Written Answers Nos. 26-45
26. Deputy Gino Kenny asked the Minister for Health the reason many children with scoliosis continue to suffer while they are left waiting indefinitely for essential life-changing surgery; and if he will make a statement on the matter. [39363/24]
View answerI want to acknowledge that waiting lists for scoliosis and spina bifida services are unacceptably long. I am acutely conscious of the burden that this places on patients and their families.
I committed €19 million of current and capital funding to tackle these waiting lists by creating additional capacity. There was an increase in the number of spinal procedures carried out in 2022 and 2023, compared to 2019. The expected reduction in the waiting lists were offset by increases in demand and referrals compared to previous years. These services remain priority areas under the 2024 Waiting List Action Plan.
At my request, a dedicated Paediatric Spinal Surgery Management Unit was established earlier this year to focus on delivering improvements to the waiting lists. This Unit is working on improving capacity within CHI, expanding national outsourcing, and looking to maximise the international support.
A number of international outsourcing initiatives have been finalised. Children have been seen by clinicians from Morgan Stanley Children’s Hospital in New York, Great Ormond Street Hospital London and Portland Hospital in the UK.
I have also convened a dedicated stakeholder Paediatric Spinal Taskforce to collaboratively address concerns raised by families and advocacy groups.
I am chairing monthly meetings with the HSE and CHI to ensure that everything that can be done is being done.
27. Deputy Violet-Anne Wynne asked the Minister for Health the progress made by his Department in respect of the status of the mental health de-escalation unit and the dual diagnosis programme for the mid-west; and if he will make a statement on the matter. [39430/24]
View answerThe pilot project Community Access Support Team (CAST), to be trialed in the Limerick Garda Division, is to be launched next week October 7th, with the team expected to become fully operational shortly thereafter.
It is not a de-escalation unit per se, but instead is a partnership project between An Garda Síochána and the HSE and involves a team based approach to supporting vulnerable people presenting with mental health difficulties and situational trauma.
It will complement the work of our National Clinical Programme on Dual Diagnosis,, which will develop services to people who experiences both a substance abuse problem and a mental health issue, with treatment options to address both.
The Model of Care, which I launched last year with Minister Naughton, describes a clear clinical pathway of integrated service delivery across primary care, substance misuse, community mental health and acute services, through the development of 12 Adult Specialist Dual Diagnosis Teams nationally, and 4 Adolescent Teams.
To date, funding of over €2 million has been provided to support recruitment in this area, and in Budget 2025 I have allocated €600,000 for an additional 10 WTEs.
Recruitment for the two adult teams in the Midwest and County Cork is ongoing and the teams are not yet accepting referrals, and recruitment for the two adolescent teams in the Dublin area are also at an advanced stage.
Individuals who require treatment for dual diagnosis are currently being supported by the relevant HSE social inclusion addiction services in their community.
28. Deputy David Stanton asked the Minister for Health to outline the planned usage for the existing community hospital building (details supplied) when the current residents have been moved to the new building currently being constructed on an adjacent site; and if he will make a statement on the matter. [38918/24]
View answerMidleton Community Hospital plays a vital role in providing care and support to residents and their families in the Midleton community and surrounding areas. The HSE have advised that a scoping exercise of the existing Community Hospital site is currently underway to identify possible future uses which align with existing service needs in the area, following the opening of the new Community Nursing Unit.
I have been advised that the new 50 bedded Community Nursing Unit at Midleton Community Hospital is anticipated to complete construction during late Q4 2024/early Q1 2025. The HSE are progressing workforce planning across all staff disciplines to ensure the required complement and skill mix of staff is in place to facilitate the operational schedule.
It is estimated that, pending successful registration with HIQA and recruitment, the new CNU will be fully resourced and operational during Q2, 2025.
29. Deputy Matt Carthy asked the Minister for Health his proposals to ensure improved ambulance services in County Monaghan. [39365/24]
View answerThis Government has a consistent track record of investing in our National Ambulance Service (NAS) who provide a high quality, effective and patient-centered ambulance service for people right across the country, including in the Monaghan area.
Through the HSE National Service Plan for 2024, the NAS received a significant allocation of €231 million. Increases in investment in recent years has seen the total NAS budget grow by 37% or €63 million since 2019. As a result of this increased funding, total staff numbers in the NAS at the end of July 2024 were 2,343, representing a growth of over a fifth or 410 since the end of 2019.
