Pauline Tully
Ceist:1896. Deputy Pauline Tully asked the Minister for Health the number of children waiting for paediatric neurosurgery nationwide. [35670/24]
Amharc ar fhreagraHospital Waiting Lists
Ceisteanna (1896)
Freagraí scríofa
Adult and child Inpatient and Day Case waiting lists by hospital and specialty are published monthly and are available on the National Treatment Purchase Fund's website at: ntpf.ie/home/nwld.htm
The information is now being made available through an interactive visual tool which provides users with a much-improved way of accessing and analysing waiting list information.
Healthcare Infrastructure Provision
Ceisteanna (1897)
Pauline Tully
Ceist:1897. Deputy Pauline Tully asked the Minister for Health his plans to establish a specialist menopause clinic to be based in Cavan. [35671/24]
Amharc ar fhreagraFreagraí scríofa
Specialist Complex Menopause Clinics accept referrals from GPs in the surrounding catchment and provide specialist medical advice and management to the following cohort of symptomatic women:
• Women whose treatment within primary care settings does not improve their menopausal symptoms,
• Women who are experiencing on-going troublesome or clinically significant side effects further to treatment within primary care setting e.g. bleeding
• Women who have contra-indications to HRT, and
• Women about whom there us uncertainty about the most suitable treatment option for their menopausal symptoms e.g. complex medical history.
There are six regional complex menopause services, one in each of the existing maternity networks located in each of the six hospital groups.
Specifically, these clinics are located in the Coombe Hospital, the National Maternity Hospital, the Rotunda Hospital, Galway University Hospital, Cork University Maternity Hospital and Nenagh Hospital under the clinical governance of University Maternity Hospital Limerick.
The Specialist Menopause Clinic in the Rotunda Hospital serves the RCSI Maternity Network and there is currently no plan to open a second specialist clinic in the same network i.e. Cavan.
Hospital Staff
Ceisteanna (1898)
Pauline Tully
Ceist:1898. Deputy Pauline Tully asked the Minister for Health the number of WTE clinical specialist physiotherapists in paediatric neurosciences at CHI Temple Street in the years of 2023 and to date in 2024, in tabular form. [35672/24]
Amharc ar fhreagraFreagraí scríofa
“As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.”
Health Services
Ceisteanna (1899)
Michael Lowry
Ceist:1899. Deputy Michael Lowry asked the Minister for Health to ensure adequate funding to respond to the changing needs of people supported by an organisation (details supplied); whether he will take this matter into consideration when finalising his budget 2025 plans; and if he will make a statement on the matter. [35682/24]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Hospital Staff
Ceisteanna (1900)
Richard Boyd Barrett
Ceist:1900. Deputy Richard Boyd Barrett asked the Minister for Health the number of new recruits in St. Michael’s Hospital, Dún Laoghaire, St. Vincent’s University Hospital, Elm Park and St. Columcille’s Hospital, Loughlinstown during the period 1 June and 3 September 2024; the breakdown in each hospital of the title and number of those positions; and if he will make a statement on the matter. [35708/24]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Strategies
Ceisteanna (1901)
Brendan Griffin
Ceist:1901. Deputy Brendan Griffin asked the Minister for Health the steps he is taking to ban vapes being marketed to adults and children (details supplied). [35709/24]
Amharc ar fhreagraFreagraí scríofa
I am developing a General Scheme for comprehensive legislation on nicotine inhaling products, including in relation to display, packaging, flavours and a prohibition on disposable or single use products. I intend to bring these measures to Government shortly.
Healthcare Infrastructure Provision
Ceisteanna (1902)
Seán Sherlock
Ceist:1902. Deputy Sean Sherlock asked the Minister for Health if he is aware of the HSE South/South West review of 2018-2019, relating to the location of a post-acute specialist regional rehabilitation unit for the south/south west, carried out by an external expert (details supplied) in February 2017; if he will report on the status of such a report; and if Mallow General Hospital is being considered as an option as a location for a post-acute specialist regional rehabilitation unit the South/South West Hospital Group, HSE. [35714/24]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Services Staff
Ceisteanna (1903)
Seán Sherlock
Ceist:1903. Deputy Sean Sherlock asked the Minister for Health the number of staff hired across all therapies, in each CHO and LHO, in tabular form. [35722/24]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Hospital Appointments Status
Ceisteanna (1904)
Seán Sherlock
Ceist:1904. Deputy Sean Sherlock asked the Minister for Health the reason for the delay in relation to an urgent ENT appointment for a child (details supplied). [35754/24]
Amharc ar fhreagraFreagraí scríofa
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 particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Service Executive
Ceisteanna (1905, 1926, 1927)
Jim O'Callaghan
Ceist:1905. Deputy Jim O'Callaghan asked the Minister for Health if he can intervene in the HSE decision to exclude health and social care professionals from the senior management team in the new HSE health regions; and if he will make a statement on the matter. [35756/24]
Amharc ar fhreagra
Róisín Shortall
Ceist:1926. Deputy Róisín Shortall asked the Minister for Health if role development and governance will be consistent across the new regional health areas; and his views on the director of psychology role in the south-west regional health area in this regard. [35890/24]
Amharc ar fhreagraRóisín Shortall
Ceist:1927. Deputy Róisín Shortall asked the Minister for Health if he intends to develop directorships for each discipline as part of the transition to regional health areas; if not, if this will be confined to psychology in the south-west region; and if he will make a statement on the matter. [35891/24]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 1905, 1926 and 1927 together.
