Written Answers Nos. 1-25
10. Deputy Ruairí Ó Murchú asked the Minister for Health the plans for the construction of a primary care centre in Dundalk, County Louth, the timeline of the construction and resourcing of the centre, the services and staffing numbers that will be provided at the primary care centre, and the cost of the provision of the centre; and if he will make a statement on the matter. [38774/24]
Amharc ar fhreagraI wish to thank the Deputy for allowing me to update the house on this matter.
Dundalk Primary Care Centre (PCC) is being delivered through the Operational Lease mechanism, whereby the HSE enters into agreement with a developer to build a PCC and the HSE then leases the building for a fixed period.
All Primary Care Centres delivered via the Operational Lease model are subject to the normal HSE approval processes and are rigorously examined in relation to all aspects including whether it represents value for money to the HSE.
Planning Permission was granted for Dundalk PCC, however an appeal was lodged with An Bord Pleanála. A decision by An Bord Pleanála to grant planning permission was received in mid-August 2024 with an 8-week standstill period before final grant of planning can be issued.
Once planning permission is finalised, the HSE anticipate that the developer could be on site in Q2 2025 with an estimated construction timeframe of approximately 18 to 24 months.
It is envisaged that a wide range of Primary Care Services, Disability Services, Adult Mental service alongside GP services will be delivered from the centre with staffing numbers for these services to be confirmed closer to the opening of the centre.
I assure the Deputy that my Department is actively engaged with the HSE to progress the further development of primary care centres throughout the country and I very much welcome the progress on Dundalk Primary Care Centre.
12. Deputy Louise O'Reilly asked the Minister for Health if he is concerned at Health Research Board figures outlining alcohol-related poisoning deaths for 2021, which show that alcohol played a role in the poisoning of 155 people; if he is further concerned that this data represents only 10% of all alcohol-related deaths annually, over 1,500 people, which is about four times the number of people who die from other drug use; and if the new national drugs strategy will definitely address alcohol, or if a stand-alone alcohol strategy is needed. [39177/24]
Amharc ar fhreagraThe National Drug Related Death Index (NDRDI) is the official national database for recording poisoning deaths among people who use drugs. It meets the mandatory reporting requirements of the EU and the UN on drug-related mortality, as well as being widely used to provide evidence for national policy and planning. The Health Research Board (HRB) is responsible for compiling and reporting on the NDRDI.
The HRB has recently published 2021 data on drug induced deaths. This records 354 drug poisoning deaths, a reduction of 85 on the number in 2020, a decrease of almost 20%.
Four in 5 deaths were polysubstance poisonings, highlighting the level of risk inherent in combining different drugs. Alcohol was implicated in 91 deaths in conjunction with other drugs.
Alcohol only poisoning deaths, which numbered 64 in 2021, are not included in the data reported from the NDRDI.
The proposed timeframe for the finalisation of the next national drugs strategy, which will set out the Government's health-led response to drug and alcohol use, is the first quarter of 2025.
I would like to acknowledge the loss and grief felt by the families bereaved by a drug poisoning death. It is my priority to enhance access to and delivery of drug and alcohol services in the community, in order to mitigate the risk of premature deaths from drug and alcohol use.
14. Deputy Sean Sherlock asked the Minister for Health if his attention has been drawn to the gradual diminution of anaesthesiology services at Mallow General Hospital to the point where surgical lists have been significantly reduced and the sustainability of services and maintenance of activity levels within the hospital is at risk. [35350/24]
Amharc ar fhreagraThis government has invested significantly in Mallow General Hospital. The Deputy will be aware that this government has added 34 additional beds increasing capacity from 37 beds to 71 beds. A further 24 beds are also planned under the Bed Capacity Expansion Plan.
In 2019, Mallow had a budget of €19.9m, this government has increased the budget for Mallow to €31.7m in 2024, meaning its budget has grown by €11.8m in 5 years. Staffing at the hospital has also grown, by 40% since the end of December 2019, from 252 to 353 at the end of August 2024.
I acknowledge that there are vacant posts in anaesthetic services at Mallow. However, the HSE have advised me that there has been no change to the provision of anaesthetic services provided at Mallow since 2021.
