Thursday, 11 Jul 2024

Health Services

Ceisteanna (385)

Jennifer Murnane O'Connor

Ceist:

385. Deputy Jennifer Murnane O'Connor asked the Minister for Health if a service (details supplied) will be provided in Carlow; and if he will make a statement on the matter. [30775/24]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter, I have asked the HSE to respond directly to the Deputy, as soon as possible.

Health Strategies

Ceisteanna (386)

Brendan Smith

Ceist:

386. Deputy Brendan Smith asked the Minister for Health if he will ensure that adequate funding is provided in 2025 to implement the National Cancer Strategy; and if he will make a statement on the matter. [30776/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

My Department has invested heavily in the National Cancer Strategy and associated initiatives in recent years, enabling the further development of our national cancer services, and leading to improved outcomes for cancer patients.

As 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) investment of €456m in cancer services, including €81m on cancer prevention, screening, and treatment; €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.

We have seen significant progress on the implementation of the Strategy over the past seven years, with clear evidence-based policy direction from my Department and strong implementation by the HSE's National Cancer Control Programme (NCCP).

National Cancer Registry Ireland (NCRI) data shows substantial progress being made to control the four major cancers (prostate, breast, lung and colorectal), with mortality rates falling or stabilising for each. These comprise over half of all invasive tumours (not including rarely fatal non-melanoma skin cancers).

The implementation of the National Cancer Strategy 2017-2026 is a Government priority and continued improvements in cancer services will be driven by both my Department and the NCCP. Priorities for 2024 will include the further centralisation of cancer services which has a direct impact on positive outcomes for patients, and the implementation of models of care for areas such as medical oncology and psycho-oncology, which ensure continuity of care and support for cancer patients and their families.

As with all areas, funding for the National Cancer Strategy, is considered as part of the yearly Estimates process. Decisions on future funding of the National Cancer Strategy will be made in the context of the upcoming Estimates process for 2025.

Health Services Staff

Ceisteanna (387)

Brendan Smith

Ceist:

387. Deputy Brendan Smith asked the Minister for Health if he will ensure that crucial healthcare sector posts are filled based on up-to-date workforce plans; and if he will make a statement on the matter. [30777/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

As this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Healthcare Policy

Ceisteanna (388)

Brendan Smith

Ceist:

388. Deputy Brendan Smith asked the Minister for Health if he will ensure timely access to diagnostic tests as well as life-saving treatment for all cancer patients; and if he will make a statement on the matter. [30778/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

We have seen significant progress on the implementation of the National Cancer Strategy in recent years, with clear evidence-based policy direction from my Department and strong implementation by the HSE's National Cancer Control Programme (NCCP).

Since 2017, there has been an additional investment of €456 million in cancer services, including €81 million on cancer prevention, screening and treatment; €316 million on cancer medicines; and €59 million on cancer research grants through the Health Research Board. The Government has allocated substantial funding of €50 million for national cancer treatment and screening services over the years 2021 to 2023. In the same period, the Government has allocated additional €98 million for new medicines, facilitating the introduction of 61 new cancer medicines.

Capital funding of over €140m has been used to provide state of the art radiation oncology facilities in Galway and Cork, to establish a National Cervical Screening Laboratory, and to update cancer infrastructure in chemotherapy wards and lab facilities for the benefit of patients.

The funding since 2017 has enabled the recruitment of more than 670 staff to our national cancer services. This includes an additional 200 nursing staff, 100 consultants and 180 health and social care professionals in designated cancer centres.

New treatments such as CAR T-cell therapy, radiolabelled therapy, and specialised radiotherapy treatments like SABR are now available for the first time in Ireland.

Rapid Access Clinics (RACs) for breast, lung and prostate cancer have been established in each of the eight designated cancer centres (with a Symptomatic Breast Disease Clinic also in Letterkenny University Hospital as a satellite of University Hospital Galway). The Symptomatic Breast Disease and Rapid Access Lung and Prostate clinics provide access to diagnostics for suspected breast, lung, and prostate cancer. Rapid Access Clinics accept and receive referrals primarily from GPs, but also from clinicians within the hospital system. The performance of these RACs is measured against Key Performance Indicators (KPIs) as defined in the HSE National Service Plan.