Health Regions, each led by a Regional Executive Officer (REO), are new HSE structures which now have responsibility for the planning and coordinated delivery of health and social care services for their respective populations.
Each Health Region will have an Executive Management Team (EMT) led by the REO. The EMTs are critical structures for each Region. They will provide the governance and organisational arrangements to enable the planning, management, and delivery of integrated care for people and for communities across their region. Their structure must facilitate clear lines of governance, represent an appropriate span of control for the REO, and ensure that services and staff can benefit from swift and accountable decision making. The structure for these teams has now been agreed and phased recruitment is underway.
Officials from my Department and the HSE considered several combinations for the clinical functions on the EMTs. The approved model was for a single discipline neutral clinical leadership role to sit on the Executive Management Team on the basis that this would provide for clarity of governance and support the delivery of integrated care. However, it was recognised that this might take time to achieve. The HSE CEO therefore decided to have a Regional Clinical Director and an Executive Nurse/Midwife on the Executive as an interim measure and to prepare to transfer to a single, discipline neutral, Clinical Officer over a three year period.
The clinical roles which sit on the Health Region EMT do not exist to represent their professions. Rather, they hold executive accountability for a portfolio of work, which includes collaboration and coordination across professions. This is the best way of delivering integrated care in the interests of patients and service users and breaking down professional silos.
Beyond these EMT positions, the HSE are finalising a regional clinical governance model. Each region will have a regional Clinical Executive consisting of a lead from: Population & Public Health; Medical, Executive Nurse/Midwife, Health & Social Care Professionals, General Practice, Chief Academic Officer, and Quality & Patient Safety. Regions will also develop networks of care, which provide a single governance apex and common design to ensure consistency across the system in standards of practice and service models for defined specialties. It has also been agreed that each REO will also have a regional HSCP advisor who reports directly to them.
The agreed structure does not include a role of Director of Psychology on Regional EMTs. The grade of Director of Psychology has existed in the public health service for more than three decades. It is categorised as a Health and Social Professionals grade. The HSE has delegated sanction to fill posts in any pre-existing grade without needing to seek specific sanction from the Department of Health, once the appointment of a person to any pre-existing grade is within the parameters of the HSE’s Pay & Numbers Strategy. Recruitment for Clinical roles are a matter for the HSE and the Department of Health would not normally be consulted for roles of this nature.
I have asked the HSE to reply directly to the Deputies in relation to the additional queries raised concerning the Director of Psychology post in the HSE South West Health Region.
Departmental Appointments
Ceisteanna (1906)
Seán Fleming
Ceist:1906. Deputy Sean Fleming asked the Minister for Health when a chief pharmacist will be appointed in his Department; and if he will make a statement on the matter. [35774/24]
Amharc ar fhreagraFreagraí scríofa
I am committed to the expansion of the role of pharmacy in Ireland. In July 2023, I established the Expert Taskforce to Support the Expansion of the Role of Pharmacy to examine how pharmacists can be enabled to expand their scope of practice for the benefit of patients and the wider health service.
On August 13, 2024, I published the final report of the Expert Taskforce. The Taskforce made three overarching recommendations:
That pharmacists be enabled to exercise independent, autonomous prescriptive authority within and related to the individual practitioner’s scope of practice and competence.
This should be implemented in a stepwise manner, commencing with the introduction of a common conditions service, with pharmacists provided with prescriptive authority linked to the service and its parameters.
The development, over the coming years, of models of pharmacist prescribing within primary and secondary care settings, recognising the requirements for specific enablers.
In line with the Taskforce's recommendations, I am immediately prioritising supporting pharmacists to prescribe for certain conditions under a new Common Conditions Service. I have established an Implementation Oversight Group with multiagency representation including pharmacists, to support the necessary implementation work to deliver this first phase of pharmacy expansion. I expect a Common Conditions Service to commence in early 2025.