I can advise the Deputy that the North-East region, including Cavan/Monaghan, has similarly benefitted from increased resourcing in the last 12 months with an additional 25 additional paramedics now in place, taking the total number of NAS personnel serving the region to over 240.
In the year to date to July 2024, emergency response performance in the NAS region covering Monaghan (North Leinster) is exceeding HSE National Service Plan targets. This is despite call volumes for the NAS North Leinster region being up more than 11% when compared to the same period in 2023.
30. Deputy Claire Kerrane asked the Minister for Health when the full roster of advanced paramedics will be restored on the rapid response vehicle at Roscommon hospital; and if he will make a statement on the matter. [39316/24]
View answer32. Deputy Claire Kerrane asked the Minister for Health the reason a commitment for 24-7 advanced paramedics made to the people of Roscommon following the closure of the accident and emergency service has been reneged on; and if he will make a statement on the matter. [39317/24]
View answerI propose to take Questions Nos. 30 and 32 together.
As this is a service matter, I have asked the Health Service Executive (HSE) to respond to the Deputy directly as soon as possible.
31. Deputy Sean Sherlock asked the Minister for Health if his attention has been drawn to the strategic review of anaesthesiology services within the southern region, and specifically within the South/South West Hospital Group; the proposed completion time for this review; and if he will make a statement on the matter. [35351/24]
View answer33. Deputy David Cullinane asked the Minister for Health the number of children with complex orthopaedic conditions on waiting lists with Children's Health Ireland; his plans for making treatment abroad accessible for these children; and if he will make a statement on the matter. [39368/24]
View answerThe challenge facing our acute hospital waiting lists is well recognised, and both the Government and I have acknowledged that waiting lists are too long and many patients on those lists are waiting too long to receive the care they need.
According to the latest NTPF figures, there are 3,930 children on the Children’s Health Ireland (CHI) orthopaedic outpatient waiting list and there are 764 children waiting for an inpatient or daycase orthopaedic procedure, excluding scopes. These figures include both children with complex and non-complex needs.
Scoliosis and Spina Bifida were identified as a priority in both the 2022 and 2023 Waiting List Action Plans (WLAP). The aim of the WLAP is to ensure that patients have more timely access to high-quality scheduled care in our acute hospitals and will improve patient outcomes and patient experiences of our healthcare service. There was an increase in the number of spinal procedures carried out in 2022 and 2023, compared to 2019. The expected reduction in the waiting lists were offset by increases in demand and referrals compared to previous years. These services remain priority areas under the 2024 Waiting List Action Plan.
At my request, a dedicated Paediatric Spinal Surgery Management Unit was established earlier this year to focus on delivering improvements to the spinal waiting lists. This Unit is working on improving capacity within CHI, expanding national outsourcing, and looking to maximise the international support.
A number of international outsourcing initiatives have been finalised for children waiting on spinal surgery. Children have been seen by clinicians from Morgan Stanley Children’s Hospital in New York, Great Ormond Street Hospital London and Portland Hospital in the UK.
I have also convened a dedicated stakeholder Paediatric Spinal Taskforce to collaboratively address concerns raised by families and advocacy groups.
I am chairing monthly meetings with the HSE and CHI to ensure that everything that can be done is being done.
34. Deputy Richard Bruton asked the Minister for Health if he is developing a policy for the wider use of technology in predicting health risks, picking up signs of the onset of conditions, remote consultation and patient monitoring, with a view to keeping people independently healthy in their own homes; and if he will make a statement on the matter. [39407/24]
View answer35. Deputy Paul Donnelly asked the Minister for Health to comment on the sale of illicit tobacco products online; and to clarify if social media platforms can be mandated to delete profiles engaging in this activity instead of just deleting the post. [39171/24]
View answerThe illicit trade in tobacco products and related enforcement issues are a matter for the Office of the Revenue Commissioners and my colleague the Minister for Finance. My objective is to reduce smoking prevalence and therefore reduce the demand for tobacco products which will ultimately lead to a reduction in tobacco smuggling and other aspects of illicit trade. My current legislative project is the Public Health (Tobacco) (Amendment) Act which is designed to increase the minimum legal age of sale of tobacco products and therefore protect our young people from addiction to a product that kills at least one out of every two users.
