoom on Brendan Ryan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will restore urgently ring-fenced funding for mental health services in 2016; and if he will return to the model of funding that has been in place since 2012, where funding is specifically ring-fenced in the mental health area. [13738/16]

Minister of State at the Department of Health (Deputy Helen McEntee): Information on Helen McEntee Zoom on Helen McEntee The last Government provided additional ring-fenced mental health funding of €160 million over 2012 - 16 inclusive. Funding for mental health in 2016 will increase from the 2015 outturn of €785m, to a projected budget of €826m in the 2016 NSP, an increase of €41m or 5.2%, which includes €35m ring-fenced for mental health in 2016.

The €35m allocation for mental health will fund new service developments. The HSE National Service Plan 2016 identifies priorities for allocation of the €35 million, including the continued development of early intervention and counselling services across both primary and secondary care; the provision of three new Jigsaw mental health services in Cork, Dublin City Centre and Limerick; the continued development of Community Mental Health teams; improved 24/7 response and Liaison Services; services for Psychiatry of Later Life; Perinatal Mental Health, and two new mental health clinical programmes, specifically for ADHD in Adults and Children, and for Dual Diagnosis of those with Mental Illness and Substance Misuse. The Department of Health is currently examining proposals from the HSE relating to the development of these specific enhanced priority services, as well as proposals for the ongoing development of a range of existing and new specialist mental health services. It is expected that a decision on the release of the 2016 development funding will be made shortly.

Staff recruitment is a key element of these developments. As staff recruitment takes time, however, the 2016 HSE National Service Plan envisages that time-related savings of approximately €12m from the mental health development funding will be used, on a once-off basis, to maintain services in home care and transitional care beds, and for vaccine procurement. As the initiatives planned for mental health identified in the Service Plan are approved, arrangements will be made for the release of funding, having regard to the overall Service Plan requirement.

Multi-annual Budget Plans

 92. Deputy Sean Sherlock Information on Seán Sherlock Zoom on Seán Sherlock asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to implement a new multi-annual budgeting system for health; and the role in this new funding process of the proposed new cross-party committee on health.  [13741/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Increases in the health budget have been possible both in Budget 2015 and 2016. It is this Government's intention to work with the Oireachtas to sustain these annual increases going forward. It is our intention to set out a detailed longer-term budget for the health service, underpinned by a 5 year Health Service Plan based on realistic, verifiable projections. It is acknowledged in our Programme for Government that considering ongoing demographic change and medical innovation, increases of an average of more than 3% per annum, combined with an ongoing reform agenda, to drive further efficiencies, are needed to make real improvements.

One of the key proposals in the Programme for Government is the establishment of an Oireachtas Committee to develop cross-party consensus on the future of the health service. I believe the health service would benefit enormously from a single unifying vision that can help to drive reform and development of the system over the next 10 years. The Committee will examine and make recommendations on how best to re-orientate the health service on a phased basis in as short a timeframe as possible.

This will allow the New Partnership Government to make a final decision on the best way forward to finance Universal Healthcare.

Health Services Charges

 93. Deputy Gino Kenny Information on Gino Kenny Zoom on Gino Kenny asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to refund the €100 statutory charge to patients who register at emergency departments in the hope of being treated but leave before being discharged because of onerous waiting times; and if he will make a statement on the matter.  [13749/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The provision for the €100 charge to patients who avail of the services at an Emergency Department is made under the Health (Out-Patient Charges) Regulations 2013. There are certain exemptions from the charge which include, a person with full eligibility (i.e. a medical card holder), a person who has a letter of referral from a registered medical practitioner and a person whose attendance results in admission as an in-patient. There are no exemptions provided for in the Regulations for patients who attend at the Emergency Department and then decide to leave without availing of any further services.

Under Section 6 of the Health Service Executive Governance Act 2013, the Minister may not make a direction to the Health Service Executive in respect of any function of the Executive relating to a decision concerning the making or recovery of a charge for the provision of a health or personal social service by or on behalf of the Executive to a particular person or concerning the amount of such charge.

Health Services Provision

 94. 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 is aware of a person (details supplied) in Dublin 15 who experienced difficulties with the ambulance service and treatment in hospital following strokes; the actions he will take to prevent such issues arising again; and if he will make a statement on the matter.  [13691/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

In relation to the specific case raised, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.

Health Services Staff Recruitment

 95. Deputy Willie Penrose Information on Willie Penrose Zoom on Willie Penrose asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if the Health Service Executive has suspended recruitment of doctors, nurses and midwives in hospitals until further notice, given the significant number of vacant posts across the health system; if so, when the moratorium will be lifted; and the levels of additional recruitment across all sectors of the Health Service Executive he expects in 2016.  [13734/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The HSE has focused on the recruitment of additional front line staff to support service delivery and continues to do so, as additional resources have become available. From the end of April 2014 to the end of April 2016 the total number of consultants working in the public health service increased by 175, the number of NCHDs increased by 862 and the number of nursing and midwifery staff increased by 1275 in whole time equivalent terms.

