Written Answers Nos. 1-30
2. Deputy Matt Carthy asked the Minister for Health if he will commission an appraisal of the demand for CT and MRI scanners at Monaghan Hospital, with a view to ensuring that these services are made available in Monaghan; and if he will make a statement on the matter. [25552/24]
Amharc ar fhreagraAs Minister for Health, I am committed to the ongoing development of regional hospitals, including Cavan & Monaghan Hospital, which operate together.
This Government has allocated significant resources in order to meet the needs of patients using the hospital:
• The budget for Monaghan Hospital has increased from €11m in 2021 to €14m in 2024, an increase of 27%.
• Staffing has increased by 70%, from 102 in 2020 to 174 in 2024.
• Under our bed expansion plan, a total of 97 beds will be delivered at Cavan and Monaghan Hospital by 2028. This includes 23 beds between 2021-2024 and 74 beds between 2025-2028.
• Cavan & Monaghan Hospital currently has two operating CT scanners and one MRI scanner.
• The HSE has advised my officials that clear clinical pathways already exist that support the region for access to MRI and CT scanner modality, that no service requirement has been identified for an additional MRI scanner to be installed at Monaghan Hospital, and that no business case for additional capacity has been submitted by the management of Cavan & Monaghan Hospital.
• All capital projects in the HSE have to progress through the different stages of the Public Spending Code, which at the initial stage require a detailed business case to be developed by the hospital delivering a service, ensuring value for money is achieved.
3. Deputy Rose Conway-Walsh asked the Minister for Health the number of home help workers employed directly by the HSE; and if he will make a statement on the matter. [25760/24]
Amharc ar fhreagraImproving access to home support is a priority for the Government. Since Budget 2021, we have provided approximately 230 million euro in additional funding. Preliminary data indicates that over 22 million hours of home support were provided in 2023, exceeding the HSE’s target. This is more than has ever been delivered before.
The latest preliminary data also indicates that, by the end of April, approximately 7.5 million home support hours had been delivered nationally to over 56,000 people. This is approximately 590,000 more hours than at the same time last year.
Home support is delivered through a combination of HSE direct services, provided by HSE workers, and home support delivered by private profit and not-for-profit providers under the HSE’s Authorisation Scheme.
Close to 40% of home support is delivered directly by the HSE. As of April 2024, there were 5,047 Healthcare Assistants – Home Support employed by the HSE. This represents 3,739 whole time equivalents. Since 2019, this staff cohort has increased by 174 WTE or 4.9%.
There is a recruitment pause in place in the HSE, nationally, but home support staff recruitment is exempt from this where the posts are to facilitate discharge from hospital. The HSE has also encouraged its Chief Officers, where appropriate, to consider increasing the hours of current home support staff who may have additional capacity.
17. Deputy Aindrias Moynihan asked the Minister for Health for the urgent reinstatement of podiatry services for a town in County Cork (details supplied); and if he will make a statement on the matter. [25737/24]
Amharc ar fhreagraI recognise that the provision of podiatry services is very important. Podiatry specialises in the management and treatment of disorders affecting the lower limb and can significantly improve a person’s quality of life by promoting and maintaining mobility.
Currently, podiatry services provided by the HSE are offered on a priority basis to medical card holders aged 65 and over, people with certain illnesses (such as diabetes or arthritis), and people with disabilities.
I have allocated significant resources under the Enhanced Community Care (ECC) Programme to establish Specialist Diabetes teams within community hubs to better support GPs to manage people with complicated diabetes.
Where necessary, GPs can refer these patients into ECC Chronic Disease teams, where further specialist services are provided, including podiatry, along with dietary advice, and if necessary, access to consultant-level care in the community.
I have been advised by the HSE that community podiatry services remain available across the Cork area, including North Cork.
However, I recognise that the podiatry services in County Cork are experiencing staffing challenges especially in the context of the current recruitment pause.
This has impacted their ability to deliver the full range of services. They have implemented a robust clinical prioritisation system, which allows them to focus on patients with the highest clinical needs, ensuring they receive timely and effective care.