36. Deputy Marian Harkin asked the Minister for Health if a decision has been made not to fund additional hours for home care for service users in Sligo, Leitrim and Donegal; if overtime hours of caregivers are being cut back; and if he will make a statement on the matter. [38826/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
37. Deputy Marian Harkin asked the Minister for Health when a person will receive surgery (details supplied). [39354/24]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
38. Deputy Duncan Smith asked the Minister for Health if there are plans to include the varicella or chickenpox vaccine in the childhood immunisation scheme; and if he will make a statement on the matter. [39358/24]
View answerThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). NIAC continue to revise its recommendations having regard to of the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. To date, the varicella vaccine has not been included as part of the primary childhood immunisation programme. As NIAC made a recommendation to include varicella in the programme, my Department asked HIQA to carry out a Health Technology Assessment (HTA) on the Varicella Zoster Vaccine which was published on July 13th 2023. HIQA found that there is clear and consistent evidence that the chickenpox vaccine is both safe and effective in preventing chickenpox and its complications. It also found that adding the chickenpox vaccine to the programme is likely to be cost effective. Having considered the findings of the HTA, I have approved the introduction of the varicella vaccine into the Primary Childhood Immunisation Programme from 2024.
39. Deputy David Cullinane asked the Minister for Health if he can guarantee when inpatient residential dual diagnosis services will resume in Keltoi; what has caused the delay in reopening these services; and if he will make a statement on the matter. [39372/24]
View answerEnhancement of the National Clinical Programmes in Mental Health, including Dual Diagnosis, is a priority for me, for the Government and for the HSE.
Dual Diagnosis refers to a person who experiences both a substance abuse problem and a mental health difficulty such as Depression, or an Anxiety Disorder. Treatment options must address both.
Government policies including Sharing the Vision, our national mental Health policy, and Reducing Harm, Supporting Recovery, our national Drugs Strategy, set out clear commitments to improving services for people with a Dual Diagnosis.
In particular, Sharing the Vision recognises that people with a Dual Diagnosis should have access to appropriate mental health services and supports.
An integral part of the Dual Diagnosis Programme has been the development of a Model of Care which describes a clear clinical pathway for all adolescents and adults with Dual Diagnosis support needs. There is an emphasis on integrated service delivery across primary care, substance misuse, community mental health and acute services.
The Model of Care was endorsed by the College of Psychiatrists of Ireland and was launched jointly by me and Minister Naughton in May 2023. The Model of Care recommends the development of 12 Adult Specialist Dual Diagnosis Teams nationally, and 4 Adolescent Teams.
It is being delivered by HSE Mental Health Services on regional basis and, to date, funding has come from both Mental Health and Social Inclusion Services.
I am happy to report that funding of over €2 million has been provided to support recruitment in this area up to 2023, with additional funding provided in budget 2024 and the revised estimates for additional posts.
In relation to service development, recruitment for the two adult teams in the Midwest and County Cork is ongoing and the teams are not yet accepting referrals.
Recruitment for the two adolescent teams in the Dublin area are also at an advanced stage.
In the meantime, individuals who do require treatment for Dual Diagnosis are being supported by the relevant HSE Social Inclusion addiction services in their community. For hospital admissions, people with dual diagnosis are treated through Emergency Departments.
This continued investment highlights this Government’s commitment not only to mental health, but to ensuring that the mental health services that we develop, and deliver are reflective of the needs of modern society.
In addition, a National HSE Dual Diagnosis Rehabilitation Centre has been recommended in the Model of Care for Dual Diagnosis. This is intended to be used for rehabilitation of those with serious and significant mental health difficulties and substance use disorders, accepting referrals from across Ireland. This service development (Keltoi) is being advanced as a partnership service between HSE Social Inclusion in CHO 9 and the Dual Diagnosis National Clinical Programme/HSE Mental Health Services.
The Department remains committed to developing the National Dual Diagnosis Centre (Keltoi) as envisaged under the Model of Care. The HSE are currently looking at staff requirements and other key dependencies for the development of this service and have indicated that a resource proposal will be submitted, as part of the HSE budget Estimates bid, when complete.
In the meantime, individuals who do require treatment for dual diagnosis are being supported by the relevant HSE addiction and mental health services in their community.
40. Deputy Patrick Costello asked the Minister for Health for an update on public health nurse staffing levels serving the Drimnagh area. [39329/24]
View answerAs this is an operational matter, I have asked the HSE to respond to the Deputy Directly.