The anaesthetic service at Mallow General Hospital is provided Monday to Friday between 8am and 5pm, by a Consultant Anaesthetist, employed by Mallow General Hospital who also provides services at Cork University Hospital. On the days the consultant employed by Mallow is working in CUH, additional consultant anaesthetic input is provided on an agency basis to Mallow, utilising the funding for the 1.5 WTE posts. This is in addition to their contractual commitments to the hospital that employs them.
The HSE has further advised me that the HSE South West commenced a Strategic Clinical Speciality Review of all clinical specialties including anaesthetics as part of an ‘Integrated Health Programme Review’. This strategic review will be completed by year end December 2024.
15. Deputy Duncan Smith asked the Minister for Health if he plans to develop a new national policy on palliative care for children with life-limiting conditions; and if he will make a statement on the matter. [38831/24]
Amharc ar fhreagraThe Department of Health’s 2010 Children’s Palliative Care Policy guides provision of palliative care services for children and their families in Ireland. Services are provided using a multiagency approach - including adult specialist palliative care services.
The new National Adult Palliative Care Policy contains a suite of recommendations that relate to children’s palliative care. These include implementing the 2020 ‘Bee Wee Report’ recommendations for supporting a model of care for children with life-limiting conditions, towards the end of their life, in the community.
Recurring core statutory funding for Laura Lynn Children’s Hospice was secured for the first time in Budget 2021. This funding has been used to provide a sustainable financial base to the organisation, and to increase their ‘Hospice in the Home’ service across Leinster, Munster and Connacht.
The Department of Health and the HSE are both project sponsors of work currently underway in Trinity College Dublin called ‘Enhancing Children’s Palliative Care in Ireland’. This research will greatly increase our understanding of the needs of children who require palliative care and assist with national service planning. Laura Lynn have also initiated a national needs analysis of children’s hospice beds.
Findings from both these studies will inform evidenced based policy decisions in considering the development of a new national children’s palliative policy.
16. Deputy Pat Buckley asked the Minister for Health if the new national drugs strategy will include a comprehensive policy on alcohol, or if a stand-alone national alcohol strategy is needed. [38908/24]
Amharc ar fhreagraThe national drugs strategy, Reducing Harm, Supporting Recovery, is a health-led response to drug and alcohol use, and it runs from 2017 to 2025. The Strategic action plan for 2023-2024, contains 34 actions across six strategic priorities. Three of the strategic priorities have a focus on alcohol use:
• strengthen the prevention of drug and alcohol use and the associated harms among children and young people,
• enhance access to and delivery of drug and alcohol services in the community and
• develop harm reduction responses and integrated care pathways for high risk drug users.
The Department intends to commission an independent evaluation of the strategy in Q4 2024. It is expected that the evaluation will be completed in early 2025.
The recommendations of the Citizens Assembly will be critical in shaping the future development of drugs policy. Policy will also be guided by a) the views of people with lived and living experience of drug use and b) international collaboration on evidence-based policies and practices on drugs.
The proposed timeframe for the finalisation of the new national drugs strategy is the first quarter of 2025.
Information on the Department's alcohol policy is set out on the Health & Wellbeing page on health.gov.ie.
I am fully aware of the harms of alcohol use and the overlap with other forms of drug use. It is my ambition that the next national drugs strategy will address the reasons why people use drugs and alcohol, reduce the harms associated with problematic drug and alcohol use and support recovery from drug and alcohol addiction.
17. Deputy Duncan Smith asked the Minister for Health if he will commit that there will be no further delays to the delivery of the national children's hospital; and if he will make a statement on the matter. [39356/24]
Amharc ar fhreagraTimely completion of the New Children’s Hospital is a Government priority and must be for all those involved.
In the last year alone, the contractor has deferred the date to deliver this new building four times.
Everyone will share the frustration over the repeated delays to substantial completion of the building. We need to open the doors of this world class hospital for our children, their families and our fantastic paediatric healthcare professionals.
This is not about getting into a blame game or war of words. Rather, this is about ensuring the contractor is accountable for its repeated failure to meet its own programmed schedules.
What is now needed to unlock this project is a contractually compliant and resource-loaded programme from BAM and unwavering commitment to deliver to it, to give certainty to all.
This is about ensuring the contractor is accountable for its failures to meet its own programmed schedules.