  Recent measures taken in relation to service areas in the HSE remaining within budget have been portrayed, incorrectly, as a recruitment freeze. These measures do not impact on a hospital's ability to recruit where funding exists to facilitate that recruitment; for example in the case of replacement posts or where funding has been allocated for particular roles under the HSE service plan. Recruitment can also take place in areas of critical care and emergency services. The HSE has clarified that while restrictions have been introduced in the acute hospital sector there is a mechanism in place for Hospital Group CEOs to agree priority recruitment of key posts on an exceptional basis.

  The HSE are currently working with my Department on the preparation of their 2016 Pay and Numbers Strategy. This has involved the development of 'bottom up' workforce plans at hospital and community service level. While these plans are being developed, the interim recruitment measures have been put in place by the HSE.

Ambulance Service

 96. Deputy Brendan Howlin Information on Brendan Howlin Zoom on Brendan Howlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will confirm that he has accepted all the recommendations of the recently published capacity review of the national ambulance service; when he expects these recommendations to be implemented; and the additional funding that may be required for the service. [13743/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Last month at my request, the HSE published the National Ambulance Service Capacity Review together with an action plan for implementation which incorporates the recommendations of both the Capacity Review and the 2014 HIQA Report on the National Ambulance Service.

The Capacity Review makes it clear that we need a very significant programme of investment in our ambulance services. In that context, a phased investment in a multi annual programme involving manpower, vehicles and technology is required. Additional funding of €7.2m has been provided for the National Ambulance Service in 2016 which includes €2m for new developments. The Deputy will also be aware that the Programme for Government commits to additional annual investment in terms of ambulance personnel and vehicles.

It should be noted that many of the key recommendations of both reviews are already being addressed as part of a significant programme of reform and modernisation of the National Ambulance Service which has been underway in recent years. This programme has now achieved many of its key targets including the establishment of the National Emergency Operations Centre, and the creation of an integrated deployment platform which allows the ambulance service to operate as a national fleet, rather than in regional divisions; continued delivery of improved technology to improve response times; and expansion of the Community First Responder scheme.

My Department engages on an ongoing basis with the National Ambulance Service in relation to service requirements and performance and will continue to do so to ensure that the action plan is implemented.

Hospital Groups

 97. Deputy Eoin Ó Broin Information on Eoin Ó Broin Zoom on Eoin Ó Broin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when he will publish and circulate the guidance on developing hospital group strategic plans; and if he will make a statement on the matter. [13699/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris My Department is currently finalising Guidance on Developing Hospital Group Strategic Plans which will be circulated to Hospital Groups in the near future.

The Groups will develop their Strategic Plans informed by this guidance document. Each Hospital Group will be required to develop a plan to describe how it will provide more efficient and effective patient services; reorganise these services to provide optimal care to the populations they serve; and how they will achieve maximum integration and synergy with other groups and all other health services, particularly primary care and community care services.

In developing their plans, Hospital Groups will be expected to demonstrate a co-ordinated approach to the planning and delivery of services within and across the hospital groups, with an increased focus on small hospitals managing routine urgent or planned care locally and more complex care managed in the larger hospitals.

It is acknowledged that each Group is at a different stage of implementation and the strategic planning process of each group may progress at a different pace so that issues including resource allocation and service configuration can be addressed appropriately.

The Systems Reform Division in the HSE has also been engaging with the Group Chairs and Group CEOs and will be providing them with assistance in the development of their plans.

Mental Health Services Funding

 98. Deputy Denise Mitchell Information on Denise Mitchell Zoom on Denise Mitchell asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to support the provision of a full complement of child and adolescent places, and child and adolescent mental health service teams for mental health, as recommended in A Vision for Change. [13718/16]

Minister of State at the Department of Health (Deputy Helen McEntee): Information on Helen McEntee Zoom on Helen McEntee The additional ring-fenced mental health funding of €160 million provided over 2012-16 inclusive, has contributed significantly to implementation of A Vision for Change (AVFC). Implementation of this policy takes place in the context of annual HSE Service Plans and in line with evolving service priorities and resource availability overall each year. Funding for mental health in 2016 will increase from the 2015 outturn of €785m, to a projected budget of €826m in the 2016 National Service Plan, an increase of €41m or 5.2%, including €35m ring-fenced for new developments this year.

  AVFC recommends the provision of 80 additional child and adolescent psychiatric in-patient beds nationally. The HSE Operational Plan for Mental Health 2016 indicates that there are 76 Child and Adolescent Mental Health Service (CAMHS) beds in the system, of which 66 are operational at present. In the context of expanding CAMHS bed capacity, the HSE is endeavouring at present to address staff recruitment or retention difficulties in certain CAMHS facilities, such as the Eist Linn unit in Cork. As these staffing issues are resolved, the potential exists to increase capacity, whether for in-patient or community based CAMHS care, in line with AVFC.

  The issue raised by the Deputy is kept under review by the Department of Health and the HSE.   In relation to the costing of existing or planned staffing provisions raised by the Deputy, as this is service specific, this has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.


Last Updated: 06/11/2017 15:00:30 First Page Previous Page Page of 60 Next Page Last Page