I welcome this focus on those with the greatest need. I fully acknowledge that there is a growing need for the provision of podiatry services in every local community, especially with an ageing population.
18. Deputy Louise O'Reilly asked the Minister for Health to outline Ireland's position in respect of the European Commission's revision of the general pharmaceutical legislation; if he is concerned about the impact of the proposals on the attractiveness of Ireland as a location for investment; and if he will make a statement on the matter. [23116/24]
Amharc ar fhreagraThank you, Deputy. The Commission’s aims in revising this legislation are to make medicines more available, accessible, and affordable. It also seeks to support innovation, boost the competitiveness of the EU’s pharmaceutical sector, promote higher environmental standards, and combat antimicrobial resistance .
I fully support the Commission’s ambitions in this regard. EU patients need access to safe and effective medicines, health systems need to be sustainable, and we need a strong, innovative, pharmaceutical sector.
The Department of Health, the lead Government Department for this package, continues to engage in deliberations through the Council Working Party.
To inform the national position, I established the Pharmaceutical Strategy Working Group, through which my Department led engagement across Departments and agencies, to ensure that the national position takes account of the full scope of stakeholder positions.
The Government is proud of Ireland’s pharmaceutical industry. Supporting and enabling safe and effective clinical trials, the commercialisation of innovation, and the scaling of life science companies to enable the development of life-saving products for patients, while also supporting job creation, is a priority for Government. Maintaining the EU’s investment attractiveness is therefore a key consideration of this file.
In parallel, we must find the right balance in meeting the full ambitions of the Commission. We must ensure that the needs of the health systems and objectives of the pharmaceutical industry work synergistically and in doing so ensure that timely access to new medicines for patients in Ireland is maximised.
19. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 38 of 2 May 2024, to provide an update on the SAR/PBC by the project team and the Galway University Hospital’s capital programme oversight board for the new emergency department, women and children’s block in UHG; the timeline for when it is expected to move to pre-tender stage; to provide an update on the master plan for the UGH campus; the timeline for when it is expected to be completed and published; and if he will make a statement on the matter. [25538/24]
Amharc ar fhreagraThere are a number of significant capital investment projects proposed for the University Hospital Galway (UHG) campus, which will provide state of the art facilities at UHG. These include a new Emergency Department, Women and Children’s Block, a Regional Cancer Centre, and replacement laboratories.
Due to the significant scale and complexity of these projects, a programmatic approach is necessary to ensure the continued delivery of healthcare on the busy and congested hospital campus. To achieve this, a Capital Programme Oversight Board, established by Saolta, has been tasked with developing an integrated, strategic master plan for UHG.
This Board has met eight times and is in the process of appointing a Programme Manager. A Design Team, supported by a Health Planner, is carrying out work on the strategic master plan.
The Strategic Assessment Report for the Emergency Department, Women and Children’s Block has been reviewed by my Department and has been returned to the HSE with feedback. It will now be subsumed into a Strategic Assessment Report/Preliminary Case (SAR/PBC), a document which Saolta’s Oversight Board will be developing into a more integrated and strategic plan aligned to the wider campus master planning.
This will ensure that the much-needed capital investment will address population demand, integrated service capacity needs and will ensure that delivery is achievable, affordable and represents value for money.
20. Deputy Pádraig O'Sullivan asked the Minister for Health to outline the supports available to teenagers at risk of self-harm and suicide-related ideation; and if he will make a statement on the matter. [25703/24]
Amharc ar fhreagraI thank the Deputy for raising this important and difficult topic – self-harm and suicide related ideation are complex issues, there is never any one reason why a teenager might experience them. The behaviour we refer to as self-harm is often considered to be a way of ‘managing’ difficult feelings, painful memories, or overwhelming experiences. It is a risk factor for suicide related ideation. The key message for teenagers experiencing these issues is that supports are available, and recovery is possible.