The focus of the National Paediatric Hospital Development Board is to ensure that the standards and finishes of the over 5,500 rooms are to the highest international standards. We must have a snag free hospital.
This plan, with adequate resourcing and high standard of finish, are commitments that BAM must provide.
I expect all parties to now work collaboratively to ensure this much needed hospital is opened for children, their families, and our dedicated healthcare professionals, without further delay.
18. Deputy David Stanton asked the Minister for Health his future plans for a building (details supplied); and if he will make a statement on the matter. [38919/24]
Amharc ar fhreagraThe Community Health Centre in Castlemartyr, was in use up to 2 weeks ago by the Home Help Service.
At present, the property is vacant, however the HSE plan to use the property in the provision of health services in the area. A review of service options is currently underway, which will inform the short- to medium-term use for the health centre. The service options appraisal is anticipated to take a number of weeks.
I support the actions taken by the HSE to ensure that the Health Centre remains in use for the service.
In the longer term, plans for Castlemartyr Health Centre will be finalised following on from the provision of the new Primary Care Centres in Youghal and Midleton Co.Cork.
Both primary care centres are to be delivered by Operational Lease and have the Operational Lease Terms Agreed with the preferred bidders. Both primary care centres are at early stages of the planning process, and pending granting of planning permission will progress to advanced planning stage.
An application for planning permission for Youghal PCC was resubmitted on the 26th of February 2024. Cork County Council issued a request for further information on the flood risk, road access and ecological /environmental impact of this project. These requests required additional surveys to be undertaken. The surveys have been conducted and the developer is compiling their response to Cork County Council.
The planning permission application for Midleton PCC is due to be lodged by the Developer in the coming weeks.
These modern fit-for-purpose facilities will be welcome additions to the communities in South-East Cork, adding to a number of recent developments throughout Cork county, including the new primary care centre in Cobh, which opened at the end of 2023.
This Government has made significant investment in the provision of community healthcare services and facilities. I and my Department are actively engaged with the HSE to progress the development of healthcare and community services for Castlemartyr and the region.
19. Deputy Catherine Connolly asked the Minister for Health his plans to develop healthcare infrastructure in Carraroe, County Galway, with particular reference to the development of a primary healthcare centre; and if he will make a statement on the matter. [38975/24]
Amharc ar fhreagraI wish to thank the Deputy for allowing me to update the house on this matter.
HSE Community Healthcare West is currently actively engaged in supporting the development of a Primary Care Centre in the South Connemara Primary Care team area – this area includes An Cheathrú Rua/Carraroe.
The plans for this development are at a very early stage, with the accommodation schedule and business case currently being finalised. Once completed the proposal will be submitted to the HSE National Property Review Group for consideration.
Should this development progress, the HSE will liaise with the local service to assess the optimal delivery mechanism for the Primary Care Centre in South Connemara.
At present, an Cheathrú Rua/Carraroe in County Galway is served by a Health Centre from which HSE deliver services.
This proposed Primary Care Centre for South Connemara will be in addition to other Primary Care Centres in West Galway including Maigh Cuilinn (Moycullen) Primary Care Centre which became operational in 2023 and Uachtar Ard (Oughterard) and An Spidéal (Spiddal) Primary Care Centres, both of which are at the early planning stages.
There are now 10 Primary Care Centres operational throughout County Galway, with a further eight in the early planning stages, and three of those eight Primary Care Centres are located in Connemara.
I am sure the Deputy will agree that it is welcome news that further progress is being made on the development of additional Primary Care Centres across County Galway and in South Connemara, in particular.
20. Deputy Marian Harkin asked the Minister for Health the timeframe for the reopening of the pain clinic at Sligo University Hospital; and if he will make a statement on the matter. [38825/24]
Amharc ar fhreagraI am advised that the reason for the temporary cessation of this service is that the two consultant doctors providing the chronic pain service in Sligo University Hospital have both moved to new roles.
The HSE advises that recruitment to fill these two vacant consultant anaesthetist posts in the pain service is actively ongoing. Advertisements are active in all appropriate websites and agencies for temporary posts, while the process for permanent filling of posts is undertaken. As a result, two Consultants have been recommended for temporary appointment and are currently going through pre-employment procedures. These vacant posts are expected to be filled on a temporary basis in early 2025, while permanent recruitment is ongoing.