41. Deputy Gino Kenny asked the Minister for Health if he is aware that the HSE’s 2024 pay and numbers strategy has resulted in many health service posts being eliminated and that this is causing immense problems across the health service; and if he will make a statement on the matter. [39360/24]
View answer45. Deputy David Cullinane asked the Minister for Health if he will increase the severe restrictions on recruitment in the health service under the pay and numbers strategy; if he will reverse the loss of pre-existing vacancies; if he is aware of the complications his budget has caused for people returning from leave or career breaks; and if he will make a statement on the matter. [39371/24]
View answer46. Deputy Gino Kenny asked the Minister for Health if he is aware of the severe operational difficulties the HSE’s 2024 pay and numbers strategy has caused across the health service; and if he will make a statement on the matter. [39359/24]
View answer53. Deputy Richard Boyd Barrett asked the Minister for Health the due diligence he has carried out to ensure the pay and numbers strategy is not adversely affecting patient safety across our hospitals; and if he will make a statement on the matter. [39418/24]
View answer55. Deputy Paul Murphy asked the Minister for Health if funding provided in budget 2025 will be used to reverse the decision in the HSE pay and numbers strategy to not fill all posts that were unfilled at the end of 2023; and if he will make a statement on the matter. [39379/24]
View answer58. Deputy Richard Boyd Barrett asked the Minister for Health if the current allocation of posts under the pay and numbers strategy is adequate to maintain patient safety across our hospitals and health services; and if he will make a statement on the matter. [39419/24]
View answerI propose to take Questions Nos. 41, 45, 46, 53, 55 and 58 together.
There has been an unprecedented level of investment by this Government in the health service workforce in recent years, with the growth in the number of staff recruited in 2023 being the highest since the foundation of the HSE
As of August 2024, there were 27,901 more staff working in our health service than there were at the beginning of 2020. That’s a 23% increase which includes 9,325 nurses and midwives; 4,092 health and social care professionals; and 3,330 doctors and dentists.
The HSE was funded to recruit 6,000 staff in 2023, but hired 8,239, meaning it exceeded its funded workforce targets by more than 2,200 staff.
While the increase in our workforce has been incredibly positive and has enabled significant improvements in service delivery and reductions in waiting times for patients, it is important that the HSE operate within budgeted levels and that prudent controls are in place to ensure the workforce growth is managed in an affordable and sustainable manner
In July of this year Government approved a two-year agreement on Health Expenditure for 2024 and 2025, which provided an additional €1.5 billion in funding for the health service in 2024, and a further €1.2 billion for Existing Level of Service (ELS) in 2025.
This agreement allowed for the regularisation of 2,000 posts that the HSE had recruited which, up to now, were not funded, and a further 2,000 posts recruited temporarily to support services during the COVID-19 pandemic, and which are still in place and now permanent.
This agreement has also facilitated finalisation of the HSE’s Pay and Numbers Strategy for 2024, in which there is now a new approved maximum employment ceiling for all Hospitals and CHOs within the HSE of 129,753 (excludes Disability) in 2024.
These newly agreed limits and the regularization of previously unfunded posts has removed the obstacle to normal recruitment and replacement in the remainder of the workforce, resulting in the immediate lifting of the recruitment pause.
Each Health Regions/National Services have each been provided with their own limits in which to operate and each Regional Executive Officer/National Director will have the ability to prioritise recruitment and replacement within their approved number as appropriate
In addition, provision has been made for the HSE to recruit an additional 4,210 WTE in 2024 (3,310 funded by Dept. of Health and 900WTE funded by DCEDIY).
42. Deputy Ruairí Ó Murchú asked the Minister for Health the plans for the building of the additional ten beds in the Drogheda department of psychiatry, and the timeline for its completion; if he is aware of the 55 WTE vacant posts currently in Louth-Meath mental health services; the plans the HSE has to fill these positions; and if he will make a statement on the matter. [38775/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
43. Deputy Pauline Tully asked the Minister for Health for an update on the provision of insulin pump therapy in Cavan General Hospital; and if he will make a statement on the matter. [39389/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
44. Deputy Bernard J. Durkan asked the Minister for Health if he expects to be in a position to ensure the seamless availability of back-up services for children or adults with extra needs such as mental health issues, autism diagnosis and provision of appropriate services for young adults who battle with mental health problems, to the extent that any waiting times are minimised and there is a roadmap to facilitate families thus affected; and if he will make a statement on the matter. [39442/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