The Department of Health continues to monitor the performance of cancer services, including timely access to RACs and treatment, through monthly meetings with the NCCP.

Hospital Facilities

Ceisteanna (389)

Brendan Smith

Ceist:

389. Deputy Brendan Smith asked the Minister for Health if he will abolish car parking charges at hospitals as such costs can be a substantial burden on persons/patients attending hospitals on a regular basis; and if he will make a statement on the matter. [30779/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

Hospitals that charge car parking fees are very aware of the financial implications of those costs for patients and their families. Consequently, the majority of hospitals have some form of exemption or concession in place, such as the option of flexible day passes or multi trip entry passes for regular hospital attenders, or concessions based on the type of inpatient.

The Programme for Government makes a commitment to introduce a maximum daily car parking charge for patients and visitors at all public hospitals, where possible. It also commits to introducing flexible passes in all public hospitals for patients and their families. Accordingly, significant improvements have been made in the majority of our hospitals in line with this commitment, and the HSE continues to keep all fees and concessions under review, in order to progress any opportunities that will ease the burden for those most affected.

Health Services Staff

Ceisteanna (390)

Brendan Smith

Ceist:

390. Deputy Brendan Smith asked the Minister for Health the progress to date in increasing the future supply of healthcare workers across all disciplines; and if he will make a statement on the matter. [30780/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

Building a sustainable health and social care workforce is a top priority for the Government. At the end of May 2024, there are 148,159 WTE directly employed in the provision of Health & Social Care Services by the HSE and Section 38 hospitals & agencies. This is 28,346 more WTE working in our health service than there were at the beginning of 2020, representing a 24% increase in this period which includes an additional 9,504 nurses and midwives; 4,250 health and social care professionals; and 3,105 doctors and dentists.

The number of practising doctors per 1,000 persons in Ireland has steadily grown from 2013 to 2021. Ireland has approximately 4 practising doctors per 1000 inhabitants. This is in line with the OECD average. For every 1,000 people in Ireland, there are approximately 12.73 practising nurses (figure includes midwives who have dual registration but indicated to be a practising nurse). This is above the EU average.

My department works in close collaboration with Department of Further and Higher Education, Research, Innovation and Science and the Higher Education Sector to significantly increase the number of student places across health-related disciplines.

In June 2022, an agreement was reached with the Irish Medical Schools which will see the number of Irish/EU medicine student places increase by 200 by 2026.

Over the period 2014 to 2021 first-year nursing places in Irish Higher Education Institutions (HEIs) grew from 1,570 to 2,032– an increase of almost 30%. DOH has worked with the Department of Further and Higher Education to significantly increase the number of undergraduate training places in nursing and midwifery for the academic year 2023/2024.

Over 660 additional student places have been provided in the Higher Education Sector on health-related courses in the academic year 2023/24. This includes approximately 220 student places across Nursing and Midwifery and Allied Health Professions in Northern Ireland.

In addition, an agreement has been reached between Queen’s University Belfast, Department of Health, and the Department of Further and Higher Education, which will see 25 additional medical places being made available for qualifying students from Ireland or Northern Ireland in QUB in September 2024, and a further twenty-five places in September 2025 bringing the total number of additional medicine student places available in Northern Ireland to 50.

The Department is working with HSE National Office for HSCPs, to develop a governance framework for clinical placements for HSCPs to support the expansion of student places in 2024 and future years.

Further work is underway to continue to increase the domestic supply of doctors, nurses and health and social care professionals.

Nursing Homes

Ceisteanna (391)

Brendan Smith

Ceist:

391. Deputy Brendan Smith asked the Minister for Health the additional measures, if any, that will be implemented to support the smaller scale nursing homes, particularly those that are family run, as increased costs over recent years have impacted on the viability of some nursing homes for the long-term; and if he will make a statement on the matter. [30781/24]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

The Government is conscious of the financial challenges faced by the nursing home sector, especially smaller and voluntary nursing homes that may not have access to the same economies of scale as larger homes or groups.

I have regular meetings with private nursing home provider representative groups where the issues of Government policy and support for the sector are on the agenda. I have committed to continued engagement with the sector.