A temporary consultant was put into post in early July 2024 to oversee the governance of the Pain Management and Education clinic, a psychologically based rehabilitative treatment for people with persistent pain.
In relation to existing patients on the day case list and outpatient review lists, the HSE advises that alternative arrangements are being made for these patients. Patients are being contacted directly by the hospital when arrangements are in place for their follow up treatments. I am advised that three pain relief insourcing initiatives have been approved for the region through the NTPF which will facilitate treatment for 580 patients on pain relief waiting lists.
21. Deputy Matt Carthy asked the Minister for Health if he will liaise with the RCSI Hospitals Group to deliver MRI and CT scanners at Monaghan hospital; and if he will make a statement on the matter. [39364/24]
Amharc ar fhreagraAs Minister for Health, I am committed to the ongoing development of regional hospitals, including Cavan & Monaghan Hospital. 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.
The HSE has advised that clear clinical pathways already exist for access to MRI and CT scans. Cavan & Monaghan Hospital currently has two operating CT scanners and one MRI scanner. No service requirement has been identified for additional scanners to be installed at Cavan & Monaghan Hospital.
All capital projects in the HSE have to progress through the different stages of the Infrastructure Guidelines, which at the initial stage require a detailed business case including service requirements to be developed by the hospital delivering a service, ensuring value for money is achieved. At this time, Cavan & Monaghan Hospital has not submitted a business case for additional CT or MRI capacity.
22. Deputy Pearse Doherty asked the Minister for Health the progress made in appointing a consultant in neurology services to Letterkenny University Hospital; and if he will make a statement on the matter. [39399/24]
Amharc ar fhreagraAs Minister for Health, I am committed to the ongoing development of Letterkenny University Hospital. This Government has allocated significant resources to Letterkenny which will benefit patients:
• The hospital budget has increased from €157 million in 2020 to €196 million in 2024, a 25% increase in 4 years.
• Staffing at the hospital has grown by 437 since January 2020, an increase of 25%.
• Under our hospital bed expansion plan, a total of 122 additional beds will be delivered at Letterkenny University Hospital by 2031.
Letterkenny University Hospital has an outreach service for Neurology from Sligo University Hospital. The service is operated by 3 Consultant Neurologists and is supported by a team of clinical and social care staff. Specific diagnostic work ups and treatment are delivered from Sligo University Hospital as day cases or inpatients.
The HSE has advised that a review of Neurology Services across the HSE West and North West Region has recently been completed, which recognises the requirement to enhance neurology services in the North West. This review recommends the development of two consultant teams with additional clinical supports which will be incorporated in the overall neurology service for the North West. An implementation group has been established to progress the recommendations of the review and will prepare a business case for consideration by the Regional Executive Officer.
23. Deputy Duncan Smith asked the Minister for Health to outline his plans to increase the capacity of the accident and emergency department, resuscitation area and intensive care unit at Beaumont Hospital; and if he will make a statement on the matter. [39355/24]
Amharc ar fhreagraI am delighted to inform you about some significant capital infrastructure proposals for Beaumont Hospital.
A new Emergency Department (ED) centred around a reconfiguration of the existing ED, which will include an 8-bay resuscitation area, is being proposed.
This proposal is ongoing and is at the Detailed Design stage of the process. The Beaumont Hospitals Technical Services Department, alongside HSE Capital and Estates, are currently reviewing the proposal before it progresses to the next stage.
Additionally, a 64-bed Critical Care Unit (CCU) has also been proposed and is currently at the Preliminary Design Stage. This will be located on the site of the existing Endoscopy Department and St Raphael’s Ward.
A new Endoscopy Department is required to decant the existing building to enable the development of the CCU. This proposal is also at the detailed design stage.
The process for these proposals is being managed through the HSE capital development process rather than requiring direct submission to the Department of Health or Government for consent. This is in line with the provisions of the Department of Public Expenditure, National Development Plan Delivery, and Reform’s updated Infrastructure Guidelines. Each of the proposals are, and must be, developed in line with these Infrastructure Guidelines, and must continue to represent value for money in order to move the next stage of the project lifecycle.