Family GPs are the key contact for accessing support, there are many services they refer people on to such as CAMHS and treatments such as talk therapies. As part of the National Clinical Programme on Self-Harm and Suicide, GPs are supported by Suicide Crisis Assessment Nurses (SCAN) to urgently assess people experiencing a suicidal crisis and identify the supports they need. As part of the €10m additional funding I secured this year 4 further SCAN nurses will be recruited, to work with children and teenagers.
Crisis supports include the Samaritans and the 24-hour crisis text service 50808. Spunout.ie have resources online for young people on accessing support, and they can also engage with Pieta services if they are self-harming or in a suicidal crisis. If a person is at immediate risk of harm, they should present to their local Emergency Department.
21. Deputy Duncan Smith asked the Minister for Health what State funding provisions have been provided to an organisation (details supplied); if, in Budget 2025, these provisions are to be increased; and if he will make a statement on the matter. [25064/24]
Amharc ar fhreagraThanks to continued investment in Health Services, Ireland has seen a decline in the number of deaths from cardiovascular disease (CVD). Since 2012, the mortality rate from heart disease has been reduced by 38%, mortality from stroke has been reduced by 48%. However, CVD remains a significant challenge claiming 9,000 lives annually.
The Government acknowledges the vital support, education, and advocacy offered by the Irish Heart Foundation and other patient support groups. Partnerships and collaboration are and will continue to be, enablers of our commitment to promoting the cardiovascular health of our nation.
Many patient services are embedded in policy, including the National Stroke Strategy 2022-2027 for which the government has provided over €7m to date.
In 2022 and 2023, the HSE's National Heart Programme, supported through the Enhanced Community Care Programme, sponsored two CVD risk prevention projects with the IHF.
The State, via the HSE, provides funding to the IHF, and other cardiovascular support agencies of approximately €530,000 through Service Level Agreements and Grant Aid Agreements of which €380,000 was allocated to IHF in 2024.
In 2024, the HSE advise that an additional once-off sum of €400,000 has been allocated to the Irish Heart Foundation's for a High-Risk CVD Prevention Programme which has demonstrated its effectiveness by enhancing healthcare provision, clinical outcomes, and health behaviours in patients living in deprived communities.
22. Deputy Matt Carthy asked the Minister for Health his proposals to ensure that the affected children can complete their orthodontal treatment in the orthodontal clinic in Louth County Hospital, following the resignation of their orthodontist. [25553/24]
Amharc ar fhreagraThe HSE has been asked to investigate this matter and has confirmed that recruitment to fill current orthodontist vacancies to the orthodontic service in Louth is ongoing. In addition, the existing national procurement framework which is supporting the transfer of patients to private care, supported by additional funding which I have made available, has been extended which will allow some patients to be transferred to contracted orthodontic service providers. This initiative supported over 2,000 additional patients to access orthodontic treatment in 2023 nationally, and is targeting a further additional 500 patients access to services in 2024.
To provide additional support while permanent recruitment is progressing, the HSE will be using temporary agency orthodontists. In addition, a specialist orthodontist from another area is providing an additional resource for two waiting list assessment clinics and five treatment clinics during May, June and July.
At present, HSE local management is actively engaged in scheduling appointments for orthodontic patients who have commenced active treatment and are currently waiting to be assigned to an alternative orthodontist. All patients affected have been reviewed over the past number of months. Patients will be further contacted to update them on work to date to continue their care.
My officials will continue to engage with the HSE on this matter, to ensure that patients continue to receive the necessary orthodontic care.
23. Deputy James O'Connor asked the Minister for Health if he will provide a timeline for the provision of a new ambulance base in Youghal, County Cork; and if he will make a statement on the matter. [25769/24]
Amharc ar fhreagraThe National Ambulance Service (NAS) Capital & Estates Office is in the process of updating the NAS Estates Strategy in consultation with HSE Capital & Estates.
This strategy will re-evaluate the priorities of all NAS ambulance station requirements in the context of available capital investment.
Under new Regional Health Structures, the development of Youghal Ambulance Station will be viewed in the context of ongoing service development in the HSE Southwest Health Region.
Ambulance facilities in Youghal were previously assessed by the NAS in conjunction with HSE Capital & Estates as part of the Estates Strategic Plan 2016-2020, which recommended that the base be maintained with minor ongoing capital investment.
Within Cork, HSE Capital & Estates have engaged Design Teams and are progressing plans for a new Ambulance Base in Mallow.
A NAS Regional Headquarters and Education Facility at St. Finbarr’s Hospital in Cork City are also at statutory approval stage.
24. Deputy Rose Conway-Walsh asked the Minister for Health what steps he is taking to increase productivity and health outcomes in Mayo University Hospital; and if he will make a statement on the matter. [25759/24]
Amharc ar fhreagraAs Minister for Health I am committed to the ongoing development of regional hospitals, such as Mayo University Hospital. This Government has allocated significant resources in order to improve services for patients in Mayo.?
In 2020, Mayo University Hospital had a budget of €119 million. This year, the budget is €143 million, meaning its Budget has grown by €24 million, that’s a 20% increase in just 4 years.?
Just last month, I visited Mayo University Hospital to meet with staff and see the progress of the development of the Emergency Department.
There has been a number of quality improvements at MUH such as a new discharge and transfer lounge, new electronic “Healthlinks” for endoscopy referrals and an expanded quality and patient safety team.
Further, on radiation oncology, the hospital continues to extend the working day for radiographers, facilitating extra MRI slots each day.
In January of this year I established a Productivity and Savings Taskforce with the aim of maximising the use of health funding. In April I announced an Action Plan that sets out an ambitious programme of savings targets aimed at minimising the level of financial risk the HSE is facing in 2024; and a range of productivity measures that aim to maximise access to health services for the public at all hospitals including Mayo University Hospital.
25. Deputy Richard Bruton asked the Minister for Health if he will outline the waiting list activity of the NTPF to date in 2024; if it is on track to deliver its targets for the year; and if he envisages any extension of its remit in this sphere to meet other areas where waiting times can be a problem. [25751/24]
Amharc ar fhreagraThe 2024 Waiting List Action Plan that I published in March this year set very ambitious activity targets for the National Treatment Purchase Fund (NTPF) . Within its budget of €179 million it is to arrange 163,500 episodes of care for patients on public hospital waiting lists;
• 110,000 outpatient appointments,
• 35,000 IPDC procedures
• 18,500 GI scopes.
• In addition, 117,692 patients who no longer require treatment are to be removed from waiting lists through administrative validation.
• Working with both public hospitals (insourcing) and private hospitals (outsourcing) to the end of April the NTPF is ahead of target in all four activity areas by;
• 30% for outpatients,
• 3% for IPDC,
• 15% for GI Scopes
• and 9 % for administrative validation.
• In relation to further developments, the NTPF together with the Health Service Executive and the Department has commenced a programme of work to develop full waiting list data collection and a waiting list management protocol for acute hospital radiology diagnostics. This is one element of a wider project to implement Best Practice Reporting of waiting time and waiting list reporting for patients on acute hospital outpatient, inpatient, day case and radiology diagnostic waiting lists.
26. Deputy Ruairí Ó Murchú asked the Minister for Health the number of dentists across the State still treating medical card patients; and if he will make a statement on the matter. [25718/24]
Amharc ar fhreagraThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. Services available annually and on demand include an examination including preventative elements, two fillings, extractions, and a scale and polish. More complex care, such as dentures, additional fillings and a broader range of treatments for patients with additional needs and high-risk patients, are available subject to the approval of the local HSE Principal Dental Surgeon.
There are currently 808 dentists who have contracts with the HSE and who are providing services under the Scheme. To support practitioners to provide care under the Scheme, I approved a range of measures that were put in place on 1 May 2022 to introduce and reintroduce elements of preventative care and increase the fees paid to dental contractors for most treatment items by 40-60%. These measures have improved access to care - in 2023, 154,864 additional treatments were provided under the DTSS, with over 26,700 extra patients treated when compared with 2022.
In the longer term, the Government is committed to reforming dental services, including the DTSS, through the implementation of the National Oral Health Policy (NOHP), Smile agus Sláinte. An implementation plan for the 2024-2026 phase of rollout is being drafted by my Department and the HSE, for consultation and subsequent publication in the third quarter of this year. The HSE is committed to the design and development of packages of expanded preventative care, and will consult with the profession this year on this draft design, as the first phase of reform of the DTSS.
27. Deputy Patrick Costello asked the Minister for Health for an update on the review of abortion legislation taking place by his Department; and to provide a timeline for the completion of same. [23316/24]
Amharc ar fhreagraThe Independent Review of the Operation of the Health (Regulation of Termination of Pregnancy) Act 2018 made a number of recommendations around increasing access to services, most of which are operational in nature.
The HSE, as requested by Government established a service improvement group to progress the operational recommendations. Meetings of this group are ongoing.
Significant progress has already been made in this regard, for instance six additional hospitals started providing termination services in 2023, an increase of 55%.
Termination services in early pregnancy (up to 12 weeks) are currently provided in 17 of the 19 maternity hospitals, with the remaining two expected to come onboard in 2024.
There has also been a sustained increase in community providers, approximately an additional 20 in the last 12 months alone.
Furthermore, the revised model of care introduced in response to the Covid pandemic has now been approved as the enduring model of care. Under this blended approach, it is possible for one of the two consultations required for termination in early pregnancy to take place remotely.
This will alleviate the time and expense involved in travelling to the GP's surgery twice.
The cumulative effect of these measures, now in place, will substantially reduce barriers and increase access to services for those who need it.
Safe Access Legislation passed both Houses of the Oireachtas and was signed by the President on 7th May 2024.
The Review proposals recommending legislative changes were referred to the Joint Committee on Health for consideration. The Joint Committee on Health submitted a report on the proposed legislative recommendations in December 2023. Further consideration of this issue is to take place at the Cabinet Committee on Health.
28. Deputy Patrick Costello asked the Minister for Health if he will meet with the families of individuals moved from Cherry Orchard Hospital. [23317/24]
Amharc ar fhreagraThe Department of Health has engaged with numerous representations from residents’ families and their representatives, and from local councillors and TD’s. I understand fully the upset and anxiety this has caused for the affected families. The HSE has assured me that they are doing everything possible to alleviate the distress this decision has caused. As Minister for Mental Health and Older People, I take the health and safety of residents in long-term residential care facilities very seriously. I will not ignore a directive from the Health Information and Quality Authority (HIQA) stating that there is a fire and safety risk in any facility that potentially jeopardises the welfare and wellbeing of nursing home residents and the staff who work there. HIQA is the statutory independent regulator for this sector and this responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and Quality Standards. In discharging its duties, HIQA determines through examination of all information available to it, including site inspections, whether a nursing home meets the regulations in order to achieve and maintain its registration status. I am fully supportive of HIQA and their capacity to visit any long-term residential care facility to ensure that the best practices are being implemented and the best supports are being provided to older people. It is important that we have the processes in place to ensure that standards are maintained. I have previously stated, and I wish to reiterate here, that while I am Minister of State with responsibility for Mental Health and Older People there will be no diminution of HIQA’s role vis-à-vis standards and regulations. The Department of Health has maintained open and transparent lines of communication with the families of the residents, and with the HSE, at all times throughout the process of managing the issues at Cherry Orchard Hospital and accommodating residents elsewhere on a temporary basis. It is my understanding that the HSE has met with the families several times since the safety issues at Willow and Sycamore units were first identified and explained in full detail the nature of the problems and the rationale for the decision to temporarily transfer residents from these units to facilitate completion of the remedial works. While the Department and I have been kept fully informed and updated by the HSE at all times, the HSE are closer to the situation at Cherry Orchard and are in the best position to provide an accurate, immediate, informed evaluation of these matters. It is important that the residents and their families continue to engage with the HSE in respect of these matters.