The National Treatment Purchase Fund (NTPF) is the body designated, under Section 40 of the Nursing Homes Support Scheme Act 2009, to negotiate with persons carrying on the business of a nursing home, for the purposes of reaching an agreement on the maximum prices to be charged for nursing home care, and are based on the NTPF’s cost criteria. These criteria include costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity. This is the only mechanism for funding from the public purse for nursing home residents.

I have regular interaction with the NTPF to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed.

A significant change that the NTPF have made to their negotiation process is to offer nursing home providers contracts of a shorter duration, which will aim to ensure that NTPF rate increases stay aligned with any cost pressure increases that occur over the course of the contracted period. This has allowed for more surety in the sector.

As of the end of April, 420 nursing homes have agreements with the NTPF under the Nursing Homes Support Scheme (Fair Deal). The NTPF is expected to negotiate 389 Deeds of Agreement in 2024. As of end of April, there were 301 still remaining. The average uplift is 5% to date.

There were 257 full Deeds renegotiated in 2023 which resulted in a 6-7% average uplift, with a further number of mid-Deed uplifts in addition to this (this is where Deeds were negotiated with a 2-stage uplift: one at the start and another uplift that comes 6, 12 or 18 months after but still within that Deed of Negotiation).

It should be noted that the Nursing Homes Support Scheme (or Fair Deal) was designed to protect and support vulnerable older people, to ensure equal access to nursing home care based on what they could afford. This gives certainty to people and families.Increases in year-on-year funding for the NHSS continues and will reach €1.5 billion this year. Budget 2023 saw over €40 million in additional funding for the scheme. I am cognisant that the budget must support all participating nursing home residents for the full calendar year.

It is therefore imperative that private and voluntary providers continue to engage in the process as set out in the Nursing Homes Support Scheme Act 2009.

An additional €45.6 million has also been allocated to support nursing homes in Budget 2024, including a new €10 million fund to support private and voluntary nursing homes with HIQA compliance.

The Resident Safety Improvement (RSI) Scheme has been introduced and is designed to target and support structural improvements in nursing homes to assist their meeting HIQA compliance plans in respect of protection against infection and fire precautions. It is active as from 1 January 2024 and can be backdated for eligible works to 1 January 2020.

The Government is aware of the investment trends in the Irish residential care market, the growing consolidation of the sector, and the complex investment and ownership structures that now exist.

I welcome the publication of the ESRI report ‘Long-term Residential Care in Ireland: Developments since the onset of the Covid-19 pandemic’ which brings into focus the challenges facing the long-term residential care sector in Ireland that the Government has been, and continues to, address to provide short-term stability and long-term growth to this sector.

In the context of the ongoing reform of older persons services, including long-term residential care, over the coming years, it is important that all aspects of the nursing home sector continue to be scrutinised. I am committed to ensuring that service delivery and configuration in the sector meets the needs of service users in a sustainable and safe manner.

As per the most recent HIQA report, overall, 2022 saw a net addition of 112 registered beds to total national capacity of private beds, 2023 saw a net addition of 490 beds to total national capacity of private beds and 2024 has seen an increase of 117 beds to date.This is due to the relatively larger size of new nursing homes compared to closures and the addition of capacity in existing homes.In addition, in 2023, the Department of Health convened a steering group to develop and publish design standards for long-term residential care settings for older people. Among the considerations of the group is the optimal size of nursing homes. A public consultation closed on 15 February 2024 and submissions are being analysed to inform the final version of the Design Guide.

I recently welcomed the completion of the national roll-out of a new community based mobile X-ray service which aims to reduce the number of older patients attending Emergency Departments (EDs). Following a pilot launched in 2022, from 1 March 2024 this free, community-based service is available to all residents in nursing homes and Community Nursing Units nationwide. It should also be noted that a nursing home resident's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. This means that nursing home residents who also have medical cards have the same access to GMS services regardless of whether they reside in their own homes or in a nursing home.

Furthermore, in late February, it was announced that over €3.2 million in State support will be provided for over 440 registered nurses in private nursing homes to obtain a Postgraduate Diploma in Gerontological Nursing.

All of these measures are intended to find the right balance between delivering value to the taxpayer, affordable access to long-term care for citizens and a sustainable nursing home sector which ensures that people who require care can continue to receive high quality services in the most appropriate settings.

Health Services Waiting Lists