In relation to the Taskforce's package of recommendations for the development of models of pharmacist prescribing across the health service - in other countries, this has involved pharmacists prescribing for more complex conditions in specific settings. In parallel to progressing the common conditions service, I have asked my officials to examine these wider recommendations, which includes the concept of a chief pharmacist, and consider how best to apply these models in an Irish context and the enablers that will be required to design, plan and deliver these. My Department will consider these further over the coming months and engage with stakeholders through established structures.
Medical Cards
Ceisteanna (1907)
Michael Healy-Rae
Ceist:1907. Deputy Michael Healy-Rae asked the Minister for Health if he plans to change means testing for pensioners over the age of 70 years when it comes to applying for a medical card; and if he will make a statement on the matter. [35775/24]
Amharc ar fhreagraFreagraí scríofa
Eligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
Persons aged 70 or older are assessed under medical card income thresholds which are based on gross income. The weekly gross medical card income thresholds for people aged 70 and over are currently €550 per week for a single person and €1050 for a couple. Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card. However, it should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high costs, e.g., medication, nursing home fees.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card - in particular, to take full account of difficult circumstances in the case of applicants who may be in excess of the income guidelines. In such circumstances, the HSE may exercise discretion and grant a medical card, for example:
• Discretionary medical cards issued to patients with significant medical expenses but who do not satisfy the means test.
• Emergency medical cards are issued to patients that are terminally ill, or are seriously ill, and in urgent need of medical care that they cannot afford.
• Medical cards issued to patients who are terminally ill with a prognosis of 24 months or less do not require subsequent means assessment and are not reviewed.
I can assure the Deputy that my Department keeps medical card issues under review in order to ensure the medical card system is responsive and sensitive to people's needs. Over the course of 2024 and 2025, we will review the existing eligibility framework to clearly assess what is working well and to inform policy proposals to enhance eligibility and access to services based on robust evidence. This is an important step towards delivering on universal healthcare in Ireland.
Healthcare Policy
Ceisteanna (1908)
Violet-Anne Wynne
Ceist:1908. Deputy Violet-Anne Wynne asked the Minister for Health if he will consider expanding the long-term illness scheme to more conditions such as early onset Alzheimer’s; and if he will make a statement on the matter. [35792/24]
Amharc ar fhreagraFreagraí scríofa
The Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 conditions covered by the Scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
While there are currently no plans to extend the list of conditions, it is important to remember that the LTI Scheme exists within a wider eligibility framework.
This Government has put a significant focus on improving access to and the affordability of healthcare services, advancing substantial policy, legislation and investment to deliver expanded eligibility. This includes reductions in the Drug Payment Scheme threshold, expansion of access to free GP care, and the abolition of all public in-patient hospital charges for children and adults. These measures continue to create a health and social care service that offers affordable access to quality healthcare.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card under the General Medical Services (GMS) Scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
Hospital Charges
Ceisteanna (1909)
Violet-Anne Wynne
Ceist:1909. Deputy Violet-Anne Wynne asked the Minister for Health if his attention has been drawn to accident and emergency charges of over €100 for parents of children with specialist care needs; and if he will make a statement on the matter. [35793/24]
Amharc ar fhreagraFreagraí scríofa
The Health (Out-Patient Charges) Regulations 2019 provides that, subject to certain exemptions, a charge shall be made for out-patient services provided at designated centres including an emergency department (€100) and a minor injury unit (€75). These exemptions include a person with a medical card, 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.
Subsection 5 of the Health (Out-Patient Charges) Regulations 2019 lists exemptions from the charge for out-patient services provided. Subsection 5(d) provides that the charge shall not be payable by "a child, referred to in section 56(3) of the Act, in respect of diseases and disabilities of a permanent or long term nature prescribed by the Minister with the consent of the Minister for Public Expenditure and Reform". On the basis of the exemption in section 5(d), the €100/€75 charge does not apply where out-patient services are made available in respect of a prescribed disease or disability to a child. The conditions prescribed for the purposes of subsection 56(3) are set out in the Health Services (Amendment) Regulations 1987, Statutory Instrument 114/1987, as follows: "mental handicap, mental illness, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, haemophilia and cerebral palsy."
Hospital Facilities
Ceisteanna (1910)
Violet-Anne Wynne
Ceist:1910. Deputy Violet-Anne Wynne asked the Minister for Health the safeguarding policy in place for vulnerable patients (details supplied) once admitted to the emergency department in University Hospital Limerick; and if he will make a statement on the matter. [35794/24]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the HSE to respond to the Deputy directly.
Hospital Waiting Lists
Ceisteanna (1911)
Violet-Anne Wynne
Ceist:1911. Deputy Violet-Anne Wynne asked the Minister for Health the reason a patient (details supplied) has been waiting six months for an appointment, after two GP letters regarding the suspected recurrence of skin cancer, although the patient now has an appointment for November, if the Minister is content with this level of cancer care; and if he will make a statement on the matter. [35795/24]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.