Written Answers Nos. 415-421
415. Deputy Róisín Shortall asked the Minister for Health the status of the strategic review of general practice; the timeline for completion of the final report; and if he will make a statement on the matter. [30807/24]
View answerThe Department of Health and the HSE commenced the Strategic Review of General Practice last year and the review is currently underway. With input from key stakeholders, the review is examining a range of issues affecting general practice including GP training, GP capacity, Out of Hours services reform, the eHealth Agenda, and the financial support model for general practice. The Review will then identify the arrangements necessary to improve the current system of GP care as part of a primary care-focused health service.
The review is to be completed this year. Following its completion, a report is to be presented to me outlining the findings of the review and setting out recommended actions for a more sustainable general practice.
416. Deputy Róisín Shortall asked the Minister for Health if he is aware of a practice in public hospitals (details supplied); if a directive has been issued to public hospitals in respect of this practice; if all public hospitals have KPIs for cancer care; and if he will make a statement on the matter. [30808/24]
View answerAs Minister for Health, I have supported the National Cancer Strategy with substantial funding of €50m for cancer treatment and screening services. Since 2017, there has been additional new development funding of €456m into national cancer services, including €81m on cancer treatment, screening and prevention; €316m on cancer medicines; and €59m on cancer research grants through the Health Research Board.
This funding has enabled the recruitment of more than 670 staff to our national cancer services since 2017, including an additional 200 nursing staff, 100 consultants, and 180 health and social care professionals in designated cancer centres. This means that our national cancer services have been strengthened, that more patients are receiving treatment, and that waiting times to access treatment are reduced.
For a number of cancer patients, surgery will be required as part of their treatment plan. The centralisation of cancer surgery, which concentrates resources and expertise in a smaller number of centres providing cancer surgeries and is based on best international practice, is continuing under the Strategy. Centralisation of cancer surgeries is shown to provide improved outcomes for patients, as it ensures that surgeons operate on a safe minimum number of patients to maintain expertise.
The Strategy contains a number of KPIs in relation to cancer surgery. KPI no. 11 addresses the need for cancer surgical services to be provided in approved centres and KPI no. 15 focuses on reducing waiting times for cancer surgery. The performance of cancer surgical services is closely monitored by the National Cancer Control Programme and the Department of Health.
Surgery for cancer patients can be preventive, diagnostic, or curative. In each of these cases, timely access to surgery is important. As part of the Urgent and Emergency Care Plan this year, time-critical cancer surgeries were prioritised to ensure they were performed as planned where possible.
I am advised by the HSE that it is very cognisant of the impact that a change in admission for surgery has on patients and, as such, every effort is made to avoid cancellation or postponement of planned procedures and operations. The HSE further advises that patients are scheduled based on clinical need, but that unfortunately surgery may be deferred due to consultants needing to prioritise time-sensitive or emergency cases. The decision to delay admission is not undertaken lightly and when such a decision is made, it is based on the safe delivery of care to all patients.
My Department continues to work with the HSE and the National Treatment Purchase Fund (NTPF) to identify ways to improve access to care. This includes increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services, providing virtual clinics, and increasing capacity in the public hospital system.
417. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 158 of 6 December 2023, to provide an update on the health technology assessment on the shingles (herpes zoster) vaccine; if the finalised report has been submitted to him following public consultation on the draft findings; and if he will make a statement on the matter. [30809/24]
View answerI can confirm that the Health Information and Quality Authority (HIQA) are currently carrying out a Health Technology Assessment (HTA) on the herpes zoster vaccine which protects against shingles. A HTA is a multidisciplinary research process that collects and summarises information about a health technology. The information can cover a range of fields, including clinical effectiveness and safety, cost-effectiveness and budget impact, organisational and social aspects, and ethical and legal issues. The information is collected and presented in a systematic, unbiased and transparent manner.
The outcome of the HTA, once it is complete, will inform future decision making on this matter in relation to whether or not any amendments are required to the National Immunisation Programme.
418. Deputy Róisín Shortall asked the Minister for Health the status of the application for reimbursement of the drugs Ibrutinib and venetoclax, used for the treatment of patients with previously untreated chronic lymphocytic leukaemia; and if he will make a statement on the matter. [30810/24]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
419. Deputy Mick Barry asked the Minister for Health if he will take steps to implement the recommendation of the expert review body on nursing and midwifery that the CNM2 salary scale would be extended by the addition of one further scale point, and the introduction of a long-service increment; and if he will make a statement on the matter. [30818/24]
View answerFirstly, I would like to acknowledge the very important part that Clinical Nurse and Midwife Managers play in our health sector. They have a key role in the effective coordination of care for patients in our Health Service.
Recent increases applied to the Clinical Nurse/ Midwife Manager 2 (CNM2/CMM2) scale were a result of the implementation of recommendation 45 of the Expert Review Body (ERB) on Nursing and Midwifery.
Recommendation 45 set out that the Clinical Nurse Manager 2 and Clinical Midwife Manager 2 pay scale would be extended by an additional scale point, making point 10 the new maximum of the scale. The scale would also gain a Long Service Increment at point 11.
As part of the new Public Service Agreement 2024-2026, it was agreed that ERB recommendation 45, as set out in Labour Court Recommendation, LCR22828, would be implemented with effect from 1 January 2024.
Circular 2/2024 has been issued by the Department of Health, sanctioning the implementation of this pay change from 1 January 2024.
420. Deputy Bernard J. Durkan asked the Minister for Health to indicate if he is aware of the alleged premature discharge of a person (details supplied) and discharged allegedly prematurely some days later without backup support; and if he will make a statement on the matter. [30830/24]
View answerThe Minister has not been made aware of any premature discharge of the person named in the details supplied.
The Department of Health has been in contact with the RCSI hospital group, who have advised that the person named in the details supplied was deemed medically fit for discharge on the 10th July 2023 . The person named had extensive input from the Multi Disciplinary Team including Occupational Therapist, Physiotherapist, and Medical Social Workers.
My officials have notified me that a home care package application and appropriate referrals to a GP and the public health nursing service were made on behalf of the person after discharge.
421. Deputy Bernard J. Durkan asked the Minister for Health if the new national children's hospital is nearing completion; the extent of the services likely to be provided therein; when the hospital is likely to become operational; if sufficient emphasis is on the need to complete in early date; and if he will make a statement on the matter. [30873/24]
View answerThe timely completion of the New Children’s Hospital (NCH) is a Government priority. Everything possible is being done to ensure the project is completed as soon as possible on behalf of children, young people and their families.
The two satellite centres, which represent major milestones in the programme, are open and delivering the new model of care. Construction has advanced to over 90% complete against contract value, with the fit out of rooms and installation of medical equipment well underway.
The NCH will be the single national tertiary/quaternary centre for highly specialised paediatric care for children from all over Ireland. Together with its two paediatric outpatients and urgent care centres on the campuses of Tallaght Hospital and Connolly Hospital, it will also provide all secondary, or less specialised, acute paediatric care for children from the Greater Dublin Area.
This hospital will provide 39 clinical specialties in one location and will be the hub in the national network of paediatric services envisaged by the Model of Care, supporting regional and local hospitals to deliver acute paediatric care close to home for children where clinically appropriate, providing more ambulatory care, and integrating locally with community provision.
The NCH will be a state-of-the-art hospital. It will be Ireland’s first digital public hospital providing 473 beds in total – 380 in-patient beds, and 93 daybeds. The 380 inpatient beds include 20 mental health beds, and 60 critical care beds. The 60 critical care beds will be comprised of 20 paediatric critical care, 22 cardiac critical care, and 18 neonatal critical care. The hospital will have 22 theatres and specialist procedures rooms including specialised theatres for cardiac, neuro, and orthopaedic surgery. There will also be 110 outpatient examination rooms, and 15 radiology beds. It will also include education and research facilities.
Co-location on a campus with the adult St. James’ Hospital ensures that adult specialists will be able to support paediatric colleagues to jointly manage the treatment of children and young people with specific conditions and provide better quality clinical care. Another advantage of co-location is the development of a model for transition to adult services for children with chronic conditions.
The substantial completion of NCH is informed by the contractor’s programme of works and its ability to meet the targets set out in its own programme. Last September, the main contractor set out its formal programme outlining how it could complete the construction and fit out of the hospital by 29 October 2024.
The main contractor has in it's recent monthly project update indicated that the forecasted substantial completion date has now moved to 20 February 2025. The Employer’s Representative (ER- the independent third party responsible for administering the contract) has sought a revised, formal programme to underpin and support this update.
The National Paediatric Hospital Development Board (NPHDB) continues to work with BAM to ensure it increases its resources & productivity on site and to hold the contractor accountable for its delivery of its programme under the contract.
Once substantial completion is achieved, the hospital will be handed over to Children’s Health Ireland (CHI) for a period of operational commissioning of at least 6 months. The hospital could therefore still open in 2025.
The delivery of the new children’s hospital is much more than just bricks and mortar. It also involves the integration of the three existing hospitals, operational commissioning of the building, and conversation to a solely digital way of working. Ahead of the transition to the new facilities, a significant body of work is ongoing to integrate the three hospitals from a clinical, operational, and cultural perspective.
Onsite operational commissioning is a major aspect of the Children’s Hospital Programme. This is the phase following substantial completion of the new children’s hospital and before the opening of new hospital.
Activities during the onsite operational commissioning phase include the setting up of every department in detail. Parallel to this set-up will be the installation, and commissioning, of over 36,000 pieces of equipment and integration of medical equipment with Electronic Health Records and other ICT systems. This is separate from fit out and fixed equipment installation which will be completed by the NPHDB before substantial completion. Additionally, this phase will implement the detailed training for over 4,500 staff on the new and extensive digital and technologically advanced infrastructure, equipment, and systems.
While much focus has been on the challenges faced by the project, it is important to note that once open, the NCH will provide world class facilities to its patients. The NCH is unprecedented in scale, facilities, and technological advancement. It will be transformational in how we treat and deliver care to children and their families. The hospital has been designed and constructed to be as enduring and adaptable as possible. It is a building for the next 75-100 years, rather than the 40-50 years of other hospitals internationally.