24. Deputy Mark Ward asked the Minister for Health the progress made to date by the productivity and savings task force; and if he will make a statement on the matter. [39161/24]
Amharc ar fhreagraThe ongoing work of the Productivity and Savings Taskforce aims to ensure that we maximise the use of health funding by identifying savings and opportunities to improve productivity across the health service.
The Taskforce published an Action Plan last April and have met on 10 occasions to date this year. The Action Plan and minutes of meetings are published on the Government website:
www.gov.ie/en/collection/9a22b-productivity-and-savings-taskforce-and-medicines-taskforce/
This Action Plan is a live document that is responsive to change as implemented across the HSE. Updates and recalibrations of the Plan ensure the HSE and Department continuously reflect on what is working and what is not and adapt the Plan accordingly. This keeps focus on the most successful savings and productivity measures. This approach means that ongoing learning and improvements can continuously be reflected in the Plan. The Action Plan will continue be updated with additional measures and progress achieved over the course of 2024/2025.
To date, savings of €100 million on management consultancy, medicines, and agency expenditure are on track to be achieved by end-2024. Further savings measures are being targeted by end-2024, covering both pay costs (including agency staff usage and costs), and non-pay costs / procurement efficiencies in a variety of areas.
The HSE have introduced robust controls at regional level by the Regional Executive Officers in order to deliver on savings targets for 2024 and 2025. Controls introduced include strict headcount and pay cost expenditure limits, with a limited number of people within the HSE having the ability to add net additional employees to the payroll, as well as strict non-pay expenditure controls requiring all expenditure over €20,000 to be signed off by senior management.
The Taskforce has made significant progress on Productivity measures in a number of areas. In June 2024, a National Productivity Unit was established within the HSE. In conjunction with the Taskforce, the purpose of the Unit is to enable and assure a framework of productivity within the organisation, empowering staff to innovate, leverage and scale data led and evidence-based initiatives which optimise the productivity of health and social care services for the public.
Productivity achievements to date include the publication of Outpatient Department (OPD) data for 21 hospital sites, enabling clinicians and managers across the HSE to assess their own productivity comparatively against peers, to learn from others on how productivity can be improved and to unlock barriers to productivity that are site or region specific. Publication of data for remaining sites is planned for later in the year. The Taskforce will focus in utilising this OPD productivity data to drive efficiency, increase activity and reduce waiting list times. The intended outcomes of the OPD project over the coming weeks and months are to enable the delivery of Sláintecare targets within prescribed timeframes.
25. Deputy Neasa Hourigan asked the Minister for Health to outline, given the record numbers of drug deaths in Ireland, the work undertaken within his Department to deregulate the use of Naloxone in order to reduce drug deaths; and if he will make a statement on the matter. [37294/24]
Amharc ar fhreagraThe Health Research Board has reported that 354 drug-induced deaths were recorded in 2021. This is 85 fewer deaths than in 2020, a reduction of 20 per cent.
Opioids are responsible for 7 in 10 deaths in 2021 and continue to play a major role in drug poisoning deaths. Naloxone is a lifesaving drug that can rapidly reverse the effects of an opioid overdose. Naloxone is subject to prescription controls and is included in a schedule of medications that can be supplied and administered in emergency situations by individuals in a wide range of organisations.
The Department of Health works closely with the HSE National Naloxone Oversight Quality Assurance Group, to increase awareness and accessibility of naloxone. It is important that naloxone is made more accessible to support workers, peers, and family members.
The introduction of the Medicinal products (Prescription and Control of Supply) (Amendment) (No.3) Regulation S.I. No. 238 – 2023, in May 2023, allowed the Health Service Executive to approve courses for persons who may supply and administer naloxone in an emergency.
In 2023 of over 2,000 people participated in Overdose Awareness and Naloxone Administration training.
Over six and a half thousand units of naloxone were supplied by the HSE to services in 2023 and over four thousand units were supplied by the end of July this year.
Pharmacists who have undertaken appropriate training can already administer naloxone for opioid overdoses. The HSE and the pharmacy regulator have recently taken steps to make the training more accessible for pharmacists.
I acknowledge the loss and grief felt by families by the death of a loved one due to drug poisoning. I welcome the reduction in the number of drug-induced deaths and want to acknowledge the contribution of drug services to this outcome. I am committed to expanding the Naloxone Programme in order to further mitigate the risk of drug overdose deaths linked with opioid use.