29. Deputy Pearse Doherty asked the Minister for Health what plans, if any, are in place to deal with the crisis in diabetes care at Letterkenny Hospital; and if he will make a statement on the matter. [25768/24]
Amharc ar fhreagraLetterkenny University Hospital (LUH) is fully funded for the recruitment of two consultant endocrinologist posts with 100% commitment at LUH and a further consultant endocrinologist post with a 50% commitment to LUH and 50% commitment to Primary Care/Enhanced Community Care.
Recruitment to fill those posts is currently underway. There are applicants for these posts, interview dates are being scheduled and candidates are awaiting interview.
These posts have been advertised more than once, but similar to some other Model 3 hospitals it has proven difficult to identify suitable candidates. Notwithstanding this, LUH remains committed to the recruitment process and recent recruitment advertisements have provided some re-assurance that the recruitment challenges will soon ease.
With existing resources, LUH facilitates four adult outpatient clinics per month (2 Diabetic clinics, 1 Endocrine Clinic, and 1 GIM/Endocrine clinic). In addition to these clinics there are 1 pump clinic and 1 transition clinic.
LUH runs four Paediatric Diabetes Outpatients Clinics per month. Two of these are Consultant led and the other two are nurse led.
LUH currently has two WTE Diabetes ANPs, one in Paediatric Diabetes and one in Gestational Diabetes. Injection Clinics and Pump Clinics are held twice per month and an ANP Clinic is held twice weekly. It is anticipated that the Dose Adjustment for Normal Eating (DAFNE) programme will be introduced in LUH later this year.
LUH currently employs 2.5 WTE dietitian posts in its Diabetes service, and two WTE Acute Clinical Nurse Specialists, as well as one WTE staff nurse and a clerical officer.
I, as Minister, and LUH remain fully committed to improving access to care for patients with Diabetes. Resolution of the recruitment challenges in relation to the fully-funded Consultant posts will be the key to the further development of services available and to the sustainable delivery of services to patients in the long term.
30. Deputy Ruairí Ó Murchú asked the Minister for Health the measures being taken to increase the number of GPs available to private patients in County Louth; and if he will make a statement on the matter. [25719/24]
Amharc ar fhreagraGPs are private practitioners, most of whom hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders. As self-employed practitioners, GPs may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.
Where a person who holds a medical card or GP visit card, experiences difficulty in finding a GP to accept them as a patient, that person having unsuccessfully applied to at least three GPs in the area (or fewer if there are fewer GPs in the area) can apply to the HSE National Medical Card Unit which has the power to assign a GMS patient to a GP's GMS patient list in accordance with the GMS contract.
People who do not hold a medical card or GP visit card access GP services on a private basis and can make enquiries directly to any GP practice they wish to register with. As private practitioners, it is a matter for each individual GP to decide whether to accept additional private patients.
The Government is working to increase the number of GPs practicing in the State and thereby improve access to GP services across the country.
Under the 2019 GP Agreement additional annual expenditure provided for general practice was increased by €211.6m. This provided for significant increases in capitation fees for participating GMS GPs, and new fees for additional services and increased practice supports. The GP Agreement 2023 further increased GP capitation fees, increased the existing subsidy rates for practice staff, and introduced a grant support for additional staff capacity as well a practice staff maternity leave support. These measures make general practice in Ireland a more attractive career choice for doctors.
The number of doctors entering GP training has been increased significantly in recent years, with 286 new entrants in 2023 and 350 places made available for new entrants for this year. Annual intake to the GP training scheme has been increased by over 80% from 2015 to 2023, and the number of new entrant places to be available this year is a 22% increase on last year's intake.
Furthermore, GP recruitment is ongoing under the joint International Medical Graduate Rural GP Programme between the HSE and the Irish College of General Practitioners (ICGP). 121 non-EU GPs were enrolled under the training programme last year and it is planned to recruit up to 250 more GPs from outside Ireland this year. The placement of GPs under the programme is targeted to rural and underserviced areas